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575-060-13 RIGHT OF WAY 05/01 Page 2 of 3 9. 1 certify that, except as noted below, neither my firm nor any person associated therewith in the capacity of owner, partner, director, officer, principal, investigator, project director, manager, auditor, and/or position involving the administration of Federal funds: (a) is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions, as defined in 49 CFR §29.110(a), by any Federal department or agency; (b) has within a three-year period preceding this certification been convicted of or had a civil judgment rendered against him or her for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, State or local government transaction or public contract; violation of Federal or State antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property; (c) is presently indicted for or otherwise criminally or civilly charged by a Federal, State or local governmental entity with commission of any of the offenses enumerated in paragraph 9(b) of this certification; and (d) has within a three-year period preceding this certification had one or more Federal, State or local government public transactions terminated for cause or default. 10. I(We), certify that I(We), shall not knowingly enter into any transaction with any subcontractor, material supplier, or vendor who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this contract by any Federal Agency unless authorized by the Department. Where I am unable to declare or certify as to any of the statements contained in the above stated paragraphs numbered (1) through (10), 1 have provided an explanation in the "Exceptions" portion below or by attached separate sheet. EXCEPTIONS: (Any exception listed above will not necessarily result in denial of award, but will be considered in determining bidder responsibility. For any exception noted, indicate to whom it applies, initiating agency and dates of agency action. Providing false information may result in criminal prosecution and/or administrative sanctions.) I declare under penalty of perjury that the foregoing is true and correct. CONTRACTOR: (Seal) PRP Construction Group, LLC BY: Sheltra President WITNESS:IAL,�e,N E AND TITLE PRINTED BY:4 2� WITNESS: LOX SIGNATURE Executed on this 17th day of January , 2020 FAILURE TO FULLY COMPLETE AND EXECUTE, THIS DOCUMENT MAY RESULT IN THE BID BEING. DECLARED NONRESPONSIVE 00472-2