Certification Debarment Form PDF Details

The Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Lower Tier Covered Transactions protects the integrity of federal spending. It requires every participant in a government-funded contract or subcontract to declare they are not debarred, suspended, or otherwise excluded from doing business with federal agencies.

Who Needs to File This Form

Any entity entering a lower-tier covered transaction must submit this certification. Common filers include subcontractors on federal projects, grant sub-recipients, and vendors supplying goods or services under a federal prime contract. Organizations that handle a contractor affidavit or related federal paperwork often need this document as well. Principal officers, directors, and owners with significant control over the organization are also covered by the filing requirement.

Key Requirements of the Certification

The signer must confirm three things. First, neither the entity nor its principals are currently debarred, suspended, proposed for debarment, or declared ineligible by any federal department or agency. Second, the signer agrees to notify the contracting party immediately if that eligibility status changes after submission. Third, the entity will not knowingly enter into transactions with any excluded party unless authorized by the responsible federal official. These obligations trace back to regulations published in the Federal Register on May 26, 1988.

Consequences of Non-Compliance

Filing a false certification can lead to civil penalties, criminal prosecution under 18 U.S.C. 1001, and permanent exclusion from future government transactions. Agencies may also terminate existing contracts and demand repayment of funds already disbursed. Organizations that depend on federal revenue should maintain accurate records, monitor the SAM exclusions database regularly, and submit truthful certifications on every covered transaction. For related compliance paperwork, see the certificate of compliance form available on FormsPal.

How This Certification Fits Into Federal Procurement

Federal acquisition regulations require prime contractors to collect debarment certifications from every lower-tier participant before awarding a subcontract or purchase order above $25,000. The process works as a cascading chain of assurance: the prime contractor certifies to the federal agency, and each subcontractor certifies to the prime. This layered approach keeps excluded parties out at every spending level. Contracting officers may also verify a participant's status directly through SAM.gov before finalizing an award. If your organization is dealing with a suspension form, contact the relevant agency to understand the reinstatement process before attempting to certify.

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

How to Edit Certification Debarment Form Online for Free

Fill out your debarment certification quickly using the PDFinity® online PDF editor. The tool lets you type directly into form fields, add your signature, and save a completed copy in minutes. Here is how to get started.

Step 1: Click the "Get Form" button at the top of this page to open the editor.

Step 2: Enter the required details, including your organization name, transaction reference number, and the certification statement confirming your eligibility. You can also attach supporting documents or add notes to clarify any field.

With regards to the blank fields of this particular form, here's what you need to do:

1. Complete every section of the document carefully. Double-check all entries against your official records before moving on.

The way to fill out how to 1624 part 1

Step 3: Review each field for accuracy, then press "Done" to save. You can download a PDF copy or store it in your FormsPal account for future reference.

Common Questions

What is a lower-tier covered transaction?

A lower-tier covered transaction is any contract, subcontract, or purchase order funded by federal money when the value exceeds $25,000. Participants at this level must declare their eligibility before the transaction can proceed. The threshold applies to the individual transaction, not the total project value.

How do I check if my organization is debarred?

Search the System for Award Management (SAM) exclusions database maintained by the U.S. General Services Administration at SAM.gov. Any entity listed there is currently excluded from federal procurement. Updates appear within 24 to 48 hours of an agency decision, so check close to your filing date for the most current status.

Can I use this form for state-level contracts?

This certification covers federal transactions governed by Executive Order 12549. Some states require a separate debarment certification for state-funded projects, and those forms may differ in scope and legal basis. Check your state procurement office for local requirements.

What happens if my status changes after I file?

You must notify the contracting party immediately in writing. Failing to disclose a change in debarment or suspension status can result in the same penalties as filing a false certification. Most federal contracts include a continuing obligation clause that makes this notification requirement binding throughout the contract period.

How often do I need to submit this certification?

A new certification is required for each separate lower-tier covered transaction. If your organization enters multiple subcontracts under different prime contracts, you must file a separate certification for each one. There is no blanket annual filing that covers all transactions at once.