Common use of Instructions for Certification Clause in Contracts

Instructions for Certification. By signing and submitting this CM/GC Contract, the Contractor is providing the certification set out below. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The Contractor shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the Department’s determination whether to enter into this agreement. However, failure of the Contractor to furnish a certification or an explanation shall disqualify it from entering into this agreement. The certification is a material representation of fact upon which reliance was placed when the Department determined to enter into this Contract. If it is later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default. The Contractor shall provide immediate written notice to the Department if at any time the Contractor learns that the certification is erroneous or has become erroneous by reason of changed circumstances. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this provision, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor agrees by entering into this CM/GC Contract that, should this Contract be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this agreement, unless authorized by the Department. The Contractor further agrees by signing this CM/GC Contract that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from this agreement, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Non-procurement List. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provision. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provision, if a participant in this Contract knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default.

Instructions for Certification. By signing and submitting this CM/GC ContractAgreement, the Contractor Contractor, also sometimes referred to herein as a prospective primary participant, is providing the certification set out below. The inability of a person Contractor to provide the certification required below will not necessarily result in denial of participation in this the covered transaction. The Contractor prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the DepartmentCity’s determination whether to enter into this agreementtransaction. However, failure of the Contractor prospective primary participant to furnish a certification or an explanation shall disqualify it such person from entering into participation in this agreementtransaction. The certification in this clause is a material representation of fact upon which reliance was placed when the Department City determined to enter into this Contracttransaction. If it is later determined that the Contractor prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the Department City may terminate this Contract transaction for cause or default. The Contractor prospective primary participant shall provide immediate written notice to the Department City if at any time the Contractor prospective primary participant learns that the its certification is was erroneous when submitted or has become erroneous by reason of changed circumstances. The terms "covered transaction," ", debarred," ", suspended," ", ineligible," ", lower tier covered transaction," ", participant," ", person," ", primary covered transaction," ", principal," "proposal," , proposal and "voluntarily excluded," , as used in this provisioncertification, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor prospective primary participant agrees by entering into this CM/GC Contract that, should this Contract be entered into, signing the Agreement that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this agreementcovered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the DepartmentCity, the City may terminate this transaction for cause or default. The Contractor prospective primary participant further agrees by signing this CM/GC Contract Agreement that it will include the clause titled "“Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered TransactionsTransaction," provided by ” as available through the DepartmentUnited States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from this agreementthe covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement ListPrograms. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provision, if a participant in this Contract knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default.

Instructions for Certification. By signing and submitting this CM/GC ContractAgreement, the Contractor Contractor, also sometimes referred to herein as a prospective primary participant, is providing the certification set out below. The inability of a person contractor to provide the certification required below will not necessarily result in denial of participation in this the covered transaction. The Contractor prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the DepartmentCity’s determination whether to enter into this agreementtransaction. However, failure of the Contractor prospective primary participant to furnish a certification or an explanation shall disqualify it such person from entering into participation in this agreementtransaction. The certification in this clause is a material representation of fact upon which reliance was placed when the Department City determined to enter into this Contracttransaction. If it is later determined that the Contractor prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the Department City may terminate this Contract transaction for cause or default. T The Contractor prospective primary participant shall provide immediate written notice to the Department City if at any time the Contractor prospective primary participant learns that the its certification is was erroneous when submitted or has become erroneous by reason of changed circumstances. The terms "covered transaction," ", debarred," ", suspended," ", ineligible," ", lower tier covered transaction," ", participant," ", person," ", primary covered transaction," ", principal," "proposal," , proposal and "voluntarily excluded," , as used in this provisioncertification, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor prospective primary participant agrees by entering into this CM/GC Contract that, should this Contract be entered into, signing the Agreement that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this agreementcovered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the DepartmentCity, the City may terminate this transaction for cause or default. The Contractor prospective primary participant further agrees by signing this CM/GC Contract Agreement that it will include the clause titled "“Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered TransactionsTransaction," provided by ” as available through the DepartmentUnited States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 C.F.R. part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from this agreementthe covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement ListPrograms. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provision, if a participant in this Contract knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default.

