4616.1 RFP_Attachment D_Non-Debarment Acknowledgement.pdf

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Attached to
Chief Negotiator and Labor Relations Services
Solicitation number
BPM053172
Issued by
Maryland

About this file

This is a Non-Debarment Acknowledgement form for RFP No. 4616.1 issued by Montgomery County Public Schools (MCPS) in Maryland. The form requires offerors to certify their eligibility and compliance status regarding pending litigation, debarment, and criminal convictions related to doing business with the State of Maryland, its subordinate government units, and the federal government. Bidders must acknowledge either that their firm has no pending litigation or debarment within the past five years, or disclose any such matters with supporting documentation. The acknowledgement also requires certification that no company officers, directors, partners, or employees have been convicted of bribery, attempted bribery, or conspiracy to bribe under state or federal law, and that no Board of Education members or MCPS administrative or supervisory personnel have any financial interest in the bidding company.

The form must be completed and signed by the duly authorized representative of the offeror, who certifies the accuracy of the provided information and commits to notifying MCPS of any changes in status. The document includes signature lines for both the authorized representative and a witness, serving as a mandatory compliance requirement for participation in the RFP process for Chief Negotiator and Labor Relations Services with SEIU Local 500.

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RFP No. 4616.1

Attachment D

NON-DEBARMENT ACKNOWLEDGEMENT

_____ I acknowledge that my firm has NO pending litigation and/or debarment from doing business with the State of Maryland or any of its subordinate government units and/or federal government within the past five (5) years.

_____ I acknowledge that my firm has pending litigation or has been debarred from doing business with the State of Maryland or any of its subordinate government units and/or federal government, within the past five (5) years. If so, please provide an attachment describing the pending litigation or debarment.

_____ I acknowledge none of this company's officers, directors, partners, or its employees have been convicted of bribery, attempted bribery, or conspiracy to bribe under the laws of any state or federal government; and that no member of the Board of Education of the Montgomery County

Public Schools, Administrative or Supervisory Personnel, or other employees of the Board of

Education has any interest in the bidding company except as follows

As the duly authorized representative of the Offeror, I hereby certify that the above information is correct and that I will advise Montgomery County Public Schools should there be a change in status.

By (Signature)

Name and Title

Witness Name and Title

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