Appendix C - Representations and Certifications

Appendix C – Representations and Certifications

Call for Solutions (CFS) Number and Project Name:

Offeror Information:
Name:
Address:
Unique Entity Identifier (UEI) Number:
Point of Contact:
Title/Position:

Offeror Signature: The Offeror must check the below box and type or sign name, which will serve as certification to the Government.

I certify that all the below information and certifications are true and correct. By checking this box and by typing my name below, I authorize my electronic signature to carry the same weight and legal effect as my written signature.

SignatureDate

Instructions: The Offeror shall complete the below representations and certifications in accordance with the instructions provided within each section below:

Section A – Appropriate Use of Other Transaction Authority Section B – Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment Section C – Organizational Conflicts of Interest
Section D – Hazardous Material Identification and Material Safety Data

APPROPRIATE USE OF OTHER TRANSACTION AUTHORITY

Prototype projects awarded under the authority of 10 U.S.C. § 4022 must meet one of the conditions at 10 U.S.C. § 4022(d)(1). The conditions are as follows:

(A)There is at least one nontraditional defense contractor* or nonprofit research institution participating to a significant extent** in the prototype project.

(B)All significant participants in the transaction other than the Federal Government are small businesses or nontraditional defense contractors.

(C)At least one third of the total cost of the prototype project is to be paid out of funds provided by sources other than the Federal Government.

*Pursuant to 10 U.S.C. § 3014, a Nontraditional Defense Contractor (NDC) means an entity that is not currently performing and has not performed, for at least the one-year period preceding the solicitation of sources by the Government for the procurement or transaction, any contract or subcontract for the Department of Defense that is subject to full coverage under the cost accounting standards prescribed pursuant to section 1502 of title 41 and the regulations implementing such section (see 10 U.S.C. § 3014). The phrase “the solicitation of sources” refers to the initial agreement solicitation only. A nontraditional defense contractor is considered a nontraditional defense contractor for the duration of the prototype project/agreement’s period of performance, or for any in-scope work modified under the same agreement.