Laserfiche WebLink
EXHIBIT C <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY <br />MATTERS <br />This certification is required by the Federal Regulations Implementing Executive Order 12549, <br />Debarment and Suspension, 45 CFR Part 93, Government -wide Debarment and Suspension, for the <br />Department of Agriculture (7 CFR Part 3017), Department of Labor (29 CFR Part 98), Department of <br />Education (34 CFR Parts 85, 668, 682), Department of Health and Human Services (45 CFR Part <br />76). <br />The undersigned certifies, to the best of his or her knowledge and belief, that both it and its principals: <br />1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from participation in this transaction by any federal department or agency; <br />2. Have not within a three-year period preceding this contract been convicted of or had a civil <br />judgment rendered against them for commission of fraud or a criminal offense in connection <br />with obtaining, 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 statues <br />or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, <br />making false Proposals, or receiving stolen property; <br />3. Are not presently indicated for or otherwise criminally or civilly charged by a government entity <br />with commission of any of the offense enumerated in Paragraph (2) of this certification; and, <br />4. Have not within a three-year period preceding this contract had one or more public <br />transactions terminated for cause or default. <br />Where the prospective recipient of federal assistance funds is unable to certify to any of the <br />qualifications in this certification, such prospective recipient shall attach an explanation to this <br />certification form. <br />Name of Organization/Contractor(s): <br />Signature of Authorized Representative: <br />Date: <br />Memorandum of Understanding Page 2 <br />