CDBG Suspension and Debarment

CDBG Suspension and Debarment - Submission Form

Each prime contractor (general contractor) as well as each subcontractor receiving federal funds for work performed for or through the Travis County CDBG Program shall complete the CDBG Contractor Eligibility Form. All contractors (prime and subs) much be cleared via SAM.gov. Per 2 CFR 200, Travis County must clear a prime contractor of exclusions (suspension and debarment clearance) before we enter into a contract.

Each prime contractor shall be responsible to forward this form, which contains links to the necessary information to ensure all selected subcontractors meet this documentation requirement. Ensuring subs meet this requirement prior to contract execution will greatly reduce the possibility for project delays and will enhance the overall administrative experience for all parties. Please plan ahead.

Review the following:

Complete this short form, attach the required documentation, and submit the information. Someone in the CDBG Office will follow-up via email to inform the contact noted in the form of clearance of exclusions. If additional information is needed, we will reach out via email. Before submitting the form, please review the Suspension and Debarment Guidance document linked above to gain a better understanding of the information requested.

Submission Date*

Project Name*

Prime Contractor (Company Name)*

Subcontractor (Company Name)

This field is not required (*) because the Prime contractor may or may not submit required documents on behalf of a subcontractor. If a submission is made for a subcontractor, please note the subcontractor's company name below.

Contractor Type*

Please select your contractor type:

Prime/GC

Subcontractor

Submission Type*

Prime contractors/general contractors may send this form submission link to your subcontractors so they may complete this requirement independently. Or, the prime contractor may collect then submit the required documentation on behalf of the subcontractors. Both are acceptable. Please submit one form per subcontractor. Please select an option below to convey the submission type.

For my entity

On behalf of another entity

Submitter Name*

Submitter Title*

Submitter Email*

Submitter Phone Number*

Phone

Required Documents (Upload Below)

Please do not submit this form without attaching the required documents:

Documents Required from PRIME Contractors:

Contract Attachment 5 - FOUND HERE
W-9 - FOUND HERE
SAM.gov (Active) Registration Profile

Documents Required from SUBcontractors:

Contractor Eligibility Form - FOUND HERE
W-9 - FOUND HERE
SAM.gov (Active) Registration Profile

Need Guidance before you complete and attach the required documents above?

See Suspension and Debarment Guidance

File Upload*

Upload the required documents requested above, in the space below. Please only attached the required documents, as requested above, for one entity per submission. Questions? Please email cdbg@traviscountytx.gov. Please do not email the required documents. Effective June 30, 2023, the required documents/forms noted herein will only be accepted via this online submission form.

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