10 DomesticWorkforceUtilizationCertificationForm_MultipleAward.docx
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- Attached to
- Johnstown OVR Enhanced Driving/Anc Svcs
- Solicitation number
- 6100064892
- Issued by
- Carbon County, Pennsylvania
About this file
This is a Domestic Workforce Utilization Certification form issued by the Commonwealth of Pennsylvania, Department of General Services, for use in evaluating multiple award contracts. The certification serves as a contractual obligation and is incorporated into the evaluation criteria for best value selection on individual assignments under multiple award contracts. Contractors must complete and sign the certification to receive consideration under this criterion. The form requires contractors to indicate whether all direct labor will be performed exclusively within the United States or within countries that are parties to the World Trade Organization Government Procurement Agreement, or to specify the percentage of direct labor to be performed in those approved jurisdictions. Contractors must also identify any direct labor to be performed outside the United States and outside WTO Government Procurement Agreement countries, including the specific country where such work will occur. Failure to complete and sign the certification results in no consideration for this evaluation criterion.
The certification is directly applicable to the Johnstown OVR Enhanced Driving and Ancillary Services procurement (IFB 6100061271), a supplement solicitation issued by the Pennsylvania Department of Labor and Industry on behalf of the Office of Vocational Rehabilitation for non-emergency transportation services in Cambria County. The procurement is reserved exclusively for DGS Small Businesses, requiring bidders to attach their Small Business Certificate to be deemed eligible. Maximum consideration is given to suppliers committing to perform contracted direct labor exclusively within the United States or approved WTO countries, while suppliers proposing work outside these jurisdictions receive proportionally lower scores. Any misstatements in the certification are treated as fraudulent concealment under Section 4904 of the Pennsylvania Crimes Code and are subject to criminal penalties.
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DOMESTIC WORKFORCE UTILIZATION CERTIFICATION FOR MULTIPLE AWARD CONTRACTS
To the extent permitted by the laws and treaties of the United States, this certification will be used by the Agency in making a best value selection for each particular assignment. Each quote will be evaluated for its commitment to use the domestic workforce in the fulfillment of the contract. Maximum consideration will be given to those suppliers who will perform the contracted direct labor exclusively within the geographical boundaries of the United States or within the geographical boundaries of a country that is a party to the World Trade Organization Government Procurement Agreement. Those who propose to perform a portion of the direct labor outside of the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement will receive a correspondingly smaller score for this criterion. In order to be eligible for any consideration for this criterion, suppliers must complete and sign the following certification. This certification will be included as a contractual obligation when the contract is executed. Failure to complete and sign this certification will result in no consideration being given to the supplier for this criterion.
I, ______________________[title] of ____________________________________[name of Contractor] a _______________ [place of incorporation] corporation or other legal entity, (“Contractor”) located at ________________________________________________________________ [address], do hereby certify and represent to the Commonwealth of Pennsylvania (“Commonwealth”) (Check one of the boxes below):
|_| All of the direct labor performed within the scope of services under the contract will be performed exclusively within the geographical boundaries of the United States or one of the following countries that is a party to the World Trade Organization Government Procurement Agreement: Armenia, Netherland with respect to Aruba, Australia, Austria, Belgium, Bulgaria, Canada, Chinese Taipei, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong China, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea Republic of, Latvia, Liechtenstein, Lithuania, Luxemburg, Malta, Moldovia Republic of, Montenegro, New Zealand, the Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.
OR
|_| ________________ percent (_____%) [Contractor must specify the percentage] of the direct labor performed within the scope of services under the contract will be performed within the geographical boundaries of the United States or within the geographical boundaries of one of the countries listed above that is a party to the World Trade Organization Government Procurement Agreement. Please identify the direct labor performed under the contract that will be performed outside the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement and identify the country where the direct labor will be performed:
[Use additional sheets if necessary]
The Department of General Services [or other purchasing agency] shall treat any misstatement as fraudulent concealment of the true facts punishable under Section 4904 of the Pennsylvania Crimes Code, Title 18, of Pa. Consolidated Statutes.
| Attest or Witness: | ______________________________ | |
| Corporate or Legal Entity’s Name |
| _____________________________ | ______________________________ | |
| Signature/Date | Signature/Date |
| _____________________________ | ______________________________ | |
| Printed Name/Title | Printed Name/Title |
BOP-1301.Multiple Award Revised 02/23/2018
File details come from the government source that posted it. Updated .