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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. Convicted Vendors, Section 287.133, F.S. Grantee certifies that it, its principals, recipients,
<br /> subrecipients, contractors,and subcontractors, are not on the Convicted Vendors 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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