Common use of Instructions for Certification Clause in Contracts

Instructions for Certification. 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverages sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. First Tier Participants: a. By signing and submitting this CONTRACTproposal, the prospective lower first tier participant is providing the certification set out below. 2b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or contracting agency with which may terminate this transaction originated may pursue available remedies, including suspension and/or debarmentfor cause of default. 3. d. The prospective lower first tier participant shall provide immediate written notice to the person contracting agency to which whom this CONTRACT proposal is submitted if at any time the prospective lower first tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, lower tier covered transaction, ," "participant, ," "person, primary covered transaction, ," "principal, proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning set out are defined in the Definitions 2 CFR Parts 180 and Coverages sections of rules implementing Executive Order 125491200. You may contact the person “First Tier Covered Transactions” refers to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed any covered transaction be between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). “Lower Tier Covered Transactions” refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). “First Tier Participant” refers to the participant who has entered into, it shall not knowingly enter into any lower tier a covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, grantee or voluntarily excluded from participation in this covered transaction, unless authorized by subgrantee of Federal funds (such as the department prime or agency with which this transaction originated. 6general contractor). The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,Participant” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A refers any participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters who has entered into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, First Tier Participant or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentLower Tier Participants (such as subcontractors and suppliers).

Instructions for Certification. 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverages sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with State's determination whether to enter into this agreement. However, failure of Consultant to furnish a certification or an explanation will disqualify Consultant from participation in this agreement. 3. The certification in this clause is a material representation of fact upon which reliance was placed when State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 34. The prospective lower tier participant Consultant shall provide immediate written notice to the person to which this CONTRACT is submitted State if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 45. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 1254912549 – Debarment and suspension. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulationsExec. Order No. 12,549, 51 Fed. Reg. 6370 (1986). 56. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which State before entering into this transaction originatedagreement. 67. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 78. A participant Consultant in a covered transaction may rely upon a certification of a prospective participant Subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 89. Nothing contained in the foregoing shall will be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 910. Except for transactions authorized under paragraph 5 6. of these instructions, if a participant Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. (1. ) By signing and submitting this CONTRACTproposal, the prospective lower tier participant CONSULTANT is providing the certification set out in b. below. (2) The inability of CONSULTANT to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The CONSULTANT shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the DEPARTMENT'S determination whether to enter into this transaction. However, failure of the CONSULTANT to furnish a certification or an explanation shall disqualify such person from participation in this transaction. (3) The certification in this clause is a material representation of fact upon which reliance was placed when the DEPARTMENT determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier participant CONSULTANT knowingly rendered an erroneous certification, certification in addition to other remedies available to the Federal Governmentfederal government, the department or agency with which DEPARTMENT may terminate this transaction originated may pursue available remedies, including suspension and/or debarmentfor cause or default. 3. (4) The prospective lower tier participant CONSULTANT shall provide immediate written notice to the person to which this CONTRACT is submitted DEPARTMENT if at any time the prospective lower tier participant CONSULTANT learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. (5) The terms "covered transaction", "debarred", "suspended", "ineligible", "lower tier covered transaction", "participant", "person", "primary covered transaction", "principal", "proposal", and "voluntarily excluded", as used in this clauseprovision, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted DEPARTMENT for assistance in obtaining a copy of those regulations. 5. (6) The prospective lower tier participant CONSULTANT agrees (by submitting this response proposal that, should the proposed covered transaction this MASTER CONTRACT be entered into), it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originatedDEPARTMENT. 6. (7) The prospective lower tier participant CONSULTANT further agrees by submitting this CONTRACT proposal that it will include this clause the provision titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” " section V.N., without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction (8) The CONSULTANT may rely upon a certification of a prospective participant in a lower tier covered transaction subcontractor/materials supplier that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant CONSULTANT may decide the method and frequency by which it determines the eligibility of its principals. Each participant CONSULTANT may, but is not required to, check the DEPARTMENT Disapproval List of Parties Excluded from Federal Procurement and Nonprocurement Programs(Telephone # 608/000-0000). 8. (9) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clauseprovision. The knowledge and information of a participant CONSULTANT is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. (10) Except for transactions authorized by the DEPARTMENT under paragraph 5 of these instructionssection V.M.(6), if a participant CONSULTANT in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which DEPARTMENT may terminate this transaction originated may pursue available remedies, including suspension and/or debarmentfor cause or default.

