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25 <br /> Instructions for Certification <br /> 1. By signing and submitting this form,the prospective primary participant is providing the certification <br /> set out on the reverse side in accordance with these instructions. <br /> 2. The inability of a person to provide the certification required below will not necessarily result in denial <br /> of participation in this covered transaction.The prospective participant shall submit an explanation of why it cannot <br /> provide the certification set out on this form.The certification or explanation will be considered in connection with <br /> the department or agency's determination whether to enter into this transaction.However,failure of the prospective <br /> primary participant to furnish a certification or an explanation shall disqualify such person from participation in this <br /> transaction. <br /> 3. The certification in this clause is a material representation of fact upon which reliance was placed when <br /> the department or agency determined to enter into this transaction. if it is later determined that the prospective <br /> primary participant knowingly rendered an erroneous certification,in addition to other remedies available to the <br /> Federal Government,the department or agency may terminate this transaction for cause or default. <br /> 4. The prospective primary participant shall provide immediate written notice to the department or agency <br /> to whom this proposal is submitted if at any time the prospective primary participant learns that its certification was <br /> erroneous when submitted or has become erroneous by reason of changed circumstances. <br /> 5. The terms"covered transaction,'"debarred,""suspended, "ineligible,""lower tier covered transaction,' <br /> "participant,""person, 11"primary covered transaction,""principal,""proposal,"and"voluntarily excluded,"as <br /> used in this clause,have the meanings set out in the Definitions and Coverage sections of the rules implementing <br /> Executive Order 12549.You may contact the department or agency to which this proposal is being submitted for <br /> assistance in obtaining a copy of those regulations. <br /> 6. The prospective primary participant agrees by submitting this form that,should the proposed covered <br /> transaction be entered into,it shall not knowingly enter into any lower tier covered transaction with a person who is <br /> debarred,suspended,declared ineligible,or voluntarily excluded from participation in this covered transaction, <br /> unless authorized by the department or agency entering into this transaction. <br /> 7. The prospective primary participant further agrees by submitting this form that it will include the clause titled <br /> "Certification Regarding Debarment,Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered <br /> Transactions,"provided by the department or agency entering into this covered transaction,without modification,in <br /> all lower tier covered transactions and in all solicitations for lower tier covered transactions. <br /> S. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier <br /> covered transaction that it is not debarred,suspended, ineligible,or voluntarily excluded from the covered <br /> transaction,unless it knows that the certification is erroneous.A participant may decide the method and frequency <br /> by which it determines the eligibility of its principals.Each participant may,but is not required to,check the <br /> Nonprocurement List. <br /> 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records <br /> in order to render in good faith the certification required by this clause.The knowledge and information of a <br /> participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of <br /> business dealings. <br /> 10. Except for transactions authorized under paragraph 6 of these instructions,if a participant in a covered <br /> transaction knowingly enters into a lower tier covered transaction with a person who is suspended,debarred, <br /> ineligible,or voluntarily excluded from participation in this transaction,in addition to other remedies available to <br /> the Federal Government,the department or agency may terminate this transaction for cause or default. <br /> 2 <br /> Form AD- 1 047(1/92) <br /> *U.S.GPD:19.99-757-034185012 <br />