8-I. CERTIFICATION REGARDING DEBARMENT - BL Track Reprofile.docx
DOCX document 28 KB Posted
- Attached to
- Blue Line Track Reprofile and Alignment Services
- Solicitation number
- 269- 2026-2001
- Issued by
- Mecklenburg County, Charlotte City, North Carolina
About this file
This is a Certification Regarding Debarment form (Required Form 5) for RFP #269-2026-2001 submitted to a North Carolina state or local transportation authority for Blue Line Track Reprofile and Alignment Services. The contract involves rail grinding services designed to restore rail profile, remove surface defects, improve wheel-rail interface performance, extend rail life, and reduce noise and vibration across the authority's rail network. The contractor must provide all labor, equipment, tools, materials, supervision, planning, and documentation necessary to perform the rail grinding services.
The certification form requires the bidder, contractor, or subcontractor to attest that neither they nor their officers, directors, managers, or persons holding greater than 10% equity interest have been debarred, suspended, proposed for debarment, or excluded from federal or state covered transactions; have not been convicted of fraud or criminal offenses related to public transactions within three years preceding the proposal; are not currently indicted or criminally charged with such offenses; and have not had public transactions terminated for cause or default within three years preceding the application. The bidder must sign and date the certification, acknowledging that false statements may result in proposal rejection, award termination, or criminal prosecution.
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Other files
| File | Type | Posted |
|---|---|---|
| 10-M. Exceptions Form - BL Track Reprofile.docx | DOCX document | |
| 6-E. Proposal Submission Form - BL Track Reprofile.docx | DOCX document | |
| 3-J. BYRD ANTI-LOBBYING CERTIFICATION - BL Track Reprofile.docx | DOCX document | |
| 4-Bb. Line Curve Chart and LRV Dimensions.pdf | ||
| 12-N. FORM A - List of Subcontractors (DBE and non-DBE).NO GOAL INTERIM.docx | DOCX document | |
| 9-H. Sample Services Contract - BL Track Reprofile.docx | DOCX document | |
| 7-A. Bonfire Instructions Procurement Portal -1842.docx | DOCX document | |
| 14-Aa. RFP 269-2026-2001 Blue Line Track Reprofile.Alignment.docx | DOCX document | |
| 2-C. Request for Proposal Acknowledgement - BL Track Reprofile.docx | DOCX document | |
| 13-D. Addenda Receipt Confirmation - BL Track Reprofile.docx | DOCX document | |
| 1-B. Scope Rail Grinding Technical Requirements for RFP-2025.docx | DOCX document | |
| 11-F. Pricing Worksheet - BL Track Reprofile.docx | DOCX document | |
| 5-L. References Form - BL Track Reprofile.docx | DOCX document |
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Text version
REQUIRED FORM 5 – CERTIFICATION REGARDING DEBARMENT
RFP # 269-2026-2001
Blue Line Track Reprofile and Alignment Services
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;
1. 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;
1. 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
1. 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 .