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(9) <br />CITY OF SANTA ANA <br />ATTACHMENT H <br />CERTIFICATE REGARDING DEBARMENT, SUSPENSION, INEGIBILITY AND <br />VOLUNTARY EXCLUSION <br />This certification is required by the regulations implementing Executive Order 12549, as amended, <br />Nonprocurement Debarment and Suspension, 2 CFR Part 2998, Subpart C, Responsibilities of <br />Participants Regarding Transactions. The regulations were published as Part VII of the May 26, 1988, <br />Federal Register (Pages 19160-19211), and as subsequently amended in 81 Federal Register 25585. <br />(Before completing certification, read instructions which are an integral part of certification) <br />1. Pursuant to 2 CFR 180.335, the prospective primary participant, (i.e. grantee) certifies to the best of <br />its knowledge and belief, that it and its principals: <br />a. Are not presently excluded or disqualified; <br />b. Have not been convicted within the preceding three years of any of the offenses listed in <br />2CFR 180.800(a) or had a civil judgment rendered against them for one of those offenses within <br />that time period. <br />c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity <br />(Federal, State or local) with commission of any of the offenses listed in 2 CFR 180.800(a); and <br />d. Have not had one or more public transactions (Federal, State or local) terminated within the <br />preceding three years for cause or default. <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 />Consultant <br />Stephen H. Heil <br />URTA LLC / Managing Partner <br />_ Name and Title of Official Authorized to Certify <br />On Behalf of the Consultant <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />Date <br />INSTRUCTION FOR CERTIFICATION <br />