Attachment 9 Self Certification for Antimafia Communication.pdf

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Maintenance and Repair of Photovoltaic Systems at DMC, Camp Darby, Italy
Solicitation number
W58D2M24Q0087
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This document is a self-certification form for Antimafia communication. It requires the signatory to declare that they do not have any of the prohibitions, disqualifications or suspensions referred to in Article 67 of Legislative Decree no. 159 of 06/09/2011.

The related federal contract opportunity is a Request for Quotation (RFQ) for the Maintenance and Repair of Photovoltaic Systems at DMC, USAG Italy. The service shall be performed at Camp Darby, Tirrenia (Pisa), Italy, with a performance period from 8 September 2024 to 7 September 2027 (base year plus two option years). This is a hybrid Firm-Fixed Price and Time and Material type contract. A pre-quote conference will be held on 18 June 2025. To be awarded this government contract, the vendor must have a NCAGE number and be registered in the System for Award Management (SAM) website.

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Attachment 12 - Enclosure 1 2 5801.02.03.04.05.06.07 ADDED.pdf PDF
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Attachment 15 - Enclosure 4 919_ADDED.pdf PDF
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Attachment 13 - Enclosure 1 3 5801.02.03.04.05.06.07 ADDED.pdf PDF
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Attachment 6 Standard Operating Procedures.pdf PDF
Attachment 10 Past Experience Questionnaire.pdf PDF
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Attachment 2 Enclosure 1 Drawings PV systems of bldgs. 5801 02 03 04 05 06 08 and 5882.pdf PDF
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Attachment 5 Enclosure 4 Drawings PV system of bldg. 919.pdf PDF
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Self-certification for Antimafia communication

Autocertificazione della comunicazione antimafia

Dichiarazione sostitutiva di certificazione (D.P.R. n. 445 del 28.12.2000)

Il/la sottoscritto/a (nome e cognome) _______________________________ C.F._________________ nato/a _______________________________ Prov. _________ il ______________ residente a

________________________ Prov. _____ in via/piazza ____________________

_______________________________ n. ____, in qualità di (carica ricoperta) ___________ dell’impresa (indicare la denominazione) _______________________________________________ C.F. __________________ avente la sede in _________________________ Prov. di __________ Via ___________________________ n. ______ consapevole delle sanzioni penali in caso di dichiarazioni false e della conseguente decadenza dai benefici eventualmente conseguiti (ai sensi degli artt. 75 e 76 D.P.R. 445/2000) sotto la propria responsabilità

DICHIARA

che nei propri confronti non sussistono le cause di divieto, di decadenza o di sospensione di cui all’art. 67 del D.lgs. n. 159 del 06/09/2011.

Il/la sottoscritto/a dichiara inoltre di essere informato/a, ai sensi del D.Lgs. n. 196/2003 (codice in materia di protezione di dati personali) che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nell’ambito del procedimento per il quale la presente dichiarazione viene resa.

data firma leggibile del dichiarante (2)

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