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14 <br /> CERTIFICATIONS <br /> 1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION <br /> The undersigned (authorized official signing for the contracting organization) certifies to the best of his <br /> or her knowledge and belief, that the contractor, defined as the primary participant in accordance with <br /> 45 CFR Part 76, and its principals: <br /> a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily <br /> excluded from covered transactions by any Federal Department or agency; <br /> b) have not within a 3-year period preceding this contract been convicted of or had a civil judgment <br /> rendered against them for commission of fraud or a criminal offense in connection with obtaining, <br /> attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a <br /> public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, <br /> theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving <br /> stolen property; <br /> c) are not presently indicted or otherwise criminally or civilly charged by a governmental entity (Federal, <br /> State, or local) with commission of any of the offenses enumerated in paragraph (b) of this <br /> certification; and <br /> d) have not within a 3-year period preceding this contract had one or more public transactions (Federal, <br /> State, or local) terminated for cause or default. <br /> Should the contractor not be able to provide this certification, an explanation as to why should be placed <br /> after the assurances page in the contract. <br /> The contractor agrees by signing this contract that it will include, without modification, the clause titled <br /> "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion--Lower Tier <br /> Covered Transactions" in all lower tier covered transactions (i.e., transactions with sub- grantees and/or <br /> contractors) and in all solicitations for lower tier covered transactions in accordance with 45 CFR Part <br /> 76. <br /> CONTRACTOR SIGNATURE REQUIRED <br /> SIGNATURE OF AUTHORIZED CERTIFYING TITLE <br /> OFFICIAL <br /> Please also print or type name: <br /> ORGANIZATION NAME:.(if applicable) DATE <br /> 1 2DOH N12437 12 1/2/2004 <br />