Attachment 2 Attestation AI Template -for Awareness.pdf
PDF 73 KB Posted
- Attached to
- 7G21--BNE Hillrom Voalte Nurse Call Requirement
- Solicitation number
- 36C10B27Q0040
About this file
This document is an Artificial Intelligence (AI) and Large Language Model (LLM) Certification form required for federal contract performance.
The certification requires offerors to attest that any AI or LLM used or delivered during contract performance will comply with the Office of Management and Budget Memorandum M-26-04, "Increasing Public Trust in Artificial Intelligence Through Unbiased AI Principles." Specifically, offerors must certify that their AI/LLM systems will adhere to the two Unbiased AI Principles: Truth-seeking and Ideological Neutrality, meet required transparency thresholds, and satisfy all AI/LLM Development and Operation Documentation requirements if any systems are to be delivered to the Government. The form includes an alternative checkbox for "Not Applicable" for offerors not using AI or LLM technology.
The certification requires the authorized signatory to provide their printed name and title, along with company information including the company name, addresses, and city/state/zip code. Offerors must also identify the specific name and version of any AI systems or LLMs to be used or delivered during contract performance. The form is templated with placeholder language indicating the contract and order numbers will be determined at award.
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CERTIFICATION
☐ Not Applicable.
☐ I hereby certify that any use of Artificial Intelligence (AI) and/or Large Language Models (LLM) in association with performance under Contract To Be Determined, Order To Be Determined will be compliant with the required Unbiased AI Principles as identified in the Office of Management and Budget Memorandum M-26-04, “Increasing Public Trust in Artificial Intelligence Through Unbiased AI Principles,” will meet the required transparency threshold and align with the two Unbiased AI Principles, i.e., Truth-seeking and Ideological Neutrality, and will meet the required AI/LLM Development and Operation Documentation requirements specified therein if any AI/LLM is to be delivered to the Government.
I further certify that I am authorized to execute this certification on behalf of To Be Determined (Name of Offeror).
Signee Printed Name:
Signee Printed Title:
Name (and version) of any AI System/LLM to be used and/or delivered during performance on Contract To Be Determined, Order To Be Determined:
Company Name:
Company Address 1:
Company Address 2:
Company City, State, Zip code:
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