ATTACHMENT E PROVISION REPRESENTATIONS SHEET.pdf
PDF 61 KB Posted
- Attached to
- Custodial and Related Services for TSA Location-Dane County Regional Airport, Madison, WI
- Solicitation number
- 47PF5327R0001
- Issued by
- Not on record
About this file
This document is a Provision Representations Sheet (Attachment E) template that offerors must complete and submit with their proposal in response to a federal solicitation or RFP. The form requires offerors to provide company identification information, including the solicitation/RFP number, company name, Unique Entity ID, and CAGE Code, and to confirm whether their SAM.gov registration is active.
Offerors must certify that their representations and certifications in SAM.gov are current, accurate, and complete as of the proposal submission date. The form requires offerors to represent their business size for the NAICS code identified in the solicitation, selecting either Small Business or Other than Small Business, and to identify all applicable small business designations if relevant, including Small Disadvantaged Business, Woman-Owned Small Business, Economically Disadvantaged Woman-Owned Small Business, HUBZone Small Business, Service-Disabled Veteran-Owned Small Business, Veteran-Owned Small Business, and 8(a) Participant status. Offerors must also disclose whether they take any exceptions to solicitation provisions, representations, certifications, terms, or conditions. An authorized representative of the offeror must sign and date the completed form, providing their name, title, phone number, and email address, and certify that all information provided is accurate and complete to the best of their knowledge. The Government reserves the right to verify and clarify the representations with the apparent awardee prior to contract award.
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Offerors shall complete and submitAttachment E – Provision Representations Sheetwith their proposal. The sheet must be completed in full, signed, and dated by an authorized representative of the offeror. The Government reserves the right to verify and/or clarify the completed representations with the apparent awardee prior to award.
Attachment E – Provision Representations Sheet
Solicitation/RFP Number:___________________________
Company/Offeror Name:___________________________
Unique Entity ID:___________________________
CAGE Code:___________________________
SAM.gov Registration Active?
☐ Yes ☐ No
SAM.gov Representations and Certifications
The offeror certifies that its representations and certifications in SAM.gov are current, accurate, and complete as of the date of proposal submission.
☐ Yes ☐ No — If no, explain below:
Business Size Representation
For the NAICS code identified in the solicitation, the offeror represents that it is:
☐ Small Business ☐ Other than Small Business
If applicable, check all that apply:
☐ Small Disadvantaged Business ☐ Woman-Owned Small Business ☐ Economically Disadvantaged Woman-Owned Small Business ☐ HUBZone Small Business ☐ Service-Disabled Veteran-Owned Small Business ☐ Veteran-Owned Small Business
☐ 8(a) Participant ☐ Other: ___________________________ Offerors shall complete and submitAttachment E – Provision Representations Sheetwith their proposal. The sheet must be completed in full, signed, and dated by an authorized representative of the offeror. The Government reserves the right to verify and/or clarify the completed representations with the apparent awardee prior to award.
Exceptions or Changes to Representations
Does the offeror take any exception to any solicitation provision, representation, certification, term, or condition?
☐ No ☐ Yes — If yes, explain below:
Authorized Representative
By signing below, the offeror certifies that the information provided in this Provision Representations Sheet is accurate and complete to the best of its knowledge.
Name:___________________________
Title:___________________________
Signature:___________________________
Date:___________________________
Phone:___________________________
Email:___________________________
File details come from the government source that posted it. Updated .