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DocuSign Envelope ID: E51E535C-r71e-44A8-80o0eEAe7rrA0A81 ! <br /> 9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a , <br /> covered transaction knowingh/enLembntnuhvvcrtiu,covoredouuoactinnp/ithuperuoovvhois ! <br /> suspended, debarred, ineligible, or voluntarily excluded from partici ation in this transaction, in . <br /> addition to other remedies available to the Federal Government, the department or agency with <br /> which this transaction originated may pursue available remedies, including suspension, and/or <br /> debarment. <br /> Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion- Lower <br /> Tier Covered Transactions { <br /> ! <br /> (1) The prospective lower tier participant certifies, by submission of this proposal,ibatnukbc,it . <br /> nor its principals is presently debarred, suspended, proposed for debarm ut, declared ineli ible <br /> or voluntarily excluded from participation in this transaction by any Federal department or <br /> 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 /> o"""sw""^^,: <br /> L7L� Agency director ' <br /> ~������x�N���v-- <br /> Signature ]]d* <br /> J/2l/ZOl7 <br /> personalized Patient Home Assistancc <br /> Agency/Organization Date <br /> (Certification signature should be same as Contract si uo1uoo] <br /> . <br /> [ <br /> . <br /> ' <br /> Federal Certification-Debarment(06/15) Page 2 of 2 <br />