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LATINO CENTER FOR PREVENTION AND ACTION IN HEALTH & WELFARE DBA LATINO HEALTH ACESS
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LATINO CENTER FOR PREVENTION AND ACTION IN HEALTH & WELFARE DBA LATINO HEALTH ACESS
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Last modified
4/7/2022 2:19:01 PM
Creation date
4/7/2022 2:18:05 PM
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Contracts
Company Name
LATINO CENTER FOR PREVENTION AND ACTION IN HEALTH & WELFARE DBA LATINO HEALTH ACESS
Contract #
A-2021-238-05
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
12/7/2021
Expiration Date
8/31/2022
Insurance Exp Date
1/1/1900
Destruction Year
2027
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DocuSlgn Envelope ID: 4E844E78-4F58-4861-819E-4AEA85D3A154 <br />EXHIBIT E <br />DEBARMENT <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 Part VII of the May 26,1988 Federal Re ig ster (pages 19160-19211). <br />(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - <br />Attached) <br />(1) The prospective recipient of federal assistance funds certifies, by submission of this proposal, <br />that neither it nor its principals are presently debarred, suspended, proposed for debarment, <br />declared ineligible, or voluntarily excluded from participation in this transaction by any <br />federal department or agency. <br />(2) Where the prospective recipient of federal assistance funds is unable to certify to any of the <br />statements in this certification, such prospective participant shall attach an explanation to this <br />proposal. <br />Nancy Mejia chief Program officer <br />Name and Title of Authorized Representative <br />Bocu.d by: <br />["IMM"M4.R s/1o/zozz <br />]... <br />Signature Date <br />
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