Instructions for Certification. By signing and submitting this CM/GC Contract, the Contractor is providing the certification set out below. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The Contractor shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the Department’s determination whether to enter into this agreement. However, failure of the Contractor to furnish a certification or an explanation shall disqualify it from entering into this agreement. The certification is a material representation of fact upon which reliance was placed when the Department determined to enter into this Contract. If it is later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default. The Contractor shall provide immediate written notice to the Department if at any time the Contractor learns that the certification is erroneous or has become erroneous by reason of changed circumstances. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this provision, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor agrees by entering into this CM/GC Contract that, should this Contract be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this agreement, unless authorized by the Department. The Contractor further agrees by signing this CM/GC Contract that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from this agreement, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Non-procurement List. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provisionParagraph 5 of these instructions, if a participant in this Contract a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily voluntary excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. The prospective recipient of Federal assistance funds certifies that neither it nor its principals are 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 recipient of Federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. CONTRACTOR: CONTRACT NUMBER: NAME & TITLE OF AUTHORIZED REPRESENTATIVE SIGNATURE DATE EXHIBIT E CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans and Cooperative Agreements Contractor and each lobbyist firm, as defined in Los Angeles County Code Chapter 2.160 (Ordinance 93-0031), retained by Contractor, shall fully comply with the requirements as set forth in said County Code. Contractor must also certify in writing that it is familiar with the Los Angeles County Code Chapter 2.160 and that all persons acting on behalf of Contractor will comply with the County Code. Failure on the part of Contractor and/or Lobbyist to fully comply with the County’s Lobbyist requirements shall constitute a material breach of the contract upon which the LAHSA may immediately terminate this Contract AGREEMENT, and Contractor shall be liable in a civil action. Contractor is prohibited by the Department of Interior and Related Agencies Appropriations Act, known as the Xxxx Amendments, and HUD’s 24 C.F.R. 87, from using federally appropriated funds for cause the purpose of influencing or defaultattempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, loan or cooperative agreement, and any extension, continuation, renewal, amendment or modification of said documents. Contractor must certify in writing that it is familiar with the Federal Lobbyist Requirements and that all persons and/or subcontractors acting on behalf of Contractor will comply with the Lobbyist Requirements. Failure on the part of Contractor or persons/subcontractors acting on behalf of Contractor to fully comply with the Federal Lobbyist Requirements shall be subject to civil penalties. The undersigned certifies, to the best of his or her knowledge and belief, that: No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan or cooperative agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL “Disclosure of Lobbying Activities” in accordance with its instructions.

Instructions for Certification. By signing this certification and submitting it with this CM/GC Contractproposal, the Contractor prospective recipient of State and/or Federal assistance funds is providing the certification set out below. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The Contractor shall submit an explanation of why it cannot provide the certification as set out below. The certification or explanation will be considered in connection with the Department’s determination whether to enter into this agreement. However, failure of the Contractor to furnish a certification or an explanation shall disqualify it from entering into this agreement. The certification clause is a material representation of fact upon which reliance was placed when the Department determined to enter into this Contracttransaction was entered into. If it is later determined that the Contractor prospective recipient of State and/or Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the State and/or Federal GovernmentGovernment may pursue available remedies, the Department may terminate this Contract for cause or defaultincluding suspension and/or debarment. The Contractor prospective recipient of State and/or Federal assistance funds shall provide immediate written notice to the Department person to which this proposal is submitted if at any time the Contractor prospective recipient of State and/or Federal assistance funds learns that the its certification is was erroneous when submitted or has become erroneous by reason of changed circumstances. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this provisionclause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. The Contractor prospective recipient of State and/or Federal assistance funds further agrees by entering into submitting this CM/GC Contract proposal that, should this Contract the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction transactions with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this agreementcovered transaction, unless authorized by the Department. The Contractor prospective recipient of State and/or Federal assistance funds further agrees by signing submitting this CM/GC Contract proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor A participant covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from this agreementthe covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each For contracts involving Federal funds, each participant may, but is not required to, to check the Non-procurement ListList of Parties Excluded from Procurement or Nonprocurement Programs. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provisionparagraph 5 of these instructions, if a participant in this Contract a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the State and/or Federal Government, the Department may terminate pursue available remedies, including suspension and/or debarment. In witness hereto, the parties have executed said agreement according to the terms, conditions, and effective dates listed in the agreement. APPROVED FOR THE CONTRACTOR: APPROVED FOR THE SUBCONTRACTOR: SIGNATURE SIGNATURE Xxxxx Xxxxx TYPED NAME DATE TYPED NAME DATE Executive Director TITLE/POSITION TITLE/POSITION CONCURRENCE OF THE COLLECTIVE BARGAINING AGENT Is the occupation(s) in which employment and training is to be offered in this Contract agreement subject to a collective bargaining agreement?   YES X NO If yes, has there been concurrence by the appropriate representative as to the On-The-Job Training Program and the rates of pay associated therewith?   YES   NO     TYPED NAME TITLE SIGNATURE DATE   AFFILIATION SUBSIDIZED TRANSITIONAL EMPLOYMENT INVOICE – POCONO COUNTIES WIA Subcontractor: Invoice for cause or defaultthe Month of: Address: MAY 2019 NAME S.S. # TRAINING TITLE xxx-xx-   REIMBURSEMENT PERIOD MON TUE WED THUR FRI SAT SUN TOTAL 5/1/19 TO 5/5/19 REIMBURSEMENT 5/6/19 TO 5/12/19 TOTAL TRAINING HOURS THIS INVOICE X $9.00 = A. 5/13/19 TO 5/19/19 SOCIAL SECURITY Total from A: X .0765 = B. 5/20/19 TO 5/26/19 WORKMANS COMPENSATION Total from A: X = C. 5/27/19 TO 5/31/19 TOTAL REIMBURSEMENT REQUESTED (Total of A, B and C) TOTAL HOURS *** PLEASE NOTIFY THIS OFFICE OF ALL TRAINEE TERMINATIONS AS SOON AS POSSIBLE *** EMPLOYER CERTIFICATION I certify that the information presented on this invoice is accurate and conforms to the personnel and payroll records.

