The Northern Shenandoah Valley Regional Commission (“NSVRC”) is seeking proposals from qualified firms (“Provider” or “Offeror”) interested in providing roll-off recycling containers to support regional recycling capacity in jurisdictions within the NSVRC service area.

Proposal Submission Instructions

Submission Deadline: July 31, 2026, 5PM

RFP 2027-01 is a request for an electronic sealed proposal; therefore, proposals submitted outside of the eVA system, such as via e-mail, mail, fax or hand delivery, WILL NOT be accepted. Electronic sealed proposals will be received until the closing date and time provided in the solicitation.

Prior to the due date, Offerors should:

• Check the status of the solicitation on eVA at www.eva.virginia.gov by clicking on

Business Opportunities and then click on Virginia Business Opportunities (VBO) for any updates, changes, amendments, cancellations, etc.;

• Check the Solicitation in VBO for all attachments and documents to be completed and submitted; and

• Complete all attachments, amendments, exhibits, product information, etc. and attach electronically to the Offeror’s electronic submission.

Offerors are solely responsible for reviewing, complying, and returning a complete and responsive proposal. Failure to submit any of the required information may result in the proposal receiving a lower evaluation score. Changes to the solicitation’s forms or formats are prohibited except where clearly instructed and permitted.

Questions and Clarifications All questions regarding this RFP must be submitted via email to:

Amanda Kerns, Senior Planner Email: akerns@nsvregion.org

The deadline to submit questions is Friday July, 17 2026, by 5:00 PM. No questions will be accepted after this time.

REQUEST FOR PROPOSALS

Regional Recycling Roll-Off Containers

RFP No. NSVRC 2027-001 July 1, 2026 http://www.eva.virginia.gov/ mailto:akerns@nsvregion.org

A consolidated response to all questions received by the deadline will be issued in the form of an RFP addendum and posted on the eVA website no later than 5:00 PM July 21, 2026. It is the responsibility of each Offeror to monitor eVA for updates and addenda related to this solicitation.

Proposal Submission:

Electronic proposal submission with required documents attached is required. Offerors must be registered in eVA in order to submit an electronic proposal. Offerors must submit one (1) complete copy of the proposal and all required documents and/or attachments.

The following are instructions for submitting an electronic proposal:

a. Go to www.eva.virginia.gov;

b. Click on “I Sell To Virginia”;

c. Click on “eVA Supplier Training”; and

d. Click on “Viewing and Responding to Solicitations Video”.

Note: Offerors need to ensure that they submit their electronic response to the latest version of the solicitation.

If an Offeror needs assistance submitting an electronic response, the Offeror must contact eVA Customer Care at 866-289-7367 or email eVACustomerCare@dgs.virginia.gov.

http://www.eva.virginia.gov/ mailto:eVACustomerCare@dgs.virginia.gov

1. Introduction

The Northern Shenandoah Valley Regional Commission (NSVRC), on behalf of participating local governments and solid waste management programs within the Northern Shenandoah Valley region, is soliciting sealed proposals from qualified manufacturers, fabricators, or authorized distributors for the manufacture and delivery of recycling roll-off containers.

This procurement is funded in part through the United States Environmental Protection Agency (EPA) Solid Waste Infrastructure for Recycling (SWIFR) Program and is intended to support regional recycling infrastructure improvements throughout the Northern Shenandoah Valley.

NSVRC intends to award a contract to a responsible proposer capable of providing high-quality, heavy-duty recycling containers that meet the specifications contained in this solicitation and support long-term municipal recycling operations. The resulting contract may include multiple container configurations, phased production schedules, and deliveries to multiple locations throughout the region.

All equipment furnished under this procurement shall be new, unused, and manufactured in accordance with applicable industry standards for municipal solid waste and recycling operations.

2. Project Background

The Northern Shenandoah Valley Regional Commission serves the counties of Clarke, Frederick, Page, Shenandoah, and Warren, the City of Winchester, and the fourteen incorporated towns located within those jurisdictions. Through the Regional Solid Waste Management Technical Committee, participating local governments coordinate planning and implementation of solid waste management and recycling programs on a regional basis.

In 2023, NSVRC was awarded funding through the United States Environmental Protection Agency's Solid Waste Infrastructure for Recycling (SWIFR) Program to implement projects designed to expand and optimize recycling services throughout the region. These investments support goals identified in the Northern Shenandoah Valley Regional Solid Waste Management Plan, including increasing recycling capacity, improving operational efficiency, enhancing public access to recycling opportunities, and modernizing recycling infrastructure.

