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<br />E"hibi t D <br /> <br />Certification Rel!:arding <br />Debarment. Suspension, Ineligibilitv and V oluntarv Exclusion <br />Lower Tier Covered Transactions <br /> <br />This certification is reqUJred by the regulations implementing Executive Order 12549, <br />Debarment and Suspension, 29 CFR Part 98, Section 98.5 10, Participants' Responsibilities. The <br />regulations were published as Part VII of the May 16, 1988, Federal Register (Pages 19160- <br />19211). <br />(Before completing certification, read instructions which are an integral part of certification) <br /> <br />I. The prospective primary participant, (i.e. grantee) certifies to the best of its knowledge and <br />belief, that it and its principals: <br /> <br />a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from covered transactions by any federal department or agency; <br /> <br />b. Have not within a three-year period preceding this proposal been convicted or had a <br />civil judgment rendered against them for commission of fraud or a criminal offense in <br />connection with obtaining, attempting to obtain, or performing a public (federal, state or <br />local) transaction or contract under a public transaction; violation of federal or state <br />antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or <br />destruction of records, making false statements, or receiving stolen property. <br /> <br />c. Are not presently indicted for or otherwise criminally or civilly charged by a <br />government entity (federal, state or local) with commission of any of the offenses <br />enumerated in paragraph (I )(b) of this certification; and <br /> <br />d. Have not within a three-year period preceding this application/proposal had one or <br />more public transactions (federal, state or local) terminated for cause or default. <br /> <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 /> <br />California Hispanic Commission on Alcohol and Druq Abuse, Inc. (CHCADA) <br />Grantee/Contractor Organization <br /> <br />James A. Hernandez, Executive Director <br />Name and Title of Official Authorized to Certify On Behalf of the Grantee <br /> <br />JulV 25, 2005 <br />Date <br /> <br />39 <br />