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2012-010
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Last modified
12/15/2015 11:03:49 AM
Creation date
10/1/2015 4:06:31 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
01/17/2012
Control Number
2012-010
Agenda Item Number
12.J.1
Entity Name
Florida Department of Economic Opportunity
Subject
Federally-Funded Subgrant Agreement FFY 2011
Neighborhood Revitalization
Project Number
12DB-OH-10-40-01-N01
Archived Roll/Disk#
112-R-0001
Supplemental fields
SmeadsoftID
10938
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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, ( name of subcontractor), certifies, by submission of this <br /> document, that neither it nor its principals is presently debarred , suspended , proposed for debarment, declared <br /> ineligible , or voluntarily excluded from participation in this transaction by any Federal department or agency . <br /> (2 ) Where the Contractor ' s subcontractor is unable to certify to the above statement, the prospective contractor <br /> shall attach an explanation to this form . <br /> ( Sub-Contractor' s Name) ( Recipient ' s Name) <br /> Date : <br /> (Authorized Signature) <br /> ( Print Name and Title) ( DEO Contract Number) <br /> ( Street Address ) <br /> (City , State, Zip) <br /> Rev . 3 /23 /2011 24 <br />
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