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EPA Project Control Number ®`rlr� E PA ti • P 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 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 a (Federal, State . or local) with commission of any of the offenses enumerated in paragraph (1b) of this certification ; and (d) -Have riot -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 _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. Ker± r_ etY: R . Macht , Chairman Typeo Name & Ti a ct <.ut- urized F Pres ntative G 09 - 16 - 2003 Signa,Cire o uthorr_ =c =aoresenta.tive Date �! I am urs2 = cSrtify to the above statements . My explanation is attached. SPA Form 570049 _ Page 21