rfb-dncr-2026-21.pdf

Contractor Initials

Date

STATE OF NEW HAMPSHIRE

Department of Natural and Cultural Resources

REQUEST FOR BIDS

Soil & Groundwater Sampling

Mount Washington State Park – Summit Environmental Assessment

5/21/2026 Project # CAP2610

Section 1 – Invitation to Bid

A. Invitation to Bid

The New Hampshire Department of Natural and Cultural Resources (DNCR), Division of Parks and Recreation, invites qualified environmental contractors to submit sealed bids for soil and groundwater contamination sampling at Mount Washington State Park. This project supports the Mount Washington Master Plan requirement for an independent third-party environmental assessment, including soil and groundwater investigations. The selected contractor will prepare all required sampling plans, conduct field sampling, install temporary groundwater wells, perform laboratory analyses, and complete all associated reporting as outlined in the Scope of Work.

DNCR seeks experienced firms able to meet all applicable regulatory standards, including NHDES Env-Or 600/610, PFAS soil requirements, and EPA Region 1 QAPP and QA/R-5 standards. Bidders must meet the minimum qualifications specified in this RFB and provide all required submission materials for consideration.

Sealed bids will be evaluated and awarded to the lowest responsible and responsive bidder meeting all minimum qualifications. DNCR reserves the right to amend or clarify the schedule, conduct a pre-bid conference, and issue addenda as necessary

See Section 4 – Project Specifications for a detailed description of services and requirements of this Request for Bids.

Read the entire Request for Bids prior to filling it out. Complete the “Vendor Contact Information” section; complete the pricing information in the “Offer” section (Detailed information on how to fill out the pricing information can be found in the “Offer” section); initial and date each page of the Request for Bid; and finally, fill out, sign, and notarize the Bid.

B. Bid Contact

Name: Albi Fioravante State of New Hampshire, Department of Natural and Cultural Resources Division of Parks and Recreation 172 Pembroke Road, Concord, NH 03301 Telephone: 603-724-4948 Email: albdios.v.fioravantedncr.nh.gov

C. Site Visitation

Prior to bidding, it is each Vendor’s responsibility to become thoroughly familiar with the sites of the intended service, to determine everything necessary to accomplish the services. Failure of the Vendor to make a site visit does not relieve the Vendor of responsibility to fully understand what is necessary to accomplish a successful and complete project.

D. Contract Award

The award shall be made to the Vendor meeting the criteria established in this Request for Bids and providing the lowest cost in total. The State reserves the right to reject any or all bids or any part thereof and add/delete items/locations to the contract. All awards shall be in the form of a State of New Hampshire Contract.

The successful Vendor shall not be allowed to require any other type of order, nor shall the successful Vendor be allowed to require the filling out or signing of any other document by State of New Hampshire personnel.

Section 2 – Instructions to Bidders

A. Bid Submittal

All bids shall be submitted on this form (or an exact copy), shall be typed, or clearly printed in ink, and shall be received on or before the date and time specified below.

All bid submissions will be received by the Owner until 2:00 P.M. prevailing time on Friday, June 5th, 2026. Submissions received after the date and time specified shall be marked as “Late” and shall not be considered in the evaluation process.

Interested parties may submit a bid to the State of New Hampshire, Department of Natural and Cultural Resources by email to the Bid Contact indicated above. All bids shall be clearly marked with bid/project number and date due.

All offers shall remain valid for a period of one hundred eighty (180) days from the bid submission date. A vendor’s disclosure or distribution of bids other than to the Department of Natural and Cultural Resources may be grounds for disqualification.

B. Bid Prices

Bid prices shall remain firm for the entire contract period and shall be in US dollars and shall include delivery and all other costs required by this bid invitation. Special charges, surcharges (including credit card transaction fees), or fuel charges of any kind (by whatever name) may not be added on at any time. Any and all charges shall be built into the bid price at the time of the bid. Unless otherwise specified, prices shall be F.O.B. DESTINATION, (included in the bid price), which means delivered to a state agency’s receiving dock or other designated point as specified in this contract or subsequent purchase orders without additional charge. Shipments shall be made in order to arrive at the destination at a satisfactory time for unloading during receiving hours.

Per Administrative Rule 606.01(e) “if there is a discrepancy between the unit price and the extension price in a response to an RFP, RFB or RFQ, the unit price shall be binding upon the vendor.”

