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Washington Mililary Deparlment Conlract ttumber: E2@
<br />Debarment, Suspension, lnellglblllty or Voluntary Excluslon Cer$flcation Form
<br />lnetructlons Forcertlflcatlon Regardlng D_etarment, slSpenslon,lneltglblllty and voluntary Excluslon-Lower
<br />Tler Covered Trenaacdons
<br />iIAME
<br />County of Kltlitas
<br />Ddng businoss st (DgA)
<br />Kltttas
<br />ADDRESS
<br />205WSft Sts 105
<br />Ellensburg, WA 98926
<br />AppllcaDlc Procuru[enl
<br />or Sollcttrilon t, lf any:
<br />WA Unlfom Ewhe*r
<br />ldentifier (UBl)
<br />192002673
<br />Fedoal EmployrrTax
<br />ldedifcatlon #:
<br />91-6001349
<br />GAREFULLYREAD Sl0t{llrlc THE andconlraclors ddergb!to algnabldstheolbrmSthlgcenlf,callon,wlthout ln ceneln trangrctons dlrec{yfedsralfunds.
<br />1. By. signing and submitting thb propocal, the prospective lower tier parlicipant is providing the cergfication eet outbelow'2. The certificatbn in lhis clause is a material representation of f*t upon which relhnce was ptaced when thisbansaclion was entered into. lf il is later determinid lhat_the pmspectivejoneitiei parii.ip"nr rnouiingty rendJiio
<br />"neroneous cardfication, in addilion to other remedies arrailable to ihe Federal Ooveinmani the deparrii6nt;;;;n;ywilh which lhis bansaction odginated may pursuo available rcmedies, incluAing suspension anOlor Cebannenl.3. The prospedive lower tier paiicipant shali provide immediate wrilten nofice fi ne-Oepiriment, institution or ofiice towhich this proposal is.submitted if at any time the prospectiro loiler tier particlpantieains that its ceilllication waseroneous when submilted or had become enoneous by ieason of changedcircuirstaniei.4- Thc tems covered lraneaction, debarred, suspended, ineligible, lonuer tier covered tnansac{ion, parlicipanf, person,primary covered transaction, pdncipal, proposdt, and voluntirily excluded, as used in itris clause, have the meaningsel oul in the Definitions and govgrage sections of rules implementing eiecurm oro"i izslg. Vou mav conuc,tiiie- psrson to wttich this propoaal is eubmitted for aseistance in obtainlng a-copy of thosJregui"iion".5' The proopec-live lowgr.tier.parlicipant agr€€s. by submittins iltis pr;irsat that, afuulu the proposed coveredtransacllon be anlered lnto, il shall not knowingly_inter into an'y tmei tiar coverediransaclbn wiitr d p"ieon u,tolspropced for debarment under the- applicable CFR,.debaned, susqelded, dechred inJtigitte, or voluniarly
<br />"xiiiioeofiom parlicipatbn in this cowred Gnsaction, unlEss adhbrizeb uy rde oepjnment-6g
<br />"gency wth which thistransaclion originated.6' Jle r.lospeaive lorrvsr.lier participanl tuilher agrees by submitting this proposalthat it wiil lnclude this clause tiiled-Certificalbn Regarding Debarment. Suspdsion, irntfibility-ana Voiuntarv'E"rrueiln-r.ower Tier coveredTnansaction," without modfficalion, in all loul6r tier covered-trans'aaions ano ln ati soticlt"ii rn" for lo^rer tier covoradtransaclions.7' A participanl in a covered traNadion mey rely upon a certification ol a proepective parlicipant in a lower tier covaredtransaclion that it is not proposed for debarment irnder applbable CF&'OeUined, ilsd;ied. ineligible, or voluntadtyotduded from covered lransactions, unlese it knows ttrdt'tra c€rtifacati.;-is;ndJ*5. li iliiri"hfii;;t j;;id;I;
<br />melhodand froquency by which it delermines.fie.e igibility of ils p{ncipals- eacrr part[ipaii mai, Uut iJ hor rsquirirOto. check the Lisl of Parties Excluded from Federd Pr6curimant a'no r.r6n+rocur"n[Jn[Flog'*..8. Nothing contained in.the foregolng shall be construed to requira esrauiitrmenr oi a sfiir of records in order torender in good faith. thE 994rr.natlon re_euked by lhls clause. The knowledge anoinronir*Ln ot a padicipani is notrequlrad to exceed that whlch is normally posseised by lnruden! person inihe orUinary course ot b$i66;;iliiy. -
<br />9. Except for transaclions .authorized und6r'paragraph 5 oJ'thase idsructnns, ir; ;;r#G;iin a coverad trarsactionknodngly enters lnlo a lower lier covered iranJaciion with- a person who is iroioi.o ici Jfurmenr under appticabteGFR, suspended, debared, ineligible, or voluntarily exduded'from participaiion'in nisliansiaion, ln addllbn lo otherremedies avallable to he Federal Govamment, tha deparhent or bgency with which ttris liansaaion origin;ted ;;ypursue available rsmedies, including suspension and/oi debarment.
<br />Gertlflcatlon Regardlng Debarment, Suspenslon, lneliglblllty anrl Votuntary Excluslon-Lower TlerGoverad Transactlons
<br />Tha prospectlva lower tler partlclpant certlllec,by submlsslon of thlg proposal or oonlract, that nelthor lt nor ltsprlnclprls le proeenfly dabaned, suspended,prcpoaed for debarment, declarud or voluntarlly exctudedfiom partlclpatlon ln
<br />paillclpant ls unable
<br />lnellglbto,thlc trancac,tlon by any Fadcral deparlment or agoncy. Whars ihe prorpestlve lower tlerto ceilfi to cartlflcatlon,euch prorpcctlve partlclpant ehallattach an axplanatlon to thls
<br />Bidder or Contractor Date:
<br />Print Nameand Tiile: Jerry'
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