3.a REPS-CERTS 2 Q438110.pdf

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REPRESENTATIONS AND CERTIFICATIONS

FOR ACTIONS WITH ESTIMATED VALUE > $30,000

Jefferson Science Associates, LLC (JSA) is the Managing and Operating Contractor of the Thomas Jefferson National Accelerator Facility (JTNAF / Jefferson Lab) under U.S. Department of Energy (DOE) prime contract number DE-AC05- 06OR23177. Subcontractors to Jefferson Lab are paid with government funds and are required to register in SAM (System for Award Management) and to maintain registration annually. There is no cost to register. Information requested in our Representations and Certifications may be different than that required in SAM as a result of our reporting obligations under prime contract number DE-AC05-06OR23177.

1. OFFEROR INFORMATION

Company Name as Reported in SAM.gov: SAM Registration Expiration Date:

Physical Address: City: State: Zip:

Primary Performance Location: City: State: Zip:

County and Congressional District: Remit to Address:

Phone Number: Fax Number: Taxpayer Identification #:

D-U-N-S Number: Name of Parent Organization if applicable:

D-U-N-S Number of Parent Organization if applicable: Commercial and Government Entity (CAGE) code:

2. PRIMARY POINT(S) OF CONTACT

Name: Title:

Email: Phone:

3. TYPE OF BUSINESS ORGANIZATION:

a. Legal name of business organization, if different from company name:

b. The Offeror represents that it operates as a: (Check applicable category and provide additional information, if requested.)

☐ sole proprietorship or individual ☐ partnership comprised of the following partners ☐ corporation incorporated under the laws of the State of ☐ limited liability company organized under the laws of the State of ☐ educational institution ☐ government entity

☐ federal ☐ state ☐ local

☐ international organization (per 22 U.S.C. 288-288f) ☐ nonprofit organization ☐ joint venture comprised of the following entities ☐ other (Describe below.)

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4. SMALL BUSINESS PROGRAM REPRESENTATIONS:

a. Offeror represents that it:

☐ Is a small business under NAIC’s Code(s):

☐ Is not a small business

b. Applicable NAICS Code(s) for this action is/are _______. Please check all applicable categories below for which offeror is eligible under the NAICS code applicable to this action:

☐ Disadvantaged small business ☐ Women-owned small business ☐ Veteran-owned small business ☐ Service-Disabled Veteran-Owned small business ☐ HubZone small business

c. Please indicate if Offeror holds any Government-Wide Contracts:

☐ Federal Supply Schedule (GSA) ☐ Integrated Contractor Purchasing Team (ICPT) agreements

5. EQUAL OPPORTUNITY:

a. ☐ It has participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation (FAR

52.222-26).

b. ☐ It has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation.

c. ☐ It has filed all required compliance reports (Note: If an offeror has not participated in a previous contract or subcontract subject to FAR 52.222-26, Equal Opportunity, or been required to file Standard Form 100 (EEO-1), the offeror will have filed all required compliance reports, since none were required).

OR

d. It is not required by regulations of the Office of Federal Contract Compliance Programs at 41 CFR 60-1 to file compliance reports because:

It ☐ has less than 50 employees, or It ☐ does not have a Government contract or first-tier subcontract of $50,000 or more, or It ☐ does not have a Government contract of $50,000 or more below the first tier for construction work at the site of construction

6. AFFIRMATIVE ACTION:

If offer IS NOT for construction, complete the following:

a. It ☐ has developed and has on file at each establishment affirmative action programs required by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2)

b. It ☐ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor because it has not had 50 or more employees and a Government contract or subcontract of $50,000 or more, or

c. It ☐ has not developed and does not have on file at each establishment a required affirmative action program.

If offer IS FOR construction, complete the following:

a. It ☐ has developed and has on file at each establishment affirmative action programs required by the rules and regulations of the FAR Solicitation Provisions and Contract Clauses subchapter (48 CFR 52.222-27 – Affirmative Action Compliance Requirements for Construction)

b. It ☐ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the FAR Solicitation Provisions and Contract Clauses subchapter because it has not had a Government contract or subcontract for construction of $10,000 or more, or

c. It ☐ has not developed and does not have on file at each establishment a required affirmative action program.