Price decreases shall become effective immediately as they become effective to the general trade or the Vendor’s best/preferred customer.

C. Addenda

In the event it becomes necessary to add to or revise any part of this bid prior to the scheduled bid submission date, the Department of Natural and Cultural Resources shall post on our website any Addenda. Before submitting a bid and periodically prior to the bid submission date, Vendors are required to check the site for any addenda or other materials that may have been issued affecting the bid. The web site address is: https://www.nhstateparks.org/about-nh-parks/park-proposals-rfps.

D. Timeline

The timeline below is provided as a general guideline and is subject to change. Unless stated otherwise, consider the dates below as a “no later than” date.

• RFB Posted: May 21st, 2026

• Vendor Questions Due: June 3rd, 2026

• Bid Closing Date: June 5th, 2026

• Bid Evaluation: June 5-9, 2026

• Notice of Intent to Award: June 10-12, 2026

• Contract Finalization & NTP Issued: Mid July 2026

• Final QAPP Due: August

• Fieldwork Window: June - August 2026

• Lab Data & Validation Complete: September 2026

• Draft Report: September 2026

• Final Report + EDDs October 2026 https://www.nhstateparks.org/about-nh-parks/park-proposals-rfps https://www.nhstateparks.org/about-nh-parks/park-proposals-rfps

E. Terms of Submission

All material received in response to this bid shall become the property of the State and shall not be returned to the Vendor. Regardless of the Vendor(s) selected, the State reserves the right to use any information presented in a bid response. The content of each Vendor’s bid shall become public knowledge once a contract(s) has been awarded.

A responding bid that has been signed by a Vendors representative shall constitute the Vendors acceptance of all State of New Hampshire terms and conditions and shall legally obligate the Vendor to these terms and conditions.

A signed response further signifies that from the time the bid is published (bid solicitation date and time) until a contract is awarded, no bidder shall offer or give, directly or indirectly, any gift, expense reimbursement, or honorarium, as defined by RSA 15-B, to any elected official, public official, public employee, constitutional official, or family member of any such official or employee who shall select, evaluate, or award the Request for Bid.

Furthermore, a signed response signifies that any terms and/or conditions that may be or have been submitted by the Vendor are specifically null and void and are not a part of this bid invitation or any awarded purchase order, even if said terms and/or conditions contain language to the contrary.

The form P-37 Contract attached hereto shall be part of this bid and the basis for the contract(s). The successful Vendor and the State, following notification, shall promptly execute this contract form, which is to be completed by incorporating the service requirements and price conditions established by the vendor’s offer.

Complete bids shall be filled out on the original documents and format that are a part of this bid invitation. Vendors may submit additional paperwork with pricing, but all pricing shall be on the documents provided with this bid invitation and in the State’s format.

F. Liability

The State shall not be held liable for any costs incurred by Vendors in the preparation of bids or for work performed prior to contract issuance.

G. Notification and Award of Contract(s)

Bid results shall not be given by telephone. The names of the vendors submitting bids and pricing shall be made public. Other specific response information shall not be given out. Bid results shall be made public after final approval of the contract(s).

H. Public Disclosure of Bid or Proposal Submissions

Generally, the contents of any bid (including all materials submitted in connection with it, such as attachments, exhibits, addenda, and vendor presentations) become public information upon completion of final contract or purchase order negotiations with the selected vendor. Certain information concerning bids, including but not limited to pricing or scoring, is generally available to the public even before this time, in accordance with the provisions of RSA 21-G:37.

To the extent consistent with applicable state and federal laws and regulations, as determined by the State, including, but not limited to, RSA Chapter 91-A (the “Right-to-Know” Law), the State shall, after final negotiations with the selected vendor are complete, attempt to maintain confidentiality of portions of a bid that are clearly and properly marked by bidder as confidential.

