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INSTRUCTIONS FOR CERTIFICATION <br />1. By signing and submitting this proposal, the prospective recipient of Federal assistance funds is <br />providing the certification as set out below. <br />2. The certification in this clause is material representation of fact upon which reliance was placed when <br />this transaction was entered into. If it is later determined that the prospective recipient of Federal <br />assistance funds knowingly rendered an erroneous certification, in addition to other remedies <br />available to the Federal Government, the Department of Labor (DOL) may pursue available <br />remedies, including suspension and/or debarment. <br />3. The prospective recipient of Federal assistance funds shall provide immediate written notice to the <br />person to whom this proposal is submitted if at any time the prospective recipient of Federal <br />assistance funds learns that its certification was erroneous when submitted or has become <br />erroneous by reason of changed circumstances. <br />4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered <br />transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and <br />"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and <br />Coverage sections of rules and implementing Executive Order 12549. You may contact the person <br />to whom this proposal is submitted for assistance in obtaining a copy of those regulations. <br />5. The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should <br />the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier <br />covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily <br />excluded from participation in this covered transaction, unless authorized by the DOL. <br />6. The prospective recipient of Federal assistance funds further agrees by submitting this proposal that <br />it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and <br />Voluntary Exclusion--Lower Tier Covered Transactions, "without modification, in all lower tier covered <br />transaction and in all solicitations for lower tier covered transactions. <br />7. A participant in a covered transaction may rely upon a certification of a prospective participant in a <br />lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded <br />from the covered transaction, unless it knows that the certification is erroneous. A participant may <br />decide the method and frequency by which it determines the eligibility of its principals. Each <br />participant may but is not required to, check the List of Parties Excluded From Procurement or <br />Nonprocurement Programs. <br />8. Nothing contained in the foregoing shall be construed to require establishment of a system of records <br />in order to render in good faith the certification required by this clause. The knowledge and <br />information of a participant is not required to exceed that which is normally possessed by a prudent <br />person in the ordinary course of business dealings, <br />9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a <br />covered transaction knowingly enters into a lower tier covered transaction with a person who is <br />suspended, debarred, ineligible, or voluntary excluded from participation in this transaction, in <br />addition to other remedies available to the Federal Government, the DOL may pursue available <br />remedies, including suspension and/or debarment. <br />FD118 (Rev. 9/22/04) <br />25J-10