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33 <br />Attachment C <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY <br />and VOLUNTARY EXCLUSION <br />Contractor Covered Transactions <br />(1) The prospective subcontractor of the Sub -recipient, V, u;r, gsv,� by submission of <br />this document, that neither it nor its principals is presently debarred, susp6ded, proposed for <br />debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any <br />Federal department or agency. <br />(2) Where the Sub -recipient's subcontractor is unable to certify to the above statement, the prospective <br />contract shall attach an explanation to this form. <br />CONTRACTOR <br />By: �r . <br />Signature Sub -Recipient's Name <br />7a— 4 Tf i cm�Ju � , os i�yn f t� F1 <br />Name and Title DEM Contract Number <br />Street Address FEMA Project Number <br />Ute, '_be4r_L FC 3L y� 6 <br />City, State, Zip <br />lllz-z l <br />Date <br />