Exhibit D - Debarment Certification Clause Samples
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below.
Exhibit D - Debarment Certification. EXAMPLE • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. • Any subcontractor will provide a debarment certification that includes the debarment clause as noted in preceding bullets above, without modification.
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. Contractor Contact Information. Contractor: Next Steps Marketing Address: ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Executive Director: ▇▇▇▇ ▇▇▇▇▇, Principal Telephone / Email: ▇▇▇-▇▇▇-▇▇▇▇ Communication and Marketing Plan Goals
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. County of Marin Accessibility Requirements for Delegated Direct Services
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. Part 1: Consultation on County Self-Assessment (11/14/22 – 9/30/23) Project Activities Timeframe
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. Address: ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇ CEO: ▇▇▇▇▇▇▇ ▇▇▇ Telephone/Email: ▇▇▇-▇▇▇-▇▇▇▇ / ▇▇▇▇▇▇▇.▇▇▇@▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ SERVICES TO BE PROVIDED: County of Marin Accessibility Requirements for Delegated Direct Services
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. Contractor: Homeward Bound of Marin Contract Services: Independent Living and Case Management
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. ● The certification in this clause is a material representation of fact relied upon by County. ● The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. ● Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: ▪ Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; ▪ Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; ▪ Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); ▪ Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. ● The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. ● Any subcontractor will provide a debarment certification that includes the debarment clause as noted in preceding bullets above, without modification.
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. Contract Services: Medi-Cal Beneficiary and County Responsible Inpatient Psychiatric Hospital Services Program Contact: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Owner Name: Marin Healthcare District Tax ID: ▇▇-▇▇▇▇▇▇▇ Program Address: ▇▇▇ ▇▇▇ ▇▇▇ ▇▇▇▇ Phone: ▇▇▇-▇▇▇-▇▇▇▇ Licensure: Enrolled as a Medi-Cal provider and complies with all pertinent Medi-Cal regulations and state plan standards regarding access to care and quality of services.
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. EXHIBIT “A” SCOPE OF SERVICES The following services will be provided by Contractor Multicultural Center of Marin (MCM):