CERTIFICATION_OF_CONTRACTOR_REGARDING_DEBARMENT,_SUSPENSION,_AND_OTHER_INELIGIBILITY_AND_VOLUNTARY_EXCLUSION.pdf

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Attached to
Bus Shelters, Benches, & Trash Receptacles
Solicitation number
2023-10
Issued by
Essex County, Kentucky

About this file

This document is a Certification of Contractor Regarding Debarment, Suspension, and Other Ineligibility and Voluntary Exclusion form, associated with the Lextran (Transit Authority of Lexington-Fayette Urban County Government) procurement process. The form requires an authorized company official to certify that the company and its principals are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in federal transactions. The form includes fields for company details such as name, address, contact information, and requires a signature affirming the truthfulness of the statements submitted.

The certification references 31 U.S.C. Sections 3801 et seq. and provides an opportunity for the company to attach an explanation if unable to fully certify compliance. This document appears to be a standard compliance form intended to ensure that potential contractors meet federal eligibility requirements before participating in government procurement processes. While directly connected to Lextran's Bus Shelters, Benches, & Trash Receptacles procurement (Reference Number: 2023-10), this specific form is a standard administrative document focused on verifying a contractor's eligibility status rather than providing detailed procurement specifications.

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CERTIFICATION OF CONTRACTOR REGARDING DEBARMENT, SUSPENSION, AND OTHER

INELIGIBILITY AND VOLUNTARY EXCLUSION

The undersigned, an authorized official of the Proposer stated below, certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

(If the undersigned is unable to certify to any of the statements in this certification, such official shall attach an explanation to this proposal).

THE UNDERSIGNED CERTIFIES OR AFFIRMS THE TRUTHFULNESS AND ACCURACY OF THE

CONTENTS OF THE STATEMENTS SUBMITTED ON OR WITH THIS CERTIFICATION AND

UNDERSTANDS THAT THE PROVISIONS OF 31 U.S.C. SECTIONS 3801 ET SEQ. ARE APPLICABLE

THERETO.

Company: _______________________________________________________________________

Address: ________________________________________________________________________

City: _______________________________________ State: ___________ Zip: ____________

Contact Name: __________________________________________________________________

Title: ___________________________________ Telephone: _____________________________

Signature: __________________________________________________ Date: ____________________

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