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NAME
<br />County of Kittitas
<br />Doing business as (DBA)
<br />Kittitas County
<br />ADORESS
<br />205 W. 5th Ave Suite 105
<br />Ellensburg, WA 98926
<br />Appllcable Procur6ment
<br />or Solicil,ation #, if any:
<br />WA Uniform Business
<br />ldentilier (UBl)
<br />192002673
<br />Federal Employer Tax
<br />ldentilication #:
<br />91-6001 349
<br />certification is ofa to
<br />Washington Military Department Contract Number. E21-082
<br />Debarment, Suspension, lneligibility or Voluntary Exclusion Certification Form
<br />lnstructions For Certification Regarding Debarment, Suspension, lneligibility and Voluntary Exclusion--Lower
<br />Tier Covered Transactions
<br />1 By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out
<br />below.2 The certification in this clause is a material representation of fact upon which reliance was placed when this
<br />transaction was entered into. lf it is later determined that the prospective lower tier participant knowingly rendered an
<br />erroneous certification, in addition to other remedies available to the Federal Government the departmbnt or agency
<br />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 department, instiiution or office towhich this proposal is submitted if at any time the prospective lower tier participant iearns that its certification was
<br />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,
<br />primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning
<br />set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact theperson to which this proposal is submitted for assistance in obtaining a copy of those regulations.5 The prospective lower tier participant agrees by submitting this propbsal that, should the proposed covered
<br />transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who isproposed for debarment under the applicable CFR, debarred, suspended, declared ineligible, or voluniarily excludedfrom participation in this covered transaction, unless authorized by the department or agency with which this
<br />transaction origi nated.6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause tifled"Certification Regarding Debarment, Suspension, lneligibility and Voiuntary Exclusion-Lower Tier Covered
<br />Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered
<br />transactions.7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered
<br />transaction that it is not proposed for debarment under applicable CFR, debarred, suspended, ineligible, or voluntarily
<br />excluded from covered transactions, unless it knows that the certification is erroneous. A participa-nt may decide the
<br />method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required
<br />to, check the List of Parties Excluded from Federal Procurement and Non-procurement piograms.8 Nothing contained .in the foregoing shall be construed to require establishment of a system of records in order torender in good faith the certificatton required by this clause. The knowledge and information of a participant is not
<br />required to exceed that which is normally possessed by a prudent person in the ordinary course of business activity.9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction
<br />knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under applicable
<br />CFR, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition io other
<br />remedies available to the Federal Government, the department or agency with which this transaction originated maypursue available remedies, including suspension and/or debarment.
<br />Certification Regarding Debarment, Suspension, lneligibility and Voluntary Exclusion-Lower TierCovered Transactions
<br />The prospective lower tier participant certifies,by submission of this proposal or contract, that neither it nor itsprincipals is presently debarred, suspended,proposed for debarment, declared ineligible, or voluntari ly excludedfrom participation in this transaction by any Federal department or agency. Where the p rospective lower tierparticipant is unable to certify to any of the statements in this certification, such prospective participant shallattach an explanation to this
<br />Bidder or Contractor Signature
<br />R EAD CARE FULL Y BEFORE IG NING THE CERT FICA TION Federa regulations require co ntractors nd b idders to sign andabidebythetermsofthiscertificatiolltwilhoutmodificationlnordertoparticipatetncertatntransactiodirectly
<br />n d rec U involvi federa fu nds.
<br />Print Name and riile: JudY Pless,Finanace Manager
<br />Date: 10-20-2020
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