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2016-310 Aging - Triangle J Council of Governments Area Agency on Aging - Contract for Provision of Co. Based MIPPA Services
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2016-310 Aging - Triangle J Council of Governments Area Agency on Aging - Contract for Provision of Co. Based MIPPA Services
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Last modified
7/26/2019 4:56:31 PM
Creation date
6/30/2016 9:26:00 AM
Metadata
Fields
Template:
Contract
Date
10/1/2015
Contract Starting Date
10/1/2015
Contract Ending Date
9/30/2016
Contract Document Type
Agreement
Amount
$3,500.00
Document Relationships
R 2016-310 Aging - Triangle J COG Area Agency on Aging for Medicare Improvements for Patients and Providers Act (MIPPA)
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2016
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(3)are not presently indicted for or otherwise criminally or civilly charged by a governmental entity <br /> (Federal, State, or local)with commission of any of the offenses enumerated in paragraph (a)(2) <br /> of this certification; and <br /> (4) have not within a 3-year period preceding this application/proposal had one or more public <br /> transactions (Federal, State, or local)terminated for cause or default. <br /> Should the applicant not be able to provide this certification, an explanation as to why should be <br /> placed under the assurances page in the application package. <br /> (b) Lower Tier Covered Transactions <br /> The applicant agrees by submitting this proposal that it will include, without modification, the <br /> following clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and <br /> Voluntary Exclusion --Lower Tier Covered Transaction" (Appendix B to 45 CFR Part 76) in <br /> all lower tier covered transactions(i.e., transactions with subgrantees and/or contractors)and in <br /> all solicitations for lower tier covered transactions: <br /> Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion -- <br /> Lower Tier Covered Transactions <br /> (1) The prospective lower tier participant certifies by submission of this proposal, that neither it <br /> nor its principals is presently debarred, suspended, proposed for debarment, declared <br /> ineligible, or voluntarily excluded from participation in this transaction by any Federal <br /> department or agency. <br /> (2) Where the prospective lower tier participant is unable to certify to any of the statements in <br /> this certification, such prospective participant shall attach an explanation to this proposal. <br /> In it <br /> 1 D rtmn ©i c <br /> Sign; r ctt A&w- <br /> 'A"O" h' F ing Official Name and',Tltlb Qf Aufor)zc>[Gertifyng Official <br /> rartrte-Caunfv Northrolina k �4 , .. . <br /> ., ubconfracar N�}e '>»,» fe Su�m�ffed <br /> Page 12 of 12 <br />
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