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SAMTD/Marion Co. RFI/RFQ#00-08 11 <br />Private Development of Courthouse Square North Block <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION 8~ OTHER <br />INELIGIBILITY & VOLUNTARY EXCLUSION <br />The undersigned, duly authorized representative of <br />hereby ce~tifies or affiRns that: <br />1) Neither it nor its principals is presently debarred, suspended, proposed for <br />debarment, declared ineligible, or voluntarily exduded from partiapation in this <br />transaction by any Federal department or agency; and <br />2) ~ That the contents of any statements submitted on or with this certification are <br />true and accurate, and understands that the provisions of 31 U.S.C. §§ 3801 ~ <br />~gq. Are applicable thereto. <br />(Signature) <br />(Attomey's Signature) <br />(Typed or Printed Title of <br />Authorized Official) <br />(Date) <br />Q6 <br />The undersigned, duly authorized representative of <br />hereby ce~tifies or affirms that: <br />1) It is unable to cerfify that neither it nor its prinapals is presently debamed, <br />suspended, proposed for debaRnent, declared ineligibie, or voluntarily exduded <br />from partiapatwn in this transaction by any Federal department or agency, and <br />has attached an expianation of this inability to this certification; and <br />2) That the oontents of any statements submitted on or with this certification are <br />true and accurate, and understands that the provisions of 31 U.S.C. §§ 3801 ~t. <br />~gq. Are applicable thereto. <br />(Signature) <br />(Attomey's Signature) <br />(Typed or Printed Title of <br />Authorized Representative) <br />(Date) <br />Attachment(s) [If required] <br />