TRFP26006507 Debarment.pdf
PDF 199 KB Posted
- Attached to
- Memorial Benches and Commemorative Plaques
- Solicitation number
- RFQ26006077
- Issued by
- Providence County, Rhode Island
About this file
This is a Certification Regarding Debarment, Suspension, and Other Responsibility Matters form issued by the Rhode Island Department of Environmental Management (RIDEM) for Project TRFP26006507, Warren Resilience & Managed Retreat Research & Strategies. The certification requires prospective primary participants to attest under penalty of perjury that they and their principals are not debarred, suspended, proposed for debarment, or declared ineligible from covered transactions by any Federal department or agency. Bidders must confirm they have not been convicted of or had civil judgments rendered against them for fraud, criminal offenses, antitrust violations, embezzlement, theft, forgery, bribery, falsification or destruction of records, false statements, or receiving stolen property within the three-year period preceding the proposal. Additionally, prospective participants must certify they are not currently indicted or criminally or civilly charged with any enumerated offenses and have not had public transactions terminated for cause or default within the three-year period preceding the application.
The form requires the prospective primary participant to list any exceptions to the certification statements, noting that exceptions will not necessarily result in denial of award but will be considered in determining contractor responsibility. For any exception noted, the contractor must indicate to whom it applies, the initiating agency, and the dates of the action. Contractors unable to certify to any statements must contact the Department prior to contract award to discuss exceptions. The form includes fields for the contractor's printed name, signature, and date of execution, with a notation that providing false information may result in criminal prosecution or administrative sanctions.
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Text version
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
AND OTHER RESPONSIBILITY MATTERS
PRIMARY COVERED TRANSACTIONS
In accordance with the code of Federal Regulations, Part 49 CFR Section 29.5 10, the prospective primary participant , , being duly sworn (or executed under penalty of perjury under the laws of the United States), certifies to the best of his/her knowledge and belief, that 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 judgment 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 statues 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 governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (l)(b) of this certification;
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 or default.
Contract Number:
Contract Name:
Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall list exceptions below.
Exceptions will not necessarily result in denial of award, but, will be considered in determining contractor responsibility. For any exception noted, indicate below to whom it applies, the initiating agency, and the dates of the action. Providing false information may result in criminal prosecution or administrative sanctions. If an exception is noted the contractor must contact the Department to discuss the exception prior to award of the contract.
Print Name: ___________________________________
Signature: ___________________________________ Date: __________________ Revised 4-7-22
| PrintName: |
| DateDebarment: |
| Project Number: TRFP26006507 |
| Project Name: Warren Resilience & Managed Retreat Research & Strategies |
File details come from the government source that posted it. Updated .