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o� NAY I stE�e <br />4 <br />A <br />v CONTRACTOR ANTI -BOYCOTT CERTIFICATION <br />9•fl�p'`O R4 <br />[PURSUANT TO FLORIDA STATUTE § 215.4725] <br />I, on behalf of <br />Print Name Company Name <br />certifies that �fn/ ,4Z Jso y` i,% 4W- does not: <br />Company Name <br />1. Participate in a boycott of Israel; and <br />2. Is not on the Scrutinized Companies that Boycott Israel list; and <br />3. Is not on the Scrutinized Companies with Activities in Sudan List; and <br />4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum <br />Energy Sector List; and <br />5. Has not engaged in business operations in Cuba or Syria. <br />Sigff�ture <br />/��%ffg�� <br />Title <br />/_9 9 At,> <br />Date <br />