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STATE OF CALIFORNIA <br />FEDERAL DEBARMENT CERTIFICATION FORM <br />DGS PD 2 (Rev,12119) <br />DEPARTMENT OF OUNWI. SERVICES <br />PROCUREMENT DIVISION <br />Certification Regarding Debarment, Suspension, Ineligibility <br />and Voluntary Exclusion 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 98.610, Participant's responsibilities. The regulations were <br />published as Part VII of the May 26, 198E Federal Reoister (pages 10160-19211). <br />(BEFORE COMPLETING CERTIFICATION, READ THE INSTRUCTIONS ON THE, NEXT PAGE <br />WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION) <br />I. The prospective recipient of Federal assistance funds certifies, by submission of this IFB/RFP <br />Response, that neither it nor Its principals are presently debarred, suspended, proposed for <br />debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any <br />Federal department oragenCy. <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 />IFBIRFP Response, <br />Pape f of 2 <br />