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7. EMPLOYMENT ELIGIBILITY VERIFICATION:

Select one (1) of the following:

☐ E-Verify is not applicable based on paragraph (e) of FAR 52.222-54 Employment Eligibility Verification.

☐ Offeror is currently enrolled in E-Verify and will include FAR 52.222-54 in applicable lower-tier subcontracts.

☐ Offeror is not currently enrolled but will enroll in E-Verify within 30 calendar days of subcontract award and will include FAR 52.222-54 in applicable lower-tier subcontracts.

8. COMPLETE AND RETURN WITH QUOTE/OFFER:

Company acknowledges incorporation of all terms and conditions made part of this solicitation including those incorporated by reference.

9. BUY AMERICAN ACT CERTIFICATE: (Derived from FAR 52.225-2 (MAY 2014) (Applies when supplies greater than $10,000, for use in the United States, will be acquired through the resultant purchase order of subcontract.)

a. The Offeror certifies that each end product, except those listed in paragraph (b) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product”. The terms “commercially available off-the-shelf (COTS) item”, “component”, “domestic end product”, “end product”, “foreign end product”, and “United States” are defined in FAR 52.225-1 Buy American-Supplies.

(If this certification is applicable: (1) list foreign end products, if any, below)

b. Foreign End Products: ☐ Check Box and attach list with quote if additional lines are applicable below.

Description / Line Item No. Country of Origin

c. Evaluation of offers will be in accordance with the policies and procedures of Part 25 of the Federal Acquisition Regulation.

10. CERTIFICATION REGARDING RESPONSIBILITY MATTERS.

(a) (1) The Offeror certifies, to the best of its knowledge and belief, that:

(i) The Offeror and/or any of its Principals:

(A) ☐ Are, ☐ are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) ☐ Have, ☐ not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen. property;

and

(C) ☐ Are, ☐ are not presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(i)(B) of this provision.

(D) ☐ Have, ☐ have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(1) Federal taxes are considered delinquent if both of the following criteria apply:

(i)The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

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(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in a case where enforced collection is precluded.

(2) Examples are provided in FAR 52.209-5.

(ii) The Offeror ☐ has, ☐ has not, within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

(2) "Principal," for the purposes of this certification, means officer; director; owner; partner; or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions). THIS CERTIFICATION CONCERNS A MATTER WITHIN THE JURISDICTION OF AN AGENCY OF THE UNITED STATES AND THE MAKING OF A FALSE, FICTITIOUS, OR FRAUDULENT CERTIFICATION MAY RENDER THE MAKER SUBJECT TO PROSECUTION UNDER SECTION 1001, TITLE 18, UNITED STATES CODE.

(b) The Offeror shall provide immediate written notice to the Company if, at any time prior to subcontract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Offeror's responsibility.

Failure of the Offeror to furnish a certification or provide such additional information as requested by the Company may render the Offeror non-responsible.

(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Company, the Company may terminate the subcontract resulting from this solicitation for default.

(f) Subcontractors must flow down FAR 52.209-6 Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Aug 2013) to sub-tiers if the value of any subcontract exceeds $30,000 and is not for commercially available off the shelf items.

11. CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS.

(Applicable if offer exceeds $150,000.)

A. Definitions. As used in this provision-"Lobbying contact' has the meaning provided at 2 U.S.C. 1602(8). The terms "agency," "influencing or attempting to influence," "officer or employee of an agency," "person," "reasonable compensation," and "regularly employed" are defined in the FAR clause of this solicitation entitled "Limitation on Payments to Influence Certain Federal Transactions" (52.203-12).

B. Prohibition. The prohibition and exceptions contained in the FAR clause of this solicitation entitled "Limitation on Payments to Influence Certain Federal Transactions" (52.203-12) are hereby incorporated by reference in this provision.

C. Certification. The Offeror, by signing its offer, hereby certifies to the best of its knowledge and belief that no 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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on its behalf in connection with the awarding of this subcontract.

