Code: EFAB-E (2)
Certification Regarding Debarment,
Suspension, Ineligibility
And Voluntary Exclusion
This Certification is for any contract
awarded by a grantee or sub-grantee for federally-required audit services,
regardless of dollar amount, and for any other procurement contract expected to
equal or exceed $25,000.00.
(BEFORE COMPLETING CERTIFICATION, READ
INSTRUCTIONS ON REVERSE.)
(1) The prospective bidder or participant, by
submission of this form, certifies that neither it nor its principals are
presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal
department or agency.
(2) Where the prospective bidder or
participant is unable to certify to any of the statements in this
Certification, such prospective bidder or participant shall attach an
explanation to this proposal.
___________________________________________________________________________________
Organization Name PR/Award
Number or Project Name
___________________________________________________________________________________
Name(s) and Title(s) of Authorized
Representative(s)
___________________________________________________________________________________
Signature(s) Date
Instructions for
Certification
1. By signing and submitting this form,
the prospective bidder or participant is providing the certification set out on
the reverse side in accordance with these instructions.
2. The
certification in this clause is a material representation of fact upon which
reliance was placed when this transaction was entered into. If it is later determined that the
prospective bidder or participant knowingly rendered an erroneous
certification, in addition to other remedies available, the School Food
Authority (SFA) or agency with which this transaction originated may pursue
available remedies, including suspension and/or debarment.
3. The
prospective bidder or participant shall provide immediate written notice to the
person or SFA to which this proposal is submitted if at any time the
prospective bidder or participant learns that its certification was erroneous
when submitted or has become erroneous by reason of changed circumstances.
4. The
prospective bidder or participant agrees by submitting this form that, should
the proposed transaction be entered into, it shall not knowingly enter into any
transaction with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this transaction, unless authorized
by the department or agency with which this transaction originated.
5. Nothing
contained in the foregoing shall be construed to require establishment of a
system of records in order to render in good faith the certification required
by this clause. The knowledge and
information of a bidder or participant is not required to exceed that which is
normally possessed by a prudent person in the ordinary course of business
dealings.
Adopted 3/20/14
Amended 1/20/16
Amended 11/21/17