14-Att. I. CERTIFICATION REGARDING DEBARMENT.pdf
PDF 141 KB Posted
- Attached to
- Police Pursuit Vehicles
- Solicitation number
- 269- 2026-173
- Issued by
- Mecklenburg County, Cleveland Town, North Carolina
About this file
This is a Certification Regarding Debarment, Suspension, and Other Responsibility Matters form for RFP 269-2026-173 issued by the City of Charlotte and the Charlotte-Mecklenburg Police Department (CMPD) in North Carolina for Police Pursuit Vehicles. The certification document outlines the eligibility requirements and representations that bidders, contractors, and subcontractors must make regarding their business conduct and legal standing. Bidders must certify that neither they nor their officers, directors, managers, or persons holding greater than 10% equity interest have been debarred, suspended, or excluded from covered transactions by any federal or state agency. Additionally, bidders must confirm they have not been convicted of fraud, criminal offenses, or violations of anti-trust or procurement statutes within the preceding three years, and that they have not had public transactions terminated for cause or default during that same period.
The certification also requires bidders to attest that they are not presently indicted or civilly charged with any offenses enumerated in the certification requirements. Bidders who cannot certify to all statements must provide a written explanation and indicate this by checking the applicable box on the form. The document warns that false statements on the certification may result in proposal rejection, contract termination, or criminal prosecution. Signatories must provide their printed name, signature, title, and date on the form to complete the certification.
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Text version
RFP 269-2026-173
CCPA Police Pursuit Vehicles April 14, 2026
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
The bidder, contractor, or subcontractor, as appropriate, certifies to the best of its knowledge and belief that neither it nor any of its officers, directors, or managers who will be working under the Contract, or persons or entities holding a greater than (ten percent) 10% equity interest in it (collectively “Principals”):
1. Are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department or agency in the United States;
2. Have within a three-year period preceding this proposal 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 anti-trust or procurement statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
3. Are presently indicted for or otherwise criminally or civilly charged by a government entity, (federal, state or local) with commission of any of the offenses enumerated in paragraph 2 of this certification;
and
4. Have within a three-year period preceding this application/proposal had one or more public transactions (federal, state or local) terminated for cause or default.
I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award or in some instances, criminal prosecution.
� I hereby certify as stated above:
(Print Name) Signature
Title Date
� I am unable to certify to one or more the above statements. Attached is my explanation. [Check box if applicable]
(Print Name) Signature
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
File details come from the government source that posted it. Updated .