AAA CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW (1).pdf
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- Attached to
- CGR Wall Waterproofing
- Solicitation number
- 19PL9025Q0020
- Issued by
-
Department of State
About this file
This document is a Certification Regarding Compliance with Applicable Federal Anti-Discrimination Law issued by the U.S. Embassy in Warsaw, Poland. The certification requires Department of State contractors to attest that they are in compliance with all federal anti-discrimination laws and do not operate any Diversity, Equity, and Inclusion (DEI) programs that violate such laws. Contractors must complete the form by checking compliance boxes, providing company and authorized representative details, and signing the document. The certification is considered material to government payment decisions and is subject to the False Claims Act under 31 U.S.C. 3729(b)(4). The form must be returned to the Contracting Officer/Point of Contact as specified in the accompanying communication.
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| File | Type | Posted |
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| DBA Informacja.docx | DOCX document | |
| NDAA Informacja dla Kontrahenta.pdf | ||
| 19PPL9025Q0020_SCOPE _OF_ WORK.pdf |
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Embassy of the United States of America
Warsaw, Poland
CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW
All Department of State contractors must certify that they do not operate any programs promoting DEI that violate any applicable anti-discrimination laws and agree that such certification is material for purposes of the government’s payment decision and therefore subject to the False Claims Act. See 31 U.S.C. 3729(b)(4).
DIRECTIONS FOR CONTRACTORS and/or OFFERORS
1.Read the entire certification provided below.
2.After you have read the provisions, please check the appropriate boxes.
3.Upon completion of Step 2, fill out the representation below. NOTE: This certification is made by a person with the authority to bind the contractor or offeror.
4.Return completed form to the Contracting Officer/POC shown in the e-mail.
CERTIFICATION:
The Contractor or prospective offeror certifies they:
☐ are in compliance in all respects with all applicable Federal anti-discrimination laws is material to the government’s payment decisions for purposes of section 31 USC 3729(b)(4) (False Claims Act); and
☐ do not operate any programs promoting Diversity, Equity, and Inclusion that violate any applicable Federal anti-discrimination laws.
Contractor or Offeror Name (Printed or Typed): ___________________________________________
Authorized Representative Name and Title: ______________________________________________
Authorized Representative Signature and Date: ____________________________________________
Solicitation or Contract Number: ___________________________________________________
| Embassy of the United States of America |
| Warsaw, Poland |
| are in compliance in all respects with all applicable Federal antidiscrimination laws is material to the: Off |
| do not operate any programs promoting Diversity Equity and Inclusion that violate any applicable: Off |
| fill_1: |
| Authorized Representative Name and Title: |
| Solicitation or Contract Number: |
| Signature1_es_:signer:signature: |
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