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c 4,yu77ir=ar <br />CONTRACTOR ANTI -BOYCOTT CERTIFICATION <br />i_IOySG �4 <br />[PURSUANT TO FLORIDA STATUTE § 287.1351 <br />I? , on behalf of <br />Print Name Company Name <br />certifies that <br />Company Name <br />1. Participate in a. boycott. of Israel; and <br />does not: <br />2. Is not on the Scrutinized Companies that Boycott Israel list; and <br />3. Is not on the Scrutinized Companies N,vith 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 />S. Has not engaged in business operations in Cuba or Syria. <br />Signature <br />Title <br />Date <br />