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ATTACHMENT C <br />CERTIFICATION REGARDING DEBARMENT, SUSPENSION <br />AND OTHER RESPONSIBILITY MATTERS - <br />PRIMARY COVERED TRANSACTIONS <br />Federal Transit Administration (FTA) <br />The prospective Primary Participant (potential contractor for a major third -party contract), <br />certifies to the best of its knowledge and <br />belief, that it and its principals: <br />Are not presently debarred, suspended, proposed for debarment, declared ineligible, <br />or voluntarily excluded from covered transactions by any federal department or <br />agency; <br />2. Have not within a three (3) year period preceding this Bid been convicted of or had a <br />civil judgment rendered against them for commission of fraud or a criminal offense <br />in connection with obtaining, attempting to obtain or performing a public (federal, <br />state or local) transaction or contract under a public transaction; violation of federal <br />or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, <br />falsification or destruction or records, making false statements or receiving stolen <br />property; <br />3. Are not presently indicted for or otherwise criminally or civilly charged by a <br />governmental entity (federal, state or local) with commission of any of the offenses <br />enumerated in Paragraph 2 of this certification; and <br />4. Have not within a three (3) year period preceding this Bid had one or more public <br />transactions (federal, state or local) terminated for cause or default. <br />[If the primary participant (applicant for an FTA grant, or cooperative agreement or potential <br />third -party contractor) is unable to certify to any of the statements in this certification, the <br />participant shall attach an explanation to this certification.] <br />THE PRIMARY PARTICIPANT (POTENTIAL CONTRACTOR FOR A MAJOR THIRD - <br />PARTY CONTRACT) CERTIFIES ORAFFIRMS THE TRUTHFULNESS AND ACCURACY <br />OF THE CONTENTS OF THE STATEMENTS SUBMITTED ON OR WITH THIS <br />CERTIFICATION AND UNDERSTANDS THAT THE PROVISIONS OF 31 USC SECTIONS <br />3801, ET SEQ., ARE APPLICABLE THERETO. <br />Name of Firm: <br />Authorized Signature: <br />Printed Name: <br />Title: <br />Date: <br />KY: <br />