7-CERTIFIED STATEMENT DEPARMENT.pdf

This is a Certified Statement (Debarment) form required by the Housing Authority of Monroe County (HAMC) in Pennsylvania for the RFP for Architectural and Engineering Services. The document is a notarized certification in which the president or owner of a responding company must swear under oath that neither the company nor its principal have been placed on any county, state, or federal debarment list as a result of work performed on county, state, or federal projects. The form requires completion of the respondent's name and company name, signature by the declarant, and notarization by a qualified notary public before submission with the proposal.

This debarment certification is a standard compliance requirement for the HAMC architectural and engineering consulting services contract opportunity, which has a submission deadline of April 30, 2026 at 10:00 a.m. via PennBid. The certification must be completed and submitted prior to contract award. The three-year contract term includes two optional one-year renewal periods, and the successful respondent must also provide proof of workers compensation insurance, general liability insurance with minimum limits of $1,000,000 per occurrence and $2,000,000 aggregate, and professional liability coverage with identical limits.