Attachment 3 - Offeror Information and Certification.pdf

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Attached to
Protestant Music Director
Solicitation number
FA485526Q0077
Issued by

About this file

This is a template for Offeror Information & Certification, a required federal contracting form used to collect company data and obtain legal authorization to submit proposals in response to federal solicitations.

The form requires offerors to provide company identification information including Company Name, CAGE Code, and UEI Number, along with business size metrics (Number of Employees and Total Yearly Revenue) needed to determine the offeror's size classification under the applicable NAICS code for the solicitation. Offerors must confirm which documents are included with their submission: Offer (Technical Capability), Price Proposal Worksheet, Offeror Information Document, and Conflict of Interest Statement. The form specifies whether Representations and Certifications are attached directly or incorporated by reference from the System for Award Management (SAM) at https://sam.gov/, and requires offerors to confirm their registration status in SAM. An authorized company representative must sign and date the certification, acknowledging authority to legally bind the company, submitting the offeror on behalf of the company, and confirming receipt of all addendums issued for the solicitation. The signatory must print their name and title as the authorized agent.

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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

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Check Box6: Off
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Group9: Off
Group10: Off
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Date11_af_date:
Check Box8: Off
Check Box9: Off

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