RFA-21-18-WEA Page 70 of 76
ATTACHMENT H (Page 1)
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR CONTRACTS AND GRANTS
NAME OF INDIVIDUAL, AGENCY, BUSINESS OR
ORGANIZATION
Doing business as (DBA), if applicable:
ADDRESS
Applicable Procurement or Solicitation #,
if any:
Federal Employer Tax Identification
#:
READ CAREFULLY BEFORE SIGNING THIS CERTIFICATION. Federal regulations
require contractors, bidders, and sub grantees to sign and abide by the terms of
this certification, without modification, in order to participate in certain
transactions directly or indirectly involving federal funds.
1. By signing and submitting this certification, the prospective vendor/grantee is attesting/acknowledging
the representations set out below.
2. This certification is a material representation of fact upon which the Alamo Area Council of
Governments (AACOG) will rely on when this transaction is entered into. If it is later determined that
the prospective vendor/grantee knowingly rendered an erroneous certification, in addition to other
remedies available to Federal or State departments or funding agency(s), AACOG may pursue on its
own available remedies, including contract termination, suspension and debarment.
3. The prospective vendor/grantee shall provide immediate written notice to AACOG, Director of
Administrative Services, 8700 Tesoro Drive, Suite 130, San Antonio, TX 78217, if at any time it
learns that its certification was erroneous when submitted or has become erroneous by reason
of changed circumstances.
4. The terms “covered contract”, “debarred”, “suspended”, “ineligible”, “participant”, “person”, “principal”,
“application”, and “voluntarily excluded”, as used in this certification, have meanings based upon
materials in the Definitions and Coverage sections of federal rules implementing Executive Order
12549. You may contact the person to which this application or contract is submitted for assistance in
obtaining a copy of this regulation.
5. The prospective vendor/grantee agrees, by submitting this certification, that should the proposed
contract/grant be entered into, it shall not knowingly enter into any lower-tier-covered transaction or
sub-contract with a person or entity that is proposed for debarment, debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this transaction, unless pre-authorized by the
appropriate federal or state department or agency, or by AACOG.
Do you have or do you anticipate having sub-vendors/sub-grantees under this proposed
agreement?
Yes No
6. The prospective vendor/grantee further agrees by submitting this certification, that it will include this
certification titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
for Contracts and Grants,” without modification, in all lower-tier covered transactions and sub-contracts
and in all solicitations for lower-tier covered transactions and sub-contracts.
7. A vendor/grantee may rely upon a certification of a prospective participant that it is not proposed for
debarment, debarred, suspended, ineligible, or voluntarily excluded from the transaction, unless it
knows that the certification is erroneous. Each vendor/grantee is required to check the list of parties
excluded from Federal and State Procurement and Non-procurement Programs. AACOG checks this
list for all parties to which it provides funds that are derived directly or indirectly from the
Federal Government.
8. Nothing contained in the foregoing shall be construed to require the establishment of a system of
records in order to render in good faith the certification required by this certification document.
Participants are not required to have knowledge and information exceeding that which is normally
possessed by a prudent person in the ordinary course of business activity.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
transaction knowingly enters into a lower-tier transaction or contract with a person who is proposed for
debarment, debarred, suspended, ineligible, or voluntarily excluded from participation, in addition to
other remedies available to the Federal Government, AACOG or its applicable funding agency(s) may
pursue available remedies, including contract termination, suspension and/or debarment.