1-Debarred Suspended Disqualified Bidders Certification Form Corrected.pdf

BERGEN COUNTY U.A. State Treasurer’s List of Debarred

STATE TREASURER’S LIST OF DEBARRED,

SUSPENDED AND DISQUALIFIED BIDDERS

The Contractor shall submit with his bid a sworn statement, as set forth herein signed by an officer or partner of the Contractor, indicating whether or not the Contractor is at the time of the bid, included on the State Treasurer’s List of Debarred, Suspended, or Disqualified Bidders. The Contractor will immediately notify the Owner whenever it appears that a Contractor is on the State Treasurer’s List. The

Contractor may be debarred, suspended, or disqualified from contracting with the State of New Jersey and

NJDEP if the Contractor commits any of the acts listed in N.J.A.C. 7:1D-2.2.

In accordance with N.J.A.C. 7:22-3.39:

a. No recipient shall enter into a contract for work on environmental infrastructure facilities with any person debarred, suspended or disqualified from Department contracting pursuant to N.J.A.C. 7:1D-2.

b. Recipients shall insert in every contract for work on a project a clause stating that the contractor may be debarred, suspended or disqualified from contracting on any project financially assisted by the State or the Department if the contractor commits any of the acts listed in N.J.A.C. 7:1D-2.

c. The recipient, prior to acceptance of Fund loan moneys, shall certify that no contractor or subcontractor is included on the State Treasurer’s list of debarred, suspended and disqualified bidders as a result of action by a State agency in addition to that of the

Department. If Fund loan moneys are used for disbursement to a debarred firm, the

Department reserves the right to immediately terminate (N.J.A.C. 7:22-3.44) the Fund loan and/or take such other action pursuant to N.J.A.C. 7:1D-2 as is appropriate.

d. Whenever a bidder is debarred, suspended, or disqualified from Department contracting pursuant to N.J.A.C. 7:1D-2, the recipient may take into account the loss of Fund loan moneys under these regulations which result from awarding a contract to such bidder, in determining whether such bidder is the lowest responsive and responsible bidder pursuant to laws, and the recipient may advise prospective bidders that these procedures shall be followed.

e. Any person included on the State Treasurer’s list as a result of action by a State agency, who is or may become a bidder on any contract which is or will be funded by a Fu7nd loan under this subchapter, may present information to the Department why this section shall not apply to such person. If the Department determines that it is essential to the public interest and files a finding thereof with the New Jersey Attorney General, the

Department may grant an exception from the application of this section with respect to a particular contract, in keeping with N.J.A.C. 7:1D-2.9. In the alternative, the Department may suspend or debar any such person, or take such action as may be appropriate, pursuant to N.J.A.C. 7:1D-2.

BERGEN COUNTY U.A. State Treasurer’s List of Debarred

STATE OF NEW JERSEY

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COUNTY OF

I, of the City of in the County of and the State of of full age, being duly sworn according to law on my oath depose and say that:

I am , an officer of the firm of the bidder making the Proposal for the above named work, and that

I executed the said Proposal with full authority to do so that said bidder at the time of making of this bid, is not included on the State of New Jersey, State Treasurer’s List of Debarred, Suspended and

Disqualified Bidder; and that all statements contained in said Proposal and in the affidavit are true and correct, and made with the full knowledge that the Owner as Local Unit relies upon the truth of the statements contained in said Proposal and in the statements contained in this affidavit in awarding the contract for said work.

The undersigned further warrants that should the name of the firm making this bid appear on the State

Treasurer’s List of Debarred, Suspended and Disqualified Bidders at any time prior to, and during the life of this Contract, including the Guarantee Period, that the Bergen County Utilities Authority (Loan

Applicant) shall be immediately notified by the signatory of this Eligibility Affidavit.

The undersigned understands that the firm making the bid as a Contractor is subject to debarment, suspension and/or disqualification in contracting with the State of New Jersey and the Department of

Environmental Protection if the Contractor, pursuant to N.J.A.C. 7:1D-2.2 commits any of the acts listed therein, and as determined according to applicable law and regulation.

(Insert Name and Address of Contractor)

(Insert Name and Title of Affiant)

Subscribed and sworn before me this day of 20

Notary Public of

My commission expires , 20