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<br />Certification Re2ardin2 <br />Debarment, Suspension, Ineli2ibility and Voluntary Exclusion <br />Lower Tier Coyered Transactions <br /> <br />This certification is required by the regulations implementing Executive Order l2549, <br />Debarment and SuspensIOn, 29 CFR Part 98, Section 98.5l 0, Participants' Responsibilities. <br />The regulations were published as Part VI! of the May] 6, 1988, Federal Register (Pages <br />19160-l92ll) <br /> <br />(Before completing certification, read instructions which are an integral part of <br />certification) <br /> <br />I. The prospectIve primary participant, (i.e. grantee) certifies to the best of its knowledge <br />and belief, that it and its principals: <br /> <br />a. Are not presently debarred, suspended, proposed for debarment, declared <br />ineligible, or voluntarily excluded from covered transactions by any federal <br />departn1entoragency; <br /> <br />b. Have not within a three-year period preceding this proposal been convicted or <br />had a civil judgment rendered against them for commission of fraud or a criminal <br />offense in connection with obtaining, attempting to obtain, or performing a public <br />(federal, state or local) transaction or contract under a public transaction; violation <br />of federal or state antitrust statues or commission of embezzlement, fueft, forgery, <br />bribery, falsification or destruction of records, making false statements, or receiving <br />stolen property <br />c. Are not presently indicted for or otherwise criminally or civilly charged by a <br />government entity (federal, state or local) wifu commission of any of the offenses <br />enumerated in paragraph (l )(b) of this certification; and <br /> <br />d. Have not within a three-year period preceding this application/proposal had one <br />or more public transactions (federal, state or local) terminated for cause or default <br /> <br />2. v,'here the prospective primary participant is unable to certify to any of fue statements <br />in this certification, such prospective participant shall attach an explanation to this <br />proposal. <br /> <br />~1A-lP(d[C:c1 rzYT(I(D <br />Grantee/Co~tractor Organization <br /> <br />"2.!2.a~,..:c (:fe<;.,dcd- hr!L. D,;~.,....- <br />Name nd Title of Official Authorized to Certify <br />On Behalf of the Grantee <br /> <br /> <br />-- . <br />:::> /1'1-ob <br />Date <br /> <br /><,1 <br />