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Semiannual Certificate of Compliance—Master Agreement <br />Page 2 <br />VERIFICATION <br />STATE OF TEXAS § <br />COUNTY OF LAMAR § <br />BEFORE ME, the undersigned notary, on this day personally appeared <br />the affiant, a person whose identity is known to me. After I <br />administered an oath to affiant, affiant testified: <br />"My name is . I am capable of making this verification. I have read <br />the foregoing Annual Certificate of Compliance, and I certify that the Employer Reference <br />Summary pages are true and correct copies of those reports filed with the Texas Workforce <br />Commission. I further certify that copies of the documents referenced as Items 1 and 3 <br />hereinabove are true and correct copies of same and that the information contained therein <br />is true and correct." <br />Signature of Company Representative <br />Position/Title <br />Sworn to and subscribed before me this the _ day of 20_. <br />Notary Public, State of Texas <br />