Any and all information contained in or connected to a bid that a bidder considers confidential shall be clearly designated in the following manner:

If the bidder considers any portion of a submission confidential, they shall provide a separate copy of the full and complete document, fully redacting those portions by blacking them out and shall note on the applicable page or pages of the document that the redacted portion or portions are “confidential.” Use of any other term or method, such as stating that a document or portion thereof is “proprietary”, “not for public use”, or “for client’s use only”, is not acceptable. In addition to providing an additional fully redacted copy of the bid submission to the person listed as the point of contact on Page (1) of this document, the identified information considered to be confidential must be accompanied by a separate letter stating the rationale for each item designated as confidential. The letter must specifically state why and under what legal authority each redaction has been made. Submissions which do not conform to these instructions by failing to include a redacted copy (if required), by failing to include a letter specifying the rationale for each redaction, by failing to designate redactions in the manner required by these instructions, or by including redactions which are contrary to these instructions or operative law may be rejected by the State as not conforming to the requirements of the bid. The State will generally assume that a bid submitted without an additional redacted copy contains no information which the bidder deems confidential. Bids which contain no redactions, as well as redacted versions of submissions that have been accepted by the State, may be released to the public, including by means of posting on State websites.

The State shall have no obligation to maintain the confidentiality of any portion of a bid, or related material, which is not marked in accordance with the foregoing provisions. It is specifically understood and agreed that the bidder waives any claim of confidentiality as to any portion of a response to this Request for Bid that is not marked as indicated above, and that unmarked (or improperly marked) submissions may be disseminated to any person, without limitation. Marking an entire bid, attachments, or full sections thereof confidential without taking into consideration the public’s right to know shall neither be accepted nor honored by the State.

Notwithstanding any provision of this request for submission to the contrary, proposed pricing shall be subject to public disclosure REGARDLESS of whether or not marked as confidential.

If a request is made to the State by any person or entity to view or receive copies of any portion of a bid and if disclosure is not prohibited under RSA 21-G:37 or any other applicable law or regulation, bidders acknowledge and agree that the State may disclose any and all portions of the bid or related materials which is not marked as confidential. In the case of bids, or related materials that contain portions marked confidential, the State shall assess what information it believes is subject to release; notify the bidder that the request has been made; indicate what, if any, portions of the bid or related material shall not be released; and notify the bidder of the date it plans to release the materials. The State is not obligated to comply with a bidder’s designation regarding confidentiality. The State shall have no obligation to advise a bidder that an individual or entity is attempting to electronically access, or has been referred to, materials which have been made publicly available on the state’s websites.

By submitting a bid, the bidder agrees that unless it obtains and provides to the State, prior to the date specified in the notice described in the paragraph above, a court order valid and enforceable in the State of New Hampshire, at its sole expense, enjoining the release of the requested information, the State may release the information on the date specified in the notice without any liability to the bidder.

Notwithstanding RSA 91-A:4, no information shall be available to the public, or to the members of the general court or its staff concerning specific responses to this bid invitation from the time this bid is published until the bid submission date.

Section 3 – Contract Terms and Conditions

A. Standard Contract Terms

The successful vendor(s) will be expected to enter into a contract with the State of New Hampshire. The terms and conditions set forth in Form P-37 General Provisions are mandatory and will apply to any contract awarded to the vendor. In addition, engagement specific terms and conditions will be negotiated with the vendor and included in the final contract. For the convenience of bidders, and reference only, Form P-37 has been included in Appendix A.

Vendors shall not be required to fill in the P-37 Form until after final bids are received and contract negotiations are complete.

B. Termination

The State of New Hampshire shall have the right to terminate the contract at any time by providing to the successful Vendor a thirty (30) day written notice.

C. Vendor Certifications

All Vendors shall be duly registered with the NH Bureau of Purchase and Property as State of New Hampshire vendors. All Vendors that are corporations, limited liability companies, or other limited liability business entities (this excludes sole proprietors and general partnerships) shall be duly registered with the New Hampshire Secretary of State to conduct business in the State of New Hampshire.

• STATE OF NEW HAMPSHIRE VENDOR APPLICATION: To be eligible for a contract award, a Vendor must have a completed Vendor Application Package on file with the NH Bureau of Purchase and Property. See the following website for information on obtaining and filing the required forms: https://DAS.NH.Gov/Purchasing

• NEW HAMPSHIRE SECRETARY OF STATE REGISTRATION: To be eligible for a contract award, a Vendor that is a corporation, limited liability company, or other limited liability business entity (this excludes sole proprietors and general partnerships) must be registered to conduct business in the State of New Hampshire AND in good standing with the NH Secretary of State. Please visit the following website to find out more about the requirements for registration with the NH Secretary of State:

http://sos.nh.gov/Corp_Div.aspx

• CONFIDENTIALITY & CRIMINAL RECORD: If applicable, any employee or approved subcontractor of the Vendor who will be accessing or working with records of the State of New Hampshire shall be required to sign a Confidentiality and Non-Disclosure Agreement and a Release of Criminal Record Authorization Form. These forms shall be returned to the designated State agency prior to commencing work.

