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Attachment H <br /> Certification Regarding <br /> Debarment, Suppenslon, Ineligibility <br /> 'And' Volluntary Exclusion <br /> Contractor Covered Transactions <br /> ( 1 ) The prospective contractor of the Recipient , Indian River County , certifies , by submission of this <br /> document, that neither it nor its principals is presently debarred , suspended , proposed for <br /> debarment, declared ineligible , or voluntarily excluded from participation in this transaction by any <br /> Federal department or agency . <br /> ( 2 ) Where the Recipient' s contractor is unable to certify to the above statement , the prospective <br /> contractor shall attach an explanation to this form . <br /> Indian River County <br /> Contractor' s Name and Title Recipient' s Name <br /> 06DB- 3C - 10-40-01 -W 14 <br /> Signature DCA Contract Number <br /> Firm <br /> Street Address <br /> City , State , Zip <br /> Date <br /> NOTE : SUBMISSION OF THIS FORM DOES NOT PRECLUDE RECIPIENT' S COMPLETION AND <br /> SUBMISSION OF THE " BIDDING INFORMATION AND CONTRACTOR ELIGIBILITY FORM . " <br /> 33 <br />