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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />ATTACHMENT G <br />Certification Regarding Debarment, Suspension, <br />Ineligibility _ <br />And Voluntary Exclusion <br />Contractor Covered Transactions <br />(1) The prospective Contractor or subcontractor of -Indian River County <br />certifies, by submission of this document, that neither it nor its principals <br />are presently debarred, suspended, proposed for debarment, declared <br />ineligible, or voluntarily excluded from participation by the State of <br />Florida. . <br />(2) In accordance with the requirements. of section 287.135(5), F.S., the <br />vendor certifies that it is not participating in a boycott of Israel and is not <br />on the State Board of Administration's "Quarterly List of Scrutinized <br />Companies, that Boycott Israel," available at <br />https://www.sbafla.com/governance/global-governance-mandates/: At <br />the Department's option, the .Contract may be terminated if the <br />Contractor is placed on,the Quarterly List of Scrutinized Companies that <br />Boycott Israel (referred to in statute as the "Scrutinized Companies that <br />Boycott Israel. List") or: becomes engaged in a boycott of Israel. <br />(3) If the goods or services to be provided are $1 million or more, in <br />accordance with the requirements of section 287.135, F.S., the vendor._ <br />certifies it is not on the Scrutinized Companies with Activities in Sudan <br />List or the Scrutinized Companies with Activities in the Iran Terrorism <br />Sectors List (collectively, "Scrutinized List of Prohibited Companies"); <br />does not have business -operations in Cuba or Syria; and is not on the <br />State Board of. Administration's "Scrutinized_ List of Prohibited <br />Companies" available under the quarterly reports section at <br />hftps://www.sbafla.com/reporting <br />(4) The Vendor certifies it has completed,and provided an affidavit signed <br />by an officer or a representative of the Vendor under penalty of perjury <br />attesting that the Vendor does not use coercion for labor or services as <br />defined in section 787.06, F.S. <br />CONTRACTOR: <br />Company Name <br />Name and Title <br />Indian River County <br />Recipient's Name <br />DMS -P1-25-07-17 <br />Department's Contract Number <br />DMS -P1-25-07-17 Page 1 of 1 <br />