B08-RFQ_W912PF27QA003_Attachment2_SelfCertification_AntimafiaCommunication.pdf

This document is a Self-Certification for Antimafia Communication required as Attachment 2 to RFQ W912PF27QA003, issued by the U.S. Army Corps of Engineers (indicated by the W912PF prefix). The form is an Italian substitutive declaration of certification (Dichiarazione sostitutiva di certificazione) based on D.P.R. n. 445 of December 28, 2000.

The certification requires the signatory to declare, under penalty of perjury, that they and their enterprise are not subject to the prohibition, forfeiture, or suspension causes outlined in Article 67 of Legislative Decree No. 159 of September 6, 2011 (anti-mafia legislation). The form includes fields for the declarant's name, tax identification number (C.F.), birthplace, residence address, position/title held, enterprise name, enterprise tax identification number, and enterprise address. The declarant must acknowledge awareness of criminal penalties for false declarations and loss of any benefits obtained, and must certify compliance with D.Lgs. n. 196/2003 regarding personal data protection. The declaration requires signature and date from the authorized representative. This is a template form designed to ensure contract compliance with Italian anti-organized crime regulations.