Attachment 3 Certification Regarding Debarment.pdf

STATE OF ALASKA – INVITATION TO BID (ITB) ITB 2025-1000-0240

AS-NEEDED PRE-COMMERCIAL THINNING, AND SILVICULTURE SERVICES

REV. 11/24

ATTACHMENT 3

CERTIFICATION REGARDGING DEBARMENT, SUSPENSION, INELIGIBILITY,

AND VOLUNTARY EXCLUSION

LOWER TIER COVERED TRANSATCTIONS

This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participant's responsibilities.

The regulations were published as Part VII of the May 26, 1988, Federal Register (pages 19160-19211).

(BEFORE COMPLETING CERTIFICATION, READ THE INSTRUCTIONS ON THE

FOLLOWING PAGE WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION)

The prospective recipient of federal assistance funds certifies, by submission of this bid, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

Where the prospective recipient of federal assistance funds is unable to certify to any of the Statements in this certification, such prospective participant shall attach an explanation to this bid.

Name of Representative: _____________________________________________________________.

Title of Representative: ______________________________________________________________.

Signature: __________________________________________________________________________.

Date: _____________________________________________________________________________.

1. Is this company enrolled in the Federal System for Awards Management (SAM)? YES NO

2. If Yes, please provide either the DUNS Number ________________ or the Cage Code

3. If No, the company must be enrolled in SAM before a contract can be signed or payment made on a contract involving federal funds. Failure to do so will result in cancellation of the contract.