01. BAA_Certification_08.29.2023_(D5) (1).pdf

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FDG 150 Floating Ion
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SLAC_FDG150FloatingIon_365033
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This document is a Buy American Act Certification form issued by SLAC National Accelerator Laboratory for use in federal contract solicitations (Rev. 08.29.2023).

The form requires bidders and offerors to certify whether each end product qualifies as a U.S. domestic commercial product. If the bidder answers "Yes" to this certification, they may skip to Section (C) and proceed with signature. If the answer is "No," the bidder must complete Sections (A), (B), and (C). Section (A) requires identification of any excluded end products in accordance with FAR Part 25.104. Section (B) requires certification that all end products, except those listed, are domestic source end products with no components of unknown origin mined, produced, or manufactured outside the United States. Bidders must also provide an estimate of foreign content expressed as a percentage of the total purchase order or subcontract award price, with accuracy within plus or minus 5 percent acceptable, and identify the country of origin. Section (C) requires the offeror's signature, date, printed name, title, and company name, with the certification becoming part of the quotation. The form is a one-page template designed to ensure compliance with Buy American Act requirements in federal procurement.

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BUY AMERICA ACT CERTIFICATION (REV. 08.29.2023) Page 1 of 1

SUPPLY CHAIN MANAGEMENT

BUY AMERICAN ACT CERTIFICATION

Solicitation Number

The bidder/offeror hereby certifies that each end product qualifies as a U.S. domestic commercial product.

Yes No

If the answer above is Yes, skip to Section (C). If the answer above is No, fill out Sections (A), (B) and

(C) Below:

A. Excluded end products, in accordance with FAR Part 25.104. (Mark "N/A" if not-applicable)

B. The bidder/offeror hereby certifies that each end product, except the end products listed below, is a domestic source end product (as defined in the Buy American Act provisions); and that NO components of unknown origin have been mined, produced, or manufactured outside the United States.

The bidder/offeror will represent (as an estimate), herein, before the award of a purchase order or subcontract, the percent of the foreign content of the item or service being procured expressed as a percent of the total purchase order/subcontract award price (accuracy within plus or minus 5 percent is acceptable).

Percent (%) of Foreign Content:

Country of Origin:

c. THE OFFEROR’S SIGNATURE MAKE THE ABOVE REPRESENTATIONS AND

CERTIFICATIONS PART OF THEIR QUOTATION

Offeror’s Signature: Date:

Printed Name:

Title:

Company Name:

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