A portion of the SWIFR funding is dedicated to the replacement and expansion of regional recycling collection equipment. Existing containers at landfill convenience sites, transfer stations, and public recycling locations have reached or are approaching the end of their useful service life. Additional capacity is also needed to support increasing recycling volumes and improve operational efficiency throughout the region.

Through this procurement, NSVRC seeks to acquire a combination of open-top and enclosed recycling roll-off containers that will support current recycling operations and provide long-term infrastructure improvements benefiting participating localities across the Northern Shenandoah Valley.

3. Scope of Work

The selected Contractor shall provide all labor, supervision, engineering, materials, fabrication, coatings, assembly, quality control, transportation, delivery coordination, and related services necessary to manufacture and deliver recycling roll-off containers meeting the requirements of this solicitation.

The Contractor shall furnish complete, fully operational containers suitable for continuous use in municipal recycling collection, transfer, and disposal operations. Containers will be utilized at landfill convenience sites, transfer stations, public recycling drop-off locations, and other facilities throughout the Northern Shenandoah Valley region.

Containers shall be designed to withstand repeated loading, hauling, unloading, transportation, and exposure to outdoor environmental conditions associated with high-volume municipal recycling operations. All structural components, floor systems, sidewalls, roof systems, doors, rollers, hook assemblies, reinforcements, welds, and coatings shall be designed and fabricated in accordance with recognized industry standards for heavy-duty waste and recycling equipment.

The Contractor shall coordinate production schedules and deliveries with NSVRC and participating jurisdictions. Deliveries may occur in phases and may be directed to multiple locations throughout the region.

NSVRC recognizes that manufacturers may offer alternative configurations or enhancements that improve safety, durability, operational efficiency, maintenance requirements, or public usability. Proposers may recommend modifications to the requested container configurations, including structural enhancements, access features, coating systems, identification systems, numbering schemes, decals, graphics, branding elements, or other value-added improvements. Any proposed modifications shall be clearly identified within the proposal and separately itemized within the pricing submission.

NSVRC reserves the right to accept or reject any proposed modification and may negotiate final container configurations with the selected Contractor prior to contract execution.

A. Container Quantities

NSVRC intends to procure a combination of open-top and enclosed recycling roll-off containers in multiple capacities to support varying operational needs throughout the Northern Shenandoah Valley region.

The anticipated quantities are as follows:

Container Type Approximate Quantity

30-Yard Roll-Off Containers 70

40-Yard Roll-Off Containers 1

50-Yard Open-Top Roll-Off Containers 16

The quantities identified above are estimates and are provided for proposal preparation purposes only. NSVRC reserves the right to increase or decrease quantities, modify container configurations, award by line item, award by container type, or make no award if determined to be in the best interest of the project.

B. Container Types and Intended Uses

The containers procured through this solicitation will be utilized at landfill convenience sites, transfer stations, public recycling drop-off locations, and other municipal recycling facilities throughout the Northern Shenandoah Valley region.

The procurement is anticipated to include a combination of:

• Standard open-top recycling containers;

• Fully enclosed recycling containers with roof systems;

• Sliding access doors for public recycling drop-off;

• Side-access loading doors;

• Reinforced structures suitable for high-frequency municipal recycling operations;

and

• Other manufacturers recommend configurations that improve operational efficiency, safety, or durability.

Enclosed recycling containers will primarily be utilized at staffed and semi-staffed public recycling convenience sites where contamination reduction, material security, and weather protection are operational priorities. These units are expected to incorporate roof systems and controlled-access loading openings designed to reduce illegal dumping, minimize contamination, and protect recyclable materials from precipitation and wind.

Open-top containers will primarily support high-volume collection operations, material transfer activities, and overflow recycling capacity where operational flexibility and rapid loading are necessary.

NSVRC recognizes that manufacturers may offer alternative configurations or design enhancements based upon operational experience and product performance. Proposers may recommend alternative door configurations, roof systems, structural reinforcements, access features, graphics packages, decal systems, identification markings, numbering systems, coating upgrades, or other modifications that improve functionality, longevity, maintenance requirements, or user accessibility. Any proposed modifications shall be clearly identified and separately described within the proposal and pricing submission.

