5-EXHIBIT C- Suspension and Debarment Cert.docx
DOCX document 20 KB Posted
- Solicitation number
- LEAD/OPS-KITCHEN/RFP001/2026/27
- Issued by
- Davidson County, Tennessee
About this file
This is a Suspension and Debarment Certification form issued by LEAD Public Schools, a public charter school network in Nashville, Tennessee, for use in connection with a contract opportunity to supply, deliver, install, and commission commercial kitchen equipment for a new elementary school campus. The certification requires contractors to provide company information, including legal business name, DBA, address, and authorized representative contact details, and to confirm compliance with federal executive orders and regulations governing federal fund transactions. Contractors must certify that neither they nor their principals are currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from federal transactions, and must attest to the absence of relevant criminal convictions or civil judgments within the past three years related to fraud, criminal offenses, antitrust violations, embezzlement, theft, forgery, bribery, falsification of records, false statements, or receipt of stolen property.
The certification further requires contractors to confirm they are not presently indicted or criminally or civilly charged with any listed offenses and have not had public transactions terminated for cause or default within the past three years. Contractors must agree to notify LEAD Public Schools immediately upon becoming aware of any contradictory information and must extend the same certification requirements to all subcontractors, vendors, and lower-tier participants. The form requires signature by an authorized representative and includes a statement acknowledging that false certifications may result in contract termination, suspension, or debarment. This certification is a standard compliance requirement for contracts involving federal funding and serves to protect the public interest by ensuring contractor eligibility and integrity throughout the project delivery process.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 8-ADDENDUM NO 1.docx | DOCX document | |
| 6-EXHIBIT E- Authorization to Release Information.docx | DOCX document | |
| 9-ADDENDUM NO 1.docx | DOCX document | |
| 1-RFP- RFP for Supply, Delivery, Installation, and Commissioning of School Kitchen Equipment.docx | DOCX document | |
| 2-EXHIBIT A-SCOPE OF WORK, DELIVERABLES, AND RESPONSIBILITIES.docx | DOCX document | |
| 7-EXHIBIT F- Insurance Requirements.docx | DOCX document | |
| 3-EXHIBIT B- Cost Proposal.docx | DOCX document | |
| 4-EXHIBIT D- Non-Collusion Affidavit.docx | DOCX document |
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Text version
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
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