7-Attachment 9 - Certification re Debarment Suspension.pdf
PDF 12 KB Posted
- Attached to
- Exterior Window Cleaning - Airport
- Solicitation number
- RFP-2025-033
- Issued by
- Milwaukee County, Mattoon Village, Wisconsin
About this file
The document is an Attachment 9 Certification Regarding Debarment and Suspension form, which requires applicants to certify their legal and ethical standing when applying for a public transaction or contract. The certification requires the applicant to confirm that its principals, owners, officers, shareholders, key employees, directors, and member partners: (1) are not currently debarred or suspended from federal transactions; (2) have not been convicted of fraud or criminal offenses in public transactions within the past three years; (3) are not currently criminally indicted by a governmental entity; and (4) have not had public transactions terminated for cause or default within the past three years.
The form is designed to ensure the integrity and trustworthiness of potential contractors by requiring a comprehensive self-disclosure of any legal or ethical issues that might disqualify an applicant from participating in public contracts. By signing the document, the applicant attests under their own knowledge and belief that they meet these criteria, with spaces provided for an authorized signature, printed name, title, and company information. This certification serves as a key screening mechanism for government agencies to mitigate risk and maintain high standards of conduct in public procurement processes.
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Text version
ATTACHMENT 9
CERTIFICATION REGARDING
DEBARMENT AND SUSPENSION
The applicant certifies to the best of its knowledge and belief that its principals, owners, officers, shareholders, key employees, directors and member partners: (1) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (2) have not within a three-year period preceding the date of 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 antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) are not presently indicted for or otherwise criminally charged by a governmental entity
(Federal, State or local) with commission of any of the offenses enumerated in (2) of this certification; and (4) have not within a three-year period preceding the date of this proposal had one or more public transactions (Federal, State or local) terminated for cause or default.
Authorized Signature: Date:
Printed Name: Title:
Company:
File details come from the government source that posted it. Updated .