Exhibit_5_TSP_Certification_Energy_Contract_Rev_7_27_2016.pdf

TSP Practice Certification

Exhibit 5 Rev. 7/27/2016 Certification of Work Performance – Energy Practices

Technical Service Provider Certification

Please submit the completed worksheet to your customer who will provide it to the local NRCS field office.

Your input declares that installed practices meet NRCS Standards and Specifications and improves the accuracy of the NRCS reporting system. Any supporting data needs to be attached i.e. as built drawings, plans, photos, etc.

CLIENT INFORMATION

Name: Farm Bill Program:

Contract Number:

TECHNICAL SERVICE PROVIDER INFORMATION

Name: TSP Number:

Address: TSP Expiration Date:

City, State, Zip Code: County of Service:

Phone:

PRACTICES INSTALLED / COMPLETED

Practice Information Contract

Item Practice

Code Practice Name / Description Certified

Amount

I hereby certify that the technical services I provided as a Technical Service Provider:

1. Meet applicable USDA-NRCS conservation practice standards, specifications, and program requirements,

2. Are consistent with and meet the particular conservation program goals and objectives,

3. Incorporate, where appropriate, low-cost alternatives that address the resource issues.

Technical Service Provider Signature Date

To Be Completed By Landowner

I confirm that the practice(s) above have been installed for the identified contract and farm bill program with the assistance of this Technical Service Provider.

Landowner Signature Date