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Item 20 - WIOA Youth Request for Proposal PY 2023-24 – Subgrantee Agreement
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Item 20 - WIOA Youth Request for Proposal PY 2023-24 – Subgrantee Agreement
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8/10/2023 8:48:12 AM
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City Clerk
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Agenda Packet
Agency
Clerk of the Council
Item #
20
Date
6/20/2023
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CITY OF SANT A ANA <br />EXHIBIT H <br />C'ERTIFICATION REGARDING DEBARMENT <br />This certification is required by the regulations implementing Executive Order 12549, Debarment and <br />Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The regulations were <br />published as Part VII of the May 16, 1988, Federal Register (Pages 19160-19211). <br />(Before completing certification, read instructions which are an integral part of certification) <br />1.The prospective primary participant, (i.e. grantee) certifies to the best of its knowledge and belief, that <br />it and its principals: <br />a.Are not presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from covered transactions by any federal department or organization; <br />b.Have not within a three-year period preceding this proposal been convicted or had a civil <br />judgment rendered against them for commission of fraud or a criminal offense in connection with <br />obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or <br />contract under a public transaction; violation of federal or state antitrust statues or commission of <br />embezzlement, theft, forgery, bribery, falsification or destruction of records, making false <br />statements, or receiving stolen property. <br />c.Are not presently indicted for or otherwise criminally or civilly charged by a government entity <br />(federal, state or local) with commission of any of the offenses enumerated in paragraph (1 )(b) of <br />this certification; and <br />d.Have not within a three-year period preceding this application/proposal had one or more public <br />transactions (federal, state or local) terminated for cause or default. <br />2.Where the prospective primary participant is unable to certify to any of the statements in this <br />certification, such prospective participant shall attach an explanation to this proposal. <br />Dr. h.�, t1\V\'t-r -\�\ , E�-e�ve... D .� <br />Name and Title of Official Authorized to Certify <br />On Behalf of the Grantee <br />01 /o'(/ 7<JZ3 <br />Date <br />74 <br />EXHIBIT 1
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