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O� SV%ANY Ig�FJe <br />F <br />n <br />U I <br />CONTRACTOR ANTI -BOYCOTT CERTIFICATION <br />�f 9D�rt FLaa`Oo <br />° [PURSUANT TO FLORIDA STATUTE § 215.135] <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 with Activities in Sudan List; and <br />4. Is not on the Scrutinized Companies with Activities in the Iran Terrorism <br />Sectors List; and <br />5. Has not engaged in business operations in Cuba or Syria. <br />Signature <br />Title <br />Date <br />196 <br />