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CONTFkj CTOK AIN -1 I-ISU Y COTT c TIF -ICA TI Int <br />fiJ <br />T" <br />[PURSUANT TO FLORIDA STATUTE § 215.4725] <br />I, U),0/17,1 /L , on behalf of <br />Print Name <br />Company Name <br />PANTHEON GASTROBAR�INC. <br />certifies that 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 Scn�tinized 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 />Signature <br />Title <br />Date <br />