11-Form 10 Fed Clauses FAA FY26.pdf
PDF 341 KB Posted
- Solicitation number
- 153-26-AIR-RFQ
- Issued by
- Cameron County, Texas
About this file
Summary
This is a Federal Certifications and FAA Provisions Agreement Form (Form 10) completed by the City of Brownsville for contracts funded with Federal Aviation Administration (FAA) Airport Improvement Program (AIP) funds and other federal grant assistance. The document serves as a certification and compliance framework for contractors and suppliers bidding on the City of Brownsville's Airport Landside Professional Architectural and Engineering Services contract in Texas. Rather than detailing specific project scope or deliverables, this form establishes the federal regulatory requirements and certifications that all contractors must acknowledge and comply with throughout the contract term.
The form requires contractors to certify compliance with approximately 30 federal statutes, regulations, and executive orders covering areas including telecommunications equipment restrictions (FAR 52.204-24 and 52.204-25), Davis-Bacon Act prevailing wage requirements for construction contracts exceeding $2,000, Contract Work Hours and Safety Standards Act for contracts exceeding $100,000, environmental compliance (Clean Air and Water Acts for contracts over $150,000), Buy America provisions (49 U.S.C. §50101 for FAA-funded projects), Build America Buy America Act (2 C.F.R. Part 184), record retention for three years post-award, debarment and suspension certifications, Byrd Anti-Lobbying Amendment compliance for awards exceeding $100,000, and various other requirements. The document mandates that all federal requirements flow down to subcontractors at all tiers, allows the City of Brownsville to request signed certifications or supporting documentation at any time, and subjects contractors to remedies under the False Claims Act (31 U.S.C. §3729-3733) for false statements. Contractors must initial each clause as either "YES" (agreeing to comply) or "N/A" (not applicable), with incomplete or unmarked sections potentially resulting in contractor disqualification or contract approval delays.
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Text version
Page 1 of 12 Ver 10-25
FORM 10 - FAA
City of Brownsville Federal Clauses Certification Form
FEDERAL CERTIFICATIONS & FAA PROVISIONS
AGREEMENT FUNDED BY U.S. FEDERAL GRANT
TO WHOM IT MAY CONCERN:
Federal Funds & FAA funds will be used; therefore, this form should be completed and returned.
Federal Aviation Administration (FAA) The following clauses are required when Federal Aviation Administration (FAA) Airport Improvement Program (AIP) or other FAA federal assistance funds are used. These provisions are in addition to those included in the standard Federal Clauses FY 2026 document and must be completed and incorporated into contracts and subcontracts funded, in whole or in part, with FAA funds.
Instructions for Completing this Form Suppliers and contractors must review each federal clause and indicate whether it applies to the specific contract. For every section below, please initial “YES” to confirm agreement and compliance, or “N/A” (Not applicable) if the clause does not apply to the scope of work or funding source.
Yes – Contractor/Supplier agrees to comply with the clause as written and, where applicable, will provide all required documentation or certifications.
N/A – Clause is not applicable to the contract (e.g., Davis Bacon Act for non-construction work, Buy America for non-transportation projects, etc.) Contractor/supplier must initial next to “N/A” to confirm inapplicability.
Incomplete forms or unmarked sections may disqualify contractor/supplier and/or delay contract approval.
Vendor Responsibility for Regulatory Compliance It is the responsibility of the contractor/supplier to review, verify, and comply with the most current versions of all applicable federal provisions, clauses, and regulations referenced in this document. The contractor/supplier shall refer to official U.S.
Government websites, including the Code of Federal Regulations (www.ecfr.gov), Federal Acquisition Regulation (www.acquisition.gov), and agency-specific resources (e.g., HUD, DOT, Treasury, or OMB), to ensure full and current compliance at the time of bid submission and throughout the contract term.
DEFINITIONS
Contract: A legal agreement by which a non-Federal entity purchases property or services to carry out a federally funded project.
