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State of Washington Department of Ecology Page 17 of 27 <br /> Agreement No: TCPRA-1921-EverPW-00080 <br /> Project Title: Everett Landfill Tire Fire <br /> Recipient Name: CITY OF EVERETT <br /> Funding Distribution Summary <br /> Recipient/Ecology Share <br /> Funding Distribution Name Recipient Match°Ao Recipient Share Ecology Share Total <br /> Everett Landfill Tire Fire- 50.00 % $ 290,000.00 $ 290,000.00 $ 580,000.00 <br /> Oversight <br /> Total $ 290,000.00 $ 290,000.00 $ 580,000.00 <br /> AGREEMENT SPECIFIC TERMS AND CONDITIONS <br /> N/A <br /> SPECIAL TERMS AND CONDITIONS <br /> GENERAL FEDERAL CONDITIONS <br /> If a portion or all of the funds for this agreement are provided through federal funding sources or this agreement is <br /> used to match a federal grant award,the following terms and conditions apply to you. <br /> A.CERTIFICATION REGARDING SUSPENSION,DEBARMENT,INELIGIBILITY OR VOLUNTARY <br /> EXCLUSION: <br /> 1. The RECIPIENT/CONTRACTOR,by signing this agreement,certifies that it is not suspended,debarred,proposed for <br /> debarment,declared ineligible or otherwise excluded from contracting with the federal government,or from receiving <br /> contracts paid for with federal funds.If the RECIPIENT/CONTRACTOR is unable to certify to the statements <br /> contained in the certification,they must provide an explanation as to why they cannot. <br /> 2. The RECIPIENT/CONTRACTOR shall provide immediate written notice to ECOLOGY if at any time the <br /> RECIPIENT/CONTRACTOR learns that its certification was erroneous when submitted or had become erroneous by <br /> reason of changed circumstances. <br /> 3. The terms covered transaction,debarred, suspended,ineligible,lower tier covered transaction,participant,person, <br /> primary covered transaction,principal,proposal,and voluntarily excluded,as used in this clause,have the meaning set <br /> out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact <br /> ECOLOGY for assistance in obtaining a copy of those regulations. <br /> 4. The RECIPIENT/CONTRACTOR agrees it shall not knowingly enter into any lower tier covered transaction with a <br /> person who is proposed for debarment under the applicable Code of Federal Regulations,debarred,suspended, <br /> declared ineligible,or voluntarily excluded from participation in this covered transaction. <br /> 5. The RECIPIENT/CONTRACTOR further agrees by signing this agreement,that it will include this clause titled <br /> "CERTIFICATION REGARDING SUSPENSION,DEBARMENT,INELIGIBILITY OR VOLUNTARY <br /> EXCLUSION"without modification in all lower tier covered transactions and in all solicitations for lower tier covered <br /> transactions. <br /> 6. Pursuant to 2CFR180.330,the RECIPIENT/CONTRACTOR is responsible for ensuring that any lower tier covered <br /> transaction complies with certification of suspension and debarment requirements. <br /> Template Version 10/30/2015 <br />