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Last modified
8/12/2025 9:03:04 AM
Creation date
8/12/2025 9:02:21 AM
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Contracts
Company Name
STRAIGHT TALK CLINIC
Contract #
A-2025-122-10
Agency
Community Development
Council Approval Date
6/3/2025
Expiration Date
6/30/2026
Insurance Exp Date
3/1/2026
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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, as amended, <br /> Nonprocurement Debarment and Suspension, 2 CFR fart 2099, Subpart C, Responsibilities of Participants <br /> Regarding Transactions. The ieguiations were published as Part VTI of the May 26, 1988 Federal Register <br /> (pages 19160-19211),and subsequently amended in 81 Federal Register 25585. <br /> (BEFORE COMPLETING CEWFUICATION, READ INSTRUCTIONS FOR CERTIFICATION <br /> Attached) <br /> I. The prospective recipient of federal assistance certifies to the best of its knowledge and belief,that it and <br /> its principals; <br /> a. Are not presently excluded or disqualified; <br /> b. Have not been convicted within the preceding three; years of any of the offenses listed in 2 CFR <br /> 180.800(a) convicted or had a civil judgment rendered against them for one of those offenses within that <br /> dune period. <br /> c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity(.federal, <br /> State or local)with commission of any of the offenses listed in 2 Cp'k 180.500(a); and <br /> d. Have not had one or more public transactions (Federal, State or local) terminated within the preceding <br /> three years for cause or default. <br /> 2. Where the prospective recipient of federal assistance is unable to certify to any of the statements in this <br /> certification,such,prospective participant shall attach an explanation to this proposal. <br /> o 0 _ <br /> Name and"Citle of Authorized Representative <br /> Signature_ �.�... Date <br /> EXHIBIT C <br /> Page 1 of 2 <br />
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