HomeMy WebLinkAbout2018-046 Aging - TJCOG MIPPA-SHIIP Outreachpi
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Contract Documents:
This contract consists of the folllowing documents, which are incorporated herein by
reference:
a This contract
b. General Terms and Conditions for Public Sector Contracts (Attachment A)
c. Statement of Work (Attachment B)
d. Line Item Budget and Budget Narrative (Attachment C)
e, Certifications Regarding Drug-Free Work-Place, Lobbying, and Debarment,
Suspension and Other Responsibility Matters (Attachment Di)
These d0CUrnents constitute the entire agreement between the Parties, and supersede all
prior oral ) or written statements or agreements.
2. Precedence Among Contract Documents:
In the event of a conflict between or among the terms of the Contract Documents, the terms
in the Contract Document with the highest relative precedence shall prevail. The order of
precedence shall be the order of documents as listed in the contract document section, with
the first-listed document having the highest precedence and the last-listed docurnent
having the lowest precedence. If there are multiple contract amendments, the most recent
amendment shall have the highest precedence and the oldest amendment shall have the
lowest precedence.
C,. Effective Period:
This contract shall be effective 10.1.2017 and shall terminate on 9i.30.2018.
4. Subcontractor's Diuties:
The Subcontractor shall provide the services as described In the Statement of Work
(Attachment B) and in accord�ance with the approved' Line Item Budget and' Budget
Narrative (Attachment C).
5. Provider's Duties:
The Provider shall: pay the Subcontractor in the manner and in the amounts specified in the
contract documents. The total amount paid by the Provider to the Subcontractor under this
contract shall not exceed $ 2
_�,940.00 , (from Grant # 1701 NCMIAA-01) There are no
matching! requirements.
6. Conflict of MInterest Policy/Statement:
The Provider has determined that this Contract is not subject to NCGS 14-C-6- 22 & 23,
7., Reversion of Ulnexpended Funds:
Any Linexpended grant funds shall revert to the Provider upon termination of this contract.
8. Grants:
The SUbcontractor has the responsibiflty to ensure that all sub- grantees, if any, provide all
information necessary to permit the Subcontractor to comply with the standards set forth in
this contract.
9,. Payment Provisions:
Payment provisions of this contract are as follows:
a. An amo�u,niit equal to, o ount will be made upon final
execution of contract; an�d�,
• Pending compliance with mlonithily reporting requirements outlined in, the
Statement of Wo k (Attachment sir final one-half allotment will hie
proicessed and paid upon receipt of the monthly compliance and budget
report due on July 10, 2018.
10. Contract Administrators:
All notices permitted or required to be given by one Party to the otheir and all qUestions,
about the contract from one Party to the IN shall be addressed and delivered to the other
Party's contract administrator. The name, post office address, street address, telephorie
number, fax number, and'email address of the Parties," respective initial contract
administrators are set out below. Either Party may change the name, post office address,
street address, telephone nurnber, fax number, or emall address of its contract
administrator by giving a written 30 day notice to the other Party.
For the Provider:
. ... . ........ .... ..
IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER
I MEANS
Mary K. Warren, Director, Area Agency on Aging
Triangle J Council of Governments Area Agency on Aging SAME
4307 Ernperor Blvd., Suite 110
Durham, NC 27703
Telephone : 919 558-2707
Fax: 919 5149-9390
Email: mwarren@ co .far
For the Subcontractor:
IF DELIVERED BY US POSTAL SERVICE
ige Colunity, Department o"n Agiing
1, Homestead Rd.:
pej Hill,, NC 27516
telephond'. 919-245-2023
Fax: 919963 -2093
Email: bsh!uiford,@orandecOLinty,,nq.,gov
Page 2 of 12
IF DELIIVERED BY ANY OTHER
MEANS
2551 Homestead Rd,
Chapel) Hilll,,NC 27 16',
11. Supplementation of Expenditure of Public Funds:
The Subcontractor assures that funds received pursuant to this contract shall be used only
to supplement, not to supplant, the total amount of federal, state and local public funds that
the Subcontractor otherwise expends for contract services and related prograrns. Funds
received under th,is, contract shall be used to provide additional public funding for Such
services; the funds shall not be u.usedl to reduce the Subcontractor's total expenditure of
other public funds for such services.
