S02 ATTACHMENT J_CERTIFICATION OF RECALL OR SAFETY ISSUES_PAPR_04012025.docx
DOCX document 22 KB Posted
- Attached to
- 6515--NX EQ Powered Air Purifying Respirators
- Solicitation number
- 36C10G25Q0059
About this file
This document is a certification form for a Powered Air Purifying Respirators (PAPR) solicitation. The form requires vendors to certify that their medical equipment has no outstanding recalls, no known safety issues, complies with relevant regulations, and has been thoroughly checked for safety and performance standards. Vendors must complete all fields, have an authorized representative sign the form, and submit it with their quote for Solicitation Number 36C10G25Q0059.
The solicitation is a 100% Service-Disabled Veteran Owned Small Business set-aside issued by the Department of Veterans Affairs for the Veterans Health Administration's Non-Expendable Equipment National Program. It seeks to purchase Powered Air-Purifying Respirators for VA Medical Centers through a single requirements contract. The ordering period will be one 12-month base period with four 12-month option periods, using Firm-Fixed Price Orders. The NAICS code is 339113 with a business size standard of 800 employees, and quotes must be submitted by the specified date and time in SAM.gov Contract Opportunities.
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Attachment J Certification of Recall or Safety Issues Instructions to Quoters:
1. Complete all fields in the certification form.
2. Ensure that the form is signed by an authorized representative of the company.
3. Submit the completed form along with your quote.
Certification of No Outstanding Recalls or Safety Issues Solicitation Number: 36C10G25Q0059 Requirement for: Powered Air Purifying Respirators
Company Unique Entity Identifier (UEI): __________________________________________
Certification:
By signing below, I, the undersigned, certify on behalf of the company identified by the UEI above, the medical equipment quoted in response to the above-referenced solicitation:
1. Does not have any outstanding recalls.
2. Does not have any known safety issues.
3. Complies with all relevant regulations and standards for medical equipment.
4. Has been thoroughly checked for compliance with safety and performance standards.
I understand that any false or misleading information provided in this certification may result in disqualification from the solicitation process and other penalties as permitted by law.
Authorized Representative:
Name: __________________________________________ Title: __________________________________________ Signature: __________________________________________ Date: __________________________________________
File details come from the government source that posted it. Updated .