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City of Pompano Beach,FL wITT 0'BRIEN'S <br /> Disaster Recovery Management Services <br /> VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS <br /> Respondent Vendor Name: <br /> Vendor FEIN: <br /> Section 287.135, Florida Statutes, prohibits agencies from contracting with companies, for <br /> goods or services over$1,000,000,that are on either the Scrutinized Companies with Activities <br /> in Sudan List or the Scrutinized Companies with Activities In the Iran Petroleum Energy Seer <br /> List or is engaged in business operations in Cuba or Syria. <br /> As the person authorized to sign on behalf of Respondent, I hereby certify that the company <br /> identified above is not listed on either the Scrutinized Companies with Activities In Sudan List or <br /> the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or Is <br /> engaged in business operations In Cuba or Syria. I understand that pursuant to section <br /> 287.135, Florida Statutes, the submission of a false certification may subject company to civil <br /> penalties,attorney's fees,and/or costs. <br /> Certified By: <br /> Authorized Signature Print Name and Title: <br /> REP E-67.14 Page 16 Initial <br /> September 4,2014 Page 1 74 <br />