Exhibit A_Certification_Form.docx
DOCX document 32 KB Posted
- Solicitation number
- PE-50300-RFP-2024-000000061
- Issued by
- Fulton County, Georgia
About this file
This document is an Exhibit A Certification Form for a government contract opportunity. The form requires the proposer to certify that they have read and understand the proposal materials, that the information provided is truthful and complete, and that the proposer and its employees have not been convicted of certain crimes or been subject to disciplinary actions or debarment in the past five years. The proposer must also acknowledge that the owner has the right to verify the accuracy of the information provided. A material false statement or omission is sufficient cause for disqualification.
The contract opportunity appears to be for a Student Activity and Recreation Center project at Gordon State College, with the project number PPV-89-1201. No other details about the scope of work, timeline, or contract value are provided in this document.
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Text version
Exhibit A
CERTIFICATION FORM
I, _____________________________, being duly sworn, state that I am ______________________(title) of _______________________________(firm) and hereby duly certify that I have read and understand the information presented in the attached proposal and any enclosure and exhibits thereto.
I further certify that to the best of my knowledge the information given in response to the request for proposals is full, complete and truthful.
I further certify that the proposer and any principal employee of the proposer have not, in the immediately preceding five years, been convicted of any crime of moral turpitude or any felony offense, nor has had their professional license suspended, revoked or been subjected to disciplinary proceedings.
I further certify that the proposer has not, in the immediately preceding five years, been suspended or debarred from contracting with any federal, state or local government agency, and further, that the proposer is not now under consideration for suspension or debarment from any such agency.
I further certify that the proposer has not in the immediately preceding five years been defaulted in any federal, state or local government agency contract, and further, that the proposer is not now under any notice of intent to default on any such contract.
I acknowledge, agree and authorize, and certify that the proposer acknowledges, agrees and authorizes, that the Owner may, by means that the Owner deems appropriate, determine the accuracy and truth of the information provided by the proposer and that the Owner or their agents and representatives may contact any individual or entity named in the Statement of Qualifications for the purpose of verifying the information supplied therein.
I acknowledge and agree that all of the information contained in the Statement of Qualifications is submitted for the express purpose of inducing the Owner to award a contract.
A material false statement or omission made in conjunction with this proposal is sufficient cause for disqualification.
Signature Sworn and subscribed before me
This _____ day of ________, 20__.
NOTARY PUBLIC
NOTARY SEAL
My Commission Expires: _________________
Gordon State College PPV-89-1201, Student Activity & Rec Ctr., PM RFQ/RFP
File details come from the government source that posted it. Updated .