Laserfiche WebLink
GRANTEE <br /> <br /> By: <br /> <br /> Title: <br /> <br /> Date: <br /> <br />CASS COUNTY COMMISSION CMAIR <br /> <br />STATE OF NORTH DAKOTA, BY AND THROUGH ITS <br />DEPARTMENT OF CORRECTIONS AND REHABILITATION <br />AND THE DIVISION OF JUVENILE SERVICES <br /> <br />By: <br /> <br />Title: Director <br /> <br />CERTIFICATION REGARDING DEBARMENT~ SUSPENSION, INELIGIBILITY~ <br />AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS <br /> <br />This certification is required by the regulations implementing Executive Order 12549, <br />Debarment and Suspension, 28 C.F.R. Part 67, Section 67.510, Participants' responsibilities. <br />The regulations were published as Part VII of the May 26, 1988, Federal Register (,pages <br />19160-19211). <br /> <br /> 1. The prospective lower tier participant certifies, by submission of this proposal, that <br /> neither it nor its principals are presently debarred, suspended, proposed for <br /> debarment, declared ineligible, or voluntarily excluded from participation in this <br /> transaction by any federal department or agency. <br /> 2. Where the 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 <br /> proposal. <br /> <br /> CASS COUNTY <br /> <br />Name of Grantee <br /> <br />Signature of Authorized Official Date <br /> <br /> ALON WIELA~, COMMISSION CHAIR <br />Printed Name and Title of Authorized Official <br /> <br />4 <br /> <br /> <br />