Attachment 3 - Offeror Information and Certification.pdf

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Attached to
Exhaust Troubleshooting
Solicitation number
FA485526Q0072
Issued by

About this file

This is an Offeror Information & Certification form that serves as a standardized template for companies submitting proposals to a federal solicitation.

The form requires offerors to provide essential company identification information, including company name, CAGE code, and UEI number. Offerors must also supply size-of-business data consisting of the number of employees and total yearly revenue, which are specifically designated as required information for determining business size classification under the applicable NAICS code for the solicitation. The form includes checkboxes for offerors to confirm which proposal documents are being submitted with their offer, including the technical capability offer, price proposal worksheet, offeror information document, and conflict of interest statement. Additionally, offerors must indicate whether their representations and certifications are attached to the submission or maintained in the System for Award Management (SAM) database at https://sam.gov/, and must confirm their registration status in SAM. The form concludes with a certification section requiring an authorized company representative's signature, printed name, title, and date, whereby the signatory affirms legal authority to bind the company and acknowledges receipt of all solicitation addendums.

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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 .