Project Start up forms for Wyoming Business Council 2282018W
BUSINESS COUNCIL
STANDARD PHOTO RELEASE FORM
(no payment)
Grantee: `7 ►1 1`LOCAtl Eco i\.() ryLC. et,rJ �G! l
�d�ilyrvN�
Project Name: ctq e c f er -e r r %& � 1
Responsible Official: 1 i t l k D
WBC Program: —tV SI 11 *P s S C 6 fy\ /fy\ t+ ���
The Grantee hereby authorizes the Wyoming Business Council to publish any photographs taken by
representatives of the Grantee associated with the Weatherby project and to publish pertinent information
associated with the photographs in printed publications and the website of the Wyoming Business
Council.
Grantee acknowledges that since participation in publications and websites produced by the Wyoming
Business Council is voluntary, the Grantee will receive no financial compensation. Grantee agrees that the
photographs may be edited and otherwise altered at the sole discretion of the Wyoming Business Council
and used in whole or in part for any and all broadcasting, audio/visual, and/or exhibition purposes in any
manner or media, in perpetuity, throughout the world. Grantee understands that it has no rights to the
printed publications or website or any benefits derived therefrom.
Grantee agrees to indemnify and hold harmless the Wyoming Business Council from and against all
claims, losses, expenses, and liabilities of every kind including reasonable attorney's fees arising out of
any breach of any provision of this agreement by Grantee.
This agreement will, in all respects, be governed by and interpreted, construed and enforced in accordance
with the laws of the State of Wyoming. The Courts of the State of Wyoming shall have jurisdiction over
the agreement and the parties, and the venue shall be the First Judicial District, Laramie County,
Wyoming.
The Wyoming Business Council does not waive sovereign immunity and specifically retains all
immunities and defenses available to it pursuant to Stat. § 1-39-104(a) and other applicable law.
Designations of venue, choice of law, enforcement actions, and similar provisions should not be
construed as a waiver of sovereign immunity.
This agreement represents the entire understanding of the parties and may not be amended unless
mutually agree by both part s in writing.
Grantee: Date:
Parent/Guardian: Date:
Iving 6i1drrn rn hof jot(y),i ghs) I agree that I am the parent and/or guardian of the minor child who has signed above
or is a participant in the (Project Name) Project. I agree that we are both bound by this agreement.
Standard Photo Release Form
Page 1 of 1
Proiect Contacts &Responsibilities Form
Grantee: 5 ke r 'td a h Ec o r< o r✓1 i& a n d -E o u c a 6o n J 'D -eke t o f ol-e r�4 A k-Kart+ I
Project: P (' pA< Ct & 4-e rQ i LS -e— Ck(`a_ W -e a 1 k e rto u(
Responsible Official
(Usually the mayor or
Chair of the JPB or County
Commission)
Responsibilities include: signing Grant Agreements and Amendments, signing reports,
requesting amendments, updating the Project Contacts form, and meeting all
requirements of the Grant Agreement. If desired, a written request may be submitted
to the WBC to designate signature authority to other officials.
NAME TITLE
Dr POW ( t C 4— C I
ORGANIZATION
' E E /'-e s kil e 1" -- U-) CC'D
MAILING ADDRESS
L w A fit �. k e r t d a Y\ ul J Z 9 0
PHONE
- 6-7!5 - Q A G p FAX
CELL OR OTHER
- --75 2- - J -j (p Z
EMAIL ADDRESSIl
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Responsible for
Signing Draw Down
Requests (Usually the
Clerk/Treasurer
Responsibilities include compiling information for, preparing and signing Quarterly
Reports; and meeting all related requirements of the Grant Agreement.
Responsibilities include signing all Draw Down Requests, responding to any questions
the WBC has about those requests and meeting all related requirements of the Grant
Agreement.
NAME, TITLE
D r P voknoI L 2 ClAaIr
ORGANIZATION
MAILING ADDRESS n LJjke LA i.t ^Iti LA -e r 1 d a f N W t,i R - [j
MAILING ADDRESS
/1
(,t)k w Q 'S 2 g Q
PHONE S07- $ Ci d f FAX
CELL OR OTHER
- --75 2- - J -j (p Z
EMAIL ADDRESS
CIL,) S ke f t &a r\
Responsible for
Preparing Quarterly
Reports
i
Responsibilities include compiling information for, preparing and signing Quarterly
Reports; and meeting all related requirements of the Grant Agreement.
NAME, TITLE
I
(' S i,tsc� r� -f l0 cc—
ORGANIZATION
SCE - �J w CL's
MAILING ADDRESS n LJjke LA i.t ^Iti LA -e r 1 d a f N W t,i R - [j
PHONE
-J - 5 .y FAX
CELL OR OTHER 1-302
- --75 2- - J -j (p Z
EMAIL ADDRESS I 7S i o w- (0.:. 1t i l dC- n (L-
Project Contacts & Responsibilities form
Responsible for
If this is a BRC -Business Committed project, please list all their contact
information here.
Responsibilities include reviewing all invoices to assure that billed goods and
Construction
r� s ; d nfi
services have been delivered, regularly updating the Milestones form, overseeing
Monitoring & Review
construction operations, responding to any questions the WBC has about these
of Invoices (Usually the
SV D b ('e 3 V'1-
yPHONE
activities and meeting all related requirements of the Grant Agreement.
Director of Public Works
FAX
NAME, TITLE
1'�cke- r$ e r (9 Q
ORGANIZATION
A
MAILING ADDRESS
al •e (` t'dQ n Z
PHONE
- -15 -- J Z4 4f
I FAX
CELL OR OTHER 3 0 7 i 5;— 1-7 4, Q
EMAIL ADDRESS
V. Q Y J e S Y\0 S k e r i d a h, L. LL --
Committed Business
(for BRC Business
Committed Proiects onl
If this is a BRC -Business Committed project, please list all their contact
information here.
NAME, TITLE
dam ti[J C� f
r� s ; d nfi
ORGANIZATION
ee o, r 0
MAILING ADDRESS
14 0 5 coMMJ e rc'e- LJ a
SV D b ('e 3 V'1-
yPHONE
PHONE
goo -ZZ%^ -2-0
FAX
CELL OR OTHER
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EMAIL ADDRESS
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Signed: A (L—Date:
Responsible Q ficial (as&44 on page Nof this form)
Print Name: l T— . u tl
Project Contacts & Responsibilities form