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2016-188A
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2016-188A
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Last modified
12/1/2016 11:35:28 AM
Creation date
12/1/2016 11:33:50 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
11/08/2016
Control Number
2016-188A
Agenda Item Number
8.J.
Entity Name
Timothy Rose Contracting Inc.
Subject
Contract & specifications
8th St. Sidewalk Improvements
Area
58th Ave. to 21st Ct.
Project Number
1049
Bid Number
2017009
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SECTION 00476 <br /> 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: 1 <br /> �� P)01�4, QJ4 <br /> Authorized B . <br /> (Sign) (Print Na' e) <br /> Title: �.� Date:�C(�. 9` d(y <br /> 00476 <br /> F:\Public Works\ENGINEERING DIVISION PROJECTS\1049_13th St Sidewalk Improvements(58th Ave to 21st Court)\Admim\bid <br /> documents\LAP Documents\00476-Certification Regarding Debarment.doc <br />
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