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<br /> �� . ..,i � .�_ „ �
<br /> �.xnibit D
<br /> . . . A:�..'�-�rT A
<br /> -C-�i�irZG�Q: O' P�_,*".�,Rl' P:�'ZGT�A�'T
<br /> '�ING L�-s�.�.":,�T'i', S�J��ZQr'. A\�J OI�+'� F�?�?;SI3� ??,1"T�S
<br /> �e Pri.a,�Ty Farticipa.*� (apolica.fi for an L3�'..A gra.*� or cnvr�-ative .
<br /> .nq��, ar pUterzti.al asit..�ac'�.,or f� a majnr thirzi pa.rty �r�t.Ta�).
<br /> oe..*tifies to t'�e bet of its lQ�a:lea3e aT1'3 L'�2IlEf r that it ar�d
<br /> . its principals:
<br /> 1. Are n�t pz�.�-i`,1y de.�*�ed, s.s�e*�ded, P=-o�oszd for de�x_*�-�, .
<br /> decla.*�e� ir�sig�Ie, or wlurrta..-i1y e�Zuder3 fr� c�v��ri
<br /> - t*-a.*isa��ic�n.s by ariy Fe�� �-•�,-�-it or ag�*�c.y;
<br /> - 2. Iizve nat wit'zin a thne-yc-zr p�-icd preaedirr, t'Zis pro�osal be�*�
<br /> a�nvi�..ed of or ha3 a civil ju�,.^�*it za*�e..-�d against th� f�
<br /> �. � i� of fraud or a cr'i�� offe.*ise in c�eC,ic� vith '
<br /> � �t-a;r;�, att�t;rr to c�sin, � pe_�-fo�'� a public (Fede.�l,
<br /> S+-�ate or Ioc-al) t�2.-sac��i� ar c�tra� tar3�- a g:blic trar►�ra��icsi;
<br /> viclaticcl of F��-al or State antit=us�`� ��a�.,es cr �-�-;�=i� of
<br /> �szl�ne.*zt, the�, fcr9'�-'Y, brib�*y, falsificatian or des`svc'-�
<br /> of z�cozds, makin� false �,a*.�e.zts, ar re�eiving s�..�len pivQe_�'ty;
<br /> . 3. A��-e not pz�-it3y ir�i�..ed f� ar oth��rise �**;*+��Iy ar �villy
<br /> c�a.*�ed�by a yw�r:... **'�.r1 e-:�,.:ty (Fede_,-z�1, S'-,.ate, or local) vith
<br /> r,�..issio¢� of a.� cf t'�e o��e-�zs e�..�-a�ed in Pzragr',.�h (2� of this
<br /> oe�"tificatian: a��
<br /> 4. F'save r�ot vithin a t�'�e""�= P�''iod �'� this .
<br /> . a�olicatic�/p�l hz3 a�e � m�r+e �lic tr�.nsac}�cLs (Fec:�-aI, .
<br /> S�,ate or local) t��:..�ted fo:- causz or defati:It.
<br /> (If the pr�-y paz-t.iciP�-r� (�lica;t fcr a.*� L�t'.� gra,-it, or a�ope_�tive -
<br /> a�=-�,'�, or pc�,.�e.�..:.a1 t}i� pa.-ty �:r`_�a�.:r) is 1..,--�Ie to c�.��fy t� nny
<br /> of the s��.at��-�-�s in t'�.i.,s a�-}�ficaticn, t`se p�-��..icipz.,r.t s'�I at',acz an .
<br /> expla.^atia� to this G�EI�'�1f1Q.'`..1Q�.) .
<br /> '� PR�.�Ac'�Y PARi('�� (Ai-:.IC�lt1i' FL? 1lN Ld'.iA Cs�AN: C&Z O�OP�Al"'IVE �
<br /> A��..t.�'':.=I`Ti', QR P�JI�NiIh� G?.'LZ;�^IL�Z �T.? A I�,7�t 'II-�JT PAIaY Q•i�_^T),
<br /> , �"iF"'..:5 0� J�.�i�"'S �-�; TZ.TI�r L��55 t,.�'� I�CL`�'RACY OF
<br /> T�s:,. CUir�^:.Y;S OF TI'.:' S"�A."��r5 S.� Q7 CR W':1�? T}-ZS �zZC�:l(N Ah�
<br /> �''���5""�N'� 'II-Al'" T.�. PR'7�:.5Z�v OF 31 U.S.C. Sr'�i'I(h� 3801 �' �r . AFc'i �
<br /> Ar'''FI�IC?+�T�:.�E "L-::�r."ID.
<br /> b:�a� arr3 Title of A:ithorizec: O�ficial
<br /> ZY�e t�-�de_Tsi�er3 c'�ie: Iegal c�..--szl fcs the � he.*eby
<br /> . � oe2tifies that the has aL�'�ority ia�de.� S`�ate at�d local
<br /> Iaw tc� oQ-�ly vith t'�e s�jec'� ass.:..3.-�oPs nr�d trat the c��-tificatian a�we
<br /> has be+e� lec?a11y made.
<br /> Sic�a�re of Applica�^t's Attorney I
<br /> Date ,
<br />
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