5.3_SECTION 889 COMPLIANCE FORM.pdf

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Attached to
FY21-20779-20780-Frequency Multipliers
Solicitation number
N63394-21-Q-0056
Issued by

About this file

This solicitation requests quotes for frequency multipliers to be provided to the Naval Surface Warfare Center Port Hueneme Division. The solicitation seeks eight units each of two frequency multiplier part numbers from API Tech Corp. Quotes are due by July 7, 2021 and shall be submitted electronically in PDF format to the listed point of contact. The solicitation provides details on the required products, submission instructions, questions deadline, and amendment posting location. The Department of the Navy Naval Sea Systems Command is the issuing agency for this procurement of frequency multipliers.

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5.3_21Q0056-CSS-X4-X6 Multiplier.docx DOCX document

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Text version

Merchant Name

Merchant’s Authorized Representative

Authorized Representative Signature and Date

If vendor indicates WILL or DOES, then review will be required by a Contracting Officer prior to purchase.

Contracting Officer Approval

I have reviewed and determined procurement through this vendor is authorized.

Contracting Officers Name

Signature

Solicitation or PRT #: FY21-20779/FY21-20780 / N63394-21-Q-0056

Buyer Name: Rachel T. Smith

Representation.

The Merchant represents that—

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (OCT 2020)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(c) Representations.

(1) The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

(End of provision)

Section 889 Form Compliance Form

File details come from the government source that posted it. Updated .