Attachment AB - Certification of American-Manufactured Goods.pdf
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- Solicitation number
- BPM057381
- Issued by
- Maryland
About this file
This is a Certification of American-Manufactured Goods form issued by the Maryland Department of General Services (DGS) for solicitation PJ-610-230-001 related to the Barrack J Annapolis Communication Room and Garage project. The form requires bidders and offerors to certify the manufacturing origin of goods being offered under the solicitation or contract. Bidders must select one of two primary options: certifying that all offered goods are American-manufactured as defined in COMAR 21.11.15.04B(1), or certifying that offered goods are not American-manufactured. The certification must be executed by an authorized representative of the bidder or offeror and signed with the individual's name, title, and date provided.
For bidders selecting the non-American-manufactured goods option, further classification is required through two accompanying forms. Form A requires listing of goods that are not American-manufactured but qualify as emergency life safety and property safety goods, with corresponding specification sections or drawing references. Form B requires listing of goods that are not American-manufactured and do not qualify as emergency life safety and property safety goods, also with corresponding specification references. Bidders may complete either or both forms depending on the nature of their non-American-manufactured goods. Additional sheets may be attached if necessary to accommodate all applicable goods listings.
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Text version
ATTACHMENT AC - CERTIFICATION OF AMERICAN-MANUFACTURED GOODS
DGS SOLICITATION NO. ___________________
Instructions: Select one of the options below and fill out FORM A and/or FORM B as applicable.
CHECK BOX 1 or 2
1. Bidder/Offeror identified below certifies that the offered goods under this solicitation or contract are American-manufactured goods [as defined in COMAR 21.11.15.04B(1)] whether or not such offered goods are “emergency life safety and property safety goods”;
OR
2. Bidder/Offeror certifies that the offered goods under this solicitation or contract are not American-manufactured goods [as defined in COMAR 21.11.15.04B(1)] and:
IF OPTION 2 IS SELECTED, CHECK BOX (a) AND/OR (b)
(a) They are “emergency life safety and property safety goods” as defined in COMAR 21.11.15.04B(2). [Bidder/Offeror must list emergency life safety and property safety goods in FORM A attached to this certification];
AND/OR
(b) They are not “emergency life safety and property safety goods” as defined in COMAR 21.11.15.04B(2). [Bidder/Offeror must list non-emergency life safety and non-property safety goods in FORM B attached to this certification]
The undersigned, being an authorized representative of the Bidder/Offeror, hereby affirms that the contents of this certification are true to the best of my knowledge, information, and belief.
Bidder/Offeror
By: ________________________________________
(Signature)
(Insert name of individual executing)
(Insert title/capacity of individual)
(Date)
FORM A
LIST OF GOODS THAT ARE NOT AMERICAN-MANUFACTURED GOODS
AND
ARE EMERGENCY LIFE SAFETY AND PROPERTY SAFETY GOODS
Corresponding Specification Section / Drawing
Description
(Attach additional sheets if needed)
FORM B
LIST OF GOODS THAT ARE NOT AMERICAN-MANUFACTURED GOODS
AND
ARE NOT EMERGENCY LIFE SAFETY AND PROPERTY SAFETY GOODS
Corresponding Specification Section / Drawing
Description
(Attach additional sheets if needed)
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