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401 <br />0 <br />0 <br />U.S. DEPARTMENT OF AGRICULTURE <br />Certirication Regarding Debament, Suspension, Ineligibility <br />and Voluntary Exclusion - Lower Tier Covered Transactions <br />This cera fieation Is required by the regulations implementing Executive Order 12549, Debarment and <br />Suspension, 7 CFR Part 3017, Section 3017.510, Participants' responsibilities. The regulations were: published <br />as Part N of the January 30, 1989, Fe,Qtrat Rtelgftr (pages 4722-4733). Copies of the regulations may be <br />obtained by contacting the Department or Agriculture agency with which this transaction originated. <br />(BEFORE COMPLETING CERTIFICATION, RJAD INSTRUCTIONS ON REVERSE) <br />(1) The prospective lower tier participanl certifies, by submission or this proposal, that neither It nor <br />Its principals Is presently debarred, suspended, proposed for debarment, declared Ineligible, or <br />voluntarily excluded from participation in this transaction by any Federal department or agency. <br />(2) Where the prospective lower tier participant is unable to certify to any or the statements in this <br />certification, such prospective participant shall attach an explanation to this proposal. <br />Indian River County CR 512 Corridor Improvements, Phase 11 <br />Orsaniiation Name PR/Arnrd Number or Project Name <br />Kenneth R. Macht, Chairman, Indian River County Board of County Commissioners <br />Names) and Tides) or Authorised Repmstnutbt(s) <br />tures) <br />Due <br />Indian River County I Approved <br />1 r1^;r <br />Actministralion <br />Budget <br />E <br />-rVf <br />Legal ) F <br />7-_I-cf <br />Risk Management <br />_ <br />0. <br />..l <br />I <br />f)c;tr,�r,ment <br />Form AD -10.48 (1/92) <br />Division <br />37 <br />