52.209-11_REPRESENTATION.docx
DOCX document 14 KB Posted
- Attached to
- WEP SKIN HEAD FORMS
- Solicitation number
- W911S625QA031
About this file
The document is a Federal Acquisition Regulation (FAR) representation form (52.209-11) requiring corporations to disclose any unpaid federal tax liabilities or felony convictions. The form mandates that the government will not enter into a contract with corporations that have: 1) unresolved federal tax liabilities that have not been addressed through an agreement with tax authorities, or 2) felony criminal convictions under federal law within the past 24 months, unless the agency determines suspension or debarment is unnecessary. The form requires the offeror to check boxes indicating whether they meet these criteria, with spaces for signature, printed name, and date of representation.
This representation form is associated with a solicitation (W911S625QA031) by the Department of the Army Materiel Command Mission and Installation Contracting Command at Fort Hood for a Firm-Fixed-Price contract to develop a 3D printed anthropomorphic head form for the West Desert Test Center/Chemical Test Division at Dugway Proving Ground, Utah. The head form will be used to evaluate protective measures against chemical agents and assess exposure levels, serving as a standardized and cost-effective alternative to human subjects or expensive commercial head forms. The projected award is for September 2025, with fiscal year 2025 Research, Development, Test, and Evaluation (RDTE) funds to be utilized.
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Other files
| File | Type | Posted |
|---|---|---|
| Solicitation - W911S625QA031.pdf | ||
| CTD 3665 WEP Skin and Head Forms SOW 08-18-25_Rev1_REDACTED.pdf |
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Text version
REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (FAR 52.209-11) (FEB 2016) As prescribed in 9.104-7 (d), insert the following provision:
(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that–
(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or
(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.
(b) The Offeror represents that–
(1) It is ____is not ___ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and
(2) It is ____ is not ____ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.
SIGNATURE (PRINCIPAL) DATE
PRINTED NAME
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