12. Disbursements:
As a condition of this contract, the Subcontractor acknowledges and agrees to make
disbursements in accordance with the following requirements:
a. Implement adequate internal controls over d is burse ments;
b. Pre-audit all vouchers presented for payment to determine:
• Validity and accuracy of payment
• Payment due date
• Adequacy of documentation supporting payment
• Legality of disbursement
c. Assure adequate control of signature stamps/plates;
d. Assure adequate control of negotiable instruments; and
e. Implement procedures to insure that account balance is solvent and reconcile the
account monthly,
13, Outsourcing: The subcontractor agrees that it will not outsource any jobs related to this
contract without providing notice to the Provider.
14. Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to
the terms of this agreement.
15. Iran Divesture;
By execution of this agreernent, the Parties certify that they have not been identified nor
utilized the service of any agent or subcontractor on the list created by the NC State
Treasurer pursuant to G.S. 147-86.58.
16. Federal Certifications:
Individual's and Organizations receiving federal funds must ensure compliance with certain
certifications required' by federal laws and regulations, The Subcontractor is hereby
complying with Certifications regarding Nondiscriminaflon, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, and Lobbying.
These assurances and certifications are Attachment D. The signature page is to be signed
by the Subcontractor's authorized representative.
(continued)
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The Subcontractor and the Provider have executed this contract in duplicate origin,als, with one
original being retained b,y each party.
Triangle J Council of Governments
.... ....... .. .
Lee,W,"orsley, Executive Director
PANDUMUM
ignature,
Bonnie Hammersley
Prilnted'Name,
Date
. . ..........
Date
Oran,
�e j�o t a. .... ...
Title,
Provislon for payme onies to fall due under thiis Agreement within the current federal
fiscal year have been made by appropriation duly authorized as required by' tile Local
Government Budget and Fiscal Cointrol Act
BY:
Judy A. WeHer
Finance Director
Triangle J Council of Governments
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Attachment A
Availability of Funds: The parties to this
contract agree and understand that the payment
of the SUMS specified in this contract is
dependent and contingent upon and subject to
the appropriation,, allocation, and availability of
funds for this purpose to the Contractor from
federal, state and local Sources,
Force Majeu!re: Neither party shall be deemed
to be in default of its obligations hereunder if and
so long as it is prevented from performing such
obiligiations by any act of war, hostile foreign
action, nuclear explosion, riot, strikes, civil
insurrection, earthquake, hurricane, tornado, or
other catastrophic natural event or act of God.
Survival of Promises- All promises,
requirements, terms, conditions, provisions,
representations, guarantees, and warranties
contained herein shall survive the contract
expiration or termination date Unless specifically
provided" otherwise herein, or unless superseded
by applicable Federal or State statutes of
limitation,
Copyrights and Ownership of Defiverables:
All deliverable items produced pursuant to this
contract are the exclusive property of the
Contractor. The subcontractor shall not assert a
claim of copyright or other property interest !in
Such deliverables.
Federal Intellectual Property Bankruptcy
Protection Act. The Parties agree that the
Contractor shall be entitled to all rights and
benefits of the Federal intellectual Property
Bankruptcy Protection Act, Public Law 1,00-506,
codified at 11 US.C, 365 (n) and':
any
amendments thereto,
1 111111
Compliance with Laws: The Subcontractor
shall) comply with all laws, ordinances, codes,
rules, regulations, and licensing' requirements
that are applicable to the conduct of its
business, including those of federal, state, and
local agencies having jurisdiction andlor
authority,
Eqival Ernployment Opportunity, The
Subcontractor shall comply with all federal and
State laws relating to equal employment
Opportunity.
