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08
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2012
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030612
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08
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2/29/2012 1:30:28 PM
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2/29/2012 1:30:14 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
3/6/2012
DESTRUCT DATE
15Y
DOCUMENT NO
08
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EXHIBIT N <br /> COUNTY OF ALAMEDA <br /> RFP No. 900973 <br /> for <br /> Operation and Maintenance Services of Sewer and Water Systems in the Alameda <br /> County Service Area (CSA) R-1967-1 Castlewood <br /> DEBARMENT AND SUSPENSION CERTIFICATION <br /> For Procurements Over $25,000 <br /> The bidder, under penalty of perjury, certifies that, except as noted below, bidder, its Principal, and <br /> any named and unnamed subcontractor: <br /> • Is not currently under suspension, debarment, voluntary exclusion, or determination of <br /> ineligibility by any federal agency; <br /> • Has not been suspended, debarred, voluntarily excluded or determined ineligible by any <br /> federal agency within the past three (3) years; <br /> • Does not have a proposed debarment pending; and <br /> • Has not been indicted, convicted, or had a civil judgment rendered against it by a court of <br /> competent jurisdiction in any matter involving fraud or official misconduct within the past <br /> three (3) years. <br /> If there are any exceptions to this certification, insert the exceptions in the following space. <br /> Exceptions will not necessarily result in denial of award, but will be considered in determining <br /> bidder responsibility. For any exception noted above, indicate below to whom it applies, initiating <br /> agency, and dates of action. <br /> Notes: Providing false information may result in criminal prosecution or administrative sanctions. <br /> The above certification is part of the Proposal. Signing this Proposal on the signature <br /> portion thereof shall also constitute signature of this Certification. <br /> BIDDER: <br /> PRINCIPAL: TITLE: <br /> SIGNATURE: DATE: <br /> Exhibit N <br /> Page I of I <br />
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