3-D-DFCM Termination or Debarment Certification Form, 5.8.25.docx

This is a Termination or Debarment Certification Form required by the State of Utah Division of Facilities Construction and Management (DFCM) for the Central Evidence Warehouse construction project. The form certifies that the contractor submitting the proposal is not currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from soliciting work by any government agency. The certification also confirms that the contractor has not been terminated during the performance of a previous contract or withdrawn from a contract to avoid termination. The form requires the contractor's name, signature, printed name, title, and date of the certifying official. If the contractor cannot certify to these standards, the form provides space for an explanation of circumstances.

The associated construction project is a new single-story Central Evidence Warehouse for the Department of Public Safety with approximately 18,599 square feet. The construction cost estimate for this project is $11,300,000.00. This certification form is a standard compliance document that must be completed and submitted as part of the proposal process for this DFCM construction opportunity in Utah.