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<br /> . <br /> Z?V <br /> -==* ATTACHMENT D <br /> L;,T- <br /> ..~ <br /> P-1SSS <br /> """ DEBARMENT CERTIFICATION <br /> (1) The SUBGRANTEE certifies to the:best of its knowledge and belief, that it and its principals; <br /> (a) Axe not presently debarred, suspénded, proposed for debarment, declared ineligible or voluntarily <br /> excluded from covered transactions by any federal depa.rtmeDt or agency; <br /> (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgement <br /> rendered. against then for commission of fraud or a criminal offense in connection with obtaining, attempting <br /> to obtain., or performing a federal, state or local public transaction or contract under a public transaction; <br /> violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bn"bery, <br /> falsification or destruction of records, making false statements, or receiving stolen property; <br /> (c) AIe not presently indicted for otherwise criminally or civilly charged by a federal state, or local <br /> governmental entity with commission of any of the offenses enumerated in paragraph (1)(b) of this <br /> certification; anc!-. <br /> - <br /> (d) Have not within a three-year period preceding this application/proposal had one or more federal state or <br /> local public transactions termjn~too for cause or default. <br /> (2) Where the SUBGRANTEE is unable to certify to any of the statements in this certification, such SUBGRANTEE <br /> shall attach an explHnation to this certification. <br /> .. <br /> ~ :dM <br /> l~ of Ce~ Official , <br /> C'.T'T'Y MANAGER <br /> Title <br /> \)~\l-q\o <br /> Date <br /> Page 1 of 1 <br />