CERTIFICATION_OF_CONTRACTOR_REGARDING_DEBARMENT,_SUSPENSION,_AND_OTHER_INELIGIBILITY_AND_VOLUNTARY_EXCLUSION.pdf
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- Attached to
- VoIP Phones
- Solicitation number
- 2022-14
- 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 from Lextran, a transportation agency. 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 provides spaces for company details including name, address, contact information, and signature, and includes a legal statement affirming the truthfulness of the submitted information.
The certification references 31 U.S.C. Sections 3801 et seq. and provides an opportunity for the company to attach an explanation if they cannot fully certify their compliance. This document appears to be a standard compliance form typically required in government contracting processes to ensure potential contractors meet federal eligibility requirements. It serves as a self-attestation of the company's good standing and legal compliance prior to entering into a government transaction or bidding on a contract.
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Text version
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 .