Attachment 8 - Business Status Certification.pdf
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- Attached to
- Prototype Project Opportunity Notice (PPON) Close Terrain Shaping Obstacles (CTSO) Increment 1 (INC1)
- Solicitation number
- W15QKN-22-R-0JKH
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BUSINESS STATUS CERTIFICATION (BSC)
Every significant participating entity shall complete the following table and provide a signature representing its certification.
Legal Entity Name Proposed NAICS Code Industry Size Standard (Small/Large/Foreign) *DUNS No.
*CAGE Code *Tax Identification *Active SAM Registration Yes No Expiration Date:
Address 1 Address 2 City/State/Zip POC Name/Title POC Phone/e-mail
* This information is required for the entity serving as the Prime/Lead for the prototype project and as applicable for all other entities.
The Entity named above represents that it is (check one of the following boxes):
A Nontraditional Defense Contractor (NDC) – A Nontraditional Defense Contractor is an entity that is not currently performing and has not performed, for at least the one-year period preceding the solicitation of sources by DoD for the procurement or transaction, any contract or subcontract for the DoD that is subject to full coverage under the cost accounting standards prescribed pursuant to section 1502 of title 41 and the regulations implementing such section (see 10 U.S.C. 2302(9)).
A Nonprofit Research Institution – As defined in 15 U.S.C. 3703 a nonprofit institution means an organization owned and operated exclusively for scientific or educational purposes, no part of the net earnings of which inures to the benefit of any private shareholder or individual; and includes federally funded research and development centers, as identified by the National Scientific Foundation in accordance with the government wide Federal Acquisition Regulation issued in accordance with section 1303(a)(1) of title 41 (or any successor regulation thereto).
A Traditional Defense Contractor – A Traditional Defense Contractor is an entity that does not meet the definition of a Nontraditional Defense Contractor (NDC).
The undersigned hereby certifies that the representations made herein are accurate and true regarding the entity identified above. I authorize my electronic signature to carry the same weight and legal effect as my written signature.
Signature
Name
Title
Date
| Legal Entity Name: |
| Proposed NAICS Code: |
| Industry Size Standard SmallLargeForeign: |
| DUNS No: |
| CAGE Code: |
| Tax Identification: |
| Yes No Expiration DateAddress 1: |
| Yes No Expiration DateAddress 2: |
| Yes No Expiration DateCityStateZip: |
| Yes No Expiration DatePOC NameTitle: |
| Yes No Expiration DatePOC Phoneemail: |
| A Nontraditional Defense Contractor NDC A Nontraditional Defense Contractor is an entity that is not currently: Off |
| A Nonprofit Research Institution As defined in 15 USC 3703 a nonprofit institution means an organization: Off |
| A Traditional Defense Contractor A Traditional Defense Contractor is an entity that does not meet the definition: Off |
| Name: |
| Title: |
| Date: |
| Expiration Date: |
| Check Box3: Off |
| Check Box4: Off |
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