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MME
<br />County of Kittitas
<br />Doing business as (DBA)
<br />Klttitas County
<br />ADDRESS
<br />205 W. Sth Ave Sle. 105
<br />Ellensburg, WA 98926
<br />Appllcablo Procurgmont
<br />or Sollcltadon #, ll any:
<br />WA Uniform Bwiness
<br />ldentifer (UBl)
<br />192002673
<br />I feOeratEmployerTax
<br />I ldentifrcation #:
<br />lor-ooors+e
<br />ls submlfled
<br />Washington Military Deparlment Contract Number. E22-131
<br />Debarment, Suspension, lneligibility or Voluntary Exclusion Certification Fofm
<br />lnstrucllons For Certification Regarding Debarment, Suspenslon, lneligibility and Voluntary Excluslon--Lower
<br />Tier Covered Transaetions
<br />1. By. signing and submifting this proposal, the prospective lower tier participant is providing the cerlification set out
<br />below.2. The certification in this clause is a material representation of fact upon which reliance was placed when this
<br />lransaction was entered into. lf it is later determined that the prospeclive lower tier participant knowingly rendered an
<br />eroneous certification, in addition to other remedies available to the Federal Government the departmbnt or agency
<br />with which lhis transaction originated may pursue available remedies, including suspension and/or debarment.3. The prospective lower tier participant shall provide immediate written notice iir tha department, institution or office lo
<br />which this proposal is subml[ed if at any time the prospective lower tier participant leams that its certification was
<br />eroneous when submifted or had become enoneous by reason of changed circumstances.4. The terms covered transaction, debaned, suspended, ineligible, loweilier covered transaction, participant, petson,
<br />primary covered transaction, p_rincipal, proposal, and voluntirily excluded, as used in this clause, havethe meaning
<br />set out in the Definitions and Coverage sections of rules implementing Executive Order 12S4g. you may contact thiperson to which lhis 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 />lransaclion be entered into, it shall not knowingly enter into any loner tier covered transaclion wiih d person wlro isproposed for debarment under the applicable CFR, debaned, suspended, declared ineligible, or voluniarily excluded
<br />frorn participation in this covered transaction, unless authorized by the department-or agency witn wfricn ftis
<br />transaction odginated.6. The prospective lower tier participant further agrees by submitting this proposal that il will include this clause fiUed-Certification Regarding Debarment, Suspension, lneligibility-and Voiuntary Exclusion-Lorver Tier Covered
<br />Transaction," wilhout modification, in all loryer tier coveredfransactions and in ali solicitalions for lower tier covered
<br />transactions.
<br />7. A participant in a covered transaction may rely upon a certilication of a prospective participant in a lower tier covered
<br />transaction that it is not proposed for debarm.ent under applicable CFR, debarred, srispended, ineligible, or votuntarily
<br />excluded from covered transac-tions, unless it knows that the certiftcation is erroneoui. R participint may decide thi
<br />methodand frequency by which il determines lhe eligibility of its principats. Each participaht ma!, Out is hot required
<br />to, check the List of Parties Excluded from Federal Procurement and Nonarocurement Programs.8. Nothing contained in the foregoing shall be construed to require establishment of a syslem of records in order to
<br />render in good faith the certification required by this clause. The knordedge and inforiration of a participant is not
<br />- lequired to exceed that which is normatly possessed by a prudent person in the ordinary course of bu'sinesi activig.9. Except for transaclions authorized under paragraph 5 of these instructions, if a participant in a covered transaction
<br />knorlvingly enters into a lower tier covered transac,tion with a person who is propoieO foi debarment under applicable
<br />CFR, suspended, debarrcd, ineligible, or voluntarily excluded from participation'in this transaction, in additior"i io other
<br />remedies available to the Federal Govemment, the department or agency wi[r which lhis transaction originated maypursue available remedies, including suspension and/or debarment.
<br />Gertlflcation Regarding Debarment, Suspension, lneligibility and Voluntary Exclusion-..Lower Tier
<br />Covered Transactions
<br />The prospectlve lower tler particlpant certffies,by submlssion of thls proposal or contract, that noither lt nor ltsprlncipals ls presenUy debaned, suspended,proposed for debarment, declared inellglble, or voluntarily excludedfrom particlpatlon ln
<br />partlclpant ls unable
<br />this transaction by any Federal department or agency.Where the prospectlve lower tiertosuch prospec8ve partlcipant shallattach an explanatlon to thls
<br />Bidder or Contractor
<br />READ CAREFULL Y BEFORE THE CERTIFICATION. Federal regulations rcqulru
<br />wlthout modiflcatlon, in order to particlpab
<br />contractorr and Hddere to slgn andrbldethetermsofthlscertlflcatlon,ln cerain transacllons d lrecUy or
<br />I federal funds.
<br />AQrece-Print Name and Title:
<br />to any of the statements ln this certlflcatlon,
<br />Date:tr/s/zozt
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