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U.S. Department of the Interior Certifications Regarding Debarment, Suspension and Other Responsibility Matters, Drug -Free Workplace Requirements and Lobbying Persons signing this form should refer to the regulations referenced Certification Regarding Debarment, Suspension, Ineligibility and below for complete instructions: Voluntary Exclusion - Lower Tier Covered Transactions - (See Appendix B of Subpart D of 43 CFR Part 12.) Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions - The Certification Regarding Drug -Free Workplace Requirements - Alternate prospective primary participant further agrees by submitting this I. (Grantees Other Than Individuals) and Alternate II. (Grantees Who proposal that it will include the clause titled, "Certification are Individuals) - (See Appendix C of Subpart D of 43 CFR Part 12) Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction," provided by the Signature on this form provides for compliance with certification department or agency entering into this covered transaction, requirements under 43 CFR Parts 12 and 18. The certifications shall be without modification, in all lower tier covered transactions and in treated as a material representation of fact upon which reliance will be all solicitations for lower tier covered transactions. See below for placed when the Department of the Interior determines to award the PART A:Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions language to be used or use this form for certification and sign. (See covered transaction, grant, cooperative agreement or loan. Appendix A of Subpart D of 43 CFR Part 12.) CHECK VIF THIS CERTIFICATION IS FOR A PRIMARY COVERED TRANSACTION AND IS APPLICABLE. (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three -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 commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and PART B:Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions (d) Have not within a three -year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default.(2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. CHECK IF THIS CERTIFICATION IS FOR A LOWER TIER COVERED TRANSACTION AND IS APPLICABLE. (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily 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. DI -2010 June 1995 (This form replaces DI -1953, DI -1954, DI -1955, DI -1956 and DI -1963)