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17
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2014
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041514
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17
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8/19/2015 3:30:23 PM
Creation date
4/8/2014 3:39:39 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
4/15/2014
DESTRUCT DATE
15Y
DOCUMENT NO
17
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Master Contract No. 900973, Procurement Contract No.7485 <br /> EXHIBIT A <br /> COUNTY OF ALAMEDA <br /> DEBARMENT AND SUSPENSION CERTIFICATION <br /> The contractor,under penalty of perjury, certifies that, except as noted below, contractor, <br /> its principals, and any named or unnamed subcontractor: <br /> o Is not currently under suspension,debarment, voluntary exclusion, or <br /> determination of ineligibility by any federal agency; <br /> o Has not been suspended,debarred, voluntarily excluded or determined ineligible by <br /> any federal agency within the past three years; <br /> o Does not have a proposed debarment pending; and <br /> e Has not been indicted, convicted, or had a civil judgment rendered against it by a <br /> court of competent jurisdiction in any matter involving fraud or official misconduct <br /> within the past three years. <br /> If there are any exceptions to this certification, insert the exceptions in the following space. <br /> Exceptions will not necessary result in denial of award,but will be considered in <br /> determining contractor responsibility. For any exception noted above, indicate below to <br /> whom it applies, initiating agency, and dates of action. <br /> Notes: Providing false information may result in criminal prosecution or administrative <br /> sanctions. The above certification is part of the Standard Services Agreement. <br /> Signing this Standard Services Agreement on the signature portion thereof shall <br /> also constitute signature of this Certification. <br /> CONTRACTOR: CITY OF PLEASANTON <br /> PRINCIPAL: TITLE: <br /> SIGNATURE: DATE: <br />
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