Laserfiche WebLink
Cortification Regarding <br />De)rarfnent Suspension Ineligibility and Voluntary Exclusion <br />Lower Tier Covered Transactions <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 1916019211). <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, <br />that It and Its principals; <br />a. Are not presently debarred, suspended, proposed for debarment, declared Ineligible, or <br />voluntarlly 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 agalnst them for commission of fraud or a criminal offense In connection <br />with obtalri1q, attempting to obtain, or performing a public (federal, state or local) <br />transaction or contract under a public transaction; violation of federal or state antitrust <br />statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of <br />records, makingfalse statements, or receiving stolen property. <br />c. Are not presently Indicted for or otherwise criminally or civilly charged by a government <br />entity (federal, state or local) with commission of any of the offenses enumerated In <br />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 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 />Grantee /Contractor Organization <br />Name and Title of Official Authorized to Certify <br />On Behalf of the Grantee <br />Date <br />ExhibitD <br />SAC -16 -004 <br />