Orange County NC Website
DocuSign Envelope ID: D04FOC3D- 1C80- 4E9C- AF06- 1741EB6CCB39 <br />g. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a <br />covered transaction knowingly enters into a lower tier covered transaction with a person who is <br />suspended, debarred, ineligible, or voluntarily excluded from participation 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 - Dower <br />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 ineligible, <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 />UocuSigned by, <br />h* mow Owner <br />4045A3DF29284C7... Title <br />Signature <br />KAH Care, LLC 7/6/2018 <br />Agency /Organization Date <br />(Certification signature should be same as Contract signature.) <br />Federal Certification - Debarment (06/15) Page 2 of 2 <br />