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<br /> CONTRACTOR ANTI-BOYCOTT CERTIFICATION <br /> <br />[PURSUANT TO FLORIDA STATUTE § 215.4725] <br /> <br /> <br /> <br />I, ___________________, on behalf of _________________________, <br /> Print Name Company Name <br /> <br /> <br />certifies that___________________________ does not: <br /> Company Name <br /> <br />1. Participate in a boycott of Israel; and <br /> <br />2. Is not on the Scrutinized Companies that Boycott Israel list; and <br /> <br />3. Is not on the Scrutinized Companies with Activities in Sudan List; and <br /> <br />4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum <br />Energy Sector List; and <br /> <br />5. Has not engaged in business operations in Cuba or Syria. <br /> <br /> <br /> <br /> <br /> ________________________________ <br /> Signature <br /> <br /> ________________________________ <br /> Title <br /> <br /> ________________________________ <br /> Date <br />