Attachment J.5 - Certification of Eligibility.pdf

This is a Certification of Eligibility form (Attachment J.5) required as part of a federal contract solicitation.

The form serves as a sworn certification in which the contractor or an authorized representative attests to the company's eligibility to receive federal funds. The certification requires the signatory to confirm that, except as noted, the company and its associated personnel (including owners, partners, directors, officers, principal investigators, project directors, and managers) are not currently under suspension, debarment, voluntary exclusion, or ineligibility determination under any Federal, District, or State statute. The certification further requires confirmation that the company has not been suspended, debarred, voluntarily excluded, or determined ineligible by any Federal, District, or State agency within the past three years; does not have a proposed debarment pending; and has not been indicted, convicted, or had a civil judgment rendered against it for fraud or official misconduct within the past three years. The form notes that any exceptions will be considered in determining bidder responsibility but will not necessarily result in denial of award. False statements made on the certification may result in criminal prosecution or administrative sanctions under the Program Fraud Civil Remedies Act of 1986 (Public Law 99-509). The form requires signature by the contractor, president, or authorized official, along with notarization by a notary public, including date, city, state, and notary seal.