ATTACHMENT E DEBARMENT CERTIFICATION.docx

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Attached to
RFP #2026-01 SCIENCE BUILDING CLASSROOM AUDIO-VISUAL EQUIPMENT AND INSTALLATION
Solicitation number
BD-26-1063-MCC02-MCC02-125657
Issued by
Plymouth County, Boston City, Massachusetts

About this file

This is a Debarment Certification form required by Massasoit Community College in Massachusetts for RFP #2026-01, which concerns the furnishing, installation, and configuration of classroom audio-visual equipment and systems in Building 1. The certification document establishes the legal framework and vendor attestation requirements for participation in this procurement opportunity. Vendors must complete and submit the certification form with their proposal response, providing their organization name, authorized representative's printed name, title, signature, and date of submission.

The debarment certification requires vendors to certify under penalty of perjury that neither the company nor its principals are currently debarred, suspended, proposed for debarment, or excluded from federal or state transactions. Vendors must also attest that within the three-year period preceding contract execution, they have not been convicted of or had civil judgments rendered for fraud, criminal offenses related to public transactions, violations of antitrust statutes, or crimes including embezzlement, theft, forgery, bribery, falsification of records, or destruction of documents. Additionally, vendors must confirm they are not presently indicted or criminally or civilly charged by any government entity for such offenses and have not had any public transactions terminated for cause or default within the preceding three years. This certification serves as a prerequisite for contract award and vendor eligibility determination.

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ATTACHMENT E – DEBARMENT CERTIFICATION

Massasoit Community College

RFP #2026-01

Science Building: Classroom Audio-Visual Equipment & Installation

Vendor’s Organization Name:

The Vendor certifies, to the best of their knowledge and belief, that the company and its principals: are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department or agency; have not within a three (3) year period preceding the Contract been convicted of, or had a civil judgment rendered against them from commission of fraud, or a criminal offense in connection with obtaining or attempting to obtain, or performing a public (federal, state or local) transaction or grant under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses listed above; and have not within a three (3) year period preceding this Contract had one or more public transactions (federal, state or local) terminated for cause or default.

Name (Print):

Title:

Authorized Signature:

Date:

File details come from the government source that posted it. Updated .