Instructions for Certification. (1. ) By signing and submitting this CONTRACTproposal, the CONSULTANT is certifying that the prospective lower tier participant is providing the certification set out below. (2. ) The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant participants knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentfederal government, the department or agency with which this transaction originated DEPARTMENT may pursue available remedies, including suspension and/or or debarment. (3. ) The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. (4. ) The terms "covered transaction", "debarred", "suspended", "ineligible", "lower tier covered transaction", "participant", "person", "primary covered transaction", "principal, proposal", and "voluntarily excluded", as used in this clauseprovision, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules implementing Executive Order 12549. You may contact the The person to which this CONTRACT proposal is submitted for assistance can assist in obtaining a copy of those regulations. (5. ) The prospective lower tier participant agrees by submitting this response proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originatedDEPARTMENT. (6. ) The prospective lower tier participant further agrees by submitting this CONTRACT proposal that it will include this clause provision titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” " without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (7. A ) The participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement ProgramsDEPARTMENT Disapproval List. 8. (8) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clauseprovision. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. (9. ) Except for transactions authorized under paragraph 5 of these instructionssection V.N.a.(5) above, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated DEPARTMENT may pursue available remedies, including suspension and/or or debarment.

Instructions for Certification. 1. By signing and submitting this CONTRACTAgreement, the Contractor, also sometimes referred to herein as a prospective lower tier participant primary participant, is providing the certification set out below. 2. The inability of a Contractor to provide the certification required below will not necessarily result in denial of participation in the covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the City’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The certification in this clause is a material representation of fact upon which reliance was placed when the City determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the department or agency with which City may terminate this transaction originated may pursue available remedies, including suspension and/or debarment. 3for cause or default. The prospective lower tier primary participant shall provide immediate written notice to the person to which this CONTRACT is submitted City if at any time the prospective lower tier primary participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, proposal and voluntarily excluded, as used in this clausecertification, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier primary participant agrees by submitting this response that, should signing the proposed covered transaction be entered into, Agreement that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this covered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the department or agency with which City, the City may terminate this transaction originated. 6for cause or default. The prospective lower tier primary participant further agrees by submitting signing this CONTRACT Agreement that it will include this the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” as available through the United States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Non-procurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. By signing and submitting this CONTRACTform, the prospective lower tier participant is providing the certification set out belowon the preceding page in accordance with these instructions. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms “covered transaction, ,” “debarred, ,” “suspended, ,” “ineligible, ,” “lower tier covered transaction, ,” “participant, ,” “person, ,” “primary covered transaction, ,” “principal, ,” “proposal, ,” and “voluntarily excluded, ,” as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT form that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion – Lower Tier Covered TransactionTransactions,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement ProgramsList. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal governmentFederal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Sections 3017.510, Participants’ responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722 – 4733). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTION ON THE NEXT PAGE) (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

Instructions for Certification. 1. By signing and submitting this CONTRACTproposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which whom this CONTRACT proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning meanings set out in the Definitions Definition and Coverages Coverage sections of rules implementing Executive Order 1254949 CFR Part 29. You may contact the person to which whom this CONTRACT proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part CFR Part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT proposal that is it will include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion -- Lower Tier Covered Transaction,” " without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.. (See below) 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part CFR Part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Non-procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part CFR Part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal Federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. a. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2b. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. The Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the LPA's determination whether to enter into this agreement. However, failure of the Consultant to furnish a certification or an explanation will disqualify the Consultant from participation in this agreement. c. The certification in this clause is a material representation of fact upon which reliance was placed when the State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 3. d. The prospective lower tier participant Consultant shall provide immediate written notice to the person to which this CONTRACT is submitted LPA if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules the rul es implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. f. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which LPA before entering into this transaction originatedagreement. 6. g. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by the State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant h. The Consultant in a covered transaction may rely upon a certification of a prospective participant Subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 8. i. Nothing contained in the foregoing shall will be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant the Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. j. Except for transactions authorized under paragraph 5 (f) of these instructions, if a participant the Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. 1. By signing and submitting this CONTRACTAddendum, the Vendor, also sometimes referred to herein as a prospective lower tier participant primary participant, is providing the certification set out below. 2. The inability of a Vendor to provide the certification required below will not necessarily result in denial of participation in the covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the City’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The certification in this clause is a material representation of fact upon which reliance was placed when the City determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the department or agency with which City may terminate this transaction originated may pursue available remedies, including suspension and/or debarment. 3for cause or default. The prospective lower tier primary participant shall provide immediate written notice to the person to which this CONTRACT is submitted City if at any time the prospective lower tier primary participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, proposal and voluntarily excluded, as used in this clausecertification, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier primary participant agrees by submitting this response that, should signing the proposed covered transaction be entered into, Addendum that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this covered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the department or agency with which City, the City may terminate this transaction originated. 6for cause or default. The prospective lower tier primary participant further agrees by submitting signing this CONTRACT Addendum that it will include this the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” as available through the United States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Non-procurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. First Tier Participants: a. By signing and submitting this CONTRACTproposal, the prospective lower first tier participant is providing the certification set out below. 2b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or contracting agency with which may terminate this transaction originated may pursue available remedies, including suspension and/or debarmentfor cause of default. 3. d. The prospective lower first tier participant shall provide immediate written notice to the person contracting agency to which whom this CONTRACT proposal is submitted if at any time the prospective lower first tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, lower tier covered transaction, ," "participant, ," "person, primary covered transaction, ," "principal, proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning set out are defined in the Definitions 2 CFR Parts 180 and Coverages sections of rules implementing Executive Order 125491200. You may contact the person “First Tier Covered Transactions” refers to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed any covered transaction be between a grantee or subgrantee of Federal funds and a participant (such as the prime or general contract). “Lower Tier Covered Transactions” refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). “First Tier Participant” refers to the participant who has entered into, it shall not knowingly enter into any lower tier a covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, grantee or voluntarily excluded from participation in this covered transaction, unless authorized by subgrantee of Federal funds (such as the department prime or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.general

Instructions for Certification. 1. By signing this certification and submitting it with this CONTRACTproposal, the prospective lower tier participant recipient of State and/or Federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant recipient of State and/or Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the State and/or Federal Government, the department or agency with which this transaction originated Government may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant recipient of State and/or Federal assistance funds shall provide immediate written notice to the person to which this CONTRACT proposal is submitted if at any time the prospective lower tier participant recipient of State and/or Federal assistance funds learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, " as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules implementing Executive Order 12549. You may contact the person to which whom this CONTRACT proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant recipient of State and/or Federal assistance funds further agrees by submitting this response proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6Department. The