Instructions for Certification. By signing and submitting this CM/GC Contract, the Contractor is providing the certification set out below. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The Contractor shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the Department’s determination whether to enter into this agreement. However, failure of the Contractor to furnish a certification or an explanation shall disqualify it from entering into this agreement. The certification is a material representation of fact upon which reliance was placed when the Department determined to enter into this Contract. If it is later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default. The Contractor shall provide immediate written notice to the Department if at any time the Contractor learns that the certification is erroneous or has become erroneous by reason of changed circumstances. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this provision, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor agrees by entering into this CM/GC Contract that, should this Contract be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this agreement, unless authorized by the Department. The Contractor further agrees by signing this CM/GC Contract that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from this agreement, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, to check the Non-procurement List. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provision. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provision, if a participant in this Contract knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default.

Instructions for Certification. By signing and submitting this CM/GC ContractAddendum, the Contractor Vendor, also sometimes referred to herein as a prospective primary participant, is providing the certification set out below. The inability of a person Vendor to provide the certification required below will not necessarily result in denial of participation in this the covered transaction. The Contractor prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the DepartmentCity’s determination whether to enter into this agreementtransaction. However, failure of the Contractor prospective primary participant to furnish a certification or an explanation shall disqualify it such person from entering into participation in this agreementtransaction. The certification in this clause is a material representation of fact upon which reliance was placed when the Department City determined to enter into this Contracttransaction. If it is later determined that the Contractor prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal GovernmentCity, the Department City may terminate this Contract transaction for cause or default. The Contractor prospective primary participant shall provide immediate written notice to the Department City if at any time the Contractor prospective primary participant learns that the its certification is was erroneous when submitted or has become erroneous by reason of changed circumstances. The terms "covered transaction," ", debarred," ", suspended," ", ineligible," ", lower tier covered transaction," ", participant," ", person," ", primary covered transaction," ", principal," "proposal," , proposal and "voluntarily excluded," , as used in this provisioncertification, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department for assistance in obtaining a copy of those regulations. The Contractor prospective primary participant agrees by entering into this CM/GC Contract that, should this Contract be entered into, signing the Addendum that it shall not knowingly enter into any lower tier covered transaction transactions with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, ineligible or voluntarily excluded from participation in this agreementcovered transaction. If it is later determined that the prospective primary participant knowingly entered into such a transaction, unless authorized by in addition to other remedies available to the DepartmentCity, the City may terminate this transaction for cause or default. The Contractor prospective primary participant further agrees by signing this CM/GC Contract Addendum that it will include the clause titled "“Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered TransactionsTransaction," provided by ” as available through the DepartmentUnited States Department of Homeland Security, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, ineligible or voluntarily excluded from this agreementthe covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement ListPrograms. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provision, if a participant in this Contract knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department may terminate this Contract for cause or default.