Contractor: An entity that receives a contract as defined in Contract.
Cooperative agreement: A form of federal financial assistance used when substantial involvement is expected between the federal agency or pass-through entity and the recipient.
Federal awarding agency: The U.S. federal agency providing the funding.
Federal award: The financial assistance or cost-reimbursement contract provided directly by a federal agency or indirectly through a pass-through entity to carry out a public purpose.
Non–Federal entity (NFE): A state, local government, tribe, institution of higher education, or non-profit organization that receives and administers federal funds.
Pass-Through Entity (PTE): A Non-Federal entity that provides part of its federal award to another organization (a subrecipient) to carry out a portion of the program.
http://www.ecfr.gov/ http://www.acquisition.gov/
Page 2 of 12 Ver 10-25
Subrecipient/Subaward: A Non-Federal entity that receives federal funds from a pass-through entity to carry out part of federal program. The legal instrument documenting this relationship is the subaward.
Recipient: A Non–Federal entity receiving funds directly from a federal agency.
Simplified acquisition threshold: The current small-purchase limit established under the FAR (presently $250,000, adjusted periodically for inflation).
Obligations: Orders placed on contracts or subawards made that require payment by the Non-Federal entity.
Termination: The ending of a federal award, in whole or in part, prior to the planned end of the period of performance.
These definitions are provided for reference only. For full regulatory text, see 2 C.F.R. Part 200, Subpart A (§§ 200.0-200.1).
Certification Regarding Certain Telecommunications and Video Surveillance Services or Equipment (FAR 52.204-24 & 52.204-25)
The contractor/supplier certifies compliance with the prohibitions under Section 889 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Public Law 115-232) and the Federal Acquisition Regulation (FAR) 52.204-24 and 52.204-25.
The contractor/supplier shall not provide or use any equipment, system, or service that includes covered telecommunications equipment or services from Huawei Technologies Company, ZTE Corporation, Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, Dahua Technology Company, or any subsidiary or affiliate of such entities.
If the contractor/supplier identifies any covered telecommunications equipment or services during performance, it shall immediately notify the contracting agency or the City of Brownsville in writing and provide all information required under FAR 52.204-25(d).
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
APPENDIX II TO 2 CFR PART 200 – Contract Provision for Non-Federal Entity Contracts Under Federal Awards
(A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
Pursuant to Federal Rule (A) above, when a Participating Agency expends federal funds, the Participating Agency reserves all rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(B) Termination for cause and for convenience by the grantee or subgrantee including the manner by which it will be effected and the basis for settlement. (All contracts in excess of $10,000)
Pursuant to Federal Rule (B) above, when a Participating Agency expends federal funds, the Participating Agency reserves the right to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a breach or default of the agreement by Contractor/Supplier as detailed in the terms of the contract.
Page 3 of 12 Ver 10-25
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 CFR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR part 60, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.”
Pursuant to Federal Rule (C) above, when a Participating Agency expends federal funds on any federally assisted construction contract, the equal opportunity clause is incorporated by reference herein.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction”). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non- Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non-Federal entity must report all suspected or reported violations to the Federal awarding agency.
Pursuant to Federal Rule (D) above, when a Participating Agency expends federal funds during the term of an award for all contracts and subgrants for construction or repair, contractor/supplier will be in compliance with all applicable Davis-Bacon Act provisions.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
(E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.
Pursuant to Federal Rule (E) above, when a Participating Agency expends federal funds, contractor/supplier certifies that contractor/supplier will be in compliance with all applicable provisions of the Contract Work Hours and Safety Standards Act
Page 4 of 12 Ver 10-25 during the term of an award for all contracts by Participating Agency resulting from this procurement process.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of “funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that “funding agreement,” the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any implementing regulations issued by the awarding agency.
