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Certification Regardin—a <br />Debarment Suspension, lneliaibility and N'otuntary Exclusion <br />Lower Tier Covered Transactions <br />49. <br />This certification is required by the regulations implementing 1:xecutive Order 1 __ ibi <br />Debarment and Suspension. 29 CPR Part 98, Section 98.51 U, Participants' ,Responsibilities. The <br />reculations were published as Part VI1 of the May 1 b. 1988. Federal Register (Pages 19160- <br />19211). <br />(Before completing certification, read instructions which are an integral part of certification) <br />1. The prospective primary participant, 0 e. grantee) certifies to the best of its knowledge and <br />belief. that it and its principals: <br />a. Are not presentl\ debarred, suspended_ proposed for debarment. declared ineligible, or <br />voluntandv excluded from covered transactions by any federal department or agency. <br />b. Have not within athree-year period precedmp this proposal been convicted or had a <br />civil judgment rendered against them for commission of fraud or a criminal offense -7 <br />comlection with obtaining. attempting to obtain. or perforating a public (federal. state <br />local) transaction or contract under a public transaction: violation of federal or state <br />antitrust statues or commission of embezzlement. theft. forger>�. br�bery, fals ficatton or <br />destruction of records. making false statements. or receiving stolen propemT_ <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 (1 )(b) of this certification: and <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 />2. where the prospective primary participant is unable to certify to ani° of the statements in this <br />certification. such prospective participant shall attach an explanation to this proposal. <br />- s (C L -r 7111,4) <br />S'-tci �(C <br />Grantee!Contractor Organization <br />Name ab Title of Official .Authorized to Certif- <br />On Behalf of the Grantee <br />S-1�--6 <br />Date <br />