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CERTIFICATION OF UN:f ERSTAMING <br />AND AVITIORI?_,ATION <br />Project Name: ---t0ayl�... <br />Project Numberp <br />This is to ce tity that the principals and the `iohoriced payroll officer, below, have, road uric( uudei;ttond the labor <br />stand ids clauses perminint; to the subject ptojec-t. <br />The lo(lowinp porson(s) is cicsiltnated as the payoll otticsr Aor the undersigned and is authorized to siLYn thr, Statemontof Compli,incc, ediu:h will nccompony ow WcAly ceilitied payrcill reports t`m this project: <br />1-paalun35pecs. UUC <br />12..SM0,�� Gri <br />Payroll O " `er'a Nan <br />Psryrall (J,+ " er's Sitn.rturc <br />Corrtr<rctodSul -c utiucf or <br />by-�i1..,_ <br />U! <br />_..._....... <br />_ <br />Printed Name <br />--V--E <br />Title <br />?y <br />Date <br />Contractor/5ubeonnactor License No. <br />23A-49 <br />