Pursuant to Federal Rule (F) above, when federal funds are expended by Participating Agency, the contractor/supplier certifies that during the term of an award for all contracts by Participating Agency resulting from this procurement process, the contractor/supplier agrees to comply with all applicable requirements as referenced in Federal Rule (F) above.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended—Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non- Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251- 1387).
Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA)
In the event Federal Transit Administration (FTA) or Department of Transportation (DOT) funding is used by Participating Public Agency, contractor/Supplier also agrees to include Clean Air and Clean Water requirements in each subcontract exceeding $100,000 financed in whole or in part with Federal assistance provided by FTA.
Pursuant to Federal Rule (G) above, when federal funds are expended by Participating Agency, the contractor/supplier certifies that during the term of an award for all contracts by Participating Agency member resulting from this procurement process, the contractor/supplier agrees to comply with all applicable requirements as referenced in Federal Rule (G) above.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(H) Prohibition on Fraud, Waste, and Abuse - The contractor/supplier certifies that it will take all reasonable steps to prevent, detect, and disclose any suspected fraud, waste, or abuse of federal funds associated with this contract, consistent with applicable laws and agency guidance. Any such activity will be promptly reported to the awarding agency, pass-through entity, or the Office of Inspector General, as appropriate.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(I) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220 cross-reference to Treasury/OMB Guidance Subpart C) must not be made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance with the Executive Office of the President Office of Management and Budget (OMB) guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), “Debarment and Suspension.” SAM Exclusions
Page 5 of 12 Ver 10-25 contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.
Pursuant to Federal Rule (H) above, when federal funds are expended by Participating Agency, the contractor/supplier certifies that during the term of an award for all contracts by Participating Agency resulting from this procurement process, the contractor/supplier certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal department or agency. If at any time during the term of an award the contractor/supplier or its principals becomes debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal department or agency, the contractor/supplier will notify the Participating Agency.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
(J) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352.
Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award.
Pursuant to Federal Rule (I) above, when federal funds are expended by Participating Agency, the contractor/supplier certifies that during the term and after the awarded term of an award for all contracts by Participating Agency resulting from this procurement process, the contractor/supplier certifies that it is in compliance with all applicable provisions of the Byrd Anti-Lobbying Amendment (31 U.S.C. 1352). The undersigned further certifies that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
(3) The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such subrecipients shall certify and disclose accordingly.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Page 6 of 12 Ver 10-25
Procurement of Recovered Materials 2 C.F.R. § 200.323 / 40 C.F.R Part 247
A non-Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines.
When Participating Agency expends federal funds for any contract resulting from this procurement process, contractor/supplier certifies that it will comply with 2 C.F.R. § 200.323
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS_____________
When federal funds are expended by Participating Agency for any contract resulting from this procurement process, contractor/supplier certifies that it will comply with the record retention requirements detailed in 2 CFR §§ 200.334-200.337.
The contractor/supplier further certifies that contractor/supplier will retain all records as required by 2 CFR § 200.334 for a period of three years after grantees or subgrantees submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT
When Participating Agency expends federal funds for any contract resulting from this procurement process, contractor/supplier certifies that it will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18). Cross-link 2 CFR § 200.323(b)
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS
To the extent purchases are made with Federal Highway Administration, Federal Railroad Administration, or Federal Transit Administration funds, contractor/supplier certifies that its products comply with all applicable provisions of the Buy America Act and agrees to provide such certification or applicable waiver with respect to specific products to any Participating Agency upon request. Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling for free and open competition. Additionally:
(1) The Contractor agrees to comply with 49 USC 5323(j) and 49 CFR Part 661, which provide that federal funds may not be obligated unless steel, iron and manufactured products used in FTA-funded projects are produced in the United States, unless a waiver has been granted by FTA or the product is subject to a general waiver. General waivers are listed in 49 CFR 661.7.A general public interest waiver from the Buy America requirements applies to microprocessors, computers, microcomputers, software or other such devices, which are used solely for the https://www.ecfr.gov/current/title-40/part-247
Page 7 of 12 Ver 10-25 purpose of processing or storing data. This general waiver does not extend to a product or device that merely contains a microprocessor or microcomputer and is not used solely for the purpose of processing or storing data.
