889 Representation Form.pdf
PDF 150 KB Posted
- Attached to
- Platform One Software Industry Day
- Solicitation number
- FA8307-SW-SWID
About this file
This is a federal contracting representation form requiring merchants to certify their compliance with prohibitions on covered telecommunications equipment or services.
The form requires merchants to complete representations regarding their use of covered telecommunications equipment or services as defined in FAR Clause 52.204-25. Specifically, merchants must declare whether they will provide such equipment or services to the Government and whether they currently use covered telecommunications equipment or services in their operations. The form explicitly prohibits telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (including subsidiaries and affiliates), and video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (including subsidiaries and affiliates). Merchants must conduct a reasonable inquiry before completing their representation and provide the merchant name, representative's name, signature, and validity period (30 days, 1 year, 2 years, or 3 years). Merchants representing "does not" will proceed to additional security screening and evaluation; those representing "does" or declining to complete the representation will be excluded from further evaluation. The Logistics team must retain all supporting documentation. Instructions direct merchants to review FAR 52.204-24 and 52.204-25 before completing Section 2 of the form.
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Text version
Covered Telecommunications Equipment or Services-Representation
Section 1 – References
1. FAR 52.204-24 through 26 , FAR 4.2105(a)
Section 2 – Merchant Representation Definitions. As used in this provision, “covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.
Procedures. The cardholder 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”.
Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation, (or any subsidiary or affiliate of such entities); Video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities) is strictly prohibited.
As prescribed in 4.2105(a), the Merchant shall complete the following representation in FAR Clause 52.204-24
(d) Representation. The Offeror represents that—
(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Merchant shall provide the additional disclosure information required at paragraph (c)(1) of this section if the Merchant responds “will” in paragraph (d)(1) of this section;
and
(2) After conducting a reasonable inquiry, for purposes of this representation, the Merchant represents that— It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Merchant shall provide the additional disclosure information required at paragraph (c)(2) of this section if the Merchant responds “does” in paragraph (d)(2) of this section.
Merchant Name and Signature
Representative's Name (Print or Type)
Date and Range this representation is good for (Date and 30days, 1Yr, 2Yrs or 3Yrs)
Section 3 - Instructions
A1. Merchant goes to the following FAR site:
https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#id1989I600I4C A2. Merchant reads FAR 52.204-24 and 52.204-25 & upon completion fills out the Section 2 above and returns the form.
B. If a merchant represents “does not”, merchant will continue through to additional security screening and review by pertinent functional teams.
C. If a merchant represents “does” or the merchant declines to complete the Representation – the merchant will be excluded from any further evaluation.
D. Logistics team will retain all documentation that supports this representation.
http://www.sam.gov/ https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#id1989I600I4C
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