13-Debarment and Suspension Certification - Form.pdf
PDF 51 KB Posted
- Attached to
- Lake Nasworthy Boat Ramp Construction Phase 1
- Solicitation number
- OP-01-26
- Issued by
- Travis County, Texas
About this file
This is a Debarment and Suspension Certification form issued by the City of San Angelo, Texas Purchasing Division for the Lake Nasworthy Boat Ramp Construction Phase 1 project. The City of San Angelo Operations Department is requesting bids for the replacement of three boat ramps and three boat docks at three city-owned Lake Nasworthy facilities located at Beaty Road, Knickerbocker Park, and South Concho Park. The estimated project length is 180 days with an anticipated start date between May and April 2026.
The certification form requires prospective primary vendors to certify that they and their principals are not debarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency. Vendors must also attest that within the three-year period preceding submission, they have not been convicted of or had civil judgments rendered against them for fraud, criminal offenses in connection with public transactions, antitrust violations, embezzlement, theft, forgery, bribery, falsification of records, false statements, or receipt of stolen property. Additionally, vendors must confirm they are not currently indicted or criminally or civilly charged with any enumerated offenses and have not had any public transactions terminated for cause or default within the preceding three years. Any vendor unable to certify to these statements must attach an explanation to their bid submission.
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Text version
CITY OF SAN ANGELO, TEXAS
PURCHASING DIVISION
72 West College Avenue, San Angelo, Texas 76903
325.657.4219 • sapurch@cosatx.us
CITY OF SAN ANGELO, TEXAS • DEBARMENT AND SUSPENSION CERTIFICATION
Debarment and Suspension Certification
(1) The prospective primary vendor certifies to the best of its knowledge and belief that it and its principals:
(a) Are not presently debarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;
(b) 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;
(c) 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
(d) 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 primary vendor is unable to certify to any of the statements in this certification, such prospective primary vendor shall attach an explanation to this bid.
AUTHORIZED AGENT • PLEASE PRINT
VENDOR
NAME TITLE
SIGNATURE
DATE
mailto:sapurch@cosatx.us
Debarment and Suspension Certification
File details come from the government source that posted it. Updated .