Exhibit E - Resume Self-Certification Form.pdf
PDF 102 KB Posted
- Attached to
- Information Technology Staff Augmentation
- Contract number
- 80101507-23-STC-ITSA
- Issued by
- Florida
About this file
This document is an Exhibit E Resume Self-Certification Form for the State of Florida's Information Technology Staff Augmentation Services contract, specifically Contract No. 80101507-23-STC-ITSA. The form is designed for contractors to submit candidate resumes for state contract positions, requiring candidates to provide a legally binding self-certification of their professional credentials and background information.
The contract appears to be for Information Technology Staff Augmentation Services, allowing the state to secure qualified IT personnel through a standardized recruitment and verification process. Candidates must complete this self-certification form when responding to Customer Requests for Quotes, acknowledging potential civil and criminal penalties for misrepresentation. The document mandates candidate consent for background verification and notes that all submitted documents, including resumes, are considered public records. Candidates must provide their full legal name, signature, identification details, and have the form witnessed by two contractor representatives.
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Text version
Information Technology Staff Augmentation Services Contract No. 80101507-23-STC-ITSA
Exhibit E
Resume Self-Certification Form
The Contractor’s candidates shall complete this Resume Self-Certification Form. Completed Resume Self-Certification Forms shall be submitted within the Contractor’s response to Customer’s Request for Quotes.
“I the undersigned do hereby certify, under the penalty of perjury, that information in my resume submitted for consideration of the State of Florida contract position is true, correct, complete, and made in good faith to the best of my knowledge and belief. If an omission, falsification, misstatement, or misrepresentation has been made regarding my education, work ability, experience, employment history, and/or fitness for employment as a contractor, I may be disqualified as a contractor, and the matter will be reported to appropriate agency or law enforcement personnel. I understand that there may be civil and/or criminal penalties for misrepresenting pertinent information in connection with contract positions, including, but not limited to, penalties available under sections 287.133 or 817.566, Florida Statutes. I further understand that if I am not a United States citizen, violation cases may be reported to the US Department of Homeland Security for potential deportation.”
“In addition, I the undersigned do hereby consent to the release of my information by employers, educational institutions, law enforcement agencies, and other individuals and organizations to investigators and other authorized agents of Florida for verification and investigation purposes.
I understand that any documents submitted to procure a contract(s) with the State of Florida, including resumes, are public records.”
Print Full Legal Name of Candidate
Candidate’s Signature Date
Candidate’s Form of Identification Presented Identification number
Contractor’s Witness Signature One Date Contractor’s Witness Signature Two Date
Print Name Contractor’s Witness One Print Name Contractor’s Witness Two
File details come from the government source that posted it. Updated .