D. Disclosure. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the Offeror with respect to this subcontract, the Offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The Offeror need not report regularly employed officers or employees of the Offeror to whom payments of reasonable compensation were made.

E. Penalty. Submission of this certification and disclosure is a prerequisite for making or entering this subcontract imposed by 31 U.S.C. 1352. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to civil penalties as provided for by 31 U.S.C.1352. An imposition of a civil penalty does not prevent the Government from seeking any other remedy that may be applicable.

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12. REPORTING EXECUTIVE COMPENSATION

Offeror’s Congressional District: Offeror’s nine-digit zip code:

Did your business or organization have gross income, from all sources, under $300,000 in the previous tax year?

☐ Yes – No additional information is required to be provided.

☐ No – Answer question Q1 below.

Q1: In your business or organization's preceding completed fiscal year, did your business or organization receive:

80 percent or more of your annual gross revenues from U.S. federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of U.S. federal financial assistance;

AND

$25,000,000 or more in annual gross revenues from U.S. federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of U.S. federal financial assistance?

☐ Yes – Answer question Q2 below.

☐ No – No additional information is required to be provided.

Q2: Does the public have access to information about the compensation of Offeror's executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78 m(a), 78 o(d)) or section 6104 of the Internal Revenue Code of 1986?

☐ Yes – No additional information is required to be provided.

☐ No - Provide the following additional details for each of the five most highly compensated Executives for your entity for the preceding completed fiscal year ("Executive," means officers, managing partners, or any other employees in management positions):

Names of Offeror’s Top Five Executives: *Total Compensation for each Executive

*Total Compensation means the cash and noncash dollar value earned by the executive during the Offeror's preceding fiscal year and includes the following: salary and bonus; awards of stock, stock options, and stock appreciation rights; earnings for services under non-equity incentive plans; change in pension value; above-market earnings on deferred compensation which is not tax-qualified; and other compensation, if the aggregate value of all such other compensation (e.g. severance, termination payments, value of life insurance paid on behalf of the employee, perquisites or property) for the executive exceeds $10,000.00. For more information see FAR 52.204-10 or 17 CFR 229-402(c)(2).

The salary and compensation information you provide will be made public in accordance with the Federal Funding Accountability and Transparency Act (FFATA). This Act requires that this information be supplied to the public (via usaspending.gov) in relation to federal awards (including federal contracts, federal financial assistance, and expenditures) you receive, if applicable.

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13. COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION:

Required in all solicitations that are subject to Cost Accounting Standards.

Note: This notice does not apply to small businesses, foreign governments, negotiated subcontracts that are not in excess of the FAR 15.403-4 cost or pricing data threshold, and firm-fixed price, labor-hour, or time and materials subcontracts that are for the acquisition of commercial items or awarded on the basis of adequate price competition with the submission of cost or pricing data.

This notice is in three parts, identified by Roman numerals I through Ill.

Offerors shall examine each part and provide the requested information in order to determine Cost Accounting Standards (CAS) requirements applicable to any resultant contract.

If the offeror is an educational institution, Part II does not apply unless the contemplated subcontract will be subject to full or modified CAS coverage pursuant to 48 CFR 9903.201-2(c)(5) or 9903.201-2(c)(6), respectively.

I. DISCLOSURE STATEMENT-COST ACCOUNTING PRACTICES AND CERTIFICATION

A. Any subcontract in excess of $750,000 resulting from this solicitation will be subject to the requirements of the Cost Accounting Standards Board (48 CFR Chapter 99), except for those contracts which are exempt as specified in 48 CFR 9903.201-1.

B. Any offeror submitting a proposal which, if accepted, will result in a subcontract subject to the requirements of 48 CFR Chapter 99 must, as a condition of subcontracting, submit a Disclosure Statement as required by 48 CFR 9903.202. When required, the Disclosure Statement must be submitted as a part of the offeror's proposal under this solicitation unless the offeror has already submitted a Disclosure Statement disclosing the practices used in connection with the pricing of this proposal. If an applicable Disclosure Statement has already been submitted, the offeror may satisfy the requirement for submission by providing the information requested in Paragraph C. of Part I of this provision.