prospective lower tier participant recipient of State and/or Federal assistance funds further agrees by submitting this CONTRACT proposal that it will include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered TransactionTransactions,” " without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each For contracts involving Federal funds, each participant may, but is not required to, to check the List of Parties Excluded from Federal Procurement and or Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal governmentState and/or Federal Government, the department or agency with which this transaction originated Department may pursue available remedies, including suspension and/or debarment. In witness hereto, the parties have executed said agreement according to the terms, conditions, and effective dates listed in the agreement. APPROVED FOR THE CONTRACTOR: APPROVED FOR THE SUBCONTRACTOR: SIGNATURE SIGNATURE Xxxxx Xxxxx TYPED NAME DATE TYPED NAME DATE Executive Director TITLE/POSITION TITLE/POSITION Is the occupation(s) in which employment and training is to be offered in this agreement subject to a collective bargaining agreement?   YES X NO If yes, has there been concurrence by the appropriate representative as to the On-The-Job Training Program and the rates of pay associated therewith?   YES   NO     TYPED NAME TITLE SIGNATURE DATE   AFFILIATION Subcontractor: Invoice for the Month of: Address: MAY 2019 xxx-xx-   REIMBURSEMENT PERIOD MON TUE WED THUR FRI SAT SUN TOTAL 5/1/19 TO 5/5/19 REIMBURSEMENT 5/6/19 TO 5/12/19 TOTAL TRAINING HOURS THIS INVOICE X $9.00 = A. 5/13/19 TO 5/19/19 SOCIAL SECURITY Total from A: X .0765 = B. 5/20/19 TO 5/26/19 WORKMANS COMPENSATION Total from A: X = C. 5/27/19 TO 5/31/19 TOTAL REIMBURSEMENT REQUESTED (Total of A, B and C) I certify that the information presented on this invoice is accurate and conforms to the personnel and payroll records.

Instructions for Certification. 1. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with State's determination whether to enter into this agreement. However, failure of Consultant to furnish a certification or an explanation will disqualify Consultant from participation in this agreement. 3. The certification in this clause is a material representation of fact upon which reliance was placed when State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 34. The prospective lower tier participant Consultant shall provide immediate written notice to the person to which this CONTRACT is submitted State if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 45. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 1254912549 – Debarment and suspension. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulationsExec. Order No. 12,549, 51 Fed. Reg. 6370 (1986). 56. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which State before entering into this transaction originatedagreement. 67. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 78. A participant Consultant in a covered transaction may rely upon a certification of a prospective participant Subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 89. Nothing contained in the foregoing shall will be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 910. Except for transactions authorized under paragraph 5 a.6. of these instructions, if a participant Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. 1. By signing and submitting this CONTRACTAgreement, the Contractor, also sometimes referred to herein as a prospective lower tier participant primary participant, is providing the certification set out below. 2. The inability of a contractor to provide the certification required below will not necessarily result in denial of participation in the covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the City’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The certification in this clause is a material representation of fact upon which reliance was placed when the City determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the department or agency with which City may terminate this transaction originated may pursue available remedies, including suspension and/or debarment. 3for cause or default. T The prospective lower tier primary participant shall provide immediate written notice to the person to which this CONTRACT is submitted City if at any time the prospective lower tier primary participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, proposal and voluntarily excluded, as used in this clausecertification, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier primary participant agrees by submitting this response that, should signing the proposed covered transaction be entered into, Agreement that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this covered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the department or agency with which City, the City may terminate this transaction originated. 6for cause or default. The prospective lower tier primary participant further agrees by submitting signing this CONTRACT Agreement that it will include this the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” as available through the United States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Non-procurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. a. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2b. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. The Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the LPA's determination whether to enter into this agreement. However, failure of the Consultant to furnish a certification or an explanation will disqualify the Consultant from participation in this agreement. c. The certification in this clause is a material representation re presentation of fact upon which reliance was placed when the State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 3. d. The prospective lower tier participant Consultant shall provide immediate written notice to the person to which this CONTRACT is submitted LPA if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. f. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which LPA before entering into this transaction originatedagreement. 