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DOH CONTRACT #: C17114 <br />Standard Federal Certifications and Assurances <br />Following are the Assurances, Certifications, and Special Conditions that apply to all federally funded (in <br />whole or in part) agreements administered by the Washington State Department of Health. <br />CERTIFICATIONS <br />1. CERTIFICATION REGARDING <br />DEBARMENT AND SUSPENSION <br />The undersigned (authorized official signing for <br />the contracting organization) certifies to the best <br />of his or her knowledge and belief, that the <br />contractor, defined as the primary participant in <br />accordance with 45 CFR Part 76, and its <br />principals: <br />a) are not presently debarred, suspended, <br />proposed for debarment, declared ineligible, <br />or voluntarily excluded from covered <br />transactions by any Federal Department or <br />agency; <br />b) have not within a 3-year period preceding <br />this contract been convicted of or had a civil <br />judgment rendered against them for <br />commission of fraud or a criminal offense in <br />connection with obtaining, attempting to <br />obtain, or performing a public (Federal, <br />State, or local) transaction or contract under <br />a public transaction; violation of Federal or <br />State antitrust statutes or commission of <br />embezzlement, theft, forgery, bribery, <br />falsification or destruction of records, <br />making false statements, or receiving stolen <br />property; <br />c) are not presently indicted or otherwise <br />criminally or civilly charged by a <br />governmental entity (Federal, State, or local) <br />with commission of any of the offenses <br />enumerated in paragraph (b) of this <br />certification; and <br />d) have not within a 3-year period preceding <br />this contract had one or more public <br />transactions (Federal, State, or local) <br />terminated for cause or default. <br />Should the contractor not be able to provide this <br />certification, an explanation as to why should be <br />placed after the assurances page in the contract. <br />2015-2017 Consolidated Contract <br />The contractor agrees by signing this contract <br />that it will include, without modification, the <br />clause titled "Certification Regarding <br />Debarment, Suspension, In eligibility, and <br />Voluntary Exclusion--Lower Tier Covered <br />Transactions" in all lower tier covered <br />transactions (Le., transactions with sub-grantees <br />and/or contractors) and in all solicitations for <br />lower tier covered transactions in accordance <br />with 45 CFR Part 76. <br />2. CERTIFICATION REGARDING <br />DRUG-FREE WORKPLACE <br />REQUIREMENTS <br />The undersigned (authorized official signing for <br />the contracting organization) certifies that the <br />contractor will, or will continue to, provide a <br />drug-free workplace in accordance with 45 CFR <br />Part 76 by: <br />a) Publishing a statement notifying employees <br />that the unlawful manufacture, distribution, <br />dispensing, possession or use of a controlled <br />substance is prohibited in the grantee's <br />workplace and specifying the actions that <br />will be taken against employees for violation <br />of such proh ibition; <br />b) Establishing an ongoing drug-free awareness <br />program to inform employees about <br />(I) The dangers of drug abuse in the <br />workplace; <br />(2) The contractor's policy of maintaining a <br />drug-free workplace; <br />(3) Any available drug counseling, <br />rehabilitation, and employee assistance <br />programs; and <br />(4) The penalties that may be imposed upon <br />employees for drug abuse violations <br />occurring in the workplace; <br />c) Making it a requirement that each employee <br />to be engaged in the performance of the <br />contract be given a copy of the statement <br />required by paragraph (a) above; <br />Page 11 of 17