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Exhibit G-2 Certification Regarding Debarment, Suspension and Other <br /> Responsibility Matters - Primary Covered Transactions <br /> 1. The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: <br /> A. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or vohmtarily <br /> excluded from covered transactions by any Federal department or agency; <br /> B. Have not within a three (3)year period preceding this proposal been convicted of or had a civil judgment <br /> rendered against them for commission of fraud or a criminal offense in connection with obtaining, <br /> attempting to obtain, or performing a public (Federal, State, or local)transaction or contract under <br /> a public transaction; violation of Federal or State anti-trust statues or commission of embezzlement, <br /> theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving <br /> stolen property; <br /> C. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity <br /> (Federal, State, or local)with commission of any of the offenses enumerated in paragraph(1)(b) <br /> of this certification; and <br /> D. Have not within a three (3)year period preceding this application/proposal had one or more public <br /> transactions (Federal, State and local)terminated for cause or default. <br /> II. Where the prospective primary participant is unable to certify to any of the statements in this certification, <br /> such prospective participant shall attach an explanation to this proposal. <br /> Jacobs Project Management Co. <br /> Consultant(Firm Name) <br /> Signature(Authorized Official of Consultant) Date <br /> Agreement Number: <br /> WSD®T Form 140-089 EF Exhibit G Page 1 of 1 <br /> Revised 1013012014 55 <br />