Certification - (Rev. 5, 08-30-02)

230 - Certification - (Rev. 5, 08-30-02) A1-1912, B1-4912 Medicare contractor certification by the Chief Financial Officer (CFO) is required. The CFO must input their password on the CAFM system (see Exhibit 16). Failure to record the official's password is a serious error that will prevent acceptance of the report by the CAFM system. The following statement appears at the end of the Form CMS-750A/B: I hereby CERTIFY that I have examined the Statement of Financial Position prepared by [name of contractor] for the period beginning (first day of FY) and ending (last day of quarter), and that to the best of my knowledge and belief, it is a true, correct and complete statement prepared from the books and records of the contractor in accordance with applicable instructions. NAME _______________ Date __________ Title ___________