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DocuSign Envelope ID : 31D67EE713 C= -4 % 3-86AC-6C601 CADD1 FF <br /> (3 ) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal , <br /> State , or local) with commission of any of the offenses enumerated in paragraph (a) (2) of this certification ; and <br /> (4) have not within a 3 -year period preceding this application/proposal had one or more public transactions <br /> (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 placed under <br /> 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 following clause titled <br /> " Certification Regarding Debarment, Suspension , Ineligibility, and Voluntary Exclusion -- Lower Tier <br /> Covered Transaction " (Appendix B to 45 CFR Part 76) in all lower tier covered transactions (i . e . , transactions with <br /> subrecipients and/or contractors ) and in all solicitations for lower tier covered transactions : <br /> Certification Regarding Debarment, Suspension , Ineligibility, and Voluntary Exclusion -- Lower Tier <br /> Covered Transactions <br /> ( 1 ) The prospective lower tier participant certifies by submission of this proposal , that neither it nor its <br /> principals is presently debarred , suspended , proposed for debarment , declared ineligible , or voluntarily <br /> excluded from participation in this transaction by any Federal department or agency . <br /> (2) Where the prospective lower tier participant is unable to certify to any of the statements in this <br /> certification , such prospective participant shall attach an explanation to this proposal . <br /> Signature of Authorized Certifying Official Title <br /> DocuSigned by : <br /> county Manager <br /> Subrecipient Name Date Submitted <br /> orange County , North Carolina 2 / 15 / 19 <br /> Page 15 of 15 <br />