8-H. Certification Regarding Debarment.pdf
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- Attached to
- Mechanical Engineering Design Services
- Solicitation number
- 269-2026-148
- Issued by
- Mecklenburg County, Cleveland Town, North Carolina
About this file
This is a Certification Regarding Debarment, Suspension, and Other Responsibility Matters form required for the City of North Carolina's Mechanical Engineering Design Services contract opportunity. The certification document establishes that the bidder, contractor, or subcontractor, along with all officers, directors, managers, and principals holding greater than ten percent equity interest, must confirm they are not currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department or agency. Additionally, the certifying parties must attest that within the three-year period preceding the proposal, they have not been convicted of or had civil judgments rendered against them for fraud, criminal offenses related to public transactions, violations of anti-trust or procurement statutes, embezzlement, theft, forgery, bribery, falsification of records, false statements, or receipt of stolen property.
The certification further requires that no party is presently indicted for or criminally or civilly charged with any offense enumerated in the document and that no party has had one or more public transactions terminated for cause or default within the three-year period preceding the application. The bidder must understand that false statements on this certification may result in proposal rejection, award termination, or criminal prosecution. The form provides space for the certifying officer's printed name, signature, title, and date, with an optional checkbox and explanation section if the bidder is unable to certify to one or more of the stated conditions.
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Text version
269.2026.148
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS
The bidder, contractor, or subcontractor, as appropriate, certifies to the best of its knowledge and belief that neither it nor any of its officers, directors, or managers who will be working under the Contract, or persons or entities holding a greater than (ten percent) 10% equity interest in it (collectively “Principals”):
1. Are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department or agency in the United States;
2. Have within a three-year period preceding 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 anti-trust or procurement statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
3. Are presently indicted for or otherwise criminally or civilly charged by a government entity, (federal, state or local) with commission of any of the offenses enumerated in paragraph 2 of this certification; and
4. Have within a three-year period preceding this application/proposal had one or more public transactions (federal, state or local) terminated for cause or default.
I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award or in some instances, criminal prosecution.
I hereby certify as stated above:
(Print Name) Signature
Title Date
I am unable to certify to one or more the above statements. Attached is my explanation. [Check box if applicable]
(Print Name) Signature
File details come from the government source that posted it. Updated .