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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,_su_spe_nded,_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: 4{ddt� <br /> 10 <br /> Authorized By: <br /> (Sign) :- (Print N e) <br /> Title: _ Date: <br /> 00476-1 <br /> F:\PublicWorks\ENGINEERING DIVISION PROJECTS\1123 43rd Ave Sidewalk Improvements 26th St.to Airport Dr West\Admim\bid <br /> documents\Master Contract Documents\00476-Certification Regarding Debarment.doc <br />