https://das.nh.gov/Purchasing http://sos.nh.gov/Corp_Div.aspx

• CERTIFICATE OF INSURANCE: Prior to being awarded a contract the Vendor shall be required to submit proof of comprehensive general liability insurance coverage prior to performing any service for the State. The coverage shall insure against all claims of bodily injury, death, or property damage in amounts not less than $1,000,000 per occurrence and $2,000,000 aggregate. Coverage shall also include State of New Hampshire workers’ compensation insurance to the extent required by RSA Chapter 281-A.

D. Audits and Accounting

The successful Vendor shall allow representatives of the State of New Hampshire to have complete access to all records for the purpose of determining compliance with the terms and conditions of this bid invitation and in determining the award and for monitoring any resulting contract.

At intervals during the contract term, and prior to the termination of the contract, the successful Vendor may be required to provide a complete and accurate accounting of all products and quantities ordered by each agency and institution and by political sub-divisions and authorized non-profit organizations.

E. Establishment of Accounts

Each State of New Hampshire agency shall have its own individual account number. There may also be instances where divisions or bureaus within an agency will need their own individual customer account numbers. Should any State of New Hampshire agency place an order under the contract, the successful Vendor agrees to establish an account within three business days from the date the order was placed. However, there shall be no delay in any shipment, the agency shall receive the items ordered in accordance with the delivery time required under the "Delivery Time" section of this bid invitation, as if an account already exists for the agency.

F. Invoicing

Invoices shall be submitted on a monthly basis to the requesting agency. Payment shall be made within thirty (30) days after receipt of invoice and acceptance to the State’s satisfaction.

G. Attachments

The following attachments are an integral part of this bid invitation:

• Sample P-37 Contract Form

• Site survey

Section 4 – Project Specifications

A. Scope of Services:

The Contractor shall perform comprehensive soil and groundwater contamination sampling at Mount Washington State Park. This work supports the Master Plan requirement for an independent third-party environmental assessment. Services include development of a detailed Sampling & Analysis Plan (SAP), a full EPA Region 1-compliant QAPP, and all field and laboratory tasks. Field activities shall include soil borings, collection of discrete and composite soil samples, testing of existing well for contaminants, and collection of groundwater samples following Env-Or 610.02. Analytical work shall encompass VOCs, SVOCs, PAHs, TPH, metals, and PFAS (EPA 1633). The Contractor shall also perform full data validation, prepare a Data Usability Summary Report (DUSR), and provide Draft and Final reports including figures, tables, boring logs, well construction details, laboratory reports, and electronic data deliverables (EDD).

• Contractor shall comply with NHDES Env‑Or 600, Env‑Or 610, PFAS soil standards, EPA Region 1 QAPP requirements, EPA QA/R‑5, and all other referenced environmental regulations.

• Prepare a Sampling & Analysis Plan (SAP) and full QAPP.

• Conduct 15 soil borings, and 15 soil samples near building perimeters, tank areas, infrastructure, historic-use zones, and areas of suspected contamination.

• Investigate existing well, develop and purge according to Env‑Or 610.02.

• Perform analysis for VOCs, SVOCs, PAHs, TPH, Metals, PFAS.

• Perform data validation, prepare DUSR, and submit Draft and Final Reports.

B. Scope of services for well access and well sampling:

1. Pre Trip Coordination:

• Verify summit access hours and weather forecast.

• Confirm road status with Mount Washington State Park staff

• Ensure vehicles meet Auto Road weight/size requirements

• Notify park staff of arrival time and crew roster

• Confirm required building access arrangements (keys, escorts, permissions)

2. Existing Pump Condition and Removal:

• Inspect the current well pump (if existing) to determine functionality

• If pump is not operational, not existent or interferes with sampling setup, plan for removal

• Bring appropriate tools and equipment for pump removal and new pump installation

• Document the pump condition before removal and store it safely on site

• Ensure that removal does not damage well casing, wiring, or plumbing connections

• Confirm with DNCR any required reporting or notifications related to pump handling

3. Site Arrival and Access:

• Check in with park staff if required

• Locate the well access point inside or near the Yankee Building

• Ensure the space around the well is clear

• Inspect well cap, riser, fittings, and any electrical components

4. Power and System Check:

• Verify availability of electrical power for pumps or meters

• Confirm circuits are safe for use

5. Well Preparation:

• Remove well cap

• Measure static water level

• Determine well depth and appropriate pump setting

• Install pump or tubing after removing existing pump if required

• Prepare meters for field parameter stabilization

6. Purging Setup:

• Begin purge using appropriate flow rate

• Monitor field parameters until they stabilize

• Record flow rate, and well draw down

7. Sample Handling:

• Keep bottles and preservatives above freezing temperatures

• Store samples in cooler with controlled temperature

• Complete chain of custody paperwork immediately

8. Departure and Sample Transport:

• Secure well and prepare for future use if necessary

• Remove all equipment and waste

• Transport samples off the mountain promptly

• Ensure lab delivery within holding times

9. DNCR Future Use Consideration:

• If analytical results come back clean, DNCR intends to keep the well in service

• Ensure that all equipment removal, pump reinstallation, and well integrity checks support continued potable use

• Document any modifications so DNCR can maintain compliance for future operation

Web Content Accessibility. Any reports submitted for public viewing on any NH State webpage must comply with the World Wide Web Consortium’s Web Content Accessibility Guidelines (WCAG) 2.1 AA requirements.

C. General Requirements

All services performed under this Contract(s) shall be performed between the hours of 7:00 A.M.

and 4:30 P.M., Monday through Friday, unless other arrangements are made in advance with the State. Any deviations in work hours shall be pre-approved by the Contracting Officer. The State requires ten-day advance knowledge of said work schedules to provide security and access to respective work areas. No premium charges shall be paid for any off-hour work.

The Vendor shall not commence work until a conference is held with the agency, at which representatives of the Vendor and the State are present. The conference shall be arranged by the requesting agency (State).

The State shall require correction of defective work or damages to any part of a building or its appurtenances when caused by the Vendor’s employees, equipment, or supplies. The Vendor shall replace in satisfactory condition all defective work and damages rendered thereby or any other damages incurred. Upon failure of the Vendor to proceed promptly with the necessary corrections, the State may withhold any amount necessary to correct all defective work or damages from payments to the Vendor.

The work staff shall consist of qualified persons completely familiar with the products and equipment they shall use. The Contracting Officer may require the Vendor to dismiss from the work such employees as deems incompetent, careless, insubordinate, or otherwise objectionable, or whose continued employment on the work is deemed contrary to the public interest or inconsistent with the best interest of security and the State.

The Vendor or their personnel shall not represent themselves as employees or agents of the State. While on State property, employees shall be subject to the control of the State, but under no circumstances shall such persons be deemed to be employees of the State.

All personnel shall observe all regulations or special restrictions in effect at the State Agency.

The Vendor’s personnel shall be allowed only in areas where services are being performed.

The use of State telephones is prohibited.

If sub-contractors are to be utilized, the Vendor shall provide information regarding the proposed sub-contractors including the name of the company, their address, contact person, and three references for clients they are currently servicing. Approval by the State must be received prior to a sub-contractor starting any work.

D. Obligations and Liability of the Vendor

The successful Vendor shall perform all the work and furnish all the materials, tools, equipment, and safety devices necessary to perform in the manner and within the time hereinafter specified.

Vendor shall complete the entire work to the satisfaction of the State and in accordance with the specifications herein mentioned, at the price herein agreed upon and fixed therefore. All the work, labor, and equipment to be done and furnished under this contract(s), shall be done and furnished strictly pursuant to, and in conformity with the specifications described herein, and the directions of the State representatives as given from time to time during the progress of the work, under the terms of this contract(s) and also in accordance with any contract drawings.

The successful Vendor shall take full responsibility for the work to be performed pursuant to the Scope of Services included herein; for the protection of said work; and for preventing injuries to persons and damage to property and utilities on or about said work. The Vendor shall in no way be relieved of such responsibility by any authority of the State to give permission or issue orders relating to any part of the work, by any such permission given or orders issued, or by any failure of the State to give such permission or issue such orders. The successful Vendor shall bear all losses accruing to the Vendor as a result of the amount, quality, or character of the work required, or because the nature or characteristics of the work location is different from what the Vendor estimated or expected, or due to delays or other complications caused by the weather, elements, or other natural causes.

