12-Form 14 - System for Award Management (SAM.GOV) Record Search (V2).pdf
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- Attached to
- Reconstruct Runway 18/36 Schedules I, II & III
- Solicitation number
- 126-25-AIR-IFB
- Issued by
- Cameron County, Texas
About this file
This document is Form 14: System for Award Management (SAM.gov) Record Search, which outlines federal funding requirements for contractors and vendors. The form requires all respondents to be pre-vetted and verified as not suspended or debarred through SAM.gov before participating in federally funded contract opportunities. The form mandates that vendors provide a screenshot from SAM.gov verifying their eligibility to perform the outlined scope of work and complete a Non-Debarment Certification Form.
The document specifies detailed compliance requirements under OMB Guidelines and Federal Executive Order 12549, which prohibit organizations receiving federal funds from being debarred, suspended, or excluded from federal business. Vendors must provide their Unique Entity Identifier (UEI) number, potentially a Tax Identification Number (TIN), and certify their good standing. The form includes provisions for immediate notification if a vendor's status changes, with potential consequences including contract termination and fund repayment. The verification process involves checking both federal (SAM.gov) and state (Texas Debarred Vendor List) databases to ensure comprehensive vendor eligibility.
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Text version
FORM 14: SYSTEM FOR AWARD MANAGEMENT (SAM.GOV) RECORD SEARCH
This project is funded by federal funds, which require all contractors and vendors to be in good standing according to SAM.gov and any applicable state requirements.
Verification of SAM.gov Status
1. Respondent must not be suspended or debarred at the time of the proposal submittal. The proposal response package must include a completed Non-Debarment Certification Form located on the next page herein.
2. All Respondents must be pre-vetted for eligibility to perform the outlined federally funded scope of work. A printed screenshot from the SAM.gov website verifies whether the Vendor is excluded from contract participation at the federal level
Contract Award
The federal funding recipient must verify the SAM.gov status of the Respondent(s) selected for contract award prior to execution of the contract as stated in the Non-Debarment Certification Form. The final verification of the Respondent’s SAM.gov status is completed prior to contract award, in addition to the initial verification documentation provided with the proposal response submittal.
FORM 14: SYSTEM FOR AWARD MANAGEMENT (SAM.GOV) RECORD SEARCH (CONTINUED)
NON-DEBARMENT CERTIFICATION FORM
COMPANY/ENTITY LEGAL NAME:
STREET ADDRESS:
CITY: STATE: ZIP:
CONTACT NAME:
CONTACT EMAIL: CONTACT PHONE:
*UEI # **TIN #
*Subrecipients are required to have a Unique Entity Identifier (UEI) Number prior to an award. All entities must be pre-vetted for eligibility/ability to perform the outlined ARPA funded scope of work and a record (PDF of SAM.gov screenshot) of SAM debarment clearance must be obtained prior to entering into any final contracts. **Beneficiary Entities are required to have UEI and/or TIN.
APPLICABLE REGULATIONS: As stated in federal funding requirements: "OMB Guidelines to Agencies on Government wide Debarment and Suspension (Nonprocurement), 2 CFR Part 180, including the requirement to include a term or condition in all lower-tier covered transactions (contracts and subcontracts described in 2 CFR Part 180, subpart B) that the award is subject to 2 CFR Part 180 and any applicable agency-specific implementing regulations."
Also, Federal Executive Order (E.O.) 12549: “Debarment” requires that contractors, beneficiaries or subrecipient organizations and their principals – who are receiving awards, using federal funds, are not debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any federal department or agency from doing business with the federal government. By signing this document, you certify that your organization and its principals are not debarred. Failure to comply or attempts to edit this language may disqualify you from receiving or retaining funds. Information on debarment is available at the following website: www.sam.gov
Be advised that we may pursue available remedies per 2 CFR 180.360 as an federally funded recipient entity: “If a federal agency later determines that you failed to tell the [awarding agency] that you were excluded or disqualified at the time you entered into the covered transaction with that person/awarding agency, the agency may pursue any available remedies, including suspension and debarment.”
[INITIAL] CERTIFICATION & SIGNATURE
We hereby certify that we are not excluded, disqualified, or debarred from receiving federally funded awards.
We hereby confirm that if that status should change within the course of this agreement, we will provide notification immediately. Failure to do so may result in this agreement’s termination and/or the repayment of funds.
Your signature certifies that the information provided on this form is correct and that neither you nor your principal(s) is/are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency.
SIGNATURE
PRINTED NAME & TITLE DATE
FOR DEPARTMENT USE ONLY
SAM Debarment/Certification Record of Clearance Yes [ ] No [ ] Note:
State of Texas Debarred Vendor List Cleared Yes [ ] No [ ] Note:
Verified By: Yes [ ] No [ ] Date:
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