Exhibit A _ RFQ Certification Form.docx
DOCX document 34 KB Posted
- Solicitation number
- PE-47200-RFQ-2026-000000139
- Issued by
- Terrell County, Georgia
About this file
This is a Certification Form for Request for Qualifications (RFQ) related to Project No. J-477, Renovations for Student Success and Career Services at Abraham Baldwin Agricultural College (ABAC) in Tifton, Georgia, administered by the Georgia Board of Regents. The certification form serves as a sworn statement by an authorized representative of the proposing firm confirming the accuracy, completeness, and truthfulness of all information submitted in response to the RFQ. The form requires certification that the proposer and its principal employees have not been convicted of crimes of moral turpitude or felonies within the past five years, nor have had professional licenses suspended, revoked, or subjected to disciplinary proceedings. Additionally, proposers must certify they have not been suspended or debarred from contracting with any federal, state, or local government agency in the past five years and are not currently under consideration for such suspension or debarment.
The certification further requires that proposers attest they have not defaulted on any federal, state, or local government contract within the past five years and are not currently under notice of intent to default. Proposers authorize the Board of Regents to verify the accuracy and truthfulness of all submitted information by contacting any individuals or entities referenced in the Statement of Qualifications. The form warns that material false statements or omissions may result in suspension or debarment from future state contracts, contract denial or rescission, and potential criminal prosecution under Georgia law (O.C.G.A. 16-10-20) or federal law (18 U.S.C. § 1001 or § 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 B _ Certificate of Minority Form.docx | DOCX document | |
| Exhibit D _ PM Fee Proposal Form.xlsx | XLSX spreadsheet | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| Exhibit E _ Contractor Affidavit.docx | DOCX document | |
| Exhibit F _ Proposer_s Disclosure Statement.doc | DOC document | |
| _ABAC J_477 PM RFQ_RFP.pdf | ||
| Egnyte Upload Instructions.pdf |
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 J-477 Renovations for Student Success and Career Services Abraham Baldwin Agricultural College, Tifton, Georgia
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 ________, 202__.
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 .