Laserfiche WebLink
Attachment G <br /> Qce & 'r '%Z sy e gH ' s <br /> y�gr� '' v , y"� , � e % .� � �f � • ri � w d ar� o u�sy� a <br /> a `� scr a t� ,, Z � si� ' "` a fir° a� � � +ir �'� �$.• <br /> �e`xv iso + � �'�� X1r� ti [ . �" F ^' ��5za� r �• w� y � ;£� ` t - <br /> �� ' ate` `�'wR :� ,,. 14W, . �°s• ?� � 4 a, .. r".t w.., x. n n � : sa P� £} `�+ x .u ° . ., •e <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 , proposed for <br /> debarment, declared ineligible , or voluntarily excluded from participation in this transaction by any Federal <br /> 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 /> 24 <br />