Attachment 4 Certification Regarding Debarment - Required.pdf

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Attached to
Invitation to Bid (ITB) 2027-1000-0077 As-Needed Brochures for Alaska State Parks
Solicitation number
Invitation to Bid (ITB) 2027-1000-0077 As-Needed Brochures for Alaska State Parks
Issued by
Anchorage Municipality, Alaska

About this file

This is a Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion form required for Invitation to Bid (ITB) 2027-1000-0077, issued by the State of Alaska Department of Natural Resources, Division of Parks and Outdoor Recreation. The certification applies to lower-tier covered transactions involving federal assistance funds and requires prospective bidders to certify that neither they nor their principals are debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from federal participation. Bidders must complete the form by providing the name, title, signature, and date of an authorized representative and must answer whether the company is enrolled in the Federal System for Awards Management (SAM), providing either a DUNS Number or Cage Code if applicable. Companies not enrolled in SAM must complete enrollment before contract execution or payment processing on contracts involving federal funds, with failure to do so resulting in contract cancellation.

The certification serves as a material representation of fact and places responsibility on bidders to provide immediate written notice if the certification becomes erroneous due to changed circumstances. Bidders agree not to enter into lower-tier covered transactions with debarred, suspended, ineligible, or voluntarily excluded parties and must include identical certification language in all subordinate solicitations and transactions. The Department of Labor retains the authority to pursue remedies including suspension and debarment if bidders knowingly provide false certifications or subsequently violate the debarment requirements. This document implements Executive Order 12549 and references 29 CFR Part 98, Section 98.510, establishing compliance obligations for all participants in federally funded procurement activities.

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STATE OF ALASKA – INVITATION TO BID (ITB) ITB 2027-1000-0077

AS-NEEDED BROCHURES FOR ALASKA STATE PARKS

PAGE 42 OF 47 REV. 11/24

ATTACHMENT 4

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY,

AND VOLUNTARY EXCLUSION

LOWER TIER-COVERED TRANSACTIONS

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.

STATE OF ALASKA – INVITATION TO BID (ITB) ITB 2027-1000-0077

AS-NEEDED BROCHURES FOR ALASKA STATE PARKS

PAGE 43 OF 47 REV. 11/24

INSTRUCTIONS FOR CERTIFICATION

1. By signing and submitting this bid, the prospective recipient of federal assistance funds is providing the certification as set out below.

2. The certification in this class is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment.

3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to whom this bid is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "bid," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this bid is submitted for assistance in obtaining a copy of those regulations.

5. The prospective recipient of federal assistance funds agrees by submitting this bid that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL.

6. The prospective recipient of federal assistance funds further agrees by submitting this bid that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may but is not required to check the List of Parties Excluded from Procurement or Non-procurement Programs.

8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debarment.

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