Att_2_AOC_collection.docx
DOCX document 16 KB Posted
- Attached to
- BLM FY25-1 Spring Consolidated Seed Buy.
- Solicitation number
- 140L3725R0003
About this file
This is an Area of Origin Claimed (AOC) Statement form, which is Attachment 2 to the BLM FY25-1 Spring Consolidated Seed Buy solicitation. The form is specifically required for non-certified wildland collected or non-certified germplasm cultivated seed deliveries marked as "AOC" in the schedule.
The form requires detailed documentation of seed origin information, including state, county, elevation, latitude, and longitude. For cultivated seed, this information must be provided for both the original geographic site and cultivation location. The form must be completed with signatures from both the seed collector and buyer, including their full contact information. The document includes a warning about penalties for false statements under 18 U.S.C. 1001, which can result in fines or imprisonment up to 5 years.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140L3725R0003_Amd_0003.pdf | ||
| 2025_State_Noxious_Weeds_Seed_List_0003.pdf | ||
| B09_Spring_25_1_Solicitation_Package_revised_033125_amendment_3_0003.docx | DOCX document | |
| Sol_140L3725R0003_Amd_0002.pdf | ||
| B09_140L3725R0003_Amendment_2_0002.pdf | ||
| Sol_140L3725R0003_Amd_0001.pdf | ||
| B08_Att_1-Bid_Request_Spring_25-1_revised_031925_0001.xlsx | XLSX spreadsheet | |
| A06_Spring_25_1_Solicitation_Package_revised_032125_0001.docx | DOCX document | |
| Sol_140L3725R0003.pdf | ||
| B08_Att_1-Bid_Request_Spring_25-1.xlsx | XLSX spreadsheet | |
| Att_4_Itemized_Delivery_Sheet_2025.xlsx | XLSX spreadsheet | |
| Att_3_Seed_Analysis_Request_Form_revised_072024.docx | DOCX document |
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Text version
ATTACHMENT 2
BLM - RSW SEED BUY
NON-CERTIFIED WILDLAND COLLECTED OR NON-CERTIFIED CULTIVATED SEED SPECIES/AREA OF ORIGIN CLAIMED (AOC) STATEMENT
NOTE: Attachment 2 shall be provided for all non-certified wildland collected or non-certified germplasm cultivated seed. Items identified with letter designator AOC in the schedule. This form is to be used only for non-certified germplasm seed – required at time of delivery.
I hereby claim that the seed collected was from _________________________ species.
Origin Information: (where the seed is growing).*
State: _________________________________________
County: _________________________________________
Elevation: _________________________________________
Latitude: _________________________________________
Longitude: _________________________________________
*If seed is cultivated, provide State, County, Elevation, Lat/Long and Lot Number for both the original claimed geographic site of the seed and where the cultivation site is located.
| __________________________________ | _________________ | |
| Seed Collector Signature | Date |
Seed Collector Name: __________________________________
Address: __________________________________
City/State/Zip __________________________________ Phone: _____________
Email address: __________________________________
This collected seed was sold to: __________________________________
Name and Address of Buyer: ____________________________________________________
| _______________________________________ | __________________ | ||
| Signature (Buyer) | Date |
The penalty for making false statements, relating to this statement, is as prescribed in 18U.S.C.1001, which states in part: A(a) Except as otherwise provided in this section, whoever, in any manner within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, knowingly and willfully – (1) falsifies, conceals, or covers up by a trick, scheme, or device a material fact; (2) makes any materially false, fictitious or fraudulent statement or representation; or (3) makes or uses any false writing or document knowing the same to contain any material false, fictitious, or fraudulent statement or entry; shall be fined under this title or imprisoned not more than 5 years or both.
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