5-Form - Debarment.pdf

This is a debarment certification form required for an RFP for Disaster Debris Management in Florida, submitted to coordinate with federal agencies including the Federal Emergency Management Agency (FEMA), the Florida Department of Environmental Protection (FDEP), and the Florida Department of Emergency Management (FDEM), as well as local County ordinances. The RFP seeks qualified contractor(s) capable of managing debris resulting from catastrophic events such as tornadoes and hurricanes, with responsibility for debris removal during preparation, response, recovery, and mitigation phases of emergency situations. The scope includes disaster recovery services and beach cleaning due to Red Tide or other marine-related events. Contractors must demonstrate capacity for rapid mobilization and response to wide-scale debris volumes and possess specialized experience in disaster response management and subcontractor coordination.

The certification requires the contractor to attest that neither the contractor nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from federal participation. Any prospective participant unable to certify these statements must attach an explanation to the RFP submission. Additionally, the certification requires confirmation that no member or agent of the contractor has had access to information providing an unfair advantage. The form must be signed by the proposer's authorized official with corresponding name, title, and date.