Laserfiche WebLink
Attachment H <br />Certification Regarding <br />Debarment, Suspension, Ineligibility <br />And Voluntary Exclusion <br />Subcontractor Covered Transactions <br />(1) The prospective subcontractor, , of <br />the Sub -Recipient certifies, by submission of this document, that neither it nor its principals is <br />presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded <br />from participation in this transaction by any Federal department or agency. <br />(2) Where the Sub -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: INDIAN RIVER COUNTY <br />Signature <br />Sub -Recipient's Name <br />H0259 <br />Name and Title DEM Contract Number <br />4283-95-R <br />Street Address FEMA Project Number <br />City, State, Zip <br />Date <br />51 <br />