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<br /> A1Vl'ACHMENT n <br /> Debarment Certification <br /> (Negotiated Contracts) <br /> (1) The CONTRACTOR certifies to the best ants knowledge and belief, that it and <br /> its principals: <br /> (a) Are not presently debarred, suspended, proposed for debarment, declared <br /> ineligible or voluntarily excluded from covered transactions by any federal <br /> departmen t or agency; <br /> (b) Have not within a three-year period preceding this proposal been convicted <br /> of or had a civil judgment rendered against them for commission of fraud or a <br /> criminal offense in connection with obtaining, attempting to obtain, or per- <br /> forming a public. transaction or contract under a public transaction; violation <br /> of federal or state antitrust statutes or commission of embezzlement, theft, for- <br /> gery, bribery, falsification or destruction of records, making false statements, <br /> or receiving stolen property; <br /> (c) Are not presently indicted for or otherwise criminally or civilly charged by <br /> a governmental entity* with commission of any of the offenses enumerated in <br /> paragraph (l)(b) of this certification; and <br /> (d) Have not within a three-year period preceding this application/proposal <br /> had one or more public transactions* terminated for cause or default. <br /> (2) Where the CONTRACTOR is unable to certify to any of the statements in <br /> this certification, such CONTRACTOR shall attach an explanation to this <br /> certification. <br /> *federal, state or local <br /> 1 A ~ <br /> SignaØorc.:t¡'ÔifYin¡: 0 ¡dILl ~ <br /> Ti~lc= Ny 14 atl4~ <br /> Date q--i2--'l1 <br /> ¡"orm 1734-A <br /> 4.H~ <br />