Orange County NC Website
(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 /> Janice Tyler; director <br /> Signature of Authorized Certifying Official Naine and Title of Auth©rued CertifXing Offi�tial, <br /> Orange County.Department orir Aging <br /> Subcontractor Name: Date Submitted <br /> Page 13 of 13 <br />