Attachment 3 Place of Manufacture Request Form Solicitation 1232SA26Q0806.pdf
PDF 108 KB Posted
- Solicitation number
- 1232SA26Q0806
About this file
This is a Place of Manufacture Certification form for federal contract solicitation 1232SA26Q0806 concerning a Locomotion Compensator and Insect Behavior Monitoring System. The form requires offerors to provide company identification information, including their name and Unique Entity ID (UEI), along with detailed product and manufacturing information for each line item or unique product being offered.
Offerors must complete Section 2 with specific manufacturing details for each product, including the item name, manufacturer name, manufacturing plant street address, city, state, zip code, and country of manufacture. Section 3 requires offerors to certify the place of manufacture by selecting one of three options: the offeror manufactures the end product in the United States; the offeror does not manufacture the item but the place of manufacture is within the United States; or the end product is manufactured outside the United States with specification of the country of origin. For U.S.-manufactured items, Section 4 requires certification regarding whether the cost of U.S.-mined, produced, or manufactured components exceeds the applicable FAR Buy American domestic content threshold. An authorized representative must sign the form, certifying that all information is accurate and acknowledging that the certification represents a material representation upon which the Government will rely during evaluation and award.
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Text version
Attachment 3
PLACE OF MANUFACTURE CERTIFICATION
Solicitation Number: 1232SA26Q0806
Description: Locomotion Compensator, Insect Behavior Monitoring System.
1. Offeror Info:
- Offeror Name:
- UEI (Unique Entity ID):
2. Product & Manufacturing Details:
(Complete a separate section or attached spreadsheet for each unique item)
- Item Name / Line Item (CLIN):
- Manufacturer Name:
- Manufacturing Plant Street Address:
- City, State/Province, Zip Code:
- Country of Manufacture:
3. Vendor Sourcing Check (Check one):
The offeror itself MANUFACTURES the end product in the United States.
The offeror does not manufacture the item, but the place of manufacture is WITHIN the United States.
The end product is manufactured OUTSIDE the United States.
If outside, specify country of origin:
4. Domestic Content Threshold Certification (For U.S. manufactured items):
Does the cost of components mined, produced, or manufactured in the U.S. exceed the applicable FAR Buy American domestic content threshold?
Yes No
Attachment 3
AUTHORIZED REPRESENTATIVE SIGNATURE
By signing below, the offeror certifies that the information provided is accurate and acknowledges that this certification forms a material representation upon which the Government will rely during the evaluation and award process.
Name & Title:
Signature:
Date:
Email & Phone:
| Offeror Name: |
| UEI Unique Entity ID: |
| Item Name Line Item CLIN: |
| Manufacturer Name: |
| Manufacturing Plant Street Address: |
| City StateProvince Zip Code: |
| Country of Manufacture: |
| If outside specify country of origin: |
| Name Title: |
| Date: |
| Email Phone: |
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
| Text6: |
| Text7: |
| Text8: |
| Text9: |
| Text10: |
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| Text12: |
| Check Box13: Off |
| Check Box14: Off |
| Check Box15: Off |
| Check Box16: Off |
| Check Box17: Off |
File details come from the government source that posted it. Updated .