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NAME
<br />County of Kittilas
<br />Doing business as (DBA)
<br />Kittitas County
<br />ADDRES$
<br />205 W Sth Ste 105
<br />Ellensburg, WA 98926
<br />Appllcable Procurement
<br />or Sollcllatlon il, lf any:
<br />WA Unlform Business
<br />ldentfer (UBl)
<br />192002673
<br />Federal Employer Tax
<br />ldenlificalion #:
<br />91-6001349
<br />ola
<br />Washington Military Department Contract t'lr^A"r, F&b^ I8 7
<br />Debarment, Suspension, lneligibility or Voluntary Exclusion Gertification Form
<br />lnstructions For Gertification 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 outbelow.2' The certification in lhis clause is a material representation of fact upon which reliance was placed when this
<br />transaction was entered into. lf it is later determined lhat the prospective lower tier participant knowingly rendered an
<br />erroneous certification, in addition to other remedies available to the Federal Goveinment the departirLnt or agency
<br />with which this iransaction originated may pursue available remedies, including suspension and/or debarment.3. The prospective lower tier participant shall provide immediate written notice t6 the deparlment, inslitution or office towhich this proposal is submitted if at any time lhe 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, loweitier covered lransaction, participanl, person,
<br />primary covered transaction, principal, proposal, and voluntirily excluded, as used in this clause, have'the nieaning
<br />set out in the Definitions and Coverage sections of rules irnplementing Execulive Order 1254g. Ybu may contact thepetson to which this proposal is submitted for assistance in obtaining a copy of lhose regulations.5 The prospective lower tier parlicipant agrees by submitting thfu proi:ilsal that, siould the proposed covered
<br />transaction be entered into, it shall not knowin^gly enter into any lower lier covered transaction wiih a person who isproposed for debarment under the applicable CFR, debarred, suspended, declared ineligible, or voluniarily excludedfrom participalion in this covered transaction. unless authorized by the department-or agency wittr wnicn tnistransaction originated.6' The prospective lower tier participant further agrees by submitting this proposal that il will include this clause tiiled"Certification Regarding Debarment, Suspension, lneligibility - and 'Voiuntary
<br />Exclusion-Lotrrer Tier Covered
<br />Transaction," without modification, in all tower tier covered transactions and in afi soficitations for lower tier covered
<br />transactions.7. A padicipant in a covered transaction may rely upon a cerlilicalion of a prospective participant in a lower tier covered
<br />transaction that it is not proposed for debarm.ent under appticable CFR, debarred, suspended, ineligible, or voluntarily
<br />excluded from covered transaclions, unless it knows that the certification is erroneoui. A participaiit m'ay OecUe ttr6
<br />method and frequency by which it delermines the eligibility of its principals. Each participaht may, but is not required
<br />to, check the Lisl of Parties Excluded from Federal Procurement and Non-procurement piograms.8. Nothing contained in lhe foregoing shall be construed to require establishment of a sysiem of records in order torender in good faith. the certifbation raquired 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 Uuiinesi activity,I' Except for transactions authorized under paragraph 5 of these instructions, if a partiiipanl in a covered transaction
<br />knowingly enters into a lower tier covered transaclion with a person who is propoied for debarment under applicabte
<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 departmenl or agency with which this transaction originated maypursue available remedies, including suspension and/or debarment.
<br />Certification Regardlng Debarment, Suspension, Inetigibllity and Voluntary Excluston-Lower TierCovered Transactlons
<br />The prospective lower tier participant certifies,by submlsslon of thls proposal or contract, that neither it nor itsprincipals is presently debarred,suspended,proposed for debarment, declared ineligible, or volunta rily excludedfrom participation in this transaction by any Federal department or agency. Where the prospective lower tierparticipant is unable to certfi to
<br />this form.
<br />any of the statements ln thls certification, such prospective participant shallattach an explanation to
<br />Bidder or Contractor Signature
<br />Print Name and Title:
<br />READ CAREFULLY BEFORE SIGNING THE CERTIFICA TI oN.Federal r€9u latlons reguire contractors and bidders to sign andabidebythetermsofthlscertificailon,wlthout modification,n order to particlpate ln certaln trensactl ons directly
<br />fede ral funds.
<br />-)'i;#F
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