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O� SV'ANY fs4F�e <br />� F <br />V - S <br />CONTRACTOR ANTI -BOYCOTT CERTIFICATION <br />tiff/D�+FIOPOpS <br />Tf Of SUM �M <br />[PURSUANT TO FLORIDA STATUTE § 287.1351 <br />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 />