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EPA Project Control Number ®G,® E PA t 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, or 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 CM 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 focal) 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 net presently indicted for or otherwise criminally or civilly charged by a govemment entity (Federal , State, or local) with commission of any of the offenses enumerated in paragraph (1 (b ) of this certification ; and (d) -Have not -within a --three-year period -preceding this - application/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 ,U SC Sec. 1001 , a false statement may result in a fine of up to $ 10 , 000 or imprisonment for up to 5 .years , or both. Kenr_ etr_R R . Macht , Chairman Typed Name & Ti e cr 'Authurized Peres ntative / //1 09 - 16 - 2003 / �" Date Sign . re o uthoriz . c nenresentztive i am un: a2 ! e ` c certify to the above statements . My explanation is attached . EFA Form 5700-49 Page 21