6. g. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by the State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant h. The Consultant in a covered transaction may rely upon a certification of a prospective participant Subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 8. i. Nothing contained in the foregoing shall will be construed to require requir e establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant the Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. j. Except for transactions authorized under paragraph 5 (f) of these instructions, if a participant the Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. 1. ) By signing and electronically submitting this CONTRACTbid or proposal, the prospective lower tier participant is providing the signed certification set out below. 2. ) The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated Port Authority may pursue available remedies, including suspension and/or debarment. 3. ) The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT is submitted Port Authority if at any time the prospective Prospective lower tier participant learns that its certification was erroneous when electronically submitted or had has become erroneous by reason of changed circumstances. 4. ) The terms “covered transaction, ,” “debarred, ,” “suspended, ,” “ineligible, ,” “lower tier covered transaction, ,” “participant, person, primary ,” “persons,” “lower tier covered transaction, ,” “principal, ,” “proposal, ,” and “voluntarily excluded, ,” as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules implementing Executive Order 1254912549 [49 CFR Part 29]. You may contact the person to which this CONTRACT is submitted Port Authority for assistance in both obtaining a copy of those regulations. 5. ) The prospective lower tier participant agrees by submitting this response proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized in writing by the department or agency with which this transaction originatedPort Authority. 6. ) The prospective lower tier participant further agrees by submitting this CONTRACT proposal electronically that it will include this indicate acceptance of the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” ”, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. ) A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List of Parties Excluded from Federal Procurement and Nonprocurement Programsissued by U.S. General Service Administration. 8. 8) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. ) Except for transactions authorized under paragraph Paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other all remedies available to the federal governmentFederal Government, the department or agency with which this transaction originated Port Authority may pursue available remedies, remedies including suspension and/or debarment.

Instructions for Certification. (1. ) By signing and submitting this CONTRACTform, the prospective lower tier participant is providing the certification set out belowon page 1 in accordance with these instructions. (2. ) The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or or debarment. (3. ) The prospective lower tier participant shall provide immediate written notice to the person person(s) to which this CONTRACT proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. (4. ) The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549, at 2 C.F.R. Parts 180 and 417. You may contact the person department or agency to which this CONTRACT proposal is being submitted for assistance in obtaining a copy of those regulations. (5. ) The prospective lower tier participant agrees by submitting this response form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. (6. ) The prospective lower tier participant further agrees by submitting this CONTRACT form that it will include this clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered TransactionTransactions,” " without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. (7. ) A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement ProgramsSystem for Award Management (XXX) database. 8. (8) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. (9. ) Except for transactions authorized under paragraph 5 (5) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal governmentFederal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Name of Project Point Person Organization Xxxxx Xxxxxxx, PE City of Bozeman Address City State Zip + 4 PO Box 1230 Bozeman MT 00000-0000 Phone Fax Email 000-000-0000 xxxxxxxx@xxxxxxx.xxx Name of Service Forester you will be working with on this project. If you are a service forester or other DNRC staff, please list any partner organizations or project sponsors you will work directly with to develop this proposal. Xxxxx Xxxxxx, DNRC Region 13 Service Forester Protecting and enhancing municipal water supply resiliency and critical water supply infrastructure of the City of Bozeman is the over-riding objective of this project. A severe wildfire in the Sourdough Creek municipal watershed will impair water quality of this crucial municipal water supply source, which accounts for 40% of the city’s annual water supply. City of Bozeman water treatment plant operations can be severely hampered by large amounts of ash and sediment produced from erosion following wildfire. A safe and dependable drinking water supply is essential to public health and safety as well as uninterrupted commerce in the City of Bozeman. The project seeks $270,000 to perform forest treatments on city owned property in Sourdough Canyon bordered by Xxxxxx Gallatin National Forest and private property in the wildland urban interface. Forest treatments will be strategically performed to protect the city’s existing water supply infrastructure and to produce a forest landscape that is less susceptible to the experience of devastating crown fire. Doing so enhances watershed and water supply resiliency and directly benefits adjacent private property owners, city water customers, fish and wildlife, the wood products industry, as well as the diverse array of year-round recreational users that enjoy the