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Emsnscwcr MEDICAL SERVICES Fmsr Rsspnmocx Aovxwcso L/pc SUPPORT Aanssmcmr(7/l/ZO19) <br />1. , under penalty of perjury, certifies that, except as noted below, the City, its principal, <br />and any named subcontractor: <br />1.1 Is not currently under suspension, debarment, voluntary exclusion, or determination <br />of ineligibility by any Federal agency; <br />1-2 Has not been suspended, debarred, voluntarily excluded or determined ineligible by <br />any Federal agency within the past three years; <br />L3 Does not have a proposed debarment pending; and, <br />1.4 Has not been indicted, convicted, or had a civil judgment rendered against it by a <br />court of competent jurisdiction in any matter involving fraud or official misconduct <br />within the past three years. <br />2. If there are any exceptions to this certification, insert the exceptions in the following space. <br />3. Exceptions shall not necessarily result in denial of award, but shall be considered in <br />determining Proposer responsibility, For any exception noted above, indicate below to <br />whom it applies, initiating agency, and dates of action. <br />4. Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certification is part of the Agreement. Signing the Agreement on the signature <br />portion thereof shall also constitute signature of this Certification. <br />Page F1'-3 <br />