Appendix B Suspension and Debarment Certification NOTE: This certificate must be completed for all new and renewal contract years when the contract exceeds $25,000. U. S. DEPARTMENT OF AGRICULTURE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -- LOWER TIER COVERED TRANSACTIONS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, Title 7 CFR Part 3017, Section 3017.510, Participants' Responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON THE NEXT PAGE The prospective tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Organization Name PR/Award Number or Project Name Names(s) and Title(s) of Authorized Representative(s) Signature(s) Date Instructions for Certification
Appendix B Suspension and Debarment Certification NOTE: This certificate must be completed for all new and renewal contract years when the contract exceeds $25,000. U. S. DEPARTMENT OF AGRICULTURE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -- LOWER TIER COVERED TRANSACTIONS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, Title 7 CFR Part 3017, Section 3017.510, Participants' Responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON THE NEXT PAGE The prospective tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Organization Name PR/Award Number or Project Name Names(s) and Title(s) of Authorized Representative(s) Signature(s) Date Instructions for Certification
NSLP_FSMC_RFP_Template.docx