10 DomesticWorkforceUtilizationCertificationForm_MultipleAward.docx
DOCX document 30 KB Posted
- Attached to
- Johnstown OVR Enhanced Driving/Anc Svcs
- Solicitation number
- 6100065977
- Issued by
- Carbon County, Pennsylvania
About this file
This Domestic Workforce Utilization Certification Form is a contractual requirement for multiple award contracts issued by the Commonwealth of Pennsylvania, Department of General Services. The form establishes criteria for evaluating bidders' commitments to utilizing domestic workforce in contract fulfillment, with maximum consideration given to suppliers performing direct labor exclusively within the United States or within countries that are parties to the World Trade Organization Government Procurement Agreement. The certification applies to the Johnstown OVR Enhanced Driving and Ancillary Services contract, a supplement solicitation to IFB 6100061271 issued by the Department of Labor and Industry on behalf of the Office of Vocational Rehabilitation to procure non-emergency transportation services for the Johnstown District covering Indiana, Cambria, Somerset, and Westmoreland counties. Services are required to transport Commonwealth employees and passengers with disabilities from the OVR District office to locations for performance of Commonwealth business, with drivers providing drop-off and scheduled pick-up services.
Bidders must complete and sign the certification form to receive consideration under this criterion, selecting either that all direct labor will be performed within approved geographical boundaries or specifying the percentage of labor to be performed domestically and identifying any labor to be performed outside the United States and non-WTO countries. This procurement is reserved exclusively for DGS Small Businesses, requiring bidders to attach their Small Business Certificate for eligibility. Failure to complete and sign the certification results in no consideration for this criterion, and any misstatements are treated as fraudulent concealment punishable under Section 4904 of the Pennsylvania Crimes Code. The certification becomes a contractual obligation upon contract execution.
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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 .