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

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This is a Buy American Act Certification form template used by the SLAC National Accelerator Laboratory for federal contract solicitations. The form requires bidders/offerors to certify whether each end product qualifies as a U.S. domestic commercial product under Buy American Act requirements.

The certification process follows a conditional pathway: if bidders answer "Yes" to domestic product qualification, they skip directly to Section C for signature. If bidders answer "No," they must complete Sections A, B, and C. Section A requires identification of excluded end products per FAR Part 25.104. Section B mandates certification that all end products, except those listed, are domestic source end products with no components of unknown foreign origin, and requires bidders to estimate foreign content percentage (with plus or minus 5 percent accuracy acceptable) and identify countries of origin. Section C requires the offeror's signature, date, printed name, title, and company name, with explicit language stating that the signature makes the representations and certifications part of the quotation. This is a template document without specific product requirements, response dates, pricing terms, or award information.

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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:

Check Box1:
0: Off
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File details come from the government source that posted it. Updated .