CERTIFICATION_AND_CONTRACT_OFFER.pdf
PDF 14 KB Posted
- Attached to
- Web Site Design Services
- Solicitation number
- 2020.026P
- Issued by
- Washington County, Oregon
About this file
This document is a Certification and Contract Offer form for Washington County, Oregon, specifically related to a Web Site Design Services procurement. The form is a standard certification document that potential bidders must complete to verify their eligibility and compliance with contract submission requirements. The document requires proposers to certify they are not currently debarred, suspended, or ineligible from submitting proposals, have not been convicted of specific criminal offenses within the past three years, and have not had previous government contracts terminated for default.
The certification form requires proposers to disclose any potential legal or contractual issues that might impact their ability to perform the contract, including past criminal judgments, ongoing investigations, or contract terminations. If a proposer cannot fully certify compliance with the listed conditions, they are instructed to attach an explanation. The document notes that while certain disclosures may not automatically disqualify a bidder, they will be considered in evaluating the proposer's overall responsibility. The form includes blank fields for the proposer to complete, including signature, printed name, firm details, contact information, and addresses.
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Text version
CERTIFICATION AND CONTRACT OFFER
Rev. 5/04/20
The undersigned after having carefully examined the Special Instructions, Project/Proposal Information, General Instructions and all other related material and information, agrees to comply with the terms set forth in those documents and to furnish the services described at the rates proposed.
The proposer certifies to the best of its knowledge and belief that neither it nor any of its principals:
1. Are presently debarred, suspended, proposed for debarment, or declared ineligible from submitting proposals by any federal, state or local entity, department or agency;
2. Have within a three-year period preceding this offer, been convicted or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performance of a public (Federal, state or local) contract or subcontract; violation of Federal or state antitrust statues relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement, tax evasion, or receiving stolen property;
3. Are presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph 2 of this certification;
4. Have within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal, state or local public agency.
The proposer will provide immediate written notice to the County if at any time prior to contract award, the proposer learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
Where proposer is unable to certify to any of the statements in this certification, or solicitation document, proposer shall attach an explanation to this offer. A certification that any of the items in the above paragraphs exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the proposer’s responsibility.
SIGNED BY:
DATE:
PRINTED NAME:
TITLE:
FIRM:
E-MAIL ADDRESS:
MAILING ADDRESS:
PHYSICAL ADDRESS:
CITY, STATE and ZIP
PHONE: (AREA CODE)
File details come from the government source that posted it. Updated .