11-006113.17 WHS CTAE RMA Suspension and Debarment Certification.pdf
PDF 114 KB Posted
- Attached to
- Woodstock HS CTAE RMA
- Solicitation number
- 2026.RMA.13.01
- Issued by
- Cherokee County, Georgia
About this file
This is a Suspension and Debarment Certification form for the Woodstock High School Career, Technical, and Agricultural Education (CTAE) Renovation, Modernization, and Addition (RMA) project issued by the Cherokee County School District (CCSD) in Georgia. The certification requires General Contractors seeking to bid on the construction project to complete and notarize the form as a condition of proposal submission. A mandatory Pre-Proposal Conference and site visit will be held on Monday, April 13, 2026, at 1:30 p.m. local time at the Cherokee County School District Support Service Office, located at 200 Mountain Brook Court, Canton, Georgia 30115. The contract is scheduled for execution on April 2, 2026.
The Suspension and Debarment Certification form requires contractors to certify, under penalty of perjury, that they and their owners, parent companies, or corporate principals are not debarred, suspended, proposed for debarment, or declared ineligible by any Federal department or agency. Contractors must also certify that within the preceding three years they have not been convicted of or had a civil judgment rendered against them for fraud, criminal offenses, antitrust violations, embezzlement, theft, forgery, bribery, falsification of records, or false statements in connection with public transactions. Additionally, contractors must affirm they are not currently indicted or criminally or civilly charged with such offenses and have not had any public transactions terminated for cause or default within the preceding three years. The certification must be executed and notarized by an authorized corporate officer.
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Text version
Woodstock HS CTAE RMA Cherokee County School District
2026.RMA.13.01
04.02.2026
Suspension and Debarment Certification 006113.17 - 1
SECTION 006113.17
SUSPENSION AND DEBARMENT CERTIFICATION
I _______________________, as the _____________________________(specify Corporate Authority) of _________________________________, (Corporation) hereby swear or affirm under penalty of perjury provided below. These representations apply to the Corporation as well as to the owners, parent company, or Corporation Principals.
Upon reasonable inquiry, belief, and knowledge of the corporation, as well as to the owners, parent company, or corporation principals:
1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;
2) Have not within three (3) years preceding this certification been convicted of or had a civil judgment rendered against them for the 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;
3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with the commission of any of the offenses listed above; and
4) Have not within three (3) years preceding this application had one or more public transactions (Federal, State, or local) terminated for cause or default.
In the event, you have knowledge or belief that any of the above statements are not true and correct, list any fact that supports your knowledge or belief.
Executed this _______ day of ______________, 20______.
Contractor: _____________________________
By: ___________________________________
Title: __________________________________
Sworn and subscribed before me this ______ of ______________, 20______.
NOTARY PUBLIC / My Commission Expires:
END OF SECTION 006113.17
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006113.17 CCSD - Suspension and Debarment Certification
| I: |
| as the: |
| Corporation hereby swear or affirm under penalty of perjury: |
| Executed this: |
| day of: |
| 20: |
| Contractor: |
| Title: |
File details come from the government source that posted it. Updated .