Laserfiche WebLink
Attachment G <br /> .certification Regarding <br /> '.Debar.ment, :Suspension , Ineligibility <br /> And U.oluMar "Exclusion <br /> Subcontractor Covered Transactions <br /> (1 ) The prospective subcontractor of the Recipient , certifies, by <br /> submission of this document, that neither it nor its principals is presently debarred , suspended , <br /> proposed for debarment, declared ineligible , or voluntarily excluded from participation in this <br /> transaction by any Federal department or agency . <br /> (2) Where the Recipient's subcontractor is unable to certify to the above statement , the prospective <br /> subcontractor shall attach an explanation to this form . <br /> SUBCONTRACTOR : <br /> By : <br /> Signature Recipient's Name <br /> Name and Title DCA Contract Number <br /> Street Address <br /> City , State , Zip <br /> Date <br /> 26 <br />