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SELF-CERTIFICATION FORM New York State Aid/Standard I, the undersigned, hereby certify that the attached State of requesting payment in the amount of $5 225,408.76 is Voucher dated or based upon the specific requirements set forth in Contract reasonable, eligible and allowable326 DEE Ol- 6032 s upon Purchase Order No. $3s"¢e00__ including all Appendices. I also certify that the record match, are maintained strictly in which the costs are claimed, including those claimed as local l municipal accounting practices and accordance with applicable federal, state and genera claimed as personal services. All procedures, including but not limited to those costs for a period of six years beyond documentation associated with this project will be maintained close out of any federal grant under which the end of this contract term or three years beyond the is greater. these costs are claimed by NYSDEC, whichever e with the Workplan Lalso certify that the work has been completed in conformanc of Environmental Conservation and in document as approved by the New York State Department ordinances, rules, regulations and compliance with all applicable federal, state and local laws, standards. Authorized Representative Date Chief Fiscal Officer Date