C. Fabrication Requirements

All containers shall be fabricated using new materials and shall be designed for long-term, heavy-duty municipal recycling service.

Container construction shall include structural reinforcements, heavy-duty flooring systems, wall supports, cross-members, hook assemblies, rollers, door systems, roof systems, and related components appropriate for repeated hauling cycles, loading stresses, and continuous public use.

Unless otherwise approved by NSVRC, all containers shall:

• Be fabricated from new steel materials;

• Be compatible with commonly utilized roll-off hauling equipment operating within the region;

• Include commercial-grade hook and roller assemblies;

• Incorporate primer and coating systems suitable for long-term outdoor exposure;

• Be painted in a standard blue finish unless otherwise proposed and approved;

• Be delivered fully assembled and operational;

• Be free from structural defects, material deficiencies, or fabrication flaws;

• Comply with all applicable federal, state, and local requirements;

• Comply with applicable Build America, Buy America (BABA) requirements as specified elsewhere in this solicitation; and

• Be suitable for continuous municipal recycling collection, transfer, and disposal operations.

NSVRC recognizes that manufacturers may recommend design modifications, operational improvements, or product enhancements that differ from the baseline specifications contained in this solicitation. Proposers are encouraged to identify recommendations that improve durability, service life, safety, maintenance requirements, operational efficiency, or user accessibility.

Recommended enhancements may include, but are not limited to:

• Structural reinforcements;

• Alternative access door configurations;

• Roof system enhancements;

• Coating upgrades;

• Custom colors;

• Decals, graphics, recycling education messaging, and branding packages;

• Asset identification systems;

• Serial numbering or tracking systems; and

• Other manufacturer-recommended improvements.

All proposed enhancements shall be clearly identified within the technical proposal and separately itemized within the pricing proposal. NSVRC reserves the right to accept, reject, or negotiate any proposed modification prior to contract award.

D. Delivery, Coordination, and Acceptance

The Contractor shall coordinate all manufacturing schedules, shipping activities, and delivery dates with NSVRC and designated representatives of participating jurisdictions.

Because this procurement supports multiple facilities throughout the Northern Shenandoah Valley region, deliveries may occur at multiple landfill, transfer station, convenience site, or other designated locations within the region. Delivery locations will be provided following contract award.

The proposal shall include:

• Estimated fabrication lead times;

• Proposed production schedule;

• Estimated delivery schedule;

• Shipping origin location(s);

• Identification of subcontracted transportation providers, if applicable; and

• Any unloading, staging, or site requirements necessary for delivery.

NSVRC reserves the right to:

• Request phased or staggered deliveries;

• Modify delivery sequencing based on operational needs;

• Coordinate deliveries among participating jurisdictions;

• Delay deliveries due to site readiness or storage limitations; and

• Accept partial deliveries as containers become available.

All containers shall be delivered fully assembled and operational unless otherwise approved in writing by NSVRC.

Upon delivery, NSVRC and participating jurisdictions shall inspect containers for compliance with the specifications contained in this solicitation. Inspection may include evaluation of:

• Structural integrity;

• Fabrication quality;

• Weld quality;

• Coating and paint systems;

• Door and roof system operation;

• Dimensions and configuration;

• Freight-related damage; and

• General workmanship.

NSVRC reserves the right to reject any container that is damaged, incomplete, materially deficient, or otherwise fails to conform to the requirements of this solicitation. Rejected units shall be repaired, replaced, or otherwise remedied at no additional cost to NSVRC.

E. Warranty Requirements

Proposals shall include detailed information regarding manufacturer warranties applicable to the proposed containers and associated fabricated components.

Warranty submissions shall identify:

• Duration of warranty coverage;

• Structural warranty coverage;

• Paint and coating warranty coverage;

• Coverage applicable to doors, hinges, rollers, and related components;

• Exclusions or limitations;

• Responsibilities for repair or replacement;

• Expected response times for warranty claims; and

• Procedures for submitting warranty service requests.

Preference may be given to proposals offering comprehensive warranty coverage, demonstrated responsiveness, and long-term product support.

The Contractor shall remain responsible for honoring all manufacturer warranties for equipment supplied under this contract.

F. Insurance Requirements

Prior to contract execution, the selected Contractor shall furnish certificates of insurance demonstrating coverage from an insurer authorized to conduct business in the Commonwealth of Virginia.

