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Exhibit A <br />Certification Form <br />(Provide separate Certification for each Joint Venture or Partnership entity) <br />"COMPANY NAME" "SEAL" <br />I HEREBY CERTIFY THAT THE INFORMATION CONTAINED IN THIS RESPONSE TO THE REQUEST FOR PROPOSALS IS <br />CORRECT AND TRUTHFUL TO THE BEST OF MY KNOWLEDGE AND BELIEF. <br />This the day of , 2017. <br />By: <br />Title: <br />License number under which the project will be executed: <br />Name license number above is held in: STATE <br />OF <br />COUNTY OF <br />a Notary Public in and for the County and State aforesaid, do hereby certify <br />that personally came before me this day and acknowledged that he is of and by that authority duly given and as an act of the foregoing instrument was <br />signed by As, attested by him/herself as Secretary, and sealed with the common seal of said corporation <br />IN WITNESS WHEREOF, I have hereunto set my hand and Notarial Seal this the day of <br />My commission expires: <br />ATTACHMENT B — LITIGATION HISTORY <br />If the Respondent replies yes to any of the questions below, please provide a full explanation with any required supporting relevant <br />Attachment number 2 l <br />F-9 Page 101 <br />