01. BAA_Certification_08.29.2023_(D5) (1).pdf
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- Attached to
- MISK1_S_SP_HP
- Solicitation number
- SLAC_MISK1_S_SP_HP_367608
- Issued by
-
Department of Energy Office of Science
About this file
This is a Buy American Act Certification form used by the SLAC National Accelerator Laboratory for federal contract solicitations. 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 directly to Section C and provide signature authorization. If the bidder answers "No," they must complete Sections A, B, and C, which require disclosure of excluded end products in accordance with FAR Part 25.104, certification that all end products except those listed are domestic source end products with no components of unknown foreign origin, and an estimated percentage of foreign content expressed as a percent of the total purchase order or subcontract award price, with accuracy within plus or minus 5 percent acceptable.
The form includes fields for the offeror to disclose the percent of foreign content and country of origin. Section C requires the offeror's signature, date, printed name, title, and company name, making the representations and certifications part of their quotation. This is a template document (Revision 08.29.2023) that does not address specific products or services but serves as a standardized compliance instrument for domestic content requirements in federal procurements.
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Text version
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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