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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 375-020-52 <br />STATE HIGHWAY LIGHTING MAINTENANCE AND MAINTENANCE <br />> > OGC — 02/21 <br />COMPENSATION AGREEMENT Page of <br />8. Certification <br />This document is a printout of an FDOT form maintained in an electronic format and all revisions thereto by the <br />MAINTAINING AGENCY in the form of additions, deletions, or substitutions are reflected only in an Appendix <br />entitled "Changes to Form Document' and no change is made in the text of the document itself. Hand notations on <br />affected portions of this document may refer to changes reflected in the above-named Appendix but are for <br />reference purposes only and do not change the terms of the document. By signing this document, the <br />MAINTAINING AGENCY hereby represents that no change has been made to the text of this document except <br />through the terms of the Appendix entitled "Changes to Form Document." <br />You MUST signify by selecting one of the applicable options: <br />❑ No changes have been made to this Forms Document and no Appendix entitled "Changes to Form <br />Document' is attached. <br />❑ No changes have been made to this Form Document, but changes are included on the attached Appendix <br />entitled "Changes to Form Document." <br />IN WITNESS WHEREOF, the parties hereto have executed this Agreement effective the day and year first written. <br />MAINTAINING AGENCY <br />BY: <br />(Printed Name: ) Date: <br />(Printed Title: <br />STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION <br />BY: <br />(Printed Name: Paul A. Lampley, P.E. ) Date: <br />(Printed Title: Director of Transportation Operations ) <br />FDOT Legal Review <br />BY: <br />Counsel <br />(Printed Name: Elizabeth S. Quintana <br />Date: <br />131 <br />