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11
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2016
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050316
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11
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11/30/2016 1:47:49 PM
Creation date
4/29/2016 11:51:13 AM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
5/3/2016
DESTRUCT DATE
15Y
DOCUMENT NO
11
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Master Contract No.900973,Procurement Contract No.7485 <br /> EXHIBIT D <br /> COUNTY OF ALAMEDA <br /> DEBARMENT AND SUSPENSION CERTIFICATION <br /> The contractor,under penalty of perjury,certifies that,except as noted below, <br /> contractor,its principals,and any named and unnamed subcontractor: <br /> • Is not currently under suspension,debarment,voluntary exclusion,or <br /> determination of ineligibility by any federal agency; <br /> • Has not been suspended,debarred,voluntarily excluded or determined <br /> ineligible by any federal agency within the past three 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 <br /> a court of competent jurisdiction in any matter involving fraud or official <br /> misconduct within the past three years. <br /> If there are any exceptions to this certification,insert the exceptions in the following <br /> space. <br /> Exceptions will not necessarily result in denial of award,but will be considered in <br /> determining contractor responsibility. For any exception noted above,indicate below <br /> to whom it applies,initiating agency,and dates of action. <br /> Notes: Providing false information may result in criminal prosecution or <br /> administrative sanctions. The above certification is part of the Standard Services <br /> Agreement. Signing this Standard Services Agreement on the signature portion <br /> thereof shall also constitute signature of this Certification. <br /> t <br /> CONTRACTOR: Q P/ec.ca,.j' <br /> PRINCIPAL: I, . I r I TITLE: A'real;r a sr-a.f i`dn/S <br /> SIGNATURE: !4IAPI DATE: S`i y/A <br />
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