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 photo
copied and submitted by each subcontractor. (Pursuant to 49 CFR, Part 29)
CERTIFIED (Contractor) CERTIFIED (Sub-Contractor(s))
| | | |
Company Company
| | | |
Signed By Signed By
| | | |
Name & Title Name & Title
| | | |
Date Date
DISCLOSURE OF LOBBYING ACTIVITIES
32
