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<br />Attachment H <br /> <br /> <br />&EPA EP'-~-, <br /> <br /> <br /> <br />UnIted States EnWonmentaJ Protection /tQency <br />Washington, DC 20460 <br />Certification Regarding <br />Debarment, Suspension, and Other Responsibility. Matters <br /> <br /> <br />The prospeáive participant certifIeS to the best of Its knowtedge and belief that it and Its principals: <br />(a) Are not presen11y debarred, suspended. proposed for debarment. declared Ineligible. or voluntarily <br />excluded from covered transactIons by any Federal department or agency; <br />(b) Have not within a three year period preceding this proposal been convicted of or had a eMf: Judgement <br />rendered against them for commIsSion of fraud or a crimtnal offense In connection with obtaining, <br />attempting: to obtain. or perfonnlng a public (Federal, State. or local} transaction or contract under a <br />public transaction; violation of Federal or State antitrust statutes or èommfsston of embezzfement, <br />theft. forgefy, bcibefy, falsification. or. destruction of recoo1s. making false statements, or receiving <br />stolen property. <br />(c) Are not presently indicted for or otherwise crimlnany or cMlly charged by a government entity (Federal, <br />State, or local) with commission of any of the offenses enumerated Iri paragraph (1)(b) of this <br />certification; and <br />(d) Have not within a three-year period preceding t. this application/proposal had one or more public <br />transactions (Federal. State, or local) termlnatedlor cause or default <br />I understand that a false statement on this certification may be grounds for reJection of this proposal or <br />termination of the award. In addition. under 18 use Sec. 1001, a false statement may result In a fine of up <br />to $10,000 or Imprisonment for up to 5 years, or both. <br /> <br /> <br /> <br />laJ:t:y D. Gi.lJey, CitY ~ <br />Typed Nanw & rrtle of AuthocIzecI ~1tdwe <br /> <br />, ¿, I t <br />(~ ~./ ~tf' 4 Ita I i'/ <br />$gnån of AuIhorized At9I :) \ DäI <br /> <br /> <br /> <br /> <br />0 'am unable to certify to the above statements. My explanation is attached. <br /> <br />EP A Form S7O()...4 9 ( 11 ~ ) <br />