Health Insurance Portability and
Accountability Act (HIPAA),, The
Subcontractor agrees that, if the Contractor
determines that some or all of the activities
within the scope of this contract are subject to
the Health linsurance, Portability and
Accountability Act of Il 996, P. L, 104 -51, as
amended ("HIPAK), or its implementing
regulations, it will comply with the H'IIPAA
requirements and will execute such agreements
and ) practices as the Contractor may require to
ensure compliance.
Confidentiality
Confidentiality, Any information, data,
instruments, dOCUrnents, studies or reports given
to or prepared or assembled by the
Subcontractor under this agreement shall be
kept as confidential and not divulged or made
available to any Individual or organization
without the prior written approval of the
Contractor, The Subcontractor acknowledges
that in receiving, storing, processing or
otherwise dealing with any confidential
information it will safeguard and not further
disclose the information except as otherwise
provided in this contract.
93=
Access to Persons and: Records: The
Contractor, County, Area Agency on Aging,
Divlslon of Aging and Adult Services, other
authorized officials of the Contractor, funding
authorities,, the North Carolina State Auditor,
and/or applicable federal agencies shall have
access to persons and records as a result of all
contracts or grants entered into by State
agencies or political subdivisions in accordance
with General Statute 147-64.7. Additionally, as
a State funding authority, the Department of
Health and Human Services shall have access,
to persons and records as a result of all
contracts or grants entered' into by State
agencies or political subdivisions.
Record' Retention: Records shall] not be
destroyed, purged or disposed of without the
express written consent of the Contractor. State
basic records retention policy requires all grant
records to be retained for a minimurn of five
years or until all audit exceptions have been
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resolved, whichever is longer. If the contract is
subject to federal policy and regulations, record
retention may be longer than five years since
records must be retained for a period of three
years following subrnission of the final Federal
Financial Status Report, if applicable, or three
years following the submission of a revised final
Federal Financial Status Report, Also, if any
litigation, claim, negotiation, audit, disallowance
action, or other action involving this Contract has
been started before expiration of the five-year
retention period described above, the records
must be retained until completion of the action
and resolution of all issues which, arise from it, or
until the end of the regular five-year period
described above, whichever is later. The record
retention period for Temporary Assistance for
Needy families (TAIL F) and MEDICAID and
Medical Assistance grants and prograrns rnust
be retained for a minimurn, of ten years.
Warranties and Certifications
Date and Time Warranty: The Subcontractor
warrants that the product(s) and service(s)
furnished pursuant to this contract ("product"'
includes, without limitation, any piece of
equipment, hardware, firmware, middleware,
custorn or commercial software, or internal
components, subroutines,, and interfaces
therein) that perform any date and/or time data
recognition function, calculation, or sequencing
will support a four digit year format and will
provide accurate date/firne data and leap year
calculations. This warranty shall survive the
termination or expiration of this contract.
Certification Regarding Collection! of Taxes,
G. S. 148- g,1 bars the Secretary of
Administration frorn entering into contracts, with
vendors that meet one of the conditions of G.,
105-164.8(b) and yet refuse to collect use taxes
on sales of tangibile personal property to
purchasers in North Carolina, The conditions
include: (a) maintenance of a retail
establishment or office; (b) presence of
representatives in the State that solicit sales or
transact business on behalf of the vendor; and
(c) systernatic exploitation of the market by
media-assisted, rneciia-facifitated, or media-
solicited means. The Contractor certifies that it
and all of its affiliates (if any) collect all required
taxes,
Miscellaneous
Amendment: This contract may not be
amended oralllly or by performance. Any
amendment must be made in written forrn and
executed by dully authorized representatives of
the Contractor.
Severability-, In the event that a court of
competent jurisdiction holds that a provision or
requirement of this contract violates any
applicable law, each such provision or
requirernent shall continue to be enforced to the
extent it is not in violation of law or is not
otherwise unenforceable and all other provisions
and requirements of this contract shall remain in
full force and effect.
