Certification The details contained in this document are an accurate statement of the duties, responsibilities and other requirements of the position. Manager / Supervisor Name Signature or HE Number Date Dept. / Division Head Name Signature or HE Number Date As Occupant of the position I have noted the statement of duties, responsibilities and other requirements as detailed in this document. Occupant Name Signature or HE Number Date Effective Date HSS Registration Details (to be completed by HSS)
Certification Regarding Debarment Party certifies under pains and penalties of perjury that, as of the date that this Agreement is signed, neither Party nor Party’s principals (officers, directors, owners, or partners) are presently debarred, suspended, proposed for debarment, declared ineligible or excluded from participation in Federal programs, or programs supported in whole or in part by Federal funds. Party further certifies under pains and penalties of perjury that, as of the date that this Agreement is signed, Party is not presently debarred, suspended, nor named on the State’s debarment list at: xxxx://xxx.xxxxxxx.xxx/purchasing/debarment