ATTACHMENT 4 - E.O.14730 FORM.docx

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Attached to
CATERING SERVICE IN ROME, ITALY
Solicitation number
191T7025Q0010
Issued by

About this file

This is a certification form (Attachment 4) related to Executive Order 14730 that contractors must complete to certify compliance with federal anti-discrimination laws. The form requires contractors to certify that they both comply with all applicable federal anti-discrimination laws and do not operate any Diversity, Equity, and Inclusion (DEI) programs that violate these laws. The certification is considered material for False Claims Act purposes under 31 U.S.C. 3729(b)(4).

The form is specifically associated with solicitation number 191T7025Q0010 for catering services at the U.S. Embassy in Rome, Italy. Contractors must have an authorized representative complete the form by providing the contractor's name, representative's name and title, signature, and date. The completed form must be returned to the Contracting Officer/POC specified in the accompanying email.

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ATTACHMENT 4 – E.O. 14730 FORM

CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW

All Department of State contractors must certify that they do not operate any programs promoting DEI that violate any applicable anti-discrimination laws and agree that such certification is material for purposes of the government’s payment decision and therefore subject to the False Claims Act. See 31 U.S.C. 3729(b)(4).

DIRECTIONS FOR CONTRACTORS and/or OFFERORS

1.Read the entire certification provided below.

2.After you have read the provisions, please check the appropriate boxes.

3.Upon completion of Step 2, fill out the representation below.

NOTE: This certification is made by a person with the authority to bind the contractor or offeror.

4.Return completed form to the Contracting Officer/POC shown in the e-mail

CERTIFICATION:

The Contractor or prospective offeror certifies they:

☐ are in compliance in all respects with all applicable Federal anti-discrimination laws is material to the government’s payment decisions for purposes of section 31 USC 3729(b)(4) (False Claims Act); and

☐ do not operate any programs promoting Diversity, Equity, and Inclusion that violate any applicable Federal anti-discrimination laws.

Contractor or Offeror Name (Printed or Typed): ___________________________________________

Authorized Representative Name and Title: ______________________________________________

Authorized Representative Signature and Date: ____________________________________________

Solicitation or Contract Number: 191T7025Q0010 _____________________

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