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WashingtonMilitaryDepartmentContractNumber:Eab$Debarment,Suspension,IneligibilityorVoluntaryExclusionCertificationFormNAMEDoingbusinessas(DBA)CountyofKittitasKittitasCountyADDRESSApplicableProcurementWAUniformBusinessFederalEmployerTax205W5thSte105orSolicitation#,ifany:Identifier(UBI)Identification#:Ellensburg,WA9892619200267391-6001349Thiscertificatlonissubmittedaspartofarequesttocontract.InstructionsForCertificationRegardingDebarment,Suspension,IneligibilityandVoluntaryExclusion-LowerTierCoveredTransactionsREADCAREFULLYBEFORESIGNINGTHECERTIFICATION.Federalregulationsrequirecontractorsandbidderstosignandabidebythetermsofthiscertification,withoutmodification,inordertoparticipateIncertaintransactionsdirectlyorIndirectlyinvolvingfederalfunds.1.Bysigningandsubmittingthisproposal,theprospectivelowertierpadicipantisprovidingthecertificationsetoutbelow.2.Thecertificationinthisclauseisamaterialrepresentationoffactuponwhichreliancewasplacedwhenthistransactionwasenteredinto.Ifitislaterdeterminedthattheprospectivelowertierpanicipantknowinglyrenderedanerroneouscertification,inadditiontootherremediesavailabletotheFederalGovernmentthedepadmentoragencywithwhichthistransactionoriginatedrnaypursueavailableremedies,includingsuspensionand/ordebarment.3.Theprospectivelowertierparticipantshallprovideimmediatewrittennoticetothedepartment,institutionorofficetowhichthisproposalissubmittedifatanytimetheprospectivelowertierparticipantlearnsthatitscertificationwaserroneouswhensubmittedorhadbecomeerroneousbyreasonofchangedcircumstances.4.Thetermscoveredtransaction,debarred,suspended,ineligible,lowertiercoveredtransaction,padicipant,person,primarycoveredtransaction,principal,proposal,andvoluntarilyexcluded,asusedinthisclause,havethemeaningsetoutintheDefinitionsandCoveragesectionsofrulesimplementingExecutiveOrder12549.Youmaycontactthepersontowhichthisproposalissubmittedforassistanceinobtainingacopyofthoseregulations.5.Theprospectivelowertierparticipantagreesbysubmittingthisproposalthat,shouldtheproposedcoveredtransactionbeenteredinto,itshallnotknowinglyenterintoanylowertiercoveredtransactionwithapersonwhoisproposedfordebarmentundertheapplicableCFR,debarred,suspended,declaredineligible,orvoluntarilyexcludedfromparticipationinthiscoveredtransaction,unlessauthorizedbythedepartmentoragencywithwhichthistransactionoriginated.6.Theprospectivelowertierparticipantfurtheragreesbysubmittingthisproposalthatitwillincludethisclausetitled'CedificationRegardingDebarment,Suspension,IneligibilityandVoluntaryExclusion-LowerTierCoveredTransaction,"withoutmodification,inalllowertiercoveredtransactionsandinallsolicitationsforlowertiercoveredtransactions.7.AparticipantinacoveredtransactionmayrelyuponacedificationofaprospectiveparticipantinalowertiercoveredtransactionthatitisnotproposedfordebarmentunderapplicableCFR,debarred,suspended,ineligible,orvoluntarilyexcludedfromcoveredtransactions,unlessitknowsthatthecertificationiserroneous.Aparticipantmaydecidethemethodandfrequencybywhichitdeterminestheeligibilityofitsprincipais.Eachparticipantmay,butisnotrequiredto,checktheListofPartiesExcludedfromFederalProcurementandNon-procurementPrograms.8.Nothingcontainedintheforegoingshallbeconstruedtorequireestablishmentofasystemofrecordsinordertorenderingoodfaiththecertificationrequiredbythisclause.Theknowledgeandinformationofaparticipantisnotrequiredtoexceedthatwhichisnormallypossessedbyaprudentpersonintheordinarycourseofbusinessactivity.9.Exceptfortransactionsauthorizedunderparagraph5oftheseinstructions,ifaparticipantinacoveredtransactionknowinglyentersintoalowertiercoveredtransactionwithapersonwhoisproposedfordebarmentunderapplicableCFR,suspended,debarred,ineligible,orvoluntarilyexcludedfromparticipationinthistransaction,inadditiontootherremediesavailabletotheFederalGovernment,thedepadmentoragencywithwhichthistransactionoriginatedmaypursueavailableremedies,includingsuspensionand/ordebarment.CertificationRegardingDebarment,Suspension,IneligibilityandVoluntaryExclusion--LowerTierCoveredTransactionsTheprospectivelowertierparticipantcertifies,bysubmissionofthisproposalorcontract,thatneitheritnoritsprincipalsispresentlydebarred,suspended,proposedfordebarment,declaredineligible,orvoluntarilyexcludedfromparticipationinthistransactionbyanyFederaldepartmentoragency.Wheretheprospectivelowertierparticipantisunabletocertifytoanyofthestatementsinthiscertification,suchprospectiveparticipantshallattachanexplanationtothisform.BidderorContractorSignature:Date:(6PrintNameandTitle:in-(
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