Exhibit A.docx
DOCX document 31 KB Posted
- Solicitation number
- PE-50300-RFP-2025-000000136
- Issued by
- Fulton County, Georgia
About this file
This document is an Exhibit A Certification Form related to a Design-Build Request for Qualifications and Proposals (DB-RFQP) issued by the Georgia Institute of Technology Planning, Design & Construction unit for the 10th Street Chiller Plant, Replacement of Chillers 1 & 2 project. The project is located on the Georgia Institute of Technology campus in Atlanta, Georgia, within Fulton County. The DB-RFQP is seeking Statements of Qualifications from interested firms to provide Design-Build services for this project. Respondents deemed qualified may be shortlisted for interview and invited to submit proposals. The responses to the DB-RFQP are due on 07/16/2024.
The certification form requires the proposing firm to provide information regarding its qualifications, including certifications that the firm and its principal employees have not been convicted of any crimes of moral turpitude or felonies, nor have they been suspended, debarred, or defaulted from any federal, state, or local government contracts in the past five years. The form also authorizes the Georgia Institute of Technology to verify the accuracy of the information provided.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit F Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Exhibit D Precon Cost Expense Breakdown.xlsx | XLSX spreadsheet | |
| Exhibit C.docx | DOCX document | |
| 2001_25 DB RFQP_Final.pdf | ||
| J_431 Shortlist Announcement.pdf | ||
| Exhibit G.docx | DOCX document | |
| Exhibit B.docx | DOCX document | |
| Addendum _1 Dated 08_13_2024.pdf | ||
| Exhibit E General Conditions Breakdown.xlsx | XLSX spreadsheet |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 SUBCRIBED BEFORE ME
This _______ (day) of ___________________ (month), 20_____ (year)
NOTARY PUBLIC SIGNATURE
My Commission Expires: _________________
NOTARY SEAL
Georgia Institute of Technology
Georgia Institute of Technology
File details come from the government source that posted it. Updated .