Separate requirements for rolling stock are set out at 5323(j)(2)(C) and 49 CFR 661.11.
(2) A bidder or contractor/supplier must submit to the FTA recipient the appropriate Buy America certification with all bids on FTA- funded contracts, except those subject to a general waiver. Bids or offers that are not accompanied by a completed Buy America certification must be rejected as nonresponsive. This requirement does not apply to lower-tier subcontractors.
The following certificates titled FTA and DOT Buy America Certification should be completed and returned with the response as part of FTA and DOT requirements.
FEDERAL TRANSIT ADMINISTRATION (FTA) AND DEPARTMENT OF TRANSPORTATION
(DOT) - BUY AMERICA: CERTIFICATION REQUIREMENT FOR PROCUREMENT OF ROLLING
STOCK
CERTIFICATE OF COMPLIANCE
(select one of the two options, NOT BOTH) Certificate of Compliance with 49 USC §5323(j) The proposer hereby certifies that it will comply with the requirements of 49 U.S.C. 5323(j), and the applicable regulations of 49
CFR 661.11.
Check for YES:
OR
Certificate of Non-Compliance with 49 USC §5323(j) The proposer hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j), but may qualify for an exception to the requirement consistent with 49 U.S.C. 5323(j)(2)(C), and the applicable regulations in 49 CFR 661.7.
FEDERAL TRANSIT ADMINISTRATION (FTA) AND DEPARTMENT OF TRANSPORTATION (DOT)
BUY AMERICA: CERTIFICATION REQUIREMENT FOR PROCUREMENT OF STEEL OR MANUFACTURED PRODUCTS
CERTIFICATE OF COMPLIANCE (select one of the two options, NOT BOTH) Certificate of Compliance with 49 USC §5323(j)(1) The proposer hereby certifies that it will comply with the requirements of 49 U.S.C. 5323(j)(1), and the applicable regulations in 49 CFR part 661.
OR
Certificate of Non-Compliance with 49 USC §5323(j)(1) The proposer hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j), but it may qualify for an exception to the requirement pursuant to 49 U.S.C. 5323(j)(2), as amended, and the applicable regulations in 49 CFR 661.7.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Contractor/Supplier’s Name:
Address, City, State, and Zip Code:
Phone Number:
Fax Number:
Printed Name and Title of Authorized Representative:
Page 8 of 12 Ver 10-25
Email Address:
Signature of Authorized Representative:
Date:
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
If any portion of this project is funded with U.S Department of Transportation (DOT) funds, the contractor/supplier shall also complete a Disadvantage Business Enterprise (DBE) Certification Form in accordance with 49 C.F.R. Part 26. This requirement applies only to DOT-funded projects and is not applicable to HUD, ARPA, or Treasury-funded programs.
CERTIFICATION OF COMPLIANCE WITH BUILD AMERICA, BUY AMERICA ACT (BABA)
2 C.F.R. 184
The contractor/supplier acknowledges that certain federally funded infrastructure projects are subject to the Build America, Buy America Act (Pub. L. 117-58 §§ 70901-70927) and implementing regulations at 2 C.F.R. Part 184. When applicable, the contractor/supplier certifies that all iron, steel, manufactured products, and construction materials used in the project are produced in the United States, as required by the Act.
The contractor/supplier further agrees to provide appropriate documentation, origin certifications, or approved waivers upon request by the awarding agency or pass-through entity. Where a waiver is sought, the contractor/supplier shall support the request in writing and shall not proceed with procurement or installation of foreign materials until such waiver is granted in accordance with federal guidance.
