AVEC RFP No. PUR-97G-03/12 - Alaska Village Electric Cooperative

Contractor Certification
This proposal is submitted in response to PUR-97G-03/12 issued by AVEC. The undersigned is
a duly authorized officer and hereby certifies that:
IS
IS NOT
(Contractor Name)
currently debarred, suspended, or proposed for debarment by any federal entity. The
undersigned agree to notify AVEC of any change in this status, should one occur, until such
time as a contract has been made under the RFP.
Person[s] authorized to negotiate on behalf of this firm for purposes of this RFP are:
Name:
Signature:
Name:
Signature:
Title:
Date:
Title:
Date:
Signature of Authorized Officer:
Name:
Signature:
Title:
Date: