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r <br /> Page 2 of 2 <br /> I <br /> The undersigned Contractor certifies or affirms the truthfulness and accuracy of each statement <br /> of its certification and disclosure,if any. In addition,the Contractor understands and agrees that <br /> the provisions of 31 U.S.C. A 3801,et seq., apply to this certification and disclosure, if any. <br /> Company Name: <br /> lA,JSC'�-�i�! c C <br /> Authorized Representative Name: <br /> Title: <br /> Lo, - tR <br /> Signature: <br /> Date: S� t 6L <br /> i <br /> 32 <br />