Laserfiche WebLink
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Primary <br />Covered Transactions <br />The Bidder certifies that, the firm or any person associated therewith in the capacity of owner, partner, <br />director, officer, principal, investigator, project director, manager, auditor, and/or position involving the administration <br />of federal funds: <br />(a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily <br />excluded from covered transactions, as defined in 49 CFR s29.110(a), by any federal department or agency; <br />(b) have not within a three-year period preceding this certification been convicted of or had a civil judgment <br />rendered against itfor: commission of fraud ora criminal offense in connection with obtaining, attempting to obtain, <br />or performing a federal, state, or local government transaction or public contract; violation of federal or state <br />antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, <br />making false statements, or receiving stolen property <br />(c) are not presently indicted for or otherwise criminally or civilly charged by a federal, state, or local <br />governmental entity with commission of any of the offenses enumerated in paragraph (b) of this certification; and <br />(d) have not within a three-year period preceding this certification had one or more federal, state, or local <br />government public transactions terminated for cause or default. <br />The Bidder certifies that it shall not knowingly enter into any transaction with any subcontractor, material <br />supplier, orvendorwho is debarred, suspended, declared ineligible, orvoluntarily excluded from participation in this <br />project by any federal agency unless authorized by the Florida Department of Transportation." <br />Company Name: <br />Authorized By: <br />(Sign) <br />Title: <br />Date: <br />(Print Name) <br />F:\Engineering\Capital Projects\0216-12th Street Between 16th Avenue and 11th Place\0216 Federal Contract Provisions.doc <br />P-18 s 29/ZXV4, X , -�,l <br />