Exhibit A _ Certification Form.docx
DOCX document 35 KB Posted
- Attached to
- GCSU J-461-DB Arts & Sciences Renovation
- Solicitation number
- PE-47200-RFQ-2026-000000115
- Issued by
- Barrow County, Georgia
About this file
Exhibit A - Certification Form Summary
This is a certification form document associated with a Design-Build Services contract opportunity for Georgia College and State University (GCSU) in Milledgeville, Georgia. The form serves as Exhibit A to the Request for Qualifications (RFQ) for Project No. J-461-DB Arts & Sciences Renovation. The document establishes the certification and compliance requirements that prospective bidders must complete and submit as part of their proposal response. The form functions as a mandatory submission component that verifies the bidder's qualifications, experience, and ability to perform the design-build services required for the renovation project.
The certification form establishes baseline requirements and declarations that bidders must provide to demonstrate their eligibility and capability to undertake the Arts & Sciences Renovation project. Specific details regarding pricing terms, contract duration, renewal options, and financial requirements would be contained in the primary RFQ documents and project specifications. Bidders are instructed to review all attached project documents and follow the specified upload instructions when submitting their responses, with questions directed to the contact listed in the RFQ materials.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit B _ Contractor Affidavit.docx | DOCX document | |
| GCSU J_461 Arts and Sciences Renovation DB RF.pdf | ||
| Exhibit G _ Proposer_s Disclosure Statement.doc | DOC document | |
| Egnyte Upload Instructions.pdf | ||
| Exhibit D _ Precon Cost and Expenses.xlsx | XLSX spreadsheet | |
| Exhibit C _ DB Fee Proposal.docx | DOCX document | |
| Exhibit F _ Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Exhibit E _ General Conditions Breakdown.xlsx | XLSX spreadsheet |
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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 Board of Regents may, by means that the Board of Regents deems appropriate, determine the accuracy and truth of the information provided by the proposer and that the Board of Regents or their agents 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 suspension or debarment from further contracts, or denial of rescission of any contract entered into based upon this proposal thereby precluding the firm from doing business with, or performing work for, the State of Georgia. In addition, such false statement or omission may subject the person and entity making the proposal to criminal prosecution under the laws of the State of Georgia of the United States, including but not limited to O.C.G.A. §16-10-20, 18 U.S.C. §§1001 or 1341.
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
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