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)
Company
Signed By
Name
Title
Date
Certified (Sub-Contractor(s))
Company
Signed By
Name
Title
Date
