Laserfiche WebLink
"'t -M COPY <br />ATION ON LAST PAGE <br />"i LER, CLL:�K <br />ATTACHMENT G <br />Certification Regarding Debarment, Suspension, <br />Ineligibility <br />And Voluntary Exclusion <br />Contractor Covered Transactions <br />(1) The prospective Contractor or subcontractor of Indian River County <br />certifies, by submission of this document, that neither it nor its principals <br />are presently debarred, suspended, proposed for debarment, declared <br />ineligible, or voluntarily excluded from participation by the State of <br />Florida. <br />(2) In accordance with the requirements of section 287.135(5), F.S., the <br />vendor certifies that it is not participating in a boycott of Israel and is not <br />on the State Board of Administration's "Quarterly List of Scrutinized <br />Companies that Boycott Israel," available at <br />https://www.sbafla.com/governance/global-governance-mandates/. At <br />the Department's option, the Contract may be terminated if the <br />Contractor is placed on the Quarterly List of Scrutinized Companies that <br />Boycott Israel (referred to in statute as the "Scrutinized Companies that <br />Boycott Israel List") or becomes engaged in a boycott of Israel. <br />(3) If the goods or services to be provided are $1 million or more, in <br />accordance with the requirements of section 287.135, F.S., the vendor <br />certifies it is not on the Scrutinized Companies with Activities in Sudan <br />List or the Scrutinized Companies with Activities in the Iran Terrorism <br />Sectors List (collectively, "Scrutinized List of Prohibited Companies"); <br />does not have business operations in Cuba or Syria; and is not on the <br />State Board of Administration's "Scrutinized List of Prohibited <br />Companies" available under the quarterly reports section at <br />https://www.sbafla.com/reporting/ <br />(4) The Vendor certifies it has completed and provided an affidavit signed <br />by an officer or a representative of the Vendor under penalty of perjury <br />attesting that the Vendor does not use coercion for labor or services as <br />defined in section 787.06, F.S. <br />CONTRACTOR: <br />Company Name <br />Name and Title <br />Indian River County <br />Recipient's Name <br />DMS -P1-24-07-17 <br />Department's Contract Number <br />DMS -P1-24-07-17 Page 1 of 2 <br />