4-EXHIBIT C- Suspension and Debarment Cert.docx

LEAD PUBLIC SCHOOLS

EXHIBIT-C

Suspension and Debarment Certification

1. Contractor Information Legal Business Name: __________________________________________ DBA (if applicable): __________________________________________ Address: ______________________________________________________ City, State, ZIP: ______________________________________________ Authorized Representative: _____________________________________ Title: _________________________________________________________ Phone: ________________________________________________________ Email: _________________________________________________________

2. Certification Regarding Suspension and Debarment In accordance with Executive Orders 12549 and 12689, and the regulations implementing them (2 CFR Part 180 and 2 CFR Part 200), the Contractor hereby certifies to the best of its knowledge and belief that:

1. The Contractor and its principals are NOT presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in transactions involving federal funds by any federal department or agency.

2. The Contractor has not, within the past three years, been convicted of or had a civil judgment rendered against it for:

· Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public or private agreement or transaction

· Violation of federal or state antitrust statutes

· Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property

3. The Contractor is not presently indicted or otherwise criminally or civilly charged by a governmental entity with any of the offenses listed above.

4. The Contractor has not, within the past three years, had one or more public transactions terminated for cause or default.

5. If the Contractor becomes aware of any information contradicting this certification, it will immediately notify LEAD Public Schools.

3. Lower‑Tier Covered Transactions If applicable, the Contractor agrees to require all subcontractors, vendors, and lower‑tier participants to provide the same certification before entering into any covered transaction.

4. Certification Statement By signing below, the Contractor certifies that the statements above are true, complete, and accurate. The Contractor understands that false statements may result in penalties, including termination of contract, suspension, or debarment.

Authorized Representative:

Name: __________________________________________ Title: ___________________________________________ Signature: _______________________________________ Date: ____________________________________________ image1.png