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FULL PACKET_2008-04-07
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FULL PACKET_2008-04-07
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Exhibit H <br />Certification Regarding <br />Debarment, Suspension, Ineligibility and Voluntary Exclusion <br />Lower Tier Covered Transactions <br />This certification is required by the regulations unplementing Executive Order 12549, Debarment <br />and Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The regulations <br />were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). Before <br />completing certification, read the attached instructions. <br />l: The prospective primary participant; (i.e., grantee) certifies to the best of its knowledge and <br />belief, that 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 agency; <br />b. Have not within athree-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, <br />or Iocal) 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 />destnrction of records, making false statements or receiving stolen propert}; <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 u~ paragraph (1)(b) of this certification; and <br />d. Have not within a three year period preceding this application/proposal had one or more <br />public transaction (federal, state or local) tenninated for cause or default. <br />2. ViThere the prospective primary recipient of federal funds is unable to certify to any of the <br />statements in this certification, such prospective participant shall attach an explanation to <br />this proposal. <br />CSII N A~II~%I Y S VICES COgPORATION <br />. /,'l„' <br />Grantee/Contractor Orga~uzation <br />William M. Dickerson <br />Executive Director <br />Name and Title of Official Authorized to Certify <br />On Behalf of re Grantee.. <br />Signature Date <br />25N-69 <br />
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