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FWC Agreement No. 15120
<br />Attachment B
<br />CERTIFICATIONS AND ASSURANCES
<br />The Commission will not enter this Agreement unless Grantee completes, signs and returns to the
<br />Commission, the CERTIFICATIONS AND ASSURANCES contained in this Attachment. In performance
<br />of this Agreement, Grantee, through its duly authorized representative, certifies that it has read and provides
<br />the certifications and assurances below; and acknowledges it has an ongoing obligation to give written
<br />notice to the Commission, within a reasonable time, following any change in status regarding these
<br />certifications and assurances.
<br />Part I: State Certifications and Assurances.
<br />If this Agreement is supported by State funding
<br />then the following Certifications and Assurances apply.
<br />A. Interested State Employees, Chapter 112, F.S. Grantee certifies to the best of its knowledge, that
<br />none of its officers, directors, employees or other agents is also an employee of the State of Florida
<br />who owns, directly or indirectly, an interest of five percent (5%) or more in the Grantee or its affiliates.
<br />B. Conflict of Interest, Section 200.112, OMB Uniform Guidance (2 CFR 200). If this Agreement
<br />includes a Federal award, Grantee certifies that neither it, its principals, or agents, have a conflict of
<br />interest with either the Commission or the Federal awarding agency.
<br />-----C--'C-enAc-ted—V-endors, Section -287 33,—F:S—Grantee
<br />_ _ .--are_no -on_ e_ - onvicte = =endors-List .as-maintained:by
<br />the Department of Management Services, pursuant to Section 287.133(3)(d), F.S.
<br />D. Scrutinized Companies List, Sections 287.135 and 215.473, F.S. If this Agreement is in the amount
<br />of $1 million or more, Grantee certifies that to the best of its knowledge, it, its principals, recipients,
<br />subrecipients, contractors, and subcontractors are not:
<br />a. On the Scrutinized Companies with Activities in Sudan List;
<br />b. On the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; or
<br />c. Engaged with business operations in Cuba or Syria.
<br />E. Discriminatory Vendors, Section 287.134, F.S. Grantee certifies that it, its principals, recipients,
<br />subrecipients, contractors and subcontractors are not on the Discriminatory Vendors List maintained
<br />by the Florida Department of Management Services pursuant to Section 287.134(3)(d), F.S.
<br />F. Litigation, Investigations, Arbitration, or Administrative Proceedings. Grantee certifies that it, its
<br />principals and agents, are not engaged in any civil or criminal litigation investigations, arbitration, or
<br />administrative proceedings relating to or affecting the Grantee's ability to perform under this
<br />Agreement.
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<br />Attachment B rev.6.15.15 Page 1 of 4
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