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V/SupINY IJ�F <br />J <br />CONTRACTOR ANTI -BOYCOTT CERTIFICATION <br />w OP c <br />�•, o �N [PURSUANT TO FLORIDA STATUTE § 215.1351 <br />on behalf of ( (��� C l' �� c �! � y C, <br />Print Name Company Name <br />(�30c,)V 4 <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 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 />