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Attachment G <br /> Certification Regarding <br /> Debarment, Suspension , Ineligibility <br /> And Voluntary Exclusion <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 , proposed <br /> for debarment , declared ineligible , or voluntarily excluded from participation in this transaction by any <br /> 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 /> 39 <br />