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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 /> � f , <br /> Company Name : NVU <br /> Authorized By ` p <br /> (Sign) (Print Name) <br /> }, �cJ <br /> Title: VV* Date: �, � �;Ka2. <br /> iyC- •' , <br /> 4 <br /> 00476 <br /> " FAPublic Works\ENGINEERING DIVISION PROJECTS\1102-Old Dixie Hwy Swk 8th St to SR 60-LAP\Admim\bid documents\LAP <br /> qt ,. <br /> Documents\00476 - certification Regarding Debarment.doc <br />