Sourdough Creek watershed. The project specifically addresses State and Private Forest National Themes as well as Focus Areas 1, 2, and 3 of the Montana State Assessment/Forest Action Plan by: 1) conserving working forest landscapes by actively managing forest vegetation; 2) protecting forests from harm by reducing risk of wildfire impacts; 3) enhancing public benefits from trees and forests by protecting and enhancing water quality; 4) producing merchant timber and biomass forest products. Ideally, the project will be delivered in conjunction with the Xxxxxx Gallatin National Forest’s Bozeman Municipal Watershed project, or BMW project for short. The BMW has been a work in progress for the better part of the past decade but is nearing readiness for implementation. The city has long intended to perform silviculture activities on city-owned property intermingled with the BMW project. A city Forest Management Plan exists that identifies treatment units and methods on city property that dovetail with BMW treatment units. The attached map exhibit shows city lands within the BMW project area. It readily shows the critical positioning of city-owned property particularly within the northern extents of the BMW project area. Key partners in the city’s forest management project include the USFS Xxxxxx Gallatin National Forest, the DNRC, and the Gallatin Valley Land Trust. The city and USFS enjoy a long-standing partnership in management of activities and projects in the municipal watershed that is memorialized within a formal Memorandum of Understanding. BMW project work, as well as work on city-owned property, requires close coordination and consistent public communications by the city and USFS as public access to watershed from the Sourdough Canyon trailhead will be restricted during certain portions of project implementation. Coordination and partnership with Gallatin Valley Land Trust is also essential in order to disseminate project-related communications regarding temporary trail closures that directly impact the recreating public. Further partnering opportunities assuredly exist with other local non-profit and recreational user groups although they have not been specifically identified at this stage of the proposal process. Lastly, DNRC is a key partner should LSR funding be granted under this proposal. The city looks forward to working closely with the DNRC to deliver this much-needed project. Xxxxxx Xxxxx Xxxxx Xxxxxxx Montana DNRC City of Bozeman 406.542.4221 406.582.2282 Protecting and enhancing municipal water supply resiliency and critical water supply infrastructure of the City of Bozeman is the over-riding objective of this project. A severe wildfire in the Sourdough Creek municipal watershed will impair water quality of this crucial municipal water supply source, which accounts for 40% of the city’s annual water supply. City of Bozeman water treatment plant operations can be severely hampered by large amounts of ash and sediment produced from erosion following wildfire. A safe and dependable drinking water supply is essential to public health and safety as well as uninterrupted commerce in the City of Bozeman. The project seeks $300,000 to perform forest treatments on city owned property in Sourdough Canyon bordered by Xxxxxx Gallatin National Forest and private property in the wildland urban interface. Forest treatments will be strategically performed on approximately 300-400 acres to protect the city’s existing water supply infrastructure and to produce a forest landscape that is less susceptible to devastating crown fire. Doing so enhances resiliency of watershed and water supply and directly benefits adjacent private property owners, city water customers, fish and wildlife, as well as the diverse array of year-round recreational users that enjoy the Sourdough Creek watershed. Cross-boundary efforts hinge on the implementation of Xxxxxx Gallatin National Forest’s Bozeman Municipal Watershed project (BMW). The BMW has been a work in progress for the better part of the past decade but is nearing implementation. The city has long intended to perform silviculture activities on city-owned property intermingled with the BMW project. A city Forest Management Plan exists that identifies treatment units and methods on city property that dovetail with BMW treatment units. The project specifically addresses State and Private Forest National Themes as well as Focus Areas 1, 2, and 3 of the Montana State Assessment/Forest Action Plan by: 1) conserving working forest landscapes by actively managing forest vegetation; 2) protecting forests from harm by reducing risk of wildfire impacts; 3) enhancing public benefits from trees and forests by protecting and enhancing water quality; 4) producing merchant timber and biomass forest products. Key partners in the city’s forest management project include the USFS Xxxxxx Gallatin National Forest, the DNRC, and the Gallatin Valley Land Trust. The city and USFS enjoy a long-standing partnership in management of activities and projects in the municipal watershed that is memorialized within a formal Memorandum of Understanding. BMW project work, as well as work on city-owned property, requires close coordination and consistent public communications by the city and USFS as public access to watershed from the Sourdough Canyon trailhead will be restricted during certain portions of project implementation. Coordination and partnership with Gallatin Valley Land Trust is also essential in order to disseminate project-related communications regarding temporary trail closures that directly impact the recreating public. QUARTERLY REPORT FOR SUBAWARD AGREEMENT NUMBER: xxx - xx - xxx Reporting period: Select Quarter , Select Year Total acres to be treated (Sect.4 in grant agreement): Enter acres here Acres Treated # Property Assessments / Plans # Educational Programs Completed This Quarter this quarter this quarter this quarter 1. Subrecipient’s name, address & telephone numbers. 2. Name, address, and telephone numbers of others who may be contacted concerning the project if the primary contacts are not available. 3. Funding: Total project cost and amount of subaward.