Section 5 – Bid Form

A. Vendor Contact Information Please provide contact information below for a person knowledgeable of and who can answer questions regarding this bid response.

Contact Person Telephone Number Toll Free Telephone Number

Fax Number Email Address Company Website

Vendor Company Name

Vendor Address

B. Offer / Bid Form

Vendor hereby offers to provide the services to the State of New Hampshire as specified at the prices quoted below, in complete accordance with general and detailed specifications included herewith.

Planning & QAPP

Lump Sum: $

Field Services:

Mobilization/Demobilization: $

Soil Borings: 15 @ $ each

Soil Samples: 15 @ $ each

Monitoring Well Inspection, removal and/or

Installation: $ each

Groundwater Samples: $ each

Laboratory Analyses:

VOCs (8260): @ $

SVOCs (8270): @ $

TPH: @ $

Metals: @ $

PFAS (1633): @ $

QA/QC & Validation:

DUSR + Validation: $

Reporting:

Draft Report: $

Final Report + EDDs: $

TOTAL BID PRICE: $

Signature: Date:

[Insert name of signor] , on behalf of [insert name of entity submitting bid (Vendor)] hereby submits an offer as contained in the written bid submitted herewith (“Bid”) to the State of New Hampshire in response to the above Request for Bids at the price(s) quoted herein in complete accordance with the bid.

Vendor attests to the fact that:

1. The Vendor has reviewed and agreed to be bound to the Bid.

2. The Vendor has not altered any of the language or other provisions contained in the Bid document.

3. The Bid is effective for a period of 180 days from the Bid Submission date as indicated above.

4. The prices the Vendor has quoted in the Bid were established without collusion with other vendors.

5. The Vendor has read and fully understands this Bid.

6. Further, in accordance with RSA 21-I:11-c, the undersigned Vendor certifies that neither the

Vendor nor any of its subsidiaries, affiliates, or principal officers (principal officers refers to individuals with management responsibility for the entity or association):

a. Has, within the past 2 years, been convicted of, or pleaded guilty to, a violation of RSA

356:2, RSA 356:4, or any state or federal law or county or municipal ordinance prohibiting specified bidding practices, or involving antitrust violations, which has not been annulled;

b. Has been prohibited, either permanently or temporarily, from participating in any public works project pursuant to RSA 638:20;

c. Has previously provided false, deceptive, or fraudulent information on a vendor code number application form, or any other document submitted to the State of New Hampshire, which information was not corrected as of the time of the filing a bid, proposal, or quotation;

d. Is currently debarred from performing work on any project of the federal government or the government of any state;

e. Has, within the past 2 years, failed to cure a default on any contract with the federal government or the government of any state;

f. Is presently subject to any order of the Department of Labor, the Department of Employment Security, or any other state department, agency, board, or commission is charged with implementing;

g. Is presently subject to any sanction or penalty finally issued by the Department of Labor, the Department of Employment Security, or any other state department, agency, board, or commission, which sanction or penalty has not been fully discharged or fulfilled;

h. Is currently serving a sentence or is subject to a continuing or unfulfilled penalty for any crime or violation noted in this section;

i. Has failed or neglected to advise the Department of any conviction, pleas of guilty, or finding relative to any crime or violation noted in this section; or of any debarment, within 30 days of such conviction, plea, finding, or debarment; or

j. Has been placed on the debarred parties list described in RSA 21-I:11-c within the past year.

This document shall be signed by a person who is authorized to legally obligate the responding vendor. A signature on this document indicates that all State of New Hampshire terms and conditions are accepted by the responding vendor and that any and all other terms and conditions submitted by the responding vendor are null and void, even if such terms and conditions have terminology to the contrary.

Authorized Signor’s Signature Authorized Signor’s

Title NOTARY PUBLIC/JUSTICE OF THE PEACE

COUNTY: STATE: ZIP:

On the day of , 2026, personally appeared before me, the above named , in his/her capacity as authorized representative of , known to me or satisfactorily proven, and took oath that the foregoing is true and accurate to the best of his/her knowledge and belief.

In witness thereof, I hereunto set my hand and official seal.

(Notary Public/Justice of the Peace)

My commission expires: (Date)