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FY 2021 — 2022 EMPA AGREEMENT <br />ATTACHMENT C <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY <br />EXCLUSION <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 <br />Name and Title <br />Street Address <br />City, State, Zip <br />Date <br />Recipient's Name <br />Division Contract Number <br />Project Number <br />48 <br />