Instructions for Certification. By signing this certification and submitting it with this CM/GC Contractproposal, the Contractor prospective recipient of State and/or Federal assistance funds is providing the certification set out below. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The Contractor shall submit an explanation of why it cannot provide the certification as set out below. The certification or explanation will be considered in connection with the Department’s determination whether to enter into this agreement. However, failure of the Contractor to furnish a certification or an explanation shall disqualify it from entering into this agreement. The certification clause is a material representation of fact upon which reliance was placed when the Department determined to enter into this Contracttransaction was entered into. If it is later determined that the Contractor prospective recipient of State and/or Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the State and/or Federal GovernmentGovernment may pursue available remedies, the Department may terminate this Contract for cause or defaultincluding suspension and/or debarment. The Contractor prospective recipient of State and/or Federal assistance funds shall provide immediate written notice to the Department person to which this proposal is submitted if at any time the Contractor prospective recipient of State and/or Federal assistance funds learns that the its certification is was erroneous when submitted or has become erroneous by reason of changed circumstances. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this provisionclause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the Department person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. The Contractor prospective recipient of State and/or Federal assistance funds further agrees by entering into submitting this CM/GC Contract proposal that, should this Contract the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction transactions with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this agreementcovered transaction, unless authorized by the Department. The Contractor prospective recipient of State and/or Federal assistance funds further agrees by signing submitting this CM/GC Contract proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. The Contractor A participant covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from this agreementthe covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each For contracts involving Federal funds, each participant may, but is not required torequired, to check the Non-procurement ListList of Parties Excluded from Procurement or Nonprocurement Programs. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this provisionclause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Except for transactions authorized under this provisionparagraph 5 of these instructions, if a participant in this Contract a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the State and/or Federal Government, the Department may terminate pursue available remedies, including suspension and/or debarment. In witness hereto, the parties have executed said agreement according to the terms, conditions, and effective dates listed in the agreement. APPROVED FOR THE CONTRACTOR: APPROVED FOR THE SUBCONTRACTOR: SIGNATURE SIGNATURE Xxxxxx Xxxxxxx   TYPED NAME DATE TYPED NAME DATE Executive Director   TITLE/POSITION TITLE/POSITION CONCURRENCE OF THE COLLECTIVE BARGAINING AGENT Is the occupation in which employment and training is to be offered in this agreement subject to a collective bargaining agreement? YES NO If yes, has there been concurrence by the appropriate representative as to the On-The-Job Training Program and the rates of pay associated therewith? YES NO     TYPED NAME TITLE SIGNATURE DATE   AFFILIATION ON-THE-JOB TRAINING MONTHLY INVOICE - POCONO COUNTIES WDB Invoice #   Subcontractor: Subcontract Period: FROM TO Address: Invoice Period: FROM   TO   Contract Number: CFDA Title and Number: Error: Reference source not found Contract Amount: NAME S.S. # TRAINING TITLE MAXIMUM TRAINING HRS. TRAINING HRS. REMAINING HOURLY FIXED UNIT COST X TRAINING HRS. THIS INVOICE = REIMBURSEMENT REIMBURSEMENT PERIOD MON TUE WED THUR FRI SAT SUN TOTAL TRAINEE EVALUATION   TO   EXCELLENT SATISFACTORY UNSATISFACTORY   TO   ATTENDANCE   TO   ATTITUDE   TO   JOB PERFORMANCE   TO   COMMENTS: TOTAL *** PLEASE NOTIFY THE OFFICE LISTED BELOW OF TRAINEE TERMINATIONS AS SOON AS POSSIBLE *** EMPLOYER CERTIFICATION I certify that the information presented on this invoice is accurate and conforms to the personnel and payroll records. X X Subcontractor’s Authorized Signature Title Trainee’s Signature SUBMIT THIS INVOICE TO: Xxxxx County Job Training Xxxxx County Courthouse 000 Xxxxx Xxxxxx Xxxxxxxxx, XX 00000 Phone: (000) 000-0000 Ext. 4150 Fax: (000) 000-0000 THIS SECTION FOR AGENCY USE ONLY Total Monthly Reimbursement __________________ Total Reimbursement to Date ___________________ PROGRAM DIRECTOR AUTHORIZATION I authorize payment of the reimbursement for cause or defaultthis invoice.