Form_Debarment_and_Suspension_Certification.docx
DOCX document 33 KB Posted
- Attached to
- Partnership for ADU Development (PAD) Partner
- Solicitation number
- OPCD-RFQ-2026_PAD
- Issued by
- King County, Spokane City, Washington
About this file
This is a Debarment and Suspension Certification form associated with the Seattle Office of Planning and Community Development's (OPCD) Partnership for ADU Development (PAD) Partner Request for Qualifications in Washington State. The form certifies that the applicant organization and its principals are not debarred, suspended, or otherwise excluded from federal contracts or assistance. As a condition of responding to the RFQ, eligible nonprofit organizations must complete and submit this certification to demonstrate their eligibility to receive federal funding, as the PAD program is partially funded through a HUD PRO Housing grant. The certification applies to the organization's participation in the pilot phase of the Legacy Homeowner Development Support program, which aims to support low- and moderate-income homeowners in adding accessory dwelling units to their properties.
The debarment certification requires the applicant to affirm that neither the organization nor any of its principals, owners, or key personnel appear on the federal System for Award Management (SAM) exclusions list or any other applicable debarment databases. This certification is a federal requirement tied to the HUD funding component of the PAD program and must be submitted as part of the application package. Any applicant unable to certify non-debarment status is ineligible for consideration and funding under this opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| PAD_Partners_Draft_Contract_Template.docx | DOCX document | |
| vendor-questionnaire-federal-aid.docx | DOCX document | |
| Form_Certification_Regarding_Lobbying.docx | DOCX document | |
| Form_SF_LLL_Disclosure-of-lobbying-activities.pdf |
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Debarment and Suspension Certificate of Compliance
The Consultant shall comply and facilitate compliance with applicable federal regulations regarding “Debarment and Suspension (NONPROCUREMENT),” specified in 2 C.F.R. part 180, as well as any implementing regulations of the Federal Grantor. These provisions apply to each contract at any tier of $25,000 or more, and to each contract at any tier for a federally required audit (irrespective of the contract amount), and to each contract at any tier that must be approved by the City of Seattle or the Federal department or agency official irrespective of the contract amount. As such, the Contractor shall verify that its principals, affiliates, and subcontractors are eligible to participate in this federally funded contract and are not presently declared by any Federal department or agency to be:
a) Debarred from participation in any federally assisted Award;
b) Suspended from participation in any federally assisted Award;
c) Proposed for debarment from participation in any federally assisted Award;
d) Declared ineligible to participate in any federally assisted Award;
e) Voluntarily excluded from participation in any federally assisted Award; or
f) Disqualified from participation in any federally assisted Award.
By signing and submitting its bid or proposal, the bidder or proposer certifies as follows:
The Bidder certifies compliance with federal regulations regarding “Debarment and Suspension (NONPROCUREMENT),” specified in 2 C.F.R. part 180 as well as any implementing regulations of the Federal Grantor. This certification is a material representation of fact relied upon by the City of Seattle. If it is later determined by the City of Seattle that the bidder or proposer knowingly rendered an erroneous certification, in addition to remedies available to the City of Seattle, the City of Seattle and the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. The bidder or proposer agrees to comply with the requirements of 2 C.F.R. part 180, subpart C, while this offer is valid throughout the period of any contract that may arise from this offer. The bidder or proposer further agrees to include a provision requiring such compliance in its lower tier covered transactions.
Date:
Company Name:
Printed Name of Contractor’s Authorized Representative:
Signature of Contractor’s Authorized Representative:
Debarment/Suspension Certification Form FAS Revised January 2026
File details come from the government source that posted it. Updated .