Laserfiche WebLink
r <br />I CITY OF SANTA ANA <br />ATTACHMENTI <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY, AND <br />VOLUNTARY EXCLUSION <br />This certification is required by the regulations implementing Executive Order 12549, as amended, <br />Nonprocurement Debarment and Suspension, 2 CFR Part 2998, Subpart C, Responsibilities of <br />Participants Regarding Transactions. The regulations were published as Part Vll of the May 26, j988, <br />Federal Register (Pages 19'l60-1921 1), and as subsequently amended in 81 Federal Register 25585. <br />(Before completing certification, read instructions which are an integral part of certification) <br />1. Pursuant to 2 CFR 180.335, the prospective primary participant, (i.e. grantee) certifies to the best of <br />its knowledge and belief, that it and 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 <br />2CFR 180.800(a) or had a civil judgment rendered against them for one of those offenses within <br />that time period. <br />c. Are not presently indicted for or otheiwise criminally or civilly charged by a government entity <br />(Federal, State or local) with commission of any of the offenses listed in 2 CFR 180.800(a); and <br />d. Have not had one or more pub(ic transactions (Federal, State or local) terminated within the <br />preceding three years 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 />"Cons"'ult"an<ta" \h@s===l '5&vi'A (ivr>q LL(2 <br />On Behalf of the Consultant <br />Date <br />THtS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAtN THIS FORM WILL BE CONSIDERED NONRESPONSIVE.