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25A - AGMT WIOA FORMULA
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25A - AGMT WIOA FORMULA
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Last modified
6/27/2019 5:16:41 PM
Creation date
6/27/2019 5:05:21 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25A
Date
7/2/2019
Destruction Year
2024
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EXHIBIT 2 <br />Certification Regarcifn¢ <br />Debarment, Suspension, Inelinibility.iind Voluntary Exclusion <br />Lower Tier Covered Transactions <br />This certification is required by the regulations implementing Executive Order12549, Debarment and <br />Suspension, 29 CFR Part 98, Section 98.510, Participants' Responsibilities. The regulations were <br />published as Part Vll of the May 16, 1988, Federal Register (pages 19160-19211). <br />(Before completing certification, read instructions which are an integral part of certification) <br />I. The prospective primary participant, (i.e. grantee) certifies to the best of Its knowledge and belief, <br />that it and its principals; <br />a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from covered transactions by any federal department or agency; <br />b, Have not within a three-year period precedfng this proposal been convicted 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) transaction <br />or contract under a public transaction; violation of federal or state antitrust statues or <br />commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, <br />making false statements, or receiving stolen property. <br />c. Are not presently Indicted for or otherwise criminally or civilly charged by a government <br />entity (federal, state or local) with commission of any of the offenses enumerated in paragraph <br />(1)(b) of this certification; and <br />it. Have not within a three-year period preceding this applicatfon/proposal had one or more <br />public. transactions (federal, state or local) terminated for cause or default. <br />2. Where the prospective primary participant is unable to certify to any of the statements In this <br />certification, such prospective participant shall attach an explanation to this proposal, <br />Charitable Ventures of Orange County/Project Kinship <br />Grantee/Contractor Organization <br />Ted Xim, Chief Operating Office <br />Name a nd Title of Official Authorized to Certify <br />On Behalf of the Grantee <br />May 21, 2029 <br />Date <br />25A-207 <br />
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