9-Debarment Form Prime Contractor.pdf

This is a Debarment Certification Form for the Town of Palm Beach, Florida, required as part of RFP 2026-014 for Emergency Food Services. The form requires both prime contractors and subcontractors to certify that neither they nor their principals are currently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in federally-funded transactions. The certification must be submitted as part of the proposal process, with contractors required to provide their name, title, street address, city, state, zip code, and signature. If a contractor is unable to provide the required certification, they must attach a written explanation to the form.

The debarment certification is a mandatory compliance requirement stemming from FEMA terms and conditions, as the Town of Palm Beach intends to request reimbursement from FEMA for the emergency food services contract. This certification protects federal interests by ensuring that only eligible contractors participate in federally-funded procurements. The form applies to all bidders responding to the RFP and must be completed accurately and submitted through the Town's Bonfire eProcurement platform along with other proposal documents. Contractors should retain records demonstrating their eligible status and be prepared to provide supporting documentation if requested.