4-G. CERTIFICATION REGARDING DEBARMENT.pdf
PDF 97 KB Posted
- Attached to
- Guardrail Installation and Repair Services
- Solicitation number
- 269- 2026-176
- Issued by
- Mecklenburg County, Charlotte City, North Carolina
About this file
This is a Certification Regarding Debarment document for the City of Charlotte, North Carolina's Guardrail Installation and Repair Services contract (ITB# 269-2025-176). The contract will provide guardrail installation and repair services on various city roads as needed upon request. The Engineer or designee will direct maintenance and repair activities at multiple locations throughout the city, with work scope varying based on the amount of existing or damaged guardrail on each route. Contractors must replace all necessary guardrail components as directed and ensure stabilization of guardrails and appurtenances at each site.
The certification requires bidders, contractors, and subcontractors to verify that neither they nor their officers, directors, managers, or individuals holding greater than 10% equity interest have been debarred, suspended, or excluded from federal or state transactions; convicted of fraud or criminal offenses related to public contracts within three years; currently indicted or charged with such offenses; or had public transactions terminated for cause or default within three years preceding the proposal. Bidders must sign and date the certification, with the option to attach an explanation if unable to certify to any statements. False statements on this certification may result in proposal rejection, award termination, or criminal prosecution.
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Text version
GUARDRAIL INSTALLATION & REPAIR SERVICES
ITB# 269-2025-176
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
File details come from the government source that posted it. Updated .