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2023-263
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2023-263
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Last modified
2/5/2024 9:24:59 AM
Creation date
1/4/2024 11:53:52 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
12/12/2023
Control Number
2023-263
Agenda Item Number
8.K.
Entity Name
State of Florida Division of Emergency Management
Subject
Hazard Mitigation Agreement D1495 for Dune Restoration within Beach Management Sector 4
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Attachment E <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 Recipient's Name <br />Name and Title DEM Contract Number <br />Street Address Project Number <br />City, State, Zip <br />Date <br />29 <br />
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