The Build America, Buy America Act applies to all federally funded infrastructure projects, except where otherwise waived or exempted by the awarding agency.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Domestic Preference for Procurements– 2 C.F.R. § 200.322
The contractor/supplier agrees to comply with the requirements of 2 C.F.R. § 200.322, which establishes a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States. To the greatest extent practicable, the contractor/supplier shall provide domestic end products, materials, and construction products that are manufactured in the United States. This preference applies to all procurements under federal awards, consistent with applicable statutes, regulations, and the Build America, Buy America Act requirements.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. § 200.337
Contractor/Supplier agrees that the Inspector General of the Agency or any of their duly authorized representatives shall have access to any documents, papers, or other records of contractor/supplier that are pertinent to contractor’s/supplier’s discharge of its obligations under the Contract for the purpose of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access to contractor/supplier’s personnel for the purpose of interview and discussion relating to such documents.
Page 9 of 12 Ver 10-25
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS
Contractor/Supplier agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Conflict of Interest - 2 C.F.R. § 200.318(c)(1)
The contractor/supplier affirms compliance with 2 C.F.R. § 200.318(c)(1), which requires the maintenance of written standards of conduct covering conflict of interest in the selection, award, and administration of contracts. No employee, officer, agent, or subcontractor shall participate in any procurement or contract decision where a real or apparent conflict of interest exists. The contractor/supplier further agrees to disclose in writing any potential conflicts of interest to the City of Brownsville prior to award or during contract performance.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Executive Order 14173 (2025) – Anti-DEI Certification
The contractor/supplier certifies compliance with Executive Order 14173 (2025), affirming that it operates in accordance with all applicable federal anti-discrimination laws and that no diversity, equity, or inclusion (DEI) program or policy maintained by the contractor violates such laws. The contractor/supplier acknowledges that compliance with these requirements is a material condition of this contract and that any false certification or noncompliance may subject the contractor/supplier to remedies available under the False Claims Act (31 U.S.C. §§ 3729-3733) and other applicable laws.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Non-Discrimination and Affirmative Action Plan (Executive Order 11246)
The contractor/supplier agrees to comply with all applicable federal civil rights laws and regulations, including Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794), the Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq.), the Age Discrimination Act of 1975 (42 U.S.C. § 6101 et seq.), and any other nondiscrimination provisions applicable to this contract. The contractor/supplier shall ensure that no person is excluded from participation in, denied the benefits of, or subjected to discrimination under this contract on the basis of race, color, national origin, sex, age, or disability.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Whistleblower Protection (41 U.S.C 4712)
The contractor/supplier shall comply with the whistleblower protections established under 41 U.S.C. 4712. Employees of contractors, subcontractors, and subrecipients are protected from reprisal for disclosing evidence of gross mismanagement, Page 10 of 12 Ver 10-25 waste of federal funds, abuse of authority, or violations of law related to a federal contract or grant. The contractor/supplier must inform its employees in writing of their rights and remedies under this statute. Compliance with these protections is a material condition of this contract.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Remedies for Non-Compliance - 2 C.F.R. § 200.339
The contractor/supplier acknowledges that failure to comply with the terms and conditions of this agreement or any applicable federal requirements may result in enforcement actions as provided under 2 C.F.R. § 200.339. Remedies may include, but are not limited to, temporarily withholding payments, disallowing costs, wholly or partly suspending or terminating the contract, initiating suspension or debarment proceedings, or pursuing other legally available remedies.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Termination – 2 C.F.R. § 200.340
The contractor/supplier acknowledges that this contract may be terminated in whole or in part for cause, for convenience, or by mutual agreement, in accordance with 2 C.F.R. § 200.340. The basis for termination, applicable notice, and settlement provisions shall be clearly documented in writing.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Subrecipient Monitoring – 2 C.F.R. § 200.332
The contractor/supplier acknowledges that, when acting as a pass-through entity or subrecipient of federal funds, it must comply with the requirements of 2 C.F.R. § 200.332. The contractor/supplier shall monitor the activities of any subrecipients as necessary to ensure that federal funds are used in accordance with applicable statues, regulations, and the terms and conditions of the award. This includes performing risk assessments, issuing written subaward agreements with required flow-down clauses, reviewing financial and performance reports, and taking enforcement action when necessary to address noncompliance.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
COMMUNITY DEVELOPMENT BLOCK GRANTS
Purchases made under this contract may be partially or fully funded with federal grant funds. Funding for this work may include Federal Funding sources, including Community Development Block Grant (CDBG) funds from the U.S. Department of Housing and Urban Development. When such funding is provided, Contractor/Supplier shall comply with all terms, conditions and requirements enumerated by the grant funding source, as well as requirements of the State statutes for which the contract is utilized, whichever is the more restrictive requirement. When using Federal Funding, Contractor/Supplier shall comply with all wage and latest reporting provisions of the Federal Davis-Bacon Act. HUD-4010 Labor Provisions also applies to this contract.
