Business Certification Affidavit

Attestation of Information____________________________Name of Company___________________________FEI or Social Security NumberAddress City State Zip Code( )Telephone NumberI hereby attest that the business listed above is a Women-OwnedBusiness Enterprise as defined in the original application, and thatthe information contained in the application and attached thereto isstill true, accurate, and complete to the best of my knowledge._________________________________Signature_________________________________Name (Type or Print)_________________________________TitlePlace Corporate Seal Above (Must be provided by all incorporated firms)STATE OF______________________COUNTY OF ______________________Subscribed and sworn to me thisday of ______________, 20_______._________________________________Notary Public_________________________________My Commission Expires