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Contract Amendment Form - State Of Vermont - Department Of Buildings And General Services Page 2

signed, the Contractor is in good standing with respect to, or in full

compliance with a plan to pay, any and all taxes due the State of Vermont.

7. Certification Regarding Suspension or Disbarment. Contractor certifies

under the pains and penalties of perjury that, as of the date this contract

amendment is signed, neither Party nor Party’s principals (officers,

directors, owners, or partners) are presently debarred, suspended,

proposed for debarment, declared ineligible or excluded from participation

in federal programs, or programs supported in whole or in part by federal

funds.

Party further certifies under pains and penalties of perjury that, as of the

date that this Agreement is signed, Party is not presently debarred,

suspended, nor named on the State’s debarment list at:

8. Child Support (Applicable to natural persons only; not applicable to

corporations, partnerships or LLCs):

Contractor is under no obligation to pay child support or is in good

standing with respect to or in full compliance with a plan to pay any and

all child support payable under a support order as of the date of this

amendment.

All other terms and conditions of this Contract not hereby amended shall remain in

full force and effect.

The signatures of the undersigned Parties indicate that each has read this _______

amendment to Contract # __________ in its entirety and agrees to be bound by the

provisions enumerated therein.

STATE OF VERMONT

CONTRACTOR

By: ________________________

By: ___________________________

Name: Michael J. Obuchowski

Name: ________________________

Title:

Commissioner

Title: _________________________

Date: _______________________

Date: _________________________

MASTER COPY Distributed ________

Contractor, Accounting,

DEPT ID:

FUND SOURCE:

Project:

Building #:

Page 2 of 2

July 1, 2013

Contract Amendment Form - State Of Vermont - Department Of Buildings And General Services Page 2