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COMMUNITY SENIORSERV, INC. (2) - 2016
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COMMUNITY SENIORSERV, INC. (2) - 2016
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Last modified
9/14/2016 11:14:55 AM
Creation date
9/14/2016 10:03:21 AM
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Contracts
Company Name
COMMUNITY SENIORSERV, INC.
Contract #
A-2016-174
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Council Approval Date
7/5/2016
Expiration Date
6/30/2017
Insurance Exp Date
7/1/2017
Destruction Year
2022
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Certification Regarding <br />Debarment, 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' responsibil ities. The regulations were published <br />as Part VII of the May 26, 1988 Fcderat Register (pages 19160 - 19211). <br />(BEFORE COMPLETING CERTIFICATION', READ INSTRUCTIONS FOR CERTIFICATION <br />Attached) <br />(1) The prospective recipient of 'federal assistance funds certifies, by submission of this proposal, that <br />neither it nor its principals are presently debarred, suspended, proposed for debarment, declared <br />ineligible, or voluntarily excluded from participation in this transaction by any federal department or <br />agency. <br />(2) Where the prospective recipient of federal assistance funds is unable to certify to any of the <br />statements in this certification, such prospective participant shall attach an explanation to this <br />proposal. <br />Holly Hagler, Chief Executive Officer <br />Name and Title of Authorized Representative <br />Signattire O ..�f Date <br />/b <br />EXHIBIT C <br />Page 1 of 2 <br />
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