In addition, the Contractor/supplier shall comply with the requirements of Section 3 of the Housing and Urban Development Act of 1968 (24 C.F.R. Part 75), ensuring, to the greatest extent feasible, that employment and contracting opportunities are directed to low- and moderate-income residents and Section 3 businesses.
If the project involves acquisition, demolition, or displacement activities, the contractor/supplier shall also comply with the Uniform Relocation Assistance and Real Property Acquisition Act (49 C.F.R. Part 24), ensuring fair compensation and relocation assistance for affected persons and property owners.
Page 11 of 12 Ver 10-25
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Buy American Preference (49 U.S.C § 50101)
When FAA Airport Improvement Program (AIP) funds are used, the contractor/supplier shall comply with the Buy American preferences under 49 U.S.C. § 50101. Only steel and manufactured products produced in the United States may be used in AIP-funded projects unless a waiver is granted by the FAA.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Foreign Trade Restriction Clause (49 C.F.R. Part 30) ___________________________ The contractor/supplier certifies that it will not engage in any transactions with, or procure materials or services from, countries restricted under DOT appropriations acts or FAA regulations.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Veterans Preference (49 U.S.C. § 47112(c))
In the employment of labor (except executive, administrative, and supervisory positions) for construction or maintenance work financed under FAA assistance, the contractor/supplier shall give preference to veterans, as far as practicable.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
N/A (Not applicable to this contract) __________
Compliance with Security Regulations (49 C.F.R. Part 1542)
The contractor/supplier shall comply with all applicable Transportation Security Administration (TSA) security regulations, directives, and airport-specific rules under 49 C.F.R. Part 1542. The contractor/supplier shall ensure that all employees, agents, and subcontractors obtain the necessary Security Identification Display Area (SIDA) credentials and comply with all security procedures while performing work on or within airport property.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Seismic Safety (42 U.S.C. § 7701 et seq.)
For new building construction or major renovations exceeding $100,000, the contractor/supplier certifies its compliance with seismic safety standards consistent with 49 C.F.R. Part 41 and Executive Order 12699.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
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Tax Delinquency and Felony Conviction Certification (DOT Order 4200.5)
The contractor/supplier certifies that it is not delinquent on any federal tax obligation and has not been convicted of a federal felony within the preceding 24 months.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
Flow-Down of Federal Requirements
All federal requirements contained in this agreement shall flow down to all tiers of subcontracts, suppliers, and service providers in FAA-funded work.
Does contractor/supplier agree? YES __________Initials of Authorized Representative of contractor/supplier.
The City of Brownsville reserves the right to request a signed or notarized certification, affidavit, or other supporting documentation for any of the provisions or clauses contained in this document at any time during the procurement process or contract term.
By signing below, the contractor/supplier certifies that all information provided in this document is true and accurate to the best of their knowledge and understands that any false statement may be subject to penalties under the False Claims Act (31 U.S.C. §§ 3729-3733).
The contractor/supplier further agrees to comply with all applicable federal, state, and local laws, rules, regulations, and ordinances. It is acknowledged that the contractor/supplier certifies compliance with all provisions, laws, acts, and regulations specifically noted above.
