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public transactions (Federal, State or <br />local) terminated for cause or default. <br />2) Where the prospective contractor is unable to <br />certify to any of the statements in this <br />certification, such prospective contractor <br />shall attach an explanation to this proposal. <br />CONTRACTOR SIGNATURE REQUIRED <br />SIGNATURE OF AUTHORIZED CERTIFYING <br />OFFICIAL <br />Please also print or type name: <br />Washington State <br />Health Care Authority <br />) <br />Page 50 of90 <br />TITLE <br />kG PHt <br />DATE <br />HCA Contract No . K3924