Attachment 2 - Offeror Information and Certification.pdf

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Attached to
Cisco 1000 Mbps Multi-Mode Rugged SFP Transceivers
Solicitation number
FA485526Q0073
Issued by

About this file

This is a form template titled "Attachment 3 – Offeror Information & Certification" used to collect company information and certifications from offerors responding to a federal solicitation. The form requires offerors to provide company name, Cage Code, and UEI Number for identification purposes. Business size determination information is also mandatory, specifically the number of employees and total yearly revenue, which are required to establish the company's size classification under the applicable NAICS code for the solicitation.

The form includes checkboxes for offerors to confirm which documents are included with their submission: the technical offer, price proposal worksheet, offeror information document, and conflict of interest statement. Offerors must indicate whether their representations and certifications are attached directly to the form or contained in the System for Award Management (SAM) at https://sam.gov/, and must confirm their SAM registration status. The form concludes with a certification section where an authorized company representative must sign and date the submission, confirming their authority to legally bind the company and acknowledging receipt of all solicitation addendums. This is a template document with no specific product or service requirements, response deadlines, or award information.

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Text version

Attachment 3 – Offeror Information & Certification

Company Name:

Cage Code:

UEI Number:

*Number of Employees:

*Total Yearly Revenue:

*Information Required to determine size of business for the NAICS for this solicitation.

This offer includes the following documents:

☐ Offer (Technical Capability) ☐ Price Proposal Worksheet ☐ Offeror Information Document ☐ Conflict of Interest Statement

Representations and Certifications are ☐ attached to this document OR ☐ are contained in the System for Award Management (SAM) located at https://sam.gov/.

Offeror confirms that it ☐ IS ☐ IS NOT registered in the System for Award Management.

By providing my signature I, the undersigned, certify that I am an individual who has the authority to sign for and legally bind the Company and hereby submit this offeror for the Company. My signature also acknowledges receipt of any and all addendums issued for this solicitation.

Signature Date

Printed Name and Title of Authorized Agent https://sam.gov/content/home

Text1:
Text2:
Text3:
Text4:
Text5:
Check Box6: Off
Check Box7: Off
Group9: Off
Group10: Off
Text10:
Date11_af_date:
Check Box8: Off
Check Box9: Off

File details come from the government source that posted it. Updated .