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Instructions <br /> Under Executive Order 12549, an individual or organization .debarred or e~acluded from <br /> particlpation in Federal assistance.or benefit programs may not receive any assistance award <br /> under a Federal program, or a subagreement thereunder for $25,000 or more. <br /> Accordingly, each prospective reclpient of an EPA grant, loan, or cooperative agreement and any <br /> contract or subs regiment 'cl thereunder must ete the attached certification or <br /> 9 I~ I~ comp) <br /> provide an explanation why they cannot. For further details, see 40 CFR 32.510, Participants' <br /> responsibilities, in the regulation. <br /> VVh~ere to submit <br /> The prospective EPA grant, loan, or cooperative agreemerrt reapient must return the signed <br /> certifioation or explanation with its application to the appropriate EPA Headquarters or Regional <br /> office, as required in the application instnactions. <br /> A prospective prime contractor must submit a completed certification or explanation to the <br /> individual or organization awarding the contract. <br /> Each prospective subcontractor must submit a completed certification or explanation to the prime <br /> contractor for the project. _ <br /> <br /> - How to Obtain Fom~s: . <br /> EPA includes the certification fom~, instnactions, and a copy of its implementing regulation* (40 . <br /> GFR Part 32) in each application kit. Applicarrts may reproduce these materials. as needed and <br /> provide them to their prospective prime contractor; who, in turn, may repr~oduce~and provide them <br /> to prospective.subcontractors: . _ <br /> Add'r<ional copies/assistance maybe requested from: <br /> <br /> w _ _ ~ _Offiice of-Grantsand Debam~ent- _ . _ - _ <br /> . ~ ~ Suspension and Debam~ent Division <br /> U.S. Environmental Protection AOency <br /> 401 M. Street, SW <br /> - Washington, D.C. 204060 <br /> . (Telephone: (202} 260-8025} <br /> EPA Form 5700-49 (11-88) <br /> * Regulations available @ httpJ/www.access.gpo.gov/nara/cfr/waisidx/40cfrvl.html <br /> 1 J2 <br /> 1 ~ ~ <br /> _ _ _ <br /> <br />