Declaration of the Company
Name of Company:
File number:
A)	The company and its representatives agree that Investissement Québec may contact them by electronic means at the e-mail address provided to send information of potential interest to them or to inform them of any commercial or business offer that may be of interest to them.
B)	The Company and its representatives agree not to use Investissement Québec’s name or logo in any way whatsoever and in any paper or electronic format without Investissement Québec’s prior written approval.
C)	The Company authorizes Investissement Québec and IQ Immigrants Investisseurs inc. to exchange with government departments, government agencies, interested financial institutions and personal information agents, including credit agencies, (collectively referred to as “Institutions”) any information or documents needed for the analysis of its application for financing, including this declaration. Without limiting the generality of the foregoing, the Company authorizes any Institution to exchange with Investissement Québec and IQ Immigrants Investisseurs inc. any information or document in its possession needed for the analysis of its application for financing. IQ may collect, communicate and use this type of information to maintain data integrity in its credit assessment systems and its internal credit approval process only, despite the repayment of any financing.
D)	The Company hereby declares that the owners, shareholders, members or partners of the Company and its related companies as defined by the Taxation Act and their directors are not members of the National Assembly, are not members or employees of Investissement Québec, or of IQ Immigrants Investisseurs inc., are not related as defined in the Taxation Act and deal solely at arm’s length with one or more of these persons, except for:
E)	The Company hereby declares that it is not involved in disputes, legal proceedings or investigation by a government department or a municipal, provincial or federal agency and declares that it is in good standing with these government departments or agencies, in particular the Canada Customs and Revenue Agency and Revenu Québec, except for:
F)	The Company hereby declares that it operates in compliance with all environmental legislation and neither the Company nor the former owners of the Company's assets have used the latter in contravention of environmental legislation; moreover, no proceedings have been instituted (or are anticipated) and no notice has been received in respect of an alleged violation of environmental legislation, except for:
G)	The Company hereby declares that it does not store any hazardous materials as defined in the Regulation respecting hazardous materials (CQLR, chapter Q-2, r.32) and that it does not possess a tank used to store fuel, except for: (in the case of a tank, specify its capacity and whether it is located on the surface or underground)
H)	The Company hereby declares that in respect of the project for which it is seeking the financing from Investissement Québec or IQ Immigrants Investisseurs inc., it has not received nor will it receive other government financial assistance, whether municipal, provincial or federal, except for:
I)	The Company hereby declares that its Québec business number (NEQ) is:
J)	The Company certifies that it has not made any transaction with a partnership, corporation or person with which it is not dealing at arm’s length or to which it is related as defined in the Taxation Act concerning expenses related to the project, except for:
K)	The Company declares that its shareholders, owners and members and those of any related companies are not related to a company or to the shareholders, owners or members of such company that has been granted financing by Investissement Québec, IQ Immigrants Investisseurs inc. or la Société générale de financement du Québec (SGF), with the exception of:
L)	The Company hereby declares that its key officers or shareholders whose guarantee is likely to be required under the terms of the requested financing hereby authorize Investissement Québec to contact third parties, particularly financial institutions, creditors, personal information agents etc., in order to obtain and exchange all the personal information required to establish knowledge of their financial situation. For this purpose, said individuals shall provide, on request, their address, their date of birth and any other information deemed relevant by IQ for that purpose. In addition, at the request of Investissement Québec, the Company shall ensure that said key officers or shareholders complete and sign the document entitled Personal Balance Sheet and Other Financial Information.
M)	The Company hereby declares that it has not modified the contents of this declaration.
I,	, the duly authorized representative of the Company,
hereby certify that the above information and all documents provided to Investissement Québec are (or will be) complete and true in all respects.
Title of signatory	Signature	Date
3.9.2.20A (18-07)