Attachment J Non-Debarment Acknowledgement.pdf
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- Solicitation number
- BPM058760
- Issued by
- Montgomery County, Maryland
About this file
This is a Non-Debarment Acknowledgement form required by Montgomery County Public Schools (MCPS) in Maryland for the lease of holding facilities at Grosvenor Center and Radnor Center. The form serves as a certification document that bidders must complete and submit as part of their proposal response. The acknowledgement requires the duly authorized representative of the offeror to certify their firm's eligibility to conduct business by confirming either the absence of or disclosure of any pending litigation and debarment actions from the State of Maryland, its subordinate government units, or the federal government within the preceding five years. Additionally, the form requires certification that no company officers, directors, partners, or employees have been convicted of bribery, attempted bribery, or conspiracy to bribe under state or federal law, and that no members of the MCPS Board of Education, administrative personnel, supervisory personnel, or other employees have any financial or business interest in the bidding company.
The form must be signed and witnessed by authorized representatives of the offeror. Bidders are required to indicate their debarment status by selecting one of three acknowledgement options and, if applicable, providing supporting documentation describing any pending litigation or debarment actions. The offeror also commits to notify MCPS of any changes in debarment status that occur after submission of the proposal.
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Attachment J - 1
ATTACHMENT J
NON-DEBARMENT ACKNOWLEDGEMENT
_____ I acknowledge that my firm has NO pending litigation and/or debarment from doing business with the State of Maryland or any of its subordinate government units and/or federal government within the past five (5) years.
_____ I acknowledge that my firm has pending litigation or has been debarred from doing business with the State of Maryland or any of its subordinate government units and/or federal government, within the past five (5) years. If so, please provide an attachment describing the pending litigation or debarment.
_____ I acknowledge none of this company's officers, directors, partners, or its employees have been convicted of bribery, attempted bribery, or conspiracy to bribe under the laws of any state or federal government; and that no member of the Board of Education of the Montgomery County
Public Schools, Administrative or Supervisory Personnel, or other employees of the Board of
Education has any interest in the bidding company except as follows
As the duly authorized representative of the Offeror, I hereby certify that the above information is correct and that I will advise Montgomery County Public Schools should there be a change in status.
By (Signature)
Name and Title
Witness Name and Title
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