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(3) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity <br />(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (a)(2) <br />of this certification; and <br />(4) have not within a 3 -year period preceding this application/proposal had one or more public <br />transactions (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 <br />placed under 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 <br />following clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and <br />Voluntary Exclusion -- Lower Tier Covered Transaction" (Appendix B to 45 CFR Part 76) in <br />all lower tier covered transactions (i.e., transactions with subgrantees and/or contractors) and in <br />all solicitations for lower tier covered transactions: <br />Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion -- <br />Lower 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 <br />ineligible, or voluntarily excluded from participation in this transaction by any Federal <br />department or 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 />64,1,W, <br />Amy M Dalrymple, Chair, Lee County Commissioners <br />Signature of Authorized Ceftif3fing Official Name and Title of Authorized Certifying Official <br />Subcontractor Name Date Submitted <br />Page 12 of 12 <br />