Headling!s. The Section and!, Paragraph
headings in these General Terms and
Conditions are not material parts of the
agreement and should not be used to construe
the meaning thereof.
Tirne of the Essence. Time is of the essence in
the performance of this contract.
Key Personnel: The Contractor shall not
replace any of the key personnel) assigned to the
performance of this , contract without the prior
written inotiification of the Contractor. The term
"key personnel," inicludes, any and all persons,
identified by as Such in the contract documents,
and any other persoinis, sub'sequently identified
as key personnel by the written agreement of
the parfiles.
Care of Property: The Subcontractor agrees
that it shall be responsible for the proper custody
and care of any property furnished to it for use in
connection with the performance of this contract
and will reimburse the Contractor for loss of, or
damage to, such property. At the termination of
this contract, the Subcontractor shall contact the
Area Agency on Aging for instructions as to the
disposition of such property and shall comply
with these instructions,
Travel Expenses: Reimbursement to the
Subcontractor for travel' mileage, meals, lodging
and other travel expenses incurred in the
performance of this contract shall not exceed the
rates published in the applicable State rules.
international travel shall not be reimbursed
under this contract.
Sales/Use Tax Refunds: If eligible, the
Subcontractor and all Subcontractors shall. (a)
ask the North Carolina Department of Revenue
for a refund of all sales and ) use taxes paid by
them in the performance of this contract,
pursuant to G.S. 105-16,4,14; and (b) exclude all
refundable sales and use taxes, from @H
reportable expenditures before the expenses are
entered in their reimbursernent reports.
Advertising: The Contractor shall not use the
award of this contract as a part of any news
release or commercial advertising.
Page 6 of 12
Attachimeint B
For the perio,,d 101.1.17 — 9.3I,-1?
This statement should be short summary describing what the Subcontractor does and how the
Subcontractor will use these funds, The terms of the contract between TJIAAA and the
Subcontractor requires that these goals are met for the stated period. The uses of these funds
are not limited to but MUST include the following activities,
1) Conduct a, rninimum of two outreach activities, in each county. A minimuirn, of one
outreach activity must be planned in colll'a bo ration, with a community partner(s) that
serves individuals with mental illness, and a rninirnum of one Outreach activity Must be
held that focuses on people who are aging and/or have disabilities other than!, mentall
illness,.
2) All outreach activities must include Relay for Extra Help materials provided by the Senor
Health Insurance Information (SH11P) office,
3), Coordinate with local SHlIP sites and refer individual's who are likely eligible for LIS and
Msp. 1
4) Submit Client Counseling Contact forms for individual counseling and Public & Media
Outreach forrns, fro outreach events monthly to the TJAAA office for entering in the
national SHIPtalk reporting system,
5) Develop new partnerships for planning and conducting Successful outreach events,
6) Encourage Medicare beneficiaries to participate in local disease prevention: and wellness
activities.
7) Monthly reporting forms for contracted activities and expenses incurred are to be
submitted to electronically by the 1 Ott i of each month for the month prior to Martha
Grove Hipskinn at marthagrove@tjcog.org. A final report of expenses incurred is due
on or before November 10, 20 1;: 8.
The following Scope of Work shoOd address the ways the Subcontractor wiiI accomplish the
gibove expectations and/or willinilgness to comply.
�Page '7 of 12
Planned outreach activities include monthly Welcome to Medicare classes at public
libraries and Get the Mo t Out of Medicare classes in March and August (designed for
those already receiving Medicare) at each Senior Center. Additional outreach will include
participation, in senior events at two outlying community centers in Cedar Grove and the
Eflanid-Cheeks community, We host information tables at Wal'-mart in Hillsbo► -OUgh, at
least quarterly as well) as other community health or service fairs and events. We plan' to
distribute flyers regarding new Medicare cards (May-June) and Open Enrollment
(September) through partner organizations that work with the disabled and mentally
challenged Populations in our community (Club Nova, County Mental Health
Department, Cardinal Innovations, NAMl, etc,). If possible, we will plan ain Open
Enrollment event in conjunction with one of these partners (October-(December 20,1 8).
