Exhibit A _ Certification Form.docx
DOCX document 33 KB Posted
- Solicitation number
- PE-50300-RFP-2027-000000330
- Issued by
- Fulton County, Georgia
About this file
This is a Certification Form document required by the Georgia Institute of Technology for respondents to the Construction Management (CM/GC) Services solicitation for the Architecture West Mechanical Systems Improvements project (Bid-Contract No. 2002-27, Project No. 0535-2025). The form serves as a sworn statement certifying that the proposing firm has read and understands the proposal, that all information provided is full, complete, and truthful, and that the firm and its principals meet specified eligibility requirements. The certification process involves a two-step qualification and proposal submission process, with Step 1 consisting of Statements of Qualifications (RFQ) and qualified firms being shortlisted for Step 2, which includes interviews and fee proposals for construction management services at the Georgia Tech campus in Atlanta.
The certification form requires proposers to attest that they and their principal employees have not been convicted of crimes of moral turpitude or felonies, nor have had professional licenses suspended or revoked within the preceding five years. Proposers must also certify they have not been suspended or debarred from contracting with any federal, state, or local government agency, have not defaulted on government contracts, and are not under consideration for suspension, debarment, or default notices. The form authorizes the Board of Regents to verify all submitted information and establishes that material false statements or omissions may result in suspension, debarment, contract denial, rescission of awarded contracts, and potential criminal prosecution under Georgia law and federal statutes including O.C.G.A. 16-10-20, 18 U.S.C. § 1001, and 18 U.S.C. § 1341. The certification must be notarized and signed by an authorized representative of the proposing firm.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit C _ CM_GC Fee Proposal.docx | DOCX document | |
| Exhibit E _ General Conditions_Breakdown.xlsx | XLSX spreadsheet | |
| _2002_27_ 2025_0535 CM RFPQ R_dv2.pdf | ||
| Exhibit D _ Preconstruction Cost_Expenses Bre.xlsx | XLSX spreadsheet | |
| Exhibit B _ Contractor Affidavit.docx | DOCX document | |
| Exhibit F _ Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Exhibit G _ Proposer_s Disclosure Statement.doc | DOC 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 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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