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23A - PROJ - PAVEMENT MAINTENANCE
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01/17/2017
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23A - PROJ - PAVEMENT MAINTENANCE
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Last modified
1/12/2017 3:57:50 PM
Creation date
1/12/2017 2:49:45 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
1/17/2017
Destruction Year
2022
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DEBARMENT AND SUSPENSION CERTIFICATION <br />TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 <br />The bidder, under penalty of perjury, certifies that, except as noted below, he /she or any other <br />person associated therewith in the capacity of owner, partner, director, officer, manager: <br />• is not currently under suspension, debarment, voluntary exclusion, or determination of <br />ineligibility by any Federal agency; <br />• has not been suspended, debarred, voluntarily excluded or determined ineligible by any <br />Federal agency within the past 3 years; <br />• does not have a proposed debarment pending; and <br />• has not been indicted, convicted, or had a civil judgment rendered against it by a court of <br />competent jurisdiction in any matter involving fraud or official misconduct within the <br />past 3 years. <br />If there are any exceptions to this certification, insert the exceptions in the following space. <br />N <br />Exceptions will not necessarily result in denial of award, but will be considered in determining <br />bidder responsibility. For any exception noted above, indicate below to whom it applies, <br />initiating agency, and dates of action, <br />Notes: Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certification is part of the Proposal, Signing this Proposal on the signature portion <br />thereof shall also constitute signature of this Certification. <br />23A -40 <br />
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