Contractor’s/Supplier’s Name:
Address, City, State, and Zip Code:
Phone Number: Fax Number __________________________
Printed Name and Title of Authorized Representative:
Email Address:
Signature of Authorized Representative: Date: __________
| TO WHOM IT MAY CONCERN: |
| DEFINITIONS |
| Certification Regarding Certain Telecommunications and Video Surveillance Services or Equipment (FAR 52.204-24 & 52.204-25) |
| APPENDIX II TO 2 CFR PART 200 – Contract Provision for Non-Federal Entity Contracts Under Federal Awards |
| (A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as auth... |
| (B) Termination for cause and for convenience by the grantee or subgrantee including the manner by which it will be effected and the basis for settlement. (All contracts in excess of $10,000) |
| (C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41... |
| (D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance with the Davis-Bacon Act ... |
| (E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for complianc... |
| (F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of “funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonpr... |
| (G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended—Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non- Federal award to agree to ... |
| (H) Prohibition on Fraud, Waste, and Abuse - The contractor/supplier certifies that it will take all reasonable steps to prevent, detect, and disclose any suspected fraud, waste, or abuse of federal funds associated with this contract, consistent with... |
| (J) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to... |
| ________________________________________________________________________________ |
| Procurement of Recovered Materials 2 C.F.R. § 200.323 / 40 C.F.R Part 247 |
| CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT |
| CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS |
| FEDERAL TRANSIT ADMINISTRATION (FTA) AND DEPARTMENT OF TRANSPORTATION (DOT) - BUY AMERICA: CERTIFICATION REQUIREMENT FOR PROCUREMENT OF ROLLING STOCK |
| Certificate of Compliance with 49 USC §5323(j) |
| OR |
| Certificate of Non-Compliance with 49 USC §5323(j) |
| FEDERAL TRANSIT ADMINISTRATION (FTA) AND DEPARTMENT OF TRANSPORTATION (DOT) - |
| Certificate of Compliance with 49 USC §5323(j)(1) |
| OR |
| Certificate of Non-Compliance with 49 USC §5323(j)(1) |
| CERTIFICATION OF COMPLIANCE WITH BUILD AMERICA, BUY AMERICA ACT (BABA) |
| 2 C.F.R. 184 |
| Domestic Preference for Procurements– 2 C.F.R. § 200.322 |
| CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. § 200.337 |
| CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS |
| Conflict of Interest - 2 C.F.R. § 200.318(c)(1) |
| Executive Order 14173 (2025) – Anti-DEI Certification |
| Non-Discrimination and Affirmative Action Plan (Executive Order 11246) |
| Whistleblower Protection (41 U.S.C 4712) |
| Remedies for Non-Compliance - 2 C.F.R. § 200.339 |
| Termination – 2 C.F.R. § 200.340 |
| Subrecipient Monitoring – 2 C.F.R. § 200.332 |
| COMMUNITY DEVELOPMENT BLOCK GRANTS |
| ________________________________________________________________________________ |
| Buy American Preference (49 U.S.C § 50101) |
| Veterans Preference (49 U.S.C. § 47112(c)) |
| Compliance with Security Regulations (49 C.F.R. Part 1542) |
| Seismic Safety (42 U.S.C. § 7701 et seq.) |
| Tax Delinquency and Felony Conviction Certification (DOT Order 4200.5) |
| Flow-Down of Federal Requirements |
| By signing below, the contractor/supplier certifies that all information provided in this document is true and accurate to the best of their knowledge and understands that any false statement may be subject to penalties under the False Claims Act (31 ... |
| The contractor/supplier further agrees to comply with all applicable federal, state, and local laws, rules, regulations, and ordinances. It is acknowledged that the contractor/supplier certifies compliance with all provisions, laws, acts, and regulati... |
File details come from the government source that posted it. Updated .