Debarment.pdf
PDF 109 KB Posted
- Attached to
- Crossing Guard Services
- Solicitation number
- 26/27-0008
- Issued by
- San Bernardino County, California
About this file
This is a Debarment Certification form required by Executive Order 12549 for prospective participants bidding on a Crossing Guard Services contract with the Board of Education of the Fontana Unified School District in California. The certification must be completed and submitted with the sealed proposal for RFP No. 26/27-0008 through the Procurement Portal at https://procurement.opengov.com/portal/fusd no later than 2:00 pm on Thursday, August 20, 2026. The form certifies compliance with federal debarment and suspension requirements as defined under 7 CFR Part 3017, Section 3017.510.
The prospective bidder must certify that neither the company nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency. Additionally, the bidder must confirm that within the three-year period preceding the bid, the company and its principals have not been convicted of or had a civil judgment rendered against them for fraud, criminal offenses, antitrust violations, embezzlement, theft, forgery, bribery, falsification of records, false statements, or receipt of stolen property in connection with public transactions or contracts. The bidder must also certify that they are not presently indicted or criminally or civilly charged with any such offenses, and that no public transactions have been terminated for cause or default within the preceding three years. The authorized company official must sign the form under penalty of perjury; any inability to certify to these statements requires written explanation attached to the bid.
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Text version
*DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY
MATTERS
As required by Executive Order 12549, Debarment and Suspension, for prospective participants in primary covered transactions, as defined at 7 CFR Part 3017, Section 3017.510.
(1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals:
(a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;
(b) have not within a three-year period preceding this bid been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
(c) are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and
(d) have not within a three-year period preceding this application/bid had one or more public transactions (Federal, State or local) terminated for cause or default.
(2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid.
By signature below, I certify under penalty of perjury that the information in this form is true, complete, and accurate and that I am authorized by my company to make this certification and all consents and agreements contained herein.
Company Name
Signature of Authorized Company Official
Printed Name
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