At a minimum, the Contractor shall maintain:

• Commercial General Liability Insurance;

• Automobile Liability Insurance;

• Workers’ Compensation Insurance as required by Virginia law; and

• Employer’s Liability Insurance.

Insurance coverage shall remain in effect for the duration of the contract and any applicable warranty period associated with delivery or corrective work.

NSVRC reserves the right to require additional coverage limits or endorsements prior to contract award. Failure to maintain required insurance coverage may constitute grounds for contract termination.

4. Proposal Requirements

Proposals shall include the following information:

1. Cover Letter

A cover letter signed by an authorized representative of the firm that includes:

• Company name and address;

• Primary contact person;

• Telephone number and email address;

• Acknowledgment of any addenda issued; and

• Statement that the proposer is authorized to submit the proposal.

2. Company Qualifications and Experience

Provide a brief description of the company, including:

• Years in business;

• Experience manufacturing or supplying roll-off containers;

• Experience serving municipal, solid waste, or recycling operations; and

• Three references for similar projects completed within the past five years.

3. Technical Proposal

Provide a description of the proposed containers, including:

• Manufacturer and model information;

• Product specifications and dimensions;

• Materials of construction;

• Standard features;

• Description of any proposed modifications, enhancements, decals, graphics, or optional features; and

• Identification of any exceptions to the specifications contained in this solicitation.

Manufacturer specification sheets, drawings, or product literature may be submitted to satisfy this requirement.

4. Production and Delivery Information

Provide:

• Estimated fabrication lead time;

• Estimated delivery schedule; and

• Shipping origin location.

5. Warranty Information

Provide warranty information consistent with Section 3.E

6. Required Certifications and Forms

Provide all certifications, affidavits, and federal forms required by this solicitation.

7. Pricing Proposal

Proposers shall provide pricing sufficient for NSVRC to evaluate the total cost of the proposed equipment and to assess the impact of potential quantity adjustments prior to contract award.

At a minimum, proposers shall provide:

Item Unit Price

30-Yard Roll-Off Container $______

40-Yard Roll-Off Container $______

50-Yard Open-Top Roll-Off Container $______

Proposers shall also identify any additional costs associated with:

• Enclosed roof systems;

• Side-access doors;

• Sliding access doors;

• Delivery charges, if applicable; and

• Other proposed options or modifications.

In addition to unit pricing, proposers shall describe how pricing is structured, including any:

• Quantity discounts;

• Volume-based pricing adjustments;

• Minimum production run requirements;

• Batch production pricing;

• Delivery-related pricing adjustments; or

• Other factors that may affect pricing if quantities are increased or decreased.

If proposing manufacturer-recommended enhancements, proposers shall separately itemize pricing for optional features such as structural upgrades, coating upgrades, decals, graphics, recycling education messaging, identification systems, numbering systems, or other value-added improvements.

NSVRC reserves the right to increase or decrease quantities, modify container configurations, award by line item, award by container type, or negotiate final quantities prior to contract award.

All pricing shall remain valid for a minimum of ninety (90) days following the proposal submission deadline.

5. Evaluation Criteria

Proposals will be evaluated using the following criteria:

Evaluation Criteria Maximum Points

Technical Proposal and Product Quality 40

Price Proposal 30

Company Experience and Past Performance 20

Production Capacity and Delivery Schedule 10

Total 100

6. FEDERAL REQUIREMENTS AND GRANT COMPLIANCE

This procurement is funded in whole or in part through the United States Environmental Protection Agency (EPA) Solid Waste Infrastructure for Recycling (SWIFR) grant program established under the Bipartisan Infrastructure Law. As a condition of funding, the resulting contract shall comply with all applicable federal statutes, regulations, executive orders, and EPA assistance agreement requirements.

The contractor shall cooperate with NSVRC in maintaining documentation necessary to demonstrate compliance with applicable federal procurement and grant requirements, including documentation associated with domestic sourcing, contract performance, financial accountability, and record retention.

A. Build America, Buy America (BABA)

This procurement is funded in whole or in part through the United States Environmental Protection Agency (EPA) Solid Waste Infrastructure for Recycling (SWIFR) Grant Program and is subject to the Build America, Buy America Act (BABA), Infrastructure Investment and Jobs Act (IIJA), Pub. L. 117-58, including applicable federal guidance and 2 CFR Part 184.

The Northern Shenandoah Valley Regional Commission (NSVRC) has received federal financial assistance from the EPA to procure the equipment identified in this solicitation.

