2. CERTIFICATION REGARDING DEBARMENT.PDF

Maricopa County — Formal (2020-04-08)

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Attachment 
Certification Regarding: Debarment, Suspension, 
Ineligibility and Voluntary Exclusion 
 
Agreement No.:     DI20-002264 
Description:      Community Action Services Program 
 
 
 
Intergovernmental Agreement 
 
Attachment 8 - Certification Regarding: Debarment, Suspension, Ineligibility and Voluntary 
Exclusion Lower Tier Covered Transactions 
 
This certification is required by the regulations implementing Executive Order 12549-Debarment and Suspension, 29 CFR 
Part 98, Section 98.510, Participant’s responsibilities.  The regulations were published as Part VII of the May 26, 1988 
Federal Register (pages 19160-19211). 
 
(BEFORE COMPLETING CERTIFICATION, READ ATTACHED INSTRUCTIONS WHICH ARE AN INTEGRAL PART OF 
THE CERTIFICATION) 
 
(1) 
The prospective recipient of federal assistance funds certifies, by submission of this proposal, that neither it nor 
its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily 
excluded from participation in this transaction by a federal department or agency. 
 
(2) 
Where the prospective recipient of federal assistance funds is unable to certify any of the statements in this 
certification, such prospective participant shall attach an explanation to this proposal. 
 
 
 
Name of Agency / Organization 
 
Name and Title of Authorized Representative 
 
Signature 
 
Date 
 
 
 
 
 
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Maricopa County
Clint Hickman, Chairman, Maricopa County Board of Supervisors

Attachment 
Certification Regarding: Debarment, Suspension, 
Ineligibility and Voluntary Exclusion 
 
Agreement No.:     DI20-002264 
Description:      Community Action Services Program 
 
 
 
Intergovernmental Agreement 
 
Instructions for Certification 
Debarment, Suspension, Ineligibility and Voluntary Exclusion 
 
1. By signing and submitting this document, the prospective recipient of federal assistance funds is providing the 
certification as set out below. 
 
2. The certification in this clause is a material representation of fact upon which reliance was placed when this 
transaction was entered into.  If it is later determined that the prospective recipient of federal assistance funds 
knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, 
the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment. 
 
3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which 
this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its 
certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 
 
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," 
"participant," "person," "primary covered transaction," "principal," " proposal," and "voluntarily excluded," as used in 
this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive 
Order 12549.  You may contact the person to which this proposal is submitted for assistance in obtaining a copy of 
those regulations. 
 
5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed 
covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person 
who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered 
transaction, unless authorized by the DOL. 
 
6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include 
the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion – Lower Tier 
Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower 
tier covered transactions. 
 
7. A participant in a covered transaction may rely upon a certification of prospective participant in a lower tier covered 
transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless 
it knows that the certification is erroneous.  A participant may decide the method and frequency by which it 
determines the eligibility of its principals.  Each participant may but is not required to check the List of Parties 
Excluded from Procurement or Non-Procurement Programs. 
 
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to 
render in good faith the certification required by this clause.  The knowledge and information of a participant is not 
required to exceed that which is normally possessed by a prudent person in the ordinary course of business 
dealings. 
 
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction 
knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or 
voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal 
government, the DOL may pursue available remedies including suspension and/or debarment. 
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