Certification Regarding Debarment, Suspension, Ineligibility
and Voluntary Exclusion
- Lower Tier Covered Transaction
(1) The prospective lower tier participant certifies, by submission of this bid or proposal, that neither it nor its
“principals” [as defined at 49 CFR § 29.105(p)] is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or
agency.
(2) When the prospective lower tier participant is unable to certify to the statements in this certification, such
prospective participant shall attach an explanation to this proposal.
The bidder respondent and all subcontractors hereby certifies that he/she has not been debarred or suspended from
participation in Federal contracts. Please note - separate certification may be photocopied and submitted by each
subcontractor. (Pursuant to 49 CFR, Part 29)
Certified (Contractor)
Company
Signed By
Name
Title
Date
Certified (Sub-Contractor(s))
Company
Signed By
Name
Title
Date
