2003-246 - Laserfiche WebLink

Home Browse Search

i , . 1 i A EPA Project Control Number EPA S United States Environmental Protection Agency Washington, DC 20460 Certification Regarding , Debarment , Suspension , and Other Responsibility Matters The prospective participant certifies to the best of its knowledge and belief that it and its principals: (a) Are not presently debarred , suspended , proposed for debarment, declared ineligible, for voluntarily excluded from covered transactions by any Federal department. or agency; (b) Have not within a three year period preceding this proposal been convicted of or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain , or performing a public (Federal, State, or local) transaction or contract under a public transaction ; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal , State, or local) with commission of any of the offenses enumerated in paragraph (1b) of this certification ; and (d ) -Have not-within a -- three-year period -preceding this - appHeation/proposal had one or more public transactions (Federal ; State, or local ) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award : In addition , under 18 _USC Sec. 1001 , a false statement may result in a fine of up to $ 10 , 000 or imprisonment for up to 5 years , or both. Kenneth R . Macht , Chairman Typed Name & Ti Authorized Re res ntative 09 - 16 - 2003 Sign re o uthorized pre ntative Date ❑ I am unable to certify to the above statements . My explanation is attached . EPA Form 570049 ( 11 -88) Page 21