Certification Debarment Form PDF Details

The Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Lower Tier Covered Transactions plays a critical role in maintaining the integrity and trustworthiness of business dealings within federal contracts and transactions. Stemming from regulations implementing Executive Order 12549, detailed in the Federal Register on May 26, 1988, and codified in 13 CFR Part 145, this certification mandates that entities and their principals entering into federally funded lower tier transactions declare their eligibility status in regards to debarment and suspension. This safeguard ensures that the federal government collaborates only with reliable parties that adhere to high ethical standards. The certification process demands a prospective participant to affirmatively state that neither it nor its principals are under debarment, suspension, proposed debarment, declared ineligible, or voluntarily excluded from federal transactions. This requirement, coupled with the obligation to furnish immediate notification if a previously provided certification becomes erroneous due to changed circumstances, underscores the emphasis on transparency and current eligibility status. Additionally, by submitting this certification, entities agree to avoid engaging lower tier transactions with disqualified parties, unless explicitly authorized, thereby extending the reach of these regulations to ensure compliance across all transactional levels. Further, the guidelines permit reliance on the certification provided by lower tier participants unless known discrepancies exist, reflecting a balance between trust and due diligence in federal engagements.

QuestionAnswer
Form NameCertification Debarment Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform certification regarding, prospective debarment suspension fillable, sba form certification, certification regarding debarment

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Certification Regarding

Debarment, Suspension, Ineligibility and Voluntary Exclusion

Lower Tier Covered Transactions

This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 13 CFR Part 145. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). Copies of the regulations may be obtained by contacting the person to which this proposal is submitted.

(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)

(1)The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

(2)Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

Business Name

Date

By

Name and Title of Authorized Representative

Signature of Authorized Representative

SBA Form 1624 (12/92)

This form was electronically produced by Elite Federal Forms, Inc.

- 2 -

INSTRUCTIONS FOR CERTIFICATION

1.By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below.

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 lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

3.The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

4.The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations (13CFR Part 145).

5.The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated.

6.The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

7.A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List.

8.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 participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

9.Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

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