Instructions for Certification. 1. By signing and submitting this CONTRACTform, the prospective lower tier participant is providing the certification set out below. 2on the reverse side in accordance with these instructions. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response form that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT form that it will include this clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " without modification, in all lower tier covered transactions transaction and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8List. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal governmentFederal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The undersigned certifies, to the best of his or her knowledge and belief, that: No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative Agreement, and the extension, continuation, renewal, amendment, or modification of a Federal contract, grant, loan, or cooperative Agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative Agreement, the undersigned shall complete and submit Standard Form-LLL. "Disclosure Form to Report Lobbying", in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all covered subawards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly. ________________________________________________________________________________________________ ____________________________________________________________________________________________________ This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to the title 31 U.S.C. section 1352. The filing of a form is required for each payment or Agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer of employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. Identify the status of the covered Federal action. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. Enter the full name, address, city, state and zip code of the reporting entity, Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub-award recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier, Sub-awards include but are not limited to subcontracts, sub-grants and contract awards under grants. If the organization filing the report in item 4 check "Subawardee"'. then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. Enter the Federal program name or description for the covered Federal action (item 1)). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative Agreements, loans, and loan commitments. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

Instructions for Certification. 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverages sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. C.F.R part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. a. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2b. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. The Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the LPA's determination whether to enter into this agreement. However, failure of the Consultant to furnish a certification or an explanation will disqualify the Consultant from participation in this agreement. c. The certification in this clause is a material representation of fact upon which reliance was placed when the State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 3. d. The prospective lower tier participant Consultant shall provide prov ide immediate written notice to the person to which this CONTRACT is submitted LPA if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing impl ementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. f. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily vol untarily excluded from participation in this covered transaction, unless authorized by the department or agency with which LPA before entering into this transaction originatedagreement. 6. g. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by the State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant h. The Consultant in a covered transaction may rely upon a certification of a prospective participant Subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 8. i. Nothing contained in the foregoing shall will be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant the Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. j. Except for transactions authorized under paragraph 5 (f) of these instructions, if a participant the Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department LPA may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. 1. a. By signing and submitting this CONTRACTagreement, the prospective lower tier participant Consultant is providing the certification set out below. 2b. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this project. The Consultant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the State's determination whether to enter into this agreement. However, failure of the Consultant to furnish a certification or an explanation will disqualify the Consultant from participation in this agreement. c. The certification in this clause is a material representation of fact upon which reliance was placed when the State determined to enter into this transaction was entered intoagreement. If it is later determined that the prospective lower tier participant Consultant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Governmentgovernment, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault. 3. d. The prospective lower tier participant Consultant shall provide immediate written notice to the person to which this CONTRACT is submitted State if at any time the prospective lower tier participant Consultant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, ," "lower tier covered transaction, ," "participant, ," "person, ," "primary covered transaction, ," "principal, ," "proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. f. The prospective lower tier participant Consultant agrees by submitting this response that, that should the proposed covered transaction be entered into, it shall will not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which State before entering into this transaction originatedagreement. 6. g. The prospective lower tier participant Consultant further agrees by submitting this CONTRACT that it will to include this the clause titled “"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” " provided by the State without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant h. The Consultant in a covered transaction may rely upon a certification of a prospective participant subconsultant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant Consultant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 8. i. Nothing contained in the foregoing shall will be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant the Consultant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. j. Except for transactions authorized under paragraph 5 (f) of these instructions, if a participant the Consultant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department State may terminate this agreement for cause or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentdefault.

