9-Attachment 7 Certification re Debarment Suspension.docx

DOCX document 24 KB Posted

Attached to
Acquisition and Development of land at 4320 South 6th Street, Milwaukee, WI 53221
Solicitation number
RFP-ED2602
Issued by
Milwaukee County, Mattoon Village, Wisconsin

About this file

This is a Certification Regarding Debarment and Suspension document related to a land acquisition and development project at 4320 South 6th Street, Milwaukee, Wisconsin. The certification requires the applicant to verify the eligibility status of its principals, owners, officers, shareholders, key employees, directors, and member partners. The document establishes baseline compliance requirements that must be satisfied prior to contract award.

The applicant must certify that relevant parties are not currently debarred, suspended, proposed for debarment, or voluntarily excluded from federal covered transactions. Additionally, the applicant must confirm that no debarment-triggering events have occurred within the three-year period preceding the proposal, including convictions or civil judgments related to fraud, criminal offenses in connection with public transactions, antitrust violations, embezzlement, theft, forgery, bribery, falsification of records, false statements, or receipt of stolen property. The certification also requires confirmation that relevant parties are not presently indicted or criminally charged with any enumerated offenses and have not had public transactions terminated for cause or default within three years prior to the proposal submission. The document requires authorized signature, date, printed name, title, and company information to be completed by the applicant.

View the file

Other files

File Type Posted
1-RFP 4320 S 6th St Final.pdf PDF
6-Attachment 4 Exceptions.docx DOCX document
7-Attachment 5 Vendor Information Sheet.docx DOCX document
5-Attachment 3 Sworn Statement of Proposer.docx DOCX document
3-Attachment 1 Proprietary Info Disclosure Form.docx DOCX document
2-ATTACHMENT A-D.pdf PDF
8-Attachment 6 Conflict of Interest.docx DOCX document
4-Attachment 2 EEOC Compliance.docx DOCX document

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Text version

ATTACHMENT 7

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:

File details come from the government source that posted it. Updated .