As a result, BABA domestic preference requirements apply to the manufactured products furnished under this Request for Proposals (RFP).

Proposers shall identify within their proposal whether the proposed products comply with BABA requirements. Proposers asserting compliance may be required to provide supporting documentation, manufacturer certifications, sourcing information, and other records necessary to demonstrate compliance with federal domestic content requirements.

At a minimum, proposers shall disclose:

• Manufacturing location(s);

• Final assembly location;

• Country of origin for iron and steel components; and

• Any known non-domestic materials or components incorporated into the proposed units.

All iron and steel products incorporated into the fabricated recycling containers shall be produced in the United States, including applicable manufacturing processes such as melting, forming, rolling, fabrication, coating, and assembly, unless otherwise permitted under an approved federal waiver.

If a proposer cannot fully comply with BABA requirements, the proposer shall provide written documentation identifying:

• The specific non-compliant components or materials;

• Why domestic sourcing cannot reasonably be achieved;

• Availability limitations; and

• Any associated cost impacts.

NSVRC reserves the right to request additional compliance documentation, verify submitted information, and determine whether the proposal satisfies applicable federal requirements.

The successful proposer shall provide a signed manufacturer certification letter prior to award or delivery affirming compliance with applicable BABA requirements. A sample certification letter is included in Appendix A.

Failure to comply with applicable BABA requirements may result in rejection of the proposal, withholding of payment, termination of contract, or other remedies available under applicable law.

Additional information regarding BABA requirements may be found at:

• https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-184

• https://www.whitehouse.gov/wp-content/uploads/2023/10/M-24-02-Buy-America- Implementation-Guidance-Update.pdf

B. Debarment and Suspension

Proposers shall certify that neither the company nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in federally funded transactions pursuant to 2 CFR Part 180 and other applicable federal regulations.

The successful proposer shall submit a completed Debarment Certification Form, included as Appendix B, prior to execution of a contract agreement. Failure to provide the required certification may result in withdrawal of the award or termination of negotiations.

https://www.ecfr.gov/current/title-2/subtitle-A/chapter-I/part-184 https://www.whitehouse.gov/wp-content/uploads/2023/10/M-24-02-Buy-America-Implementation-Guidance-Update.pdf https://www.whitehouse.gov/wp-content/uploads/2023/10/M-24-02-Buy-America-Implementation-Guidance-Update.pdf

NSVRC reserves the right to verify contractor eligibility through the federal System for Award Management (SAM.gov) and to request additional documentation related to federal eligibility requirements at any time during the procurement process.

C. System for Award Management (SAM) Registration

The selected Contractor shall maintain an active registration in the System for Award Management (SAM.gov) throughout the duration of the contract and shall provide a valid Unique Entity Identifier (UEI) upon request.

Failure to maintain active SAM registration may constitute grounds for termination of the contract.

D. Equal Employment Opportunity and Nondiscrimination

The contractor shall comply with all applicable federal nondiscrimination requirements including:

• Title VI of the Civil Rights Act of 1964;

• Section 504 of the Rehabilitation Act;

• Americans with Disabilities Act;

• Age Discrimination Act; and

• applicable EPA nondiscrimination regulations.

The contractor shall not discriminate on the basis of race, color, national origin, sex, religion, disability, age, or other protected status in the performance of the resulting contract.

E. Byrd Anti-Lobbying Amendment

For contracts exceeding applicable federal thresholds, contractors shall comply with the Byrd Anti-Lobbying Amendment, 31 U.S.C. §1352, and shall disclose any lobbying activities associated with the award of federal assistance.

F. Access to Records and Audit Requirements

The Contractor shall maintain all books, documents, papers, accounting records, and other evidence pertaining to costs incurred and work performed under the resulting contract.

Such records shall be made available upon request for inspection, audit, examination, and copying by NSVRC, EPA, the Comptroller General of the United States, the EPA Office of Inspector General, or other authorized governmental representatives.

Records shall be retained for the period required by applicable federal regulations following final payment and closeout of the federal award.

G. Compliance with Federal Contract Requirements

The Contractor shall comply with all applicable federal contract provisions required under 2 CFR Part 200 Appendix II and any additional EPA assistance agreement requirements applicable to this procurement.

