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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 1 <br />Certification Regarding <br />Debarment, Suspension, Ineligibility and Voluntary Exclusion <br />Lower Tier Covered Transactions <br />This certification is required by the regulations implementing Executive Order 12549, Debarment and <br />Suspension, 29 CFR Part 98, Section 98,510, Participants' Responsibilities. The regulations were <br />published as Dart VIJ of the May 16, ]988, federal Register (Pages 19:16U-19211). <br />(Before completing eertificatian, read Instructions which are an integral part of certification). <br />1. The prospective primary participant, (i.e. grantee) certifies to the best of its knowledge and belief, <br />Nil: it -and its principals: <br />a. Ari not presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from covered transactions by any federal department or ageniy; <br />b. Have not within a three-year period preceding this proposal been convicted or had a civil <br />judgment rendered against them for commission of fraud or criminal offense in connection <br />with obtaining, attempting to obtain, or performing a public (federal, state or local) tfansaction <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 />malting 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 Inca•I) with commission of any of the offenses enumerated In paragraph <br />(1)(b) of this certification; and <br />d. Have not within a three-year period preceding this application/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 />0c C\,�.1Anet,ls <br />Grantee/Contractor QrganlzaLion <br />Name and Title of Official Authorized to Certify 3 . <br />on Behalf of the Grantee <br />Date <br />25A-93 <br />
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