7-Debarment-Suspension Certification Document.pdf
PDF 624 KB Posted
- Solicitation number
- 25/0222
- Issued by
- Harris County, Texas
About this file
This document is a Vendor Certification form from the Harris County Juvenile Probation Department, designed to verify a vendor's legal and ethical standing before entering into a public transaction or contract. The form requires vendors to certify that they and their principals are not currently debarred, suspended, or excluded from federal transactions, and have not been convicted of or charged with specific criminal offenses within the past three years. Vendors must either affirm their compliance by checking the "I certify" box or explain their inability to certify by selecting "I am unable to certify" and providing a detailed explanation.
The certification covers a comprehensive range of legal and ethical standards, including protection against fraud, criminal offenses related to public transactions, antitrust violations, and potential termination of previous public contracts. The document is structured to ensure transparency and accountability for vendors seeking to do business with the Harris County Juvenile Probation Department, with spaces provided for the vendor's name, representative's signature, and date of certification. The form is revision dated 8/2021, indicating it is a current administrative document used in the vendor qualification process.
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Text version
rev. 8/2021
HARRIS COUNTY JUVENILE PROBATION DEPARTMENT
VENDOR CERTIFICATION
Vendor certifies that it and its principals (as defined in 2 CFR Part 180.995):
Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal Court, or voluntarily excluded from participation in this transaction by any federal department or agency;
Have not within a three-year period preceding this application 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; or
Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in the above bullet; and have not within a three-year period preceding this application had one or more public transactions (federal, state, or local) terminated for cause or default.
Select the appropriate response, provide requested information, and sign:
I certify.
I am unable to certify.
If you selected “I am unable to certify”, please provide an explanation as to why the applicant agency cannot certify the statements.
Explanation:________________________________________________________
Vendor Name Representative's Signature
Date
File details come from the government source that posted it. Updated .