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2018-165
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Last modified
1/4/2021 10:59:32 AM
Creation date
9/18/2018 4:03:26 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/11/2018
Control Number
2018-165
Agenda Item Number
8.M.
Entity Name
State of Florida, Division of Emergency Management
Subject
2018/2019 State Funded Subgrant Agreement
Hazardous Analysis Grant
Area
Agreement Number: 19-CP-11-10-40-01-__
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Attachment I <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, <br />proposed for debarment, declared ineligible, or voluntarily excluded from participation in this <br />transaction by any 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 />31 <br />
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