2. All outreach activities include information about Extra Help and other programs for those
with limited resources or high cost medications.
1 We provide space and coordination for the Orange County SHIP program at our two
senior centers (Hillsborough, and Chapel Hill). Appointments with certified counselors at
least 2 days per rnonth at each center. Ali counselors, are trained to screen and
complete Extra Help applications. Clients who appear to qualify for MSP or Medicaid
are referred to the DSS Social Worker that is located at that Center,
4. Client Contacts and Public/Media Activities are entered) into SHIPTalk by the 15ti" of the
following month.
5 Diuring 2018, our focus will be on! deepening the relationships which we initiated in 2017
These inc�luide directors at low income senior apartments Pied'mioint Community Health
Center, YMCA, and the two outlying community centers. We also plan to re-establish
is
our relatioinshiip with Club No ort
also required to maintain our extensive partnerships with the public libraries, primary
ca:re physician offices, large emlpl'oyers anid seniior center staff,
& Information about preventive services are included in all classes and information tables.
We will continue to identify opportunities to participate in community health and wellness
fairs throughout the year,
7. We will provide a reporting, form, for activities from 10/1/2017 through 2/28/18 by March
10t�' and monthly thereafter.
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Attachment C
For the period 11, 0. 1. 17 — 9.30.18
WITWWWWWORMW Mi I
Using the budget fine items listed below, please provide a budget and a short narrative on how
you plan to spend the fun6ng arnount reflIected in the agreement. Allowable expenses include
telephone, postage, salary /stipends, equipment purchases, internet services, etc. New CMS
regUlations, stipulate that federal dollars cannot be used to purchase food. If any of your
outreach events ji nclude food, it must be paid for from other funds. Additionally, please note that
indirect charges wall not be allowed under this agreement.
I III I
ilIiiii Hill III !I WMAINMEMM
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The undersigned (authorized official) certifies that it will provide a drug-free workplace in accordance with
the Druig-Free Work-Place Act of 1988, 45 Cpl Part 76, subparl: F, The certification set out below is a
material representation of fact upon which reliance will be placed when awardlin,g the grant. False
certification or violation of the certification shall be grounds for suspension of payments, suspensions or
termination of grants or government wide suspension or debarment.
The grantee certifies that it will or will continue to provide a drug-free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against employees for violation of
such prohibition,*
(b) Establishing an on-going drulg-free awareness program to inform employees about—
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug-free workplace;
(3) Any available drug counseling:, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
(c) Making it a requirement that each employee to be engaged in the performance of the grant be
given a copy of this statement required by paragraph (a); above;
(d) Notifying the employee in the statement required by paragraph (a) that, as a condition of
employment under the grant, the employee will—
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in then orkplace no later than five calendar days after such conviction;
(e) Notifying the agency, in writing, within 10 calendar days after receiving notice under
Subparagraph (d)(2), above, from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position title, to
Agency on whose grant activity the convicted employee was working.
Notices, shall include the identification number(s) of each affected grant;
(f) -raking one of the following actions, within 30 days of receiving notice under subparagraph
(d)(2), above, with respect to any employee who is so conOcted-
(1) Taking appropriate personnel action against such an employee,, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, State, or local health,
law enforcement, or other appropriate agency;
(g) Making a good! faith effort to continue to maintain a drug -free workplace through
implementation of paragraphs (a), (b), (c), (d), (e), and (f)�,
The grantee certifies, that, as a condition of the grant, it will not engage in the Unlawful manufacture,
distribution, dispensing, possession or use of a controlled substance in conducting any activity with the
grant.
