SARC Subcontractor Annual RepsCerts Rev 8

FERMI FORWARD DISCOVERY GROUP, LLC

Subcontractor Annual Representations & Certifications (SARC) Offeror Name:

Parent Company Name: (If Applicable)

Street:

Street:

City:

State/Province:

City:

State/Province:

Zip/Postal:

Country:

Zip/Postal:

Country:

Phone:

# of Employees:

Phone:

# of Employees:

EIN/TIN:

Parent Website:

Website:

Billing Information: (if different from offeror address):

NAICS U.S. Industry #:

Street:

DUNS #:

City:

State/Province:

Offeror IS NOT Registered in SAM.gov

Zip/Postal:

Country:

Offeror IS Registered in SAM.gov Entity

SAM.gov Unique Entity Identifier (UEI):

Registration Expiration Date:
NOTE TO EXISTING SUBCONTRACTORS THAT HAVE PREVIOUSLY COMPLETED A FERMI FORWARD DISCOVERY GROUP OR FERMI RESEARCH ALLIANCE (FRA) ANNUAL SUBCONTRACTOR CERTIFICATION: ANY COMPANY NAME OR ADDRESS CHANGE NOTIFICATIONS MUST BE PROVIDED ON COMPANY LETTERHEAD. A CURRENT IRS FORM W-8 OR W-9 IS REQUIRED FOR COMPANY NAME CHANGES.
The procurement of material, supplies, or services (including construction) for a U.S. Government contract requires compliance by Prime Contractors, Subcontractors, and Suppliers with various programs enacted by Statute, Executive Order, or Federal Regulation.
The following certifications are effective for a period of 12 months beginning on the date of signature of this document. If there is any change to the information provided within any section of this document during the period, you are required to promptly inform Fermi Forward Discovery Group, LLC (FermiForward) in writing, no later than 15 days from the change in status.
Please complete all sections.

Form SARC (Rev. 8
Previous editions are
obsolete

Section I: Business Category
A. The Offeror, by checking the applicable box, represents that: 1.

Ownership of the Entity is: (Check one box)
U.S. Owned
U.S. Incorporated with Foreign Parent
Foreign Owned, registered for business in (provide country)

2.

It operates as: (Check all that apply)
A Corporation incorporated under the laws of: State:
Country:
Privately Held Corporation OR

Publicly Traded Corporation

S-Corporation
Limited Liability Company
Partnership
Sole Proprietorship
Joint Venture or Consortium
Educational Institution [Educational institution means a public or nonprofit institution of higher education, such as an accredited college or university, as defined in section 1201(a) of Public Law 89329, November 8, 1965, Higher Education Act of 1965 (20 U.S.C. 1142(a))] Non-Profit, Non-Educational Organization [Non-Profit organization means an organization of the type