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INSTRUCTION FOR CERTIFICATION <br />1.By signing and submitting this proposal, the prospective recipient of Federal assistance funds is <br />providing the certification as set out below. <br />2.The certification in this clause is a material representation of fact upon which reliance was placed <br />when this transaction was entered into. If it is later determined that the prospective recipient of <br />Federal assistance funds knowingly rendered an erroneous certification, in addition to other <br />remedies available to the Federal Government, the Department of Labor (DOL) may pursue available <br />remedies, including suspension and/or debarment. <br />3.The prospective recipient of Federal assistance funds shall provide immediate written notice to the <br />person to which this proposal is submitted if at any time the prospective recipient of Federal <br />assistance funds learns that its certification was erroneous whom submitted or has become <br />erroneous by reason of changed circumstances. <br />4.The terms “covered transaction”, “debarment”, “suspension”, “disqualified,” “ineligible”, “lower tier <br />covered transaction”, “participant”, “person”, “primary covered transaction”, “principal”, <br />“proposal”, and “voluntarily excluded”, as used in this cause, have the meanings set out in the <br />Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact <br />the person to whom this proposal is submitted for assistance in obtaining a copy of those <br />regulations. <br />5.The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should <br />the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier <br />covered transaction with a person who is debarred, suspended, disqualified, declared ineligible, or <br />voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. <br />6.The prospective recipient of Federal assistance funds agrees by submitting this proposal, that it will <br />include the clause title “Certification Regarding Debarment, Suspension, Ineligible, or voluntarily <br />excluded from the covered transaction” unless it knows that the certification is erroneous. <br />7.Nothing contained in the foregoing shall be construed to require establishment of a system of <br />records in order to render in good faith the certification required to exceed that which is normally <br />possessed by a prudent person in the ordinary course of business dealings. <br />8.Except for transactions authorized under paragraph 5 of these instructions, if a participant in a <br />covered transaction knowingly enters into a lower tier covered transaction with a person who is <br />suspended, debarred, ineligible, or voluntary excluded from participation in this transaction, in <br />addition to other remedies available to the Federal Government, the DOL may pursue available <br />remedies, including suspension and/or debarment. <br />ATTACHMENT H <br />CERTIFICATION REGARDING DEBARMENT, INELIGIBILITY AND VOLUNTARY EXCLUSION <br />ATTACHMENT H (continued) <br />CERTIFICATION REGARDING DEBARMENT, INELIGIBILITY AND VOLUNTARY EXCLUSION <br />City of Santa Ana RFP 24-080A Page 42 of 42 <br />16Tangram Interiors | City of Santa Ana