Attachment 4 Country of Origin Request Solicitation 1232SA26Q1189.docx

This is a Country of Origin Request form attachment for a Request for Quotation (RFQ) issued by the Department of Agriculture Agricultural Research Service under solicitation number 1232SA26Q1189. The form requires vendors to provide detailed origin and compliance information for a High-Speed Optical Coherence Tomography (OCT) System designed for analysis of poultry tissue. Respondents must specify the brand and model, country of origin, country of final assembly, and certify compliance with both the Buy American Act (BAA) and Trade Agreements Act (TAA) requirements. The form must be completed and signed by an authorized representative with their name, title, date, and signature.

This is an unrestricted, commercial items acquisition for one OCT system with an applicable North American Industry Classification Standard Code of 334516 and a small business size standard of 1,000 employees. The acquisition is not set-aside for small business concerns, allowing all responsible sources to submit quotations. The form serves as a mandatory compliance document that bidders must complete as part of their quotation response to demonstrate their product's eligibility under applicable federal procurement regulations.