8-Attachment 9 - Certification re Debarment Suspension.pdf
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- Solicitation number
- RFP-2026-002
- Issued by
- Milwaukee County, Mattoon Village, Wisconsin
About this file
This is a Certification Regarding Debarment and Suspension document required by Milwaukee County, Wisconsin for the Air Service Development Consulting and Related Market Research contract opportunity at Milwaukee Mitchell International Airport. The certification serves as a prerequisite attestation from applicants and their principals, owners, officers, shareholders, key employees, directors, and member partners regarding their eligibility to participate in the procurement process.
The certification requires applicants to affirm under penalty of law that they and their key personnel are not currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency. Applicants must further certify that within the three-year period preceding proposal submission, they have not been convicted of or had civil judgments rendered against them for fraud, criminal offenses related to public transactions or contracts, violations of Federal or State antitrust statutes, or crimes including embezzlement, theft, forgery, bribery, falsification or destruction of records, false statements, or receiving stolen property. Additionally, applicants must confirm they are not presently indicted for or criminally charged with any enumerated offenses and have not had any public transactions terminated for cause or default within the preceding three years. The document requires authorized signature, date, printed name, title, and company name to formalize the certification.
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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:
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