6-00 63 00 Certified statement debarrment.pdf
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- Attached to
- Noble House
- Solicitation number
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- Issued by
- Northampton County, Pennsylvania
About this file
This is a certified statement of debarment form required for bid submission to St. John's United Church of Christ for the Noble House renovation project located at 201 South Broad Street, Nazareth, Pennsylvania 18064. The project involves the conversion of an existing single-family dwelling into two individual dwelling units and includes selective demolition, general construction, mechanical construction, electrical construction, and plumbing construction. Sealed bids are due online via the PennBid Program by 10:00 A.M. prevailing time on Tuesday, March 31, 2026. Contract documents became available online at no cost beginning Thursday, February 26, 2026 at 9:00 A.M. prevailing time through the Penn Bid Program at https://pennbid.bonfirehub.com. A pre-bid meeting is scheduled for Thursday, March 12, 2026 at 10:00 A.M. prevailing time at the project site, with attendance encouraged for all prospective bidders.
Bids must be accompanied by a bid bond in the amount of five percent (5%) of the total bid amount. The successful bidder must furnish both a Performance Bond and Payment Bond, each in the amount of one hundred percent (100%) of the total contract value. This project is subject to the Davis-Bacon Act of 1931, and prevailing wage rates apply to all work performed. The certified debarment statement must be completed and notarized by the company president or owner, certifying that neither the company nor its president/owner has been placed on any county, state, or federal debarment list as a result of work on public projects. Qualified Minority Business Enterprises, Women Business Enterprises, and Section 3 qualified firms are encouraged to submit bids, and all applicable Equal Employment Opportunity requirements for federally assisted contracts are in effect.
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Text version
00 63 00 -1 02.26.2026
NOBLE HOUSE CERTIFIED STATEMENT (DEBARMENT) BID DOCUMENTS
CERTIFIED STATEMENT (DEBARMENT)
State of )
)SS
County of )
On this date of 20 , before me personally came and appeared, , to me known, (Name) who being by me duly sworn did depose and say that he/she is the president/owner of
(circle one) and that neither the company or the president/owner
(circle one) of the company has ever been placed on a county, state, or federal debarment list as a result of work performed on a county, state, or federal projects.
Signature
Name
Date
SUBSCRIBED AND SWORN TO BEFORE ME THIS
DAY OF , 20______
BY:
TITLE:
MY COMMISSION EXPIRES 20
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