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I (WE) JOINTLY ANDSEVERALLY AGREE TRA—T.- 1. HAT:1. All records pertaining to the claims included in this Claim Application will be retained for a period of at least three years from the date of final payment on the last phase of work reimbursed from the Fund. This three year period of retention shall be extended unfit completion of any audit in progress at the conclusion of the three year retention period. All such records shall be made available to the State Board, or any designated representative thereof, upon request. 112. All reimbursements made pursuant to this Claim Application are subject to audit by the State Board or any representative thereof. Claimant(s) will reimburse the State for any casts finally disallowed pursuant to such an audit. XII. VERIFICATION 1(WE)HEREBY DECLARE UNDER PENALTY OF PERJURY THAT All PACTS AND STATEMENTS SLIT FORTH AS A PART OF THIS CLAIM APPLICATION ARE TRUE AND CORRECT TO THE BEST OF MY(OUR)KNOWLEDGE AND BELIEF. j EXECUTED AT Irvine CALIFORNIA ON T1413 16th DAY OF Tanuary . II ;I�) SIGNATURE: CLAIMANT OR AUTHOR7ZE0 REPRESENTATIVE CLAIMANT OR AUTHORIZED REPRESENTATIVE CW MANT OR AVTHORIZED REPRESENTATIVE CLUMAIIT OR AUTHORIZED REPRESENTATIVE CLAIMANT OR AUTHORIZED REFRESENTATNE CLAIMANT OR AUTHORIZED FAPMSENTATNE CLAIMANT OR AUTHORIZED REPRESENTATIVE CLAIMANT OR AUTHORIZED REPRESENTATIVE CLAIMANT OR AUTHOR=REPRESENTATIVE CLAIMANT OR AUTHORIZED REPRESENTATIVE C W MANT OR AUTHORIZED REPRESENTATNE CLAIMANT OR AUTHORIZED RETRESENTATNE DELIVER COMPLETED CLAIM TO: OR MAIL COMPLETED CLAIM APPLICATION TO. STATE WATER RESOURCES CONTROL BOARD STATE WATER RESOURCES CONTROL BOARD DIVISION OF CLEAN WATER PROGRAMS DIVISION OF CLEAN WATER PROGRAMS UST CLEANUP FUND PROGRAM UST CLEANUP FUND PROGRAM 2014 T STREET. SUITE 130 P.O. BOX 944212 SACRAMENTO, CA 95814 SACRAMENTO, CA 94244-2120 (NEW 12'91) 'lag S