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Miami -Dade County Solicitation RTQ-00918 -MiamDade County Contractor Due Diligence Affidavit Per MiamDade County Board of County Commissioners (BoarollResolutldp0hurRy Vendors and Contractors shall disclose the foil. condition of award for any contract that exceeds one million dollars ($1,000,000) or that otherwise must be presented to the Board to (1) Provide a list of all lawsuits in the five (5) years prior to bid or proposal submittal that have been filed against the firm, its dire and/or board members based on a breach of contract by the firm; include the case name, number and disposition; (2) Provide a list of any instances in the five (5) years prior to bid or proposal submittal where the firm has defaulted; include circumstances; (3) Provide a list of any instances in the five (5) years prior to bid or proposal submittal where the firm has been debarred or rE noncompliance or npsrformance, such as a notice to cure or a suspension from participating or bidding for contracts, whet Dade County or not. All of the above information shall be attached to the executed affidavit and submitted to the Procurement Contracting Officer (PCO overseeing this solicitation. The Vendor/Contractor attests to providing all of the above information, if applicable, to the PCO. Federal Employer Contract No. :— Identification Number (FEIN): Contract Title: Printed Name of Affiant Printed Title of Affiant Signature of Affiant Name of Firm Address of Firm State Notary-PutfUtate of Notaly Public Information County of Subscribed and sm(onaffmmed) before me this day of, by Type of identification produced Signature of Notary Public I —® Date I__ Zip Code 20 He or she is personally known to me ias produced identification Print or Stamp of Notary Public Expiration Date Serial Number Notary Public Seal 5/3/2019 7:48 AM p. 15