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CHAPTER 2252 CERTIFICATION <br />I, m _...... ---1 the undersigned representative of <br />(company name or business name) <br />being an adult over the age of eighteen (18) years of age, pursuant to Texas Government Code, <br />Chapter 2252, Section 2252.152 and Section 2252.153, certify that the company named above is <br />not listed on the website of the Comptroller of the State of Texas concerning the listing of <br />companies that are identified under Sections 806.051, 807.051, 808.051, or Section 2252.153. I <br />further certify that should the above-named company enter into a contract that is on this listing of <br />companies on the website of the Comptroller of the State of Texas which do business with Iran, <br />Sudan, or any Foreign Terrorist Organization, I will immediately notify the <br />Name of Company Representative (Print) <br />Signature of Company Representative <br />Date <br />17 <br />name of public entity). <br />