B08_Att_2_AOC_collection.docx

DOCX document 16 KB Posted

Attached to
FY24 STAND ALONE SEED BUY Federal contract opportunity
Solicitation number
140L3724R0001
Issued by
Department of the Interior Bureau of Land Management Idaho Region

About this file

This document contains an attachment for a federal contract solicitation. The attachment is a form for sellers of non-certified wildland or cultivated seed to the Bureau of Land Management to claim the area of origin for their seed. It requires the seed collector and buyer to provide information such as the species, state, county, elevation, and latitude and longitude of where the seed was collected or cultivated. The penalty for making false statements on the form is a fine or imprisonment according to federal law.

The related federal contract opportunity is a solicitation from the Bureau of Land Management Idaho Region for its FY24 stand-alone seed buy. The solicitation number and name are provided. No other details regarding the required products or services, response dates, pricing terms, or other salient information are included in this document.

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Other files for this federal contract opportunity

Other files attached to FY24 STAND ALONE SEED BUY, newest first.
File Type Posted
Sol_140L3724R0001_Amd_0001.pdf PDF
B08_Attachment_1_Requested_Seed_Fall_2023_Stand_Alone_Seed_Buy.xlsx XLSX spreadsheet
Sol_140L3724R0001.pdf PDF
B08_Att_3_Seed_Analysis_Request_Form_Revised_2023.docx DOCX document
B08_Att_4_Itemized_Delivery_Sheet.xlsx XLSX spreadsheet

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Text version

ATTACHMENT 2

BLM - RSW SEED BUY

NON-CERTIFIED WILDLAND COLLECTED OR NON-CERTIFIED CULTIVATED SEED SPECIES/AREA OF ORIGIN CLAIMED (AOC) STATEMENT

NOTE: Attachment 2 shall be provided for all non-certified wildland collected or non-certified germplasm cultivated seed. Items identified with letter designator AOC in the schedule. This form is to be used only for non-certified germplasm seed – required at time of delivery.

I hereby claim that the seed collected was from _________________________ species.

Origin Information: (where the seed is growing).*

State: _________________________________________

County: _________________________________________

Elevation: _________________________________________

Latitude: _________________________________________

Longitude: _________________________________________

*If seed is cultivated, provide State, County, Elevation, Lat/Long and Lot Number for both the original claimed geographic site of the seed and where the cultivation site is located.

___________________________________________________
Seed Collector SignatureDate

Seed Collector Name: __________________________________

Address: __________________________________

City/State/Zip __________________________________ Phone: _____________

Email address: __________________________________

This collected seed was sold to: __________________________________

Name and Address of Buyer: ____________________________________________________

_________________________________________________________
Signature (Buyer)Date

The penalty for making false statements, relating to this statement, is as prescribed in 18U.S.C.1001, which states in part: A(a) Except as otherwise provided in this section, whoever, in any manner within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, knowingly and willfully – (1) falsifies, conceals, or covers up by a trick, scheme, or device a material fact; (2) makes any materially false, fictitious or fraudulent statement or representation; or (3) makes or uses any false writing or document knowing the same to contain any material false, fictitious, or fraudulent statement or entry; shall be fined under this title or imprisoned not more than 5 years or both.

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