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Certification Regarding Debarment, Suspension, Ineligibility and Voluntary <br /> Exclusion- Primary Covered Transactions <br /> _ The Bidder certifies that, the firm or any person associated therewith in the capacity of <br /> owner, partner, director, officer, principal , investigator, project director, manager, auditor, and/or <br /> position involving the administration of federal funds : <br /> (a ) are not presently debarred , suspended , proposed for debarment, declared ineligible , or <br /> voluntarily excluded from covered transactions , as defined in 49 CFR s29. 110 (a) , by any federal <br /> department or agency; <br /> (b ) have not within a three-year period preceding this certification been convicted of or had <br /> a civil judgment rendered against it for: commission of fraud or a criminal offense in connection <br /> -- with obtaining , attempting . to obtain , or performing a federal , state, or local government transaction <br /> or public contract; violation of federal or state antitrust statutes; or commission of embezzlement, <br /> theft , forgery , bribery, falsification or destruction of records , making false statements , or receiving <br /> stolen property <br /> (c) are not presently indicted for or otherwise criminally or civilly charged by a federal , <br /> state , or local governmental entity with commission of any of the offenses enumerated in <br /> paragraph (b ) of this certification ; and <br /> _ (d ) have not within a three-year period preceding this certification had one or more federal , <br /> state , or local government public transactions terminated for cause or default. <br /> The Bidder certifies that it shall not knowingly enter into any transaction with any <br /> subcontractor, material supplier, or vendor who is debarred , suspended , declared ineligible, or <br /> voluntarily excluded from participation in this project by any federal agency unless authorized by <br /> the Florida Department of Transportation ." <br /> -- Company Name: Melvin Bush Construction , Inc <br /> -- Authorized By :.z2y 6 Melvin Bush <br /> Sign) ( Print Name) <br /> Title : President Date : 9 / 08 / 2010 <br /> 00476 <br /> r FAPublic Works\ENGINEERING DIVISION PROJECTSW744-8th St-US1 to 6th AveWdmimlbid documents10744 CONTRACT <br /> DOCUMENTS\00476 - Certification Regarding Debarmentdoc <br />