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Form Cert-131 - Exemption For Projects Of The Connecticut Resources Recovery Authority And Solid Waste-To-Energy Facilities Page 2

Name of Purchaser

Address

CT Tax Registration Number

Federal Employer ID Number

(If None, explain)

Name of Seller

Address

CT Tax Registration Number

Federal Employer ID Number

(If None, explain)

Check One Box

Blanket Certificate

Certificate for One Purchase Only

Address of CRRA Project or Solid Waste-To-Energy Facility

Name of Owner (If purchaser is lessee or operator)

Address of Owner

Check Appropriate Box(es) and Provide a Written Description of Each Item Purchased

Tangible Personal Property

Services

Description

Declaration by Purchaser

The item(s) described on this certificate are tangible personal property or services being purchased under the exemption provided in

Conn. Gen. Stat.§12-412(92) and (95).

In accordance with Conn. Gen. Stat. §12-412(92) or (95), the purchase of the described item(s) is exempt from sales and use taxes.

I, the authorized representative of the purchaser named above, declare under penalty of law that I have examined the information in this

certificate and to the best of my knowledge and belief it is true, complete, and correct. I understand the penalty for willfully delivering a false

return to DRS is a fine of not more than $5,000, or imprisonment for not more than five years, or both.

Name of Purchaser

By:

Signature

Title

Date

CERT-131 (Back)

(Revised 08/03)

Form Cert-131 - Exemption For Projects Of The Connecticut Resources Recovery Authority And Solid Waste-To-Energy Facilities Page 2