Attachment A_Authorization Certification~3.pdf
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- Attached to
- Polygraph Examination Services
- Solicitation number
- PD-25-605
- Issued by
- California
About this file
This is an Authorization & Certification form for the City of Long Beach used in Request for Proposals (RFP) processes. The document establishes the authorization requirements, certifications, and compliance standards that proposers must meet when submitting bids for City of Long Beach contract opportunities. The form requires authorized representatives to certify their authority to submit proposals on behalf of their organizations, with signature requirements varying by business entity type: sole proprietors and limited liability companies require one signature; partnerships require general partner signatures; and corporations require either two officer signatures or one signature accompanied by a certified corporate resolution. Proposers must acknowledge their understanding of and agreement to comply with all terms and conditions specified in the RFP, including submission of all required documents by the deadline and proper labeling of attachments in the Long Beach Buys procurement system.
The certification section includes compliance requirements related to federal grant funding, requiring proposers to certify that neither the organization nor its principals have been suspended, debarred, excluded, or declared ineligible by any federal agency within the three-year period preceding the proposal submission. Proposers must also certify they have not been indicted, convicted, or had civil judgments rendered against them for fraud or official misconduct, and that no public transactions have been terminated for cause or default within the preceding three years. The form includes a section for proposers to document any exceptions to terms and conditions, though the City notes that exceptions are uncommon and not encouraged, and that any award is contingent upon successful negotiation of final contract terms. The City reserves the right to negotiate with another contractor or withdraw the RFP if contract negotiations cannot be concluded successfully.
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Text version
Template 24.11.24 | 1
Attachment A: Authorization & Certification I certify that:
i. I am authorized to submit this Request for Proposals on behalf of the Proposer.
a. INDIVIDUAL (Doing Business As): The only acceptable signature is the owner of the company.
(Only one signature is required.)
b. PARTNERSHIP: The only acceptable signature(s) is/are that of the general partner or partners.
c. CORPORATION: Two (2) officers of the corporation must sign; OR the signature of one officer or the signature of person other than an officer is acceptable if the Bid is accompanied by a certified corporate resolution granting authority to said person to execute contracts on behalf of the corporation.
d. LIMITED LIABILITY COMPANY: The signature on the bid must be a member or, if the Articles provide for a manager, must be the manager. (Only one signature is required.)
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. I have read and agree to abide by the requirements in the City of Long Beach Vendor Code of Conduct.
iv. The proposal is submitted as a firm and fixed request valid and open for 90 days from the submission deadline.
v. I understand if I don’t submit all documents required as specified in section 4.2, I will not be considered for the opportunity and deemed nonresponsive. I also have confirmed that I have reviewed the attachments tab in my quote for this proposal in Long Beach Buys and have uploaded and labeled all attachments correctly.
vi. This proposal is genuine, and not a 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.
vii. 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 this proposal, the undersigned, under penalty of perjury, certifies that the participant, or 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.
https://www.longbeach.gov/globalassets/city-manager/media-library/documents/ethics-commission/resources/vendor-code-of-conduct-2023
Template 24.11.24 | 2
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
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