Page 1, gl of 12
HUMEW
Title 311 of the United States Code, Section 1352, entitled "Limitation on use of appropriated funds to
influence certain Federal contracting and financial transactions," generally prohibits recipients, of Federal
grants and cooperative agreements, from using Federal (appropriated) funds for lobbying the Executive or
Legislative Branches of the Federal Government in connection with a SPECIFIC grant or cooperative
agreement. Section 1352 also requires that each person who request or received a Federal grants or
cooperative agreement must disclose lobbying undertaking with non-Federal (non-appropriated) funds.
These requirements apply to grants and cooperative agreements EXCEEDIN 100,000 in total costs
(45 CFR Part93),
The Undersigned (authorized official) certifies, to the blest of his or her knowledge and belief, that:
(a) No Federal appropriated fund's 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
any agency, a member of Congress, any officer or employee of Congress, or an employee of a
Member of Congress iln connection with the awarding, any Federal contract, the making of any
Federal grant, the niakingi of any Federal loan, the entering into of any cooperative agreement,
and the extension, continuation,, renewal, amendment, or modification of any Federal grant, loan
or cooperative agreernenitp
(b), If any funds other than Federal appropriated: funds have been il 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 Mernber of Congress in
connection with this Federal contract, grant, loan or cooperative agreement, the undersigned
shall complete and subrnit Standard Form - LLL, "Disclosure of Lobbying Activities,," in
accordance with its instructions;
(c) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, contracts and
contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify
and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, US. Coldie, Any person who falls to file the required
certification shall be subject to a civil penalty of not less than $1O,000 and not more than $l100,000 for
each such failure,
3. Debarment, Suspension and Other Responsibift Matters
NOTE: In accordance with 45 CFR Part 76, arnended June 26, 19,95, any debarment, suspension,
proposed debarment or other government wide exclusion initiated under the Federal Acquisition
Regulation (FAR) on or after august 25, 19195, shall Ibe recognized by and effective for Executive Branch
agencies, and participants as an exclusion under 45 CFR Part 76.
The undersigned (authorized official) certifies to the best of his or her knowledge and belief, that
the applicant, defined as the primary participant in accordance with 45 CFR Part 76, and its
principals:
(1) are not presently dleblarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded) by any Federal department or agency;
(2), have not within: a 3-year period preceding this proposal been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal, State, or, local) transaction or
contract under a public transaction, violation of Federal or State antitrust statutes or comrnission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making: false
statements,, or receiving stolen property;
Page 11 of 12
(3) are not presently indicted for or otherwise cdminally olr civilly charged by a governmental entity
(Federal, State, or local) with comnnissllon of any of the offenses enumerated in paragraph (a)(2)
of this certification; and
(4) have not within a 3-year period preceding this app[ication/proposal had one or more public
transactions (Federal, State, or local) terminated for cause or default.
Should, the applicant not be able to provide this certification, an explanation as to why should be
placed under the assurances page in, the application package.
(b) Lower Tier Covered Transactions
The applicant agrees by submitting this proposal that it will include, without modification, the
following clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and
Voluntary Exclusion -- Lower Tier Covered Transaction" (Appendix B to 45 CFR Part 76) in
alll lover tier covered transactions, (i,e., transactions with subgraintees and/or contractors) and in
all solicitations, for lower tier covered transactions;
Certification Regarding Debarment, Suspension, Ineligibility,, and Voluntary Exclusion --
Lower Tier Covered Transactions
(1), The prospective lower tier participant'certifies by submission of this proposal, that neither it
nor its principal's is presently debarred, suspended, proposed for debarment, declared
ineligible, or vollluntarily excluded from participation in this transaction by any Federal
department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in
this certification!, such prospective participant shall attach an explanation to this proposal.
j6d ice Tyler�i Director:
Aythiori*'Cl6 Off! i I� N64te � and Title of, Auth
a 6 ed C rti ingOffic al
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brana6 d6Unty,Qtp.grLme.!2j..6 1 Aging
Subcontractor'Narne Date Submitted
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