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<br />CERTIFICATE OF NON-DEBARMENT / SUSPENSION <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER <br />INELIGIBILITY AND VOLUNTARY EXCLUSION <br />LOWER TIER COVERED TRANSACTIONS <br /> <br />The Lower Tier Participant (Applicant for a third party subcontract or subgrant under a federal funded <br />project), <br /> hereinafter referred to as Contractor, certifies, by submission <br />of this document, that neither it nor its principals is presently debarred, suspended, proposed for <br />debarment, declared ineligible or voluntarily excluded from participation in this transaction by any <br />federal department or agency. <br /> <br />Where the Contractor is unable to certify to any of the statements in this certification, such Contractor <br />must attach an explanation to this submittal. <br /> <br />The Contractor, , certifies or affirms the truthfulness and <br />accuracy of the contents of the statements submitted on or with this certification and understands <br />that the provisions of 31 U.S.C. Section 3801 et seq. are applicable thereto. <br /> <br /> <br /> _______________________________________________ <br />Signature of Authorized Official <br /> <br /> _______________________________________________ _______________________________ <br />Title of Authorized Official Date <br /> <br /> <br />THIS FORM MUST BE COMPLETED BY THE PRIME CONTRACTOR AND ANY SUB-TIER CONTRACTOR <br />THAT WILL BE AFFILIATED WITH THE WORK LISTED ON THE ATTACHED DOCUMENTS. <br />