Instructions for Certification. 1. First Tier Participants: a. By signing and submitting this CONTRACTproposal, the prospective lower first tier participant is providing the certification set out below. 2b. The inability of a person to provide the certification set out below will not necessarily result in denial of participation in this covered transaction. The prospective first tier participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in this transaction. 2 CFR 180.320. c. The certification in this clause is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or contracting agency with which may terminate this transaction originated may pursue available remedies, including suspension and/or debarmentfor cause of default. 2 CFR 180.325. 3. d. The prospective lower first tier participant shall provide immediate written notice to the person contracting agency to which whom this CONTRACT proposal is submitted if at any time the prospective lower first tier participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 2 CFR 180.345 and 180.350. 4. e. The terms "covered transaction, ," "debarred, ," "suspended, ," "ineligible, lower tier covered transaction, ," "participant, ," "person, primary covered transaction, ," "principal, proposal, ," and "voluntarily excluded, ," as used in this clause, have the meaning set out are defined in the Definitions 2 CFR Parts 180, Subpart I, 180.900-180.1020, and Coverages sections of rules implementing Executive Order 125491200. You may contact the person “First Tier Covered Transactions” refers to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed any covered transaction be between a recipient or subrecipient of Federal funds and a participant (such as the prime or general contract). “Lower Tier Covered Transactions” refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). “First Tier Participant” refers to the participant who has entered into, it shall not knowingly enter into any lower tier a covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, recipient or voluntarily excluded from participation in this covered transaction, unless authorized by subrecipient of Federal funds (such as the department prime or agency with which this transaction originated. 6general contractor). The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction,Participant” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A refers any participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters who has entered into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, First Tier Participant or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarmentLower Tier Participants (such as subcontractors and suppliers).

Instructions for Certification. 1. By signing and submitting this CONTRACT, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this CONTRACT is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverages sections of rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this CONTRACT that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Exclusion‐‐Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Instructions for Certification. 1. By signing and submitting this CONTRACTAddendum, the Consultant, also sometimes referred to herein as a prospective lower tier participant primary participant, is providing the certification set out below. 2. The inability of a Consultant to provide the certification required below will not necessarily result in denial of participation in the covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the City’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. The certification in this clause is a material representation of fact upon which reliance was placed when the City determined to enter into this transaction was entered intotransaction. If it is later determined that the prospective lower tier primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the department or agency with which City may terminate this transaction originated may pursue available remedies, including suspension and/or debarment. 3for cause or default. The prospective lower tier primary participant shall provide immediate written notice to the person to which this CONTRACT is submitted City if at any time the prospective lower tier primary participant learns that its certification was erroneous when submitted or had has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, proposal and voluntarily excluded, as used in this clausecertification, have the meaning meanings set out in the Definitions and Coverages Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this CONTRACT is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier primary participant agrees by submitting this response that, should signing the proposed covered transaction be entered into, Addendum that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this covered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the department or agency with which City, the City may terminate this transaction originated. 6for cause or default. The prospective lower tier primary participant further agrees by submitting signing this CONTRACT Addendum that it will include this the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Exclusion - Lower Tier Covered Transaction,” as available through the United States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. CFR part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from the covered transactionstransaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Non-Procurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.