Such requirements may include, as applicable:

• Administrative, contractual, and legal remedies;

• Termination for cause and convenience;

• Equal Employment Opportunity requirements;

• Clean Air Act requirements;

• Federal Water Pollution Control Act requirements;

• Byrd Anti-Lobbying Amendment requirements;

• Debarment and Suspension requirements;

• Procurement integrity requirements; and

• Other federal provisions required by law or incorporated into the EPA award.

H. Conflict of Interest

The Contractor shall disclose any actual, apparent, or potential conflicts of interest that may arise in connection with this procurement or the resulting contract.

Failure to disclose a conflict of interest may result in disqualification, contract termination, or other remedies available to NSVRC.

I. Federal Compliance Responsibility

By submitting a proposal, the proposer acknowledges that this procurement is funded through a federal assistance award and agrees to comply with all applicable federal requirements associated with the project.

The selected Contractor shall execute all certifications, assurances, affidavits, and compliance documents required by NSVRC, EPA, or other authorized governmental agencies prior to contract execution.

7. NSVRC Reservation of Rights

NSVRC reserves the right to reject any or all proposals, waive minor informalities or irregularities, request clarifications, conduct discussions or negotiations with proposers, and request revised proposals or best and final offers.

NSVRC may award a contract based upon the initial proposals received, make no award, make multiple awards, award by container type or line item, or award in any manner determined to be in the best interest of the project.

NSVRC further reserves the right to increase or decrease quantities, modify specifications, delivery schedules, or project requirements, accept or reject proposed modifications or enhancements, and negotiate final pricing, quantities, and contract terms with the selected proposer.

NSVRC may cancel, revise, postpone, or reissue this solicitation at any time and shall not be liable for any costs incurred by proposers in the preparation or submission of proposals.

Issuance of this solicitation does not obligate NSVRC to award a contract.

APPENDIX A: BUILD AMERICA, BUY AMERICA (BABA) CERTIFICATION

[Date]

Northern Shenandoah Valley Regional Commission Attn: Amanda Kerns, Regional Planner 1729 N Shenandoah Ave, 2nd Floor Front Royal, VA 22630

Subject: Build America, Buy America Certification for SWIFR-Funded Roll-Off Container Procurement

Dear Ms. Kerns:

This letter certifies that the following product(s): [product name(s)] manufactured in (city, state):

and proposed for delivery under the Northern Shenandoah Valley Regional Commission's SWIFR-funded Roll-Off Container Procurement are in full compliance with the Build America, Buy America Act (BABA) requirements established under the Infrastructure Investment and Jobs Act (IIJA), Pub. L. 117-58, and 2 CFR Part 184.

The undersigned manufacturer certifies that the proposed manufactured products satisfy all applicable domestic preference requirements and exceed the required United States-manufactured component threshold for manufactured products established under applicable federal regulations.

The manufacturer further certifies that all information contained herein is accurate and complete to the best of its knowledge and that any material change affecting compliance with Build America, Buy America requirements will be promptly disclosed to the Northern Shenandoah Valley Regional Commission.

This certification is provided in support of the proposer's submission in response to the NSVRC Request for Proposals for Roll-Off Recycling Containers.

Sincerely, Authorized Signature

Printed Name: _____________________________________________

Title: _____________________________________________

Manufacturer Name

Manufacturer Address

Telephone Number

Email Address

Date: _________________________________

Appendix B: Certification Regarding Debarment, Suspension, and Ineligibility

This certification is required by the U.S. Environmental Protection Agency (EPA) regulations, including 2 CFR Part 180 and Executive Order 12549, and applies to recipients of federal funds passed through the Virginia Department of Environmental Quality (DEQ) to the Northern Shenandoah Valley Regional Commission (NSVRC).

By signing below, the proposer certifies that:

1. Neither the organization nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in any federally funded program or activity.

2. The organization has not been convicted or had a civil judgment rendered against it within the past three years for fraud, a criminal offense, or other violations related to public funds.

3. The organization is not currently indicted or otherwise criminally or civilly charged by a government entity for any of the offenses listed in 2 CFR 180.800.

4. The organization has not had a public contract or agreement terminated for cause or default within the past three years.

If the proposer is unable to certify to any of the statements above, an explanation must be attached to this form.

This certification is a material representation of fact upon which NSVRC will rely when evaluating proposals. If it is later determined that the proposer knowingly rendered an erroneous certification, the proposal may be rejected or the contract terminated.

Authorized Representative:

Organization Name: _______________________________________________________________

Name & Title: ______________________________________________________________________

Signature: _____________________________________________ Date:_____________________