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EPA" 'a Environmental Protection <br />Agency <br />0MB Control No: <br />Approved: <br />Approval Expires: <br />Disadvantaged Business Enterprise (DBE) Program <br />DBE Subcontractor Performance Form <br />I certify under penalty of perjury that the forgoing statements are true and correct. Signing this form does not <br />signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a <br />subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302 ( c ). <br />nature Print Name <br />M . $1 <br />Date <br />Subcontractor Sign ature Print Name <br />M &eco Kris Bowen <br />Title Date <br />President 11/21/22 <br />The public reporting and record keeping burden for this collection of information is estimated to average three (3) hours <br />per response. Send comments on the Agency's need for this information, the accuracy of the provided burden <br />estimates, and any suggested methods for minimizing respondent burden, including through the use of automated <br />collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 <br />Pennsylvania Ave., NW, Washington, D.C. 20460. Include the 0MB control number in any correspondence. Do not send <br />the completed form to this address. <br />EPA FORM 6100-3 (DBE Subcontractor Performance Form)