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DocuSign Envelope ID: A07C4620 -D9F0- 4228- 9B2F- lD499E5F8796 <br />9. Except for transactions authorized in paragraph 5 of these instructions, if 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 - Lower <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 />Docu''Signed by, <br />0bV'&& A.. FAM'46t& Agency director <br />73BC2FODOAA94BE... <br />Signature Title <br />Personalized Patient Home Assista7r%?c2/2018 <br />Agency /Organization Date <br />(Certification signature should be same as Contract signature.) <br />Federal Certification - Debarment (06115) Page 2 of 2 <br />