Exhibit O Certification Regarding Debarment S.docx
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- Solicitation number
- PE-72600-NONST-2024-000000010
- Issued by
- Talbot County, Georgia
About this file
The document is a certification form regarding debarment, suspension, and other responsible matters required for a state and local contract opportunity for progressive design-build services for a sewer implementation project in Spalding County, Georgia. The contract requires the proposed prime contractor or subcontractor to certify that they are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions, and have not been convicted of fraud, criminal offenses, or had public transactions terminated for cause in the past three years. Failure to complete this certification may result in rejection of the proposal or termination of the award.
The state and local contract opportunity is for progressive design-build services for a 2024 sewer implementation project in Spalding County, Georgia. The services include Phase 1 preconstruction services such as planning, surveying, assessment, alternatives analysis, permitting, detailed design, constructability reviews, value engineering, and cost estimating, as well as Phase 2 final design, construction, and commissioning services. No other details about pricing, set asides, incumbents, funding, or contract term are provided.
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Text version
Exhibit “O” CERTIFICATION BY PROPOSED PRIME CONTRACTOR OR SUBCONTRACTOR REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBLE MATTERS Proposed Prime Contractor
Proposed Subcontractor
Under Executive Order 12549 individuals or organizations debarred from participation in federal assistance programs may not receive an assistance award under federal program or sub-agreement there under for $25,000 or more. Accordingly, each recipient of a state loan or a contract (engineering or construction) awarded under a loan must complete the following certification (see 2 CFR §1532.220). The prospective participant certifies to the best of its knowledge and belief that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency.
(b) Have not within a three year period preceding this proposal been convicted of or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and
(d) Have not within a three-year period preceding this application/proposal had one or more public transactions (federal, state, or local) terminated for cause of default.
I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. (A willfully false statement is punishable by law – U.S. Code, Title 18, Section 1001.)
PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE OF CONTRACTOR OR SUBCONTRACTOR
| _________________________________________ | ______________ | |
| SIGNATURE OF AUTHORIZED REPRESENTATIVE | DATE |
________ I am unable to certify to the above statements. My explanation is as follows:
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