Excluded Party List. If this is a covered transaction as defined below, the contractor certifies by its signature it has not been suspended or debarred, its principals have not been suspended or debarred, and/or that its subcontractors and the subcontractors’ principals have not been suspended or debarred as provided in OMB guidance, 2 CFR part 180, implementing Executive Orders 12549 and 12689. A “Covered Transaction” is defined as those procurement contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative agreement) that are expected to equal or exceed $25,000.00 or meet other specified criteria. Contractor certifies it has completed the verification by checking the “Excluded Parties List System” (EPLS) (xxxxx://xxx.xxx.gov/portal/public/XXX/?portal:componentId=1f834b82-3fed-4eb3-a1f8- ea1f226a7955&portal:type=action&navigationalstate=JBPNS_rO0ABXdcACJqYXZheC5mYWNlcy5wb3J0bGV0YnJpZ GdlLlNUQVRFX0lEAAAAAQApdmlldzphMzMzOWFlMS0xNWQzLTRmYWYtYWVlOC1kNWZhNTRmMzA3OGQAB19fR U9GX18*&interactionstate=JBPNS_rO0ABXc0ABBfanNmQnJpZGdlVmlld0lkAAAAAQATL2pzZi9uYXZpZ2F0aW9uLmp zcAAHX19FT0ZfXw**).
Excluded Party List. If this is a covered transaction as defined below, the Contractor certifies by its signature it has not been suspended or debarred, its principals have not been suspended or debarred, and/or that its subcontractors and the subcontractors’ principals have not been suspended or debarred as provided in OMB guidance, 2 CFR part 180, implementing Executive Orders 12549 and 12689. A “Covered Transaction” is defined as those procurement contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative agreement) that are expected to equal or exceed $25,000.00 or meet other specified criteria. Contractor certifies it has completed the verification by checking the “Excluded Parties List System” (EPLS). Under penalty of xxxxxxx, I am authorized to execute the contract upon the behalf of and to bind the Contractor, and the statements and representations in Paragraphs 3, 7, and 13(a) through 13(k) are true to the best of my information and belief. CONTRACTOR: By: Print Name/Title: COUNTY: BOARD OF COUNTY COMMISSIONERS OF THE COUNTY OF GRAND, STATE OF COLORADO By: Xxxxxxx Xxxxxxx, Chair Board of County Commissioners ATTEST By: Xxxx X. Xxxxxx, Grand County Clerk & Recorder OPTION: By: Xxxxxx X. Xxxxx, III, County Manager
Excluded Party List. If this is a covered transaction as defined below, the Contractor certifies by its signature it has not been suspended or debarred, its principals have not been suspended or debarred, and/or that its subcontractors and the subcontractors’ principals have not been suspended or debarred as provided in OMB guidance, 2 CFR part 180, implementing Executive Orders 12549 and 12689. A “Covered Transaction” is defined as those procurement contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative agreement) that are expected to equal or exceed $25,000.00 or meet other specified criteria. Contractor certifies it has completed the verification by checking the “Excluded Parties List System” (EPLS). Under penalty of perjury, I am authorized to execute the contract upon the behalf of and to bind the Contractor, and the statements and representations in Paragraphs 3, 7, and 13(a) through 13(k) are true to the best of my information and belief. CONTRACTOR: By: Print Name/Title: COUNTY: GRAND COUNTY, COLORADO By: Xxxxxx Xxxxx, Chairman
Excluded Party List. Scribe Service Provider represents that neither it or any of its affiliates or personnel is currently (a) named, or excluded, on, or from, any of the following lists: (i) HHS/OIG List of Excluded Individuals/Entities; (ii) The GSA’s System for Award Management, which was formerly known as the GSA List of Parties Excluded from Federal Programs; and (iii) OFAC “SDN and Blocked Individuals”; or (b) under investigation or otherwise aware of any circumstances which would result in Scribe Service Provider being excluded from participation in any Federal health care program, as defined under 42 U.S.C. § 1320a-7b(f). Scribe Service Provider represents that neither it nor any of its affiliates or personnel has ever been either convicted of a criminal offense, assessed civil monetary penalties pursuant to the Civil Monetary Penalties Law, 42 U.S.C. § 1320a-7a, 42 U.S.C. § 1320a-7(b)(1)-(3) or excluded from the Medicare program or any state health care program. Scribe Service Provider further represents that neither it nor any of its affiliates or personnel is subject to an action or investigation that could lead to the conviction of a criminal offense, the assessment of civil monetary penalties, or exclusion from the Medicare program or any state health care program. Scribe Service Provider shall notify Augmedix, immediately, if an action or investigation arises that could result in the conviction of a criminal offense, or the exclusion of it, or any of its affiliates or personnel from the Medicare program, any state health care program or would otherwise result in it, its affiliates or personnel being excluded as set forth in this Section 4.4. Failure to timely notify Augmedix of any action or investigation shall give Augmedix the right to terminate this Agreement effective immediately upon written notice. In the event that Scribe Service Provider becomes excluded, for any reason, during the Term of this Agreement or any Statement of Work or Addition of Work, Augmedix shall be entitled to terminate this Agreement and any such Statement of Work or Addition of Work, effective immediately upon written notice. CERTAIN CONFIDENTIAL INFORMATION CONTAINED IN THIS DOCUMENT, MARKED BY [*], HAS BEEN OMITTED BECAUSE IT IS NOT MATERIAL AND WOULD LIKELY CAUSE COMPETITIVE HARM TO AUGMEDIX, INC. IF PUBLICLY DISCLOSED.
