Attachment A Authorization and Certification Form~23.pdf
PDF 1 MB Posted
- Attached to
- Climate Action Accelerator
- Solicitation number
- CM-23-340
- Issued by
- California
About this file
This is an Authorization & Certification form for the City of Long Beach's Request for Proposals (RFP) process. The document serves as a formal attestation by proposers regarding their authorization, eligibility, and compliance with procurement standards. Proposers must certify that they are authorized representatives of their organizations, have read and understand the RFP terms and conditions, and submit proposals as firm and fixed offers valid for 90 days from the submission deadline. The form explicitly requires proposers to affirm that their proposals are genuine and not collusive, and that neither their organizations nor their members have conflicts of interest in the selection, award, or administration of any resulting subcontracts.
The document includes mandatory federal compliance certifications required because the City of Long Beach may provide federal grant funds to contractors. Proposers must certify under penalty of perjury that neither their business entities nor any principals (owners, directors, partners, officers, managers, or persons with substantial influence) are currently suspended, debarred, or ineligible for federal funds, and have not been suspended, debarred, or declared ineligible within the preceding three years. Additional certifications address the absence of pending debarment proceedings, federal indictments or convictions involving fraud or misconduct within three years, and the absence of terminated public transactions due to cause or default within three years. Proposers unable to certify to any statement must attach written explanations. The form also requires notice of any organizational changes, management turnover, or changes in principals' status within 21 days. A separate section provides space for proposers to document any exceptions to RFP terms and conditions, though the City notes it is not obligated to accept exceptions and reserves the right to negotiate with another contractor or withdraw the RFP if negotiations cannot be concluded successfully.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B Equal Benefits Ordinace Form~19.pdf | ||
| Climate Action Accelerator RFP V3_Final.pdf |
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Text version
Attachment A: Authorization & Certification I certify that:
i. I am authorized to submit this Request for Proposals on behalf of the organization above.
ii. I have read, understand and agree to comply with the terms and conditions specified in this
Request for Proposal. Any exceptions to the terms and conditions that will be requested have been documented in the table below, Exceptions to Terms & Conditions.
iii. The proposal is submitted as a firm and fixed request valid and open for 90 days from the submission deadline.
iv. This proposal is genuine, and not sham or collusive, nor made in the interest or in behalf of any person not herein named; the Proposer has not directly or indirectly induced or solicited any other Proposer to put in a sham proposal and the Proposer has not in any manner sought by collusion to secure for himself or herself an advantage over any other Proposer.
v. In addition, this organization and its members are not now and will not in the future be engaged in any activity resulting in a conflict of interest, real or apparent, in the selection, award, or administration of a subcontract.
Furthermore, as a current or potential Contractor for the City of Long Beach (City) your firm, through its business relationship with the City, may be the recipient of federal grant funds. As such, the City is required to document that neither your business entity or organization, nor any of your principals are debarred, suspended, ineligible, or have voluntarily been excluded from receiving federal grant funds.
Consistent with Executive Order No. 12549 Title 2 CFR Part 180 Subpart C, all potential recipients of federal grant funds are required to comply with the requirements specified below. By submission of proposal/bid/agreement, the undersigned, under penalty of perjury, certifies that the participant, nor any of its principals in the capacity of owner, director, partner, officer, manager, or other person with substantial influence in the development or outcome of a covered transaction, whether or not employed by the participant:
i. Are not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any Federal department or agency;
ii. Have not, within a three (3) year period preceding this bid/agreement/proposal, been suspended, debarred, voluntarily excluded or declared ineligible by a federal agency;
iii. Do not presently have a proposed debarment proceeding pending;
iv. Have not, within a three (3) year period preceding this bid/agreement/proposal, been indicted or convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct;
v. Have not, within a three (3) year period preceding this bid/agreement/proposal, had one or more public transactions (Federal, State, or local) terminated for cause or default.
vi. If reorganization, management turnover, or a shift or change of principals’ status occurs, written notice must be submitted within 21 days. Subsequent disclosure of unfavorable information will be subject to thorough review and remedial action. Updated versions of this certification may be requested on a routine basis.
vii. Where the potential prospective recipient of Federal assistance funds is unable to certify to any of the statement in this certification, such prospective participant shall attach an explanation to the applicable bid/agreement/proposal.
Name Signature Date
Exceptions to Terms & Conditions
EXCEPTIONS TO TERMS AND CONDITIONS (IF APPLICABLE)
Exceptions to terms and conditions are uncommon, and Proposers are not encouraged to take exception to terms and conditions. However, in the event there are terms that should be reviewed as part of potential negotiation of a final contract, they should be listed here. The City of Long Beach has no obligation to accept any exceptions to terms and conditions. Any award is contingent upon the successful negotiation of final contract terms. If contract negotiations cannot be concluded successfully, the City reserves the right to negotiate a contract with another
Contractor or withdraw the RFP.
Term & Condition Number Explanation of Objection
| Date: |
| Name: |
| Term Condition Number: |
| Explanation of Objection: |
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