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EXHIBIT C G10-UPA-89 <br />CERTIFICATION <br />I certify under penalty of perjury that the information I have entered on this application is true and complete to the <br />best of my knowledge and that I am an employee of the applicant authorized to submit the application of behalf <br />of the application. I further understand that any false, incomplete, or incorrect statements may result in the <br />disqualification of this application. By signing this application, I waive any and all rights to privacy and <br />confidentiality of the proposal on behalf of the applicant, to the extent provided in this program. <br />Applicant Signature <br />Lori Smith <br />ri n ncu rvaine or mppucani <br />Page 3 of 3 <br />20A-13