TRFP27006986 Debarment.pdf
PDF 200 KB Posted
- Solicitation number
- TRFP27006986
- Issued by
- Rhode Island
About this file
This is a Certification Regarding Debarment, Suspension, and Other Responsibility Matters form issued by the Rhode Island Department of Transportation (RIDOT) for a Stormwater and Drainage System Maintenance, Construction, Asset Management & Prevention project (TRFP27006986). The certification requires prospective primary participants to affirm that they and their principals are not presently debarred, suspended, proposed for debarment, or declared ineligible from covered transactions by any Federal department or agency. Bidders must also certify that within the three-year period preceding the proposal, they have not been convicted of or had civil judgment rendered against them for fraud, criminal offenses related to public transactions, violation of antitrust statutes, or crimes including embezzlement, theft, forgery, bribery, falsification of records, false statements, or receiving stolen property. Additionally, prospective participants must confirm they are not presently indicted or criminally or civilly charged by any governmental entity for such offenses, and that they have not had public transactions terminated for cause or default within the preceding three years.
The form requires bidders to list any exceptions to these certifications, noting that exceptions will not necessarily result in denial of award but will be considered in determining contractor responsibility. For any exceptions noted, the contractor must identify to whom the exception applies, the initiating agency involved, and the dates of the action. Bidders must acknowledge that providing false information may result in criminal prosecution or administrative sanctions, and any contractor noting an exception must contact RIDOT prior to contract award to discuss the exception. The form requires the prospective participant's printed name, signature, and date of certification.
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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: TRFP27006986 |
| Project Name: Stormwater and Drainage System Maintenance, Construction, Asset Management & Prevention |
File details come from the government source that posted it. Updated .