ATTM 003 CERTIFICATION REGARDING DEBARMENT SUSPENSION INELIGIBIL.docx

This is a Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion form for lower tier covered transactions related to South Carolina's Medicaid Eligibility Operations Services contract opportunity. The document serves as a compliance certification that prospective lower tier participants must complete and submit with their proposals. By signing and submitting the certification, the prospective lower tier participant attests that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in federal transactions by any federal department or agency, as defined under 45 CFR Part 76.

The certification requires that if a prospective lower tier participant is unable to certify compliance with the debarment and suspension requirements, it must attach an explanation to its proposal. Additionally, the prospective lower tier participant agrees to include this certification clause without modifications in all lower tier covered transactions and in all solicitations for lower tier covered transactions related to this opportunity. The document requires authorization by signature from an authorized representative of the proposing organization.