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07/12/2022
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07/12/2022
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Last modified
8/2/2022 2:50:43 PM
Creation date
8/2/2022 2:00:02 PM
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Meetings
Meeting Type
BCC Regular Meeting
Document Type
Agenda Packet
Meeting Date
07/12/2022
Meeting Body
Board of County Commissioners
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Attachment F <br />Certification Regarding Debarment, Suspension, Ineligibility, 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 are 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 />B1 <br />Recipient's Signature <br />Name and Title <br />Street Address <br />City, State, Zip <br />Date <br />Recipient's Printed Name <br />FDEM Agreement Number <br />Project Number (if applicable) <br />40 <br />
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