10-Appendix E Certification Regarding Debarment and Suspension (5).pdf
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- Attached to
- Advantage Arts Academy- Food Service Management
- Solicitation number
- RA26-144
- Issued by
- Salt Lake County, Hildale City, Utah
About this file
This is a Certification Regarding Debarment and Suspension form required for the Food Service Management contract opportunity with Advantage Arts Academy in Utah. The form implements Executive Order 12549 and 12689 and the regulations under Title 2 CFR Part 180, which restrict awards and contracts with parties that are debarred, suspended, declared ineligible, or voluntarily excluded from Federal assistance programs. Prospective participants must certify that neither they nor their principals are presently debarred, suspended, proposed for debarment, or declared ineligible; have not been convicted of or had a civil judgment rendered against them for fraud or criminal offenses related to public transactions within the preceding three years; are not presently indicted or criminally or civilly charged with any enumerated offenses; and have not had one or more public transactions terminated for cause or default within the preceding three years. The issuing office is Advantage Arts Academy, with questions due by June 5, 2026 at 5:00 PM MDT and proposals due by June 29, 2026 at 3:00 PM MDT to Kelly Simonsen at 6171 W 11800 S Herriman, UT 84096.
The certification requires the Food Service Management Company (FSMC) authorized representative to complete and sign the form, providing the company name, street address, printed name, title, and signature of the authorized signatory. Any prospective participant unable to certify to the statements in the certification must attach a written explanation to their proposal. This certification is a mandatory compliance requirement for participation in the procurement and does not address pricing, set-asides, or other financial terms, as those details are contained in separate solicitation documents.
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Appendix E
Certification Regarding Debarment and Suspension Ineligibility and Voluntary Exclusion
This certification is required by the regulations implementing Executive Order 12549 and 12689, “Debarment and Suspension” (Title 2 CFR Part 180). These regulations restrict awards, subawards, and contracts with certain parties that are debarred, suspended, or otherwise excluded from or ineligible for participation in Federal assistance programs or activities.
1. Certification of Prospective Participant
a. The prospective participant certifies, by submission of this proposal, that neither it nor its principals:
i. Are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency;
ii. Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
iii. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
iv. Have not within a three-year period preceding this application had one or more public transactions (Federal, State, or local) terminated for cause or default.
2. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.
Name of FSMC
Street address (City, State, Zip)
Printed Name of FSMC Authorized Representative
FSMC Authorized Representative Title
FSMC Authorized Representative Signature
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| FSMC Authorized Representative Title: |
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