00 73 73a Steel Products Procurement Certification.pdf

STEEL PRODUCTS PROCUREMENT CERTIFICATION: Contractors

A. TO BE COMPLETED BY ALL CONTRACTORS:

1. Name of Contractor's firm: 2. Date Submitted:

3. Firm's address: 4. Phone Number: ( )

5. Contract No. 6. Contract title:

7. Steel Product:

8. Name and address of supplier:

B. TYPE OF STEEL PRODUCT (check and complete applicable category)

1. Identifiable steel product: 100% of the steel in a product is identifiably marked as manufactured in the United

States.

a. Other documentation required: NONE

b. Manner in which steel product is identifiable:

2. Non-identifiable structural steel: Less than 100% of the steel contained in the product is identifiable as provided above. Structural steel is defined as steel products used as a basic structural element of a project (i.e. steel beams, columns, decking, stairways, reinforcing bars, structural lintels, pipes, etc.)

a. Other documentation required: Bills of lading, invoices and mill certificates that certify that the steel contained in the product was melted or manufactured in the United States.

3. Non-identifiable non-structural steel: all other steel products including door and window frames, machines, equipment, etc.

a. Other documentation required: i.e. certification from supplier/fabricator.

C. CERTIFICATION: I, the undersigned officer of the above named firm, do certify that, to the best of my knowledge, the steel product listed above complies with the provisions of the Steel Products Procurement Act (73 P.S. §1881 et seq, as amended). I understand that by signing this document I certify that the facts contained herein are true. I further understand that this document is subject to the provisions of the Unsworn Falsification to Authorities Act (18 P.S. §4904) and the

Steel Products Procurement Act, which provide penalties including, but not limited to, debarment from bidding on any

Commonwealth of Pennsylvania public works project for a period of five years.

Witness:

________________________________(SEAL)

Secretary or Treasurer President or Vice President

(Corporate Seal)

This form must be executed by the Contractor and delivered to the Engineer before any item containing steel may be incorporated into any public works project in the Commonwealth of Pennsylvania. Execute and present this form for each type of steel product to be incorporated as provided above.