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City of Eugene /State of Oregon -Dept. of Transportation <br /> Agreement No. 25,384 <br /> 1. Are not presently debarred, suspended, The Contractor is advised that by signing this <br /> proposed for debarment, declared Contract, the Contractor is deemed to have <br /> ineligible or voluntarily excluded from signed this certification. <br /> covered .transactions by any Federal <br /> department or agency; II. INSTRUCTIONS FOR CERTIFICATION <br /> REGARDING DEBARMENT, SUSPENSION, <br /> 2. Have not within a three-year period AND OTHER RESPONSIBILITY MATTERS- <br /> preceding this Contract been convicted PRIMARY COVERED TRANSACTIONS <br /> of or had a civil judgment rendered <br /> against them for commission of fraud or 1. By signing this Contract, the Contractor <br /> a criminal offense in connection with is providing the certification set out <br /> obtaining, attempting to obtain or below. <br /> performing a public (federal, state or <br /> local) transaction or contract under a 2. The inability to provide the certification <br /> public transaction; violation of federal or required below will not necessarily result <br /> state antitrust statutes or commission of in denial of participation in this covered <br /> embezzlement, theft, forgery, bribery transaction. The Contractor shall <br /> falsification or destruction of records, explain why he or she cannot provide <br /> making false statements or receiving the certification set out below. This <br /> stolen property; explanation will be considered in <br /> connection with the Department <br /> 3. Are not presently indicted for or determination to enter into this <br /> otherwise criminally or civilly charged transaction. Failure to furnish an <br /> by a governmental entity (federal, state explanation shall disqualify such person <br /> or local) with commission of any of the from participation in this transaction. <br /> offenses enumerated in paragraph <br /> (1)(b) of this certification; and 3. The certification in this clause is a <br /> material representation of fact upon <br /> 4. Have not within a three-year period which reliance was placed when the <br /> preceding this Contract had one or more Department determined to enter into this <br /> public transactions (federal, state or transaction. If it is later determined that <br /> local) terminated for cause or default. the Contractor knowingly rendered an <br /> erroneous certification, in addition to <br /> <br /> Where the Contractor is unable to certify to any other remedies available to the Federal <br /> of the statements in this certification, such Government or the Department may <br /> prospective participant shall submit a written terminate this transaction for cause of <br /> explanation to Department. default. <br /> List exceptions. For each exception noted, 4. The Contractor shall provide immediate <br /> indicate to whom the exception applies, initiating written notice to the Department if at any <br /> agency, and dates of action. If additional space time the Contractor learns that its <br /> is required, attach another page with the certification was erroneous when <br /> <br /> following heading: Certification Exceptions submitted or has become erroneous by <br /> continued, Contract Insert. reason of changed circumstances. <br /> EXCEPTIONS: 5. The terms "covered transaction", <br /> "debarred", "suspended", "ineligible", <br /> Exceptions will not necessarily result in denial of "lower tier covered transaction", <br /> award, but will be considered in determining "participant", "person", "primary covered <br /> Contractor responsibility. Providing false transaction", "principal", and "voluntarily <br /> information may result in criminal prosecution or excluded", as used in this clause, have <br /> administrative sanctions. the meanings set out in the Definitions <br /> and Coverage sections of the rules <br /> Page 13 of 19 <br /> <br />