RFQ 18-904-27 | U.S.-Made UAS for DEC Emergency Response Operations

Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion Lower-tier
Covered Transactions
NOTE: Before completing the certification, please read the instructions on the
second page, as they are an essential component of the certification process.
The regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98,
Section 98.510, and the participant's responsibilities require this certification. The regulations were
published as Part VII of the May 26, 1988, under the Federal Register on pages 19160 through 19211.
By submitting this bid, the prospective recipient of Federal assistance funds certifies that neither it
nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
Where the prospective recipient of Federal assistance funds cannot certify any of the Statements in
this certification, such prospective participant shall attach an explanation to this Proposal.
Printed Name and Title of Authorized Representative
Signature Date
DUNS Number or Cage Code
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Instructions for Certification
By signing and submitting this proposal, the prospective recipient of Federal assistance funds will
provide the certification as set out below.
The certification in this class is a material representation of fact upon which reliance was placed when
this transaction was entered into. If it is later determined that the prospective recipient of Federal
assistance funds knowingly rendered an erroneous certification and other remedies available to the
Federal Government, the Department of Labor (DOL) may pursue available remedies, including
suspension and/or debarment.
The prospective recipient of Federal assistance funds shall provide immediate written notice to the
person to whom this Proposal is submitted if, at any time, the prospective recipient of Federal
assistance funds learns that its certification was erroneous when submitted or has become erroneous
due to changed circumstances.
The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "Proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
whom this Proposal is submitted for assistance obtaining a copy of those regulations.
The prospective recipient of Federal assistance funds agrees by submitting this Proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into any lower-tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by the DOL.
The prospective recipient of Federal assistance funds further agrees by submitting this Proposal that
it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility, and
Voluntary Exclusion - Lower Tier Covered Transactions," without modification, in all lower-tier
covered transactions and in all solicitations for lower-tier covered transactions.
A participant in a covered transaction may rely upon a prospective participant in a lower-tier covered
transaction's certification that it is not debarred, suspended, ineligible, or voluntarily excluded from
the covered transaction unless it knows that the certification is erroneous. A participant may decide
the method and frequency by which it determines the eligibility of its principals. Each participant
may but is not required to check the List of Parties Excluded from Procurement or Non-procurement
Programs.
Nothing in the foregoing shall be construed to require the establishment of a system of records to
render in good faith the certification required by this clause. A participant's knowledge and
information are not required to exceed that which is normally possessed by a prudent person in the
ordinary course of business dealings.
Except for transactions authorized under paragraph five (5) of these instructions, if a participant in a
covered transaction knowingly enters into a lower-tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction in
addition to other remedies available to the Federal Government, the DOL may pursue available
remedies, including suspension and/or debarment.
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