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Attachment G <br /> cormspon <br /> Dreibt , Iwok I <br /> And bur ry'low . . . <br /> Subcontractor Covered Transactions <br /> (1 ) The prospective subcontractor of the Recipient , certifies , by <br /> submission of this document, that neither it nor its principals is presently debarred , suspended , <br /> proposed for debarment, declared ineligible , or voluntarily excluded from participation in this <br /> transaction by any Federal department or agency . <br /> (2) Where the Recipient's subcontractor is unable to certify to the above statement , the prospective <br /> subcontractor shall attach an explanation to this form . <br /> SUBCONTRACTOR : <br /> By : <br /> Signature Recipient's Name <br /> Name and Title DCA Contract Number <br /> Street Address <br /> City, State , Zip <br /> Date <br /> 44 <br />