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Attachment G <br />4 TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />R SMITH, CLERK <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 DEM Contract Number <br />Street Address Project Number <br />City, State, Zip <br />Date <br />34 <br />