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t4A <br /> @I'1 b <br /> 1 <br /> CITY OF SANTA ANA <br /> CERTIFICATION REGARDING DEBARMENT <br /> This certification is required by the regulations implementing Executive Order 12549, Debarment and <br /> Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The regulations were <br /> published as Part VII of the May 16, 1988, Federal Register (Pages 19160-19211). <br /> (Before completing certification, read instructions which are an integral part of certification) <br /> 1. The prospective primary participant, (i.e. grantee) certifies to the best of its knowledge and belief, that <br /> 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 organization; <br /> b. Have not within a three-year period preceding this proposal been convicted or had a civil <br /> judgment rendered against them for commission of fraud or a criminal offense in connection with <br /> obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or <br /> contract under a public transaction; violation of federal or state antitrust statues or commission of <br /> embezzlement, theft, forgery, bribery, falsification or destruction of records, making false <br /> statements, or receiving stolen property. <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 enumerated in paragraph (1)(b) of <br /> this certification; and <br /> d. Have not within a three-year period preceding this application/proposal had one or more public <br /> transactions (federal, state or local) terminated 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 /> Taller San Jose Hope Builders <br /> Grantee/Contractor Organization <br /> Shawna Smith, Executive Director <br /> Name and Title of Official Authorized to Certify <br /> On Behalf of the Grantee <br /> 03/16/2026 <br /> Date <br />