CAUTION: In the absence of specific regulations or agreement, a practice disclosed in a Disclosure Statement shall not, by virtue of such disclosure, be deemed to be a proper, approved, or agreed-to practice for pricing proposals or accumulating and reporting subcontract performance cost data.

C. Check the appropriate box below:

☐ 1. Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows:

ii. Original and one copy to the cognizant DOE Contracting Officer or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and

iii. One copy to the cognizant Federal auditor.

(Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable. Forms may be obtained from the loose-leaf version of the FAR.)

Date of Disclosure Statement:

Name and Address of DOE Contracting Officer/Federal Official or cognizant Federal Auditor.

Offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

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☐ 2. Certificate of Previously Submitted Disclosure Statement. Offeror hereby certifies that the required Disclosure Statement was filed as follows:

Date of Disclosure Statement:

Name and Address of DOE Contracting Officer/Federal Official or cognizant Federal auditor.

Offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

☐ 3. Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Jefferson Lab Procurement Officer immediately.

☐ 4. Certificate of Interim Exemption. The offeror hereby certifies that: (i) the offeror first exceeded the monetary exemption for disclosure, as defined in 3. of this Subsection, in the cost accounting period immediately preceding the period in which this offer was submitted; and (ii) in accordance with 48 CFR 9903.202-1, the offeror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a revised certificate to the Jefferson Lab Procurement Officer, in the form specified under Paragraph C.l. or C.2. of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

Caution: Offerors currently required to disclose because they were awarded a CAS-covered prime contract or lower-tier subcontract of $50 million or more in the current cost accounting period may not claim this exemption. Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

☐ 5. Certificate of Disclosure Statement Due Date by Educational Institution. If the offeror is an educational institution that, under the transition provisions of 48 CFR 9903.202-l(f), is or will be required to submit a Disclosure Statement after receipt of this award, the offeror hereby certifies that (check one and complete):

☐ A Disclosure Statement Filing Date of _____________ has been established with the cognizant Federal agency

☐ The Disclosure Statement will be submitted within the 6-month period ending _________ months after receipt of this award.

II. COST ACCOUNTING 5TANDARDS-ELIGIBILITY FOR MODIFIED CONTRACT COVERAGE

If the offeror is eligible to use the modified provisions of 48 CFR 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant subcontract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause.

☐ Offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAS-covered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Jefferson Lab Procurement Officer immediately.

Caution: An offeror may not claim the above eligibility for modified subcontract coverage if this proposal is expected to result in the award of a CAS-covered contract of $50 million or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more.

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Ill. ADDITIONAL COST ACCOUNTING STANDARDS APPLICABLE TO EXISTING CONTRACTS

Offeror shall indicate below whether award of the contemplated subcontract would, in accordance with Paragraph A.3. of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing Government contracts and Jefferson Lab subcontracts and lower-tier subcontracts. ☐ Yes ☐ No

14. INTELLECTUAL PROPERTY (Required for all solicitations.)

A. Patent Rights.

Offeror is:

☐ A University or other institution of higher education or an organization of the type described in Section 501(c)(3) of the Internal Revenue Code of 1954 (26 USC 501(c)) and exempt from taxation under Section 501(a) of the Internal Revenue Code (26 USC 501(a); or

☐ A nonprofit scientific or educational organization qualified under a State nonprofit organization statute. Please identify the Statute: __________

☐ A small business concern as defined at Section 2 of Public Law 85-536 (15 USC 632) and implementing regulations of the Administrator of the Small Business Administration;

☐ None of the above.

