My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ANAHEIM, CITY OF (10)
Clerk
>
Contracts / Agreements
>
A
>
ANAHEIM, CITY OF (10)
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/19/2024 2:05:21 PM
Creation date
10/25/2023 3:27:53 PM
Metadata
Fields
Template:
Contracts
Company Name
ANAHEIM, CITY OF
Contract #
A-2023-182
Agency
Police
Council Approval Date
10/17/2023
Expiration Date
3/31/2025
Destruction Year
2030
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
40
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
EXHIBIT B <br /> CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER <br /> RESPONSIBILITY MATTERS <br /> Applicants should refer to the regulations cited below to determine the certification to which they are required <br /> to attest. Applicants should also review the instructions for certification included in the regulations before <br /> completing this form. Signature of this form provides for compliance with certification requirements under <br /> the applicable CFR covering New Restrictions on Government-wide Debarment and Suspension <br /> (Nonprocurement).The certification shall be treated as a material representation of fact upon which reliance <br /> will be placed when the Agency determines to award the covered transaction or cooperative agreement. <br /> As required by Executive Order 12549, Debarment and Suspension, and implemented under the applicable <br /> CFR, for prospective participants in covered transactions, as defined in the applicable CFR <br /> A. The applicant certifies that it and its principals: <br /> (a) Are not presently debarred,suspended,proposed for debarment,declared ineligible,sentenced to <br /> a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered <br /> transactions by any Federal department or agency; <br /> (b) Have not within a three-year period preceding this application been convicted of or had a civil <br /> judgment rendered against them for commission of fraud or a criminal offense in connection with <br /> obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or <br /> contract under a public transaction; violation of Federal or State antitrust statutes or commission <br /> of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false <br /> statements,or receiving stolen property; <br /> (c) Are not presently indicted for or otherwise criminally or civilly charged by a govenunent entity <br /> (Federal State or local) with commission of any of these offenses enumerated in paragraph (1) <br /> (b)of this certification;and <br /> (d) Have not within a three-year period preceding this application had one or more public transactions <br /> (Federal, State or local)terminated for cause or default; and <br /> B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall <br /> attach an ex lanation to this application. <br /> Address: 5,4,V7/4 A,s.'A t�v�2 pt Pi�KTaur�r <br /> Authorize ger ature <br /> DAVTD VAaNTIN 6O CJVZ c, CtN'rtK pLZ <br /> Printed or Typed Name <br /> CARE Dt P041 .E SAN-711 ANA gZ70 1 <br /> Title <br />
The URL can be used to link to this page
Your browser does not support the video tag.