ATTACHMENT_1_TO_COMBINED_SYNOPSIS.docx

ATTACHMENT 1 TO COMBINED SYNOPSIS & SOLICITATION

AG-04N7-S-16-0011 – SUPPLY OF CONTAINERIZED SEEDLINGS

(Q-PLUG)

Complete the following and return with offer:

AGAR 452.209 – 70 - REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW – FISCAL YEAR 2015 APPROPRIATIONS AND BEYOND (DEVIATION 2015-01)

(a) In accordance with sections 744 and 745 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), none of the funds made available by this or any other Act may be used to 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 the agency has considered suspension or debarment of the corporation and has made a determination that this further action 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 a Federal agency has considered suspension or debarment of the corporation and has made a determination that this further action is not necessary to protect the interests of the Government.

(b) The Offeror represents that –

(1) It is [ ], is not [ ] (check one) a corporation that has any unpaid Federal 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,

(2) It is [ ], is not [ ] (check one) a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

· Government Employees, Former USDA Employees, and USDA Retirees

The offeror/quoter represents and certifies that --

A. It [ ] is, [ ] is not a current Federal Government employee.

B. It [ ] is, [ ] is not a former USDA employee.

C. It [ ] is, [ ] is not a retired USDA employee. If retired, give date of retirement:_________.

D. It [ ] is, [ ] is not related by blood or marriage to a current Forest Service employee on the ______ National Forest. If so, list employee's name and location:______________________________.

E. It [ ] is, [ ] is not substantially owned or controlled by a former USDA employee or retiree.

· DUNS NUMBER: __________________________________________________

· TAX IDENTIFICATION NUMBER (TIN):_____________________________

· EMAIL ADDRESS: ____________________________________________

OFFEROR’S SIGNATURE:_________________________ DATE:___________