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Cerfillcation <br />r certify' on bcholf of subcontractor/ consultent thrt the informrtion provided in rerponse to thisrnformatlon Requect ir complete lud accurate. r_further *.tiry r[.i r lave the authorlty to providethe requerted informstlon and erecute this cerrification on tetianor iuucontrecton r,sst, r certifythrt Subcontnrctor has been notilied rnd is rware thrt the lnformrtion provided in response to thisfnforrnation Requestwill be made public. <br />FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT <br />Data Collection Form <br />( <br />Name <br />Date <br />3