Draft B2 09.1 Reps and Certs Supplement

SUPPLY CHAIN MANAGEMENT

Representations and Certifications Supplement
Stanford University has executed and is engaged in the performance of Prime Contract DE-AC02-76SF00515 with the United States Department of Energy (DOE), for the management and operation of SLAC National Accelerator Laboratory in Menlo Park, CA. The following representations and certifications must be completed, and this form must be signed and returned with the Offeror’s proposal.

BUSINESS INFORMATION

Business Name:
Business Address:
“Doing Business As” (DBA):
Unique Entity Identifier (UEI):
Tax Identification Number (TIN):

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Duns and Bradstreet Number (DUNS):

SYSTEM FOR AWARD MANAGEMENT (SAM) ELECTRONIC REPRESENTATION AND CERTIFICATION APPLICATIONS: The Offeror certifies that the annual Representations and Certifications available electronically via the System for Award Management (SAM) have been completed and by submission of this offer, the Offeror further certifies that the information contained therein is current, accurate, complete, and fully responsive to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer. Those Representations and Certifications are incorporated in this offer by reference (see FAR 4.1201).

EMPLOYMENT VERIFICATION ELIGIBILITY (E-VERIFY)

Offeror represents that:

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(Applicable to proposals exceeding $3,500)

E-Verify is not applicable based on paragraph (e) of FAR 52.222-54 Employment Eligibility Verification. is not currently enrolled in E-Verify

D

it is

if not currently enrolled, it will enroll in E-Verify with 30 calendar days of subcontract award. It will include FAR 52.222-54 in applicable lower-tier subcontracts.

EMPLOYEE-VENDOR RELATIONSHIP CERTIFICATION

An affirmative response in the following certification will require the University to evaluate your offer to determine whether a conflict of interest exists. A determination that a conflict of interest exist may necessitate rejection of your offer. The fact that an employee or former employee of Stanford University, or near relative of an employee owns, controls, or has a significant financial interest in your organization will not, in and of itself, necessarily be cause for rejection of your offer.

DEFINITIONS

Employee: Any individual who is presently employed by any entity of Stanford University, including the Stanford Linear Accelerator Center. Former Employee: An individual who has retired or separated from Stanford University, was dismissed, or was otherwise