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NAME
<br />County of Kittitas
<br />Doing business as (DBA)
<br />Kittitas County
<br />ADDRESS
<br />205 W Sth Ste 105
<br />Ellensburg, WA 98926
<br />Appllcable Procurement
<br />or Sollcllallon #, lf any:
<br />WA Uniform Euslness
<br />ldentifier (UBl)
<br />192002673
<br />TaxFederal Employer
<br />ldenlifcation #:
<br />91-6001349
<br />certlllcatlon ls lo
<br />Washington Military Department Contract Numbel E22-264
<br />Debarment, Suspension, lneligibility or Voluntary Exclusion Certification Form
<br />lnstructions For Certlflcatlon Regarding Debarment, Suspension, lneligibillty and Voluntary Exclusion--Lower
<br />Tier Govered Transactions
<br />1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out
<br />below.
<br />2. The cefiification in this clause is a matsriat representation of fact upon which reliance was ptaced when this
<br />transaction was entered into. lf it is later determined that the prospective lower lier parlicipant knowingly rendered an
<br />erroneous certification, in addition to other remedies available to lhe Federal Goveinment the departmbd or agencywith which this transaction originated may pursue available remedies, including suspension and/or debarment.3' The prospective lower tier participant shall provide immediate written notice tb tha department, institution or ofiice 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 erroneoqs by reason of changed circumstances.4. The terms covered transaction, debarred, suspended, ineligibte, lower tier covered transaclion, participant, person,
<br />primary covered transaction, p_rincipal, proposal, and voluntarily excluded, as used in this clause, have'ttre nieaning
<br />sel out in the Definitions and Coverage sections of rules imptemenling Executive Order 12549. Vou may contact the_ person to which this proposal is submitted for assistance in obtaining a copy of lhose regulations.5. The prospective lower. tier participant agrees by submitting thii pro'pbsal that, s-hould the proposed covered
<br />transaction be entered into, it shall not knowingly enter into any lower tier covered transaclion wiih a person who isproposed for debarmenl under the applicable CFR, debaned, suspended, declared ineligible, or voluniarily excludedfrom parlicipation in this covered transaction, unless authorized by the depadment-or agency with 'wtrictr thistransaction originated.6. Jle ngspgctive lower tier participant furlher agrees by submitting this proposal that it wilt include this clause tiiled-Certification Regarding Debarment, Suspenslon, inelpibility-and'Voiunlary Exclusion-Lower Tier Covered
<br />Transaction," without modification, in all lower tier coveredlransaclions and in ail solicitatbns for lower tier covered
<br />lransactions.
<br />7. A parlicipant in a covered iransaction may rely upon a certification of a prospective participant in a lower tier covered
<br />transaclion that it is nol proposed for debarment under applicable GFR, debirred, suspendeU, ineligible, or voluntarily
<br />excluded from covered transactions, unless it knows thdt-ttre certffication is erroneoui. A participa'nt may decide thi
<br />melhod and frequency by which it determines the eligibilily of its principals. Each participant may, but is not required
<br />to, check the List of Parties Excluded from Federal Procurement and N6n-procuremenl piograms.8. Nothing contained in the foregoing shall be construed to require establishment of a sysGm of records in order to
<br />render in good faith. the cerlification required by this clause. The knowledge and information of a pafiicipant is not
<br />required to exceed that which is normally possessed by a prudent person in ihe ordinary course of Uu'siness ac6v1y.9. Except for transactions authorized under paragraph 5 of lhese instructions, if a participant in a covered transaction
<br />knowingly enters into a lower lier covered transaclion with a person who is propoled foi debarmenl under applicable
<br />CFR, suspended, debarred, ineligible, or voluntarily excluded from participation'in this transaction, in addilbd io other
<br />remedies available to the Federal Government, the deparlment or agency with which this transaction originated maypursue available remedies, including suspension and/or debarment.
<br />Certification Regarding Debarment, Suspenslon, tneligibility and Voluntary Exclusion--Lower Tier
<br />Covered Transactions
<br />The prospective lower tler participant certifias,by submission of thls proposal or contract, that nelther it nor ltsprinclpals is presently debarred, suspended,proposed for debarment, declared lneligible,or voluntarily excludedfrom participation in this transaction any Federal department or agency.Where the prospective lower tierparticlpant ls unable to certify to
<br />thls form.
<br />in thls certiflcation, such prospectlve participant shallattach an axplanation to
<br />Bidder or Contractor Sig
<br />Print Name and Title:Jer'ry
<br />zbal-'-Date:
<br />CAREFULLREAD BEFOREY IGNINGs TH ntractorsco dan dercbid to andelgnabldetermsthethisofwlthoulbycertification,cofiain transacllonsin d lrectly
<br />funds.federal
<br />{atn,k-
<br />by
<br />the
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