Excluded Party List. Vendor certifies that neither Vendor nor any of its employees or subcontractors who may provide services pursuant to any Contract with University is currently the subject of an investigation or proceeding to exclude it as a provider under Medicare or Medicaid or under any other federal or state health care program or under any third party insurance program, nor is it currently excluded or debarred from submitting claims to Medicare or Medicaid or to any other federal or state health care program or to any third party insurer. Vendor represents and warrants it has checked the U. S. General Service Administration’s (GSA) Excluded Party Listing System (EPLS) which lists parties excluded from Federal procurement and non-procurement programs. The EPLS website includes GSA/EPLS, the U. S. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG) List of Excluded Individuals/Entities (LEIE), and the U.S. Department of Treasury’s (Treasury) Specially Designated Nationals (SDN) list. Vendor also represents and warrants it has checked the Illinois Department of Public Aid (IDPA) OIG Provider Sanctions list of individuals and entities excluded from state procurement with respect to Vendor’s employees and agents. See the following websites: xxxx://xxxx.xxxxx.xxx and xxxx://xxx.xxxxx.xx.xx/agency/oig/search.asp. Vendor certifies that neither Vendor, nor any of its employees or subcontractors who may provide services pursuant to any Contract with University, is not currently on any State or Federal Excluded Party List. University will terminate this Contract without penalty to University if Vendor becomes excluded during the life of this Contract.
Excluded Party List. If this is a covered transaction as defined below, the contractor certifies by its signature it has not been suspended or debarred, its principals have not been suspended or debarred, and/or that its subcontractors and the subcontractors’ principals have not been suspended or debarred as provided in OMB guidance, 2 CFR part 180, implementing Executive Orders 12549 and 12689. A “Covered Transaction” is defined as those procurement contracts for goods or services awarded under a non-procurement transaction (e.g. grant or cooperative agreement) that are expected to equal or exceed $25,000.00 or meet other specified criteria. Contractor certifies it has completed the verification by checking the “Excluded Parties List System” (EPLS) (xxxxx://xxx.xxx.gov/portal/public/XXX/?portal:componentId=1f834b82-3fed-4eb3-a1f8-ea1f226a7955&portal:type=action&navigationalstate=JBPNS_rO0ABXdcACJqYXZheC5mYWNlcy5wb3J0bGV0YnJpZGdlLlNUQVRFX0lEAAAAAQApdmlldzphMzMzOWFlMS0xNWQzLTRmYWYtYWVlOC1kNWZhNTRmMzA3OGQAB19fRU9GX18*&interactionstate=JBPNS_rO0ABXc0ABBfanNmQnJpZGdlVmlld0lkAAAAAQATL2pzZi9uYXZpZ2F0aW9uLmpzcAAHX19FT0ZfXw**). Under penalty of perjury, I am authorized to execute the contract upon the behalf of and to bind the Contractor, and the statements and representations in Paragraphs 3, 7, and 13(a) through 13(k) are true to the best of my information and belief. CONTRACTOR: _______________________. By: _________________________________ Print Name/Title: _______________________________ COUNTY: GRAND COUNTY, COLORADO By: ________________________________ Xxxxxxx Xxxxxxx, Chairman Board of County Commissioners ATTEST By: _________________________________ Xxxx Xxxxxx Grand County Clerk
Excluded Party List. If this is a covered transaction as defined below, Project Owner and Project Contractor certifies by its signature that it has not been suspended, debarred, voluntarily excluded, or otherwise rendered ineligible, its principals have not been suspended, debarred, voluntarily excluded or otherwise rendered ineligible to participate in a federal payment program by any Federal or State of Colorado department or agency as provided in OMB guidance, 2 CFR part 180, implementing Executive Orders 12549 and 12689. A “Covered Transaction” is defined as those procurement contracts for goods or services awarded under a non- procurement transaction (e.g. grant or cooperative agreement) that are expected to equal or exceed $25,000.00 or meet other specified criteria. Consultant certifies that it has completed the verification by checking the “Excluded Parties List System” (EPLS) at xxx.XXX.gov.