Subcontractors who have checked NONE OF THE ABOVE have the right to request, in advance of or within 30 days after execution of the subcontract, in accordance with applicable statutes and DEAR 952.227-84, a waiver of all or any part of the rights of the United States in Subject Inventions. If the Subcontractor intends to request a waiver to such invention rights pursuant to DEAR 952.227-84, please indicate:

☐ I intend to request an advance waiver in accordance with DEAR 952.227-84

☐ I do not intend to request an advance waiver

B. Rights in Proposal Data.

It is DOE policy for a subcontract award based on a proposal that, in consideration of the award, the Government and Jefferson Lab shall obtain unlimited rights in the technical data contained in the proposal unless the offeror marks those portions of the technical information as "proprietary data" or specifies those portions of such technical data that are not directly related to or will not be utilized in the work to be funded under the subcontract. Accordingly, please indicate:

☐ No restriction on Government or Jefferson Lab rights in the proposal technical data; or

☐ The following identified technical data is proprietary or is not directly related to or will not be utilized in the work to be funded under the subcontract: ______________________________.

C. Identification of Technical Data That Is Proprietary.

The Rights in Technical Data clause proposed to be used for this subcontract may not permit the utilization of proprietary data in the subcontract work or, if the use of proprietary data is permitted, may not be adequate to meet programmatic requirements. Use of data which is proprietary may prevent the offeror from meeting the data requirements of the subcontract (including delivery of data).

Your attention is particularly drawn to the use of LICENSED COMPUTER SOFTWARE. As used in this representation, "LICENSED COMPUTER SOFTWARE" means software in which you own proprietary rights AND which you license to others.

Please indicate that you have reviewed the requirements in the technical scope of work and to the best of your knowledge:

1. PROPRIETARY DATA.

☐ No proprietary data will be utilized in the subcontract work.

☐ Proprietary data as follows will be utilized in the performance of the subcontract work, and will be delivered in accordance with the requirements of the Statement of Work (please provide comprehensive, non-proprietary description of the data to be delivered): ________________

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☐ Proprietary data will be utilized in the performance of the subcontract work but will NOT be delivered (Do NOT provide a description of the proprietary data to be used.)

2. COMPUTER SOFTWARE (Does NOT include off-the-shelf commercial software)

☐ No LICENSED COMPUTER SOFTWARE will be utilized in the subcontract work.

☐ LICENSED COMPUTER SOFTWARE as follows will be utilized in the subcontract work _________________________.

15. REPRESENTATION OF THE LIMITED RIGHTS DATA AND RESTRICTED COMPUTER SOFTWARE.

Required for solicitations where limited rights data or restricted computer software are likely to be used in meeting the data delivery requirements set forth in the solicitation.

This solicitation sets forth Jefferson Lab/Government known delivery requirements for data (as defined in the clause at 52.227-14, Rights in Data-General). Any resulting contract may also provide the Government or Jefferson Lab the option to order additional data under the Additional Data Requirements clause at 52.227-16, if included in the subcontract. Any data delivered under the resulting subcontract will be subject to the Rights in Data-General clause at 52.227-14 included in this subcontract. Under the latter clause, a

Subcontractor may withhold from delivery data that qualify as limited rights data or restricted computer software, and deliver form, fit, and function data instead. The latter clause also may be used with its Alternates II and/or Ill to obtain delivery of limited rights data or restricted computer software, marked with limited rights or restricted rights notices, as appropriate. In addition, use of Alternate V with this latter clause provides the Government or Jefferson Lab the right to inspect such data at the Subcontractor’s facility.

By completing the remainder of this paragraph, the offeror represents that it has reviewed the requirements for the delivery of technical data or computer software (Check appropriate block below:

☐ None of the data proposed for fulfilling the data delivery requirements qualifies as limited rights data or restricted computer software; OR

☐ Data proposed for fulfilling the data delivery requirements qualify as limited rights data or restricted computer software and are identified as follows: ______

Any identification of limited rights data or restricted computer software in the offeror’s response is not determinative of the status of the data should a subcontract be awarded to the offeror.

16. SIGNATURE / CERTIFICATION:

By signing below, the Offeror certifies that these representations and certifications are accurate, current, and complete. The Offeror further certifies that it will immediately notify the Procurement Officer assigned to this solicitation/resultant subcontract) of any changes to these representations and certifications which may occur from the date of this certification through the end of the term of any resultant subcontract that may be awarded to the Offeror.

Signature of the Authorized Officer or Employee responsible for this submittal*

Typed Name and Title of the Officer or Employee*

Date* *Digital signature with information above is acceptable.