Attachment E - Patent Certification AMS Form 032 Rev 1 dated 71917.pdf
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- Solicitation number
- 444510
- Issued by
-
Department of Energy Office of Science
About this file
This is a Patent Certification form (AMS-Form-032, Revision 1.0) used by Brookhaven National Laboratory's Procurement and Property Management Division. The form, approved on 07/19/17, requires contractors to certify their compliance with patent-related requirements under Department of Energy contracts.
The form includes sections for both interim and final certification where contractors must certify that: 1) they have followed all procedures for identifying and disclosing subject inventions, 2) declare any subcontracts or purchase orders involving research and development, and 3) list any inventions or discoveries made under the contract, including title, inventor, date reported, and DOE "S" number. The form requires the contractor's signature, title, address, and certification date, along with the contract period covered by the certification. This document appears to be a standard template form rather than a completed certification.
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Text version
Date Printed 1/27/2023 1 of 1 Date Approved 07/19/17
PROCUREMENT AND PROPERTY MANAGEMENT DIVISION
BROOKHAVEN NATIONAL LABORATORY
Managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy
ACQUISITION MANAGEMENT SYSTEM FORM
Form No. AMS-Form-032
Revision No. 1.0
APPROVED BY:
Anthony Guadagni / 7/19/17
PPM Manager/Date
Patent Certification
Contractor: Interim Certification
Contract Number: Final Certification
Contractor hereby certifies that :
1. All procedures for identifying and disclosing subject inventions as required by the patent clause of the contract have been followed thought the reporting period.
2. There were no subcontracts or purchase orders involving research, development, and demonstration except as follows:
3. No inventions or discoveries were made or conceived in the course of or under this contract other than the following (Certification includes , does not include all subcontracts):
TITLE INVENTOR DATE REPORTED DOE “S” NO.
4. The completion date of this contract is as follows:
5. The following period is covered by this certification:
To
Month Day Year Month Day Year
Contractor Signature
Title
Address Date of Certification
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