ATTACHMENT H - CERTIFICATION OF RECALL OR SAFETY ISSUES_NX EQ Image-Guided Surgical Navigation System.docx
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- Solicitation number
- 36C10X27R0004
About this file
This is a Certification of Recall or Safety Issues form required as part of Solicitation Number 36C10X27R0004 for NX EQ Image-Guided Surgical Navigation Systems. Offerors must complete and submit this certification form signed by an authorized company representative along with their proposal to the Department of Veterans Affairs Strategic Acquisition Center Frederick. The certification requires the offeror to attest that the medical equipment being quoted has no outstanding recalls, no known safety issues, complies with all relevant medical equipment regulations and standards, and has been thoroughly checked for compliance with safety and performance standards. Submission of false or misleading information in this certification may result in disqualification from the solicitation process and other penalties permitted by law.
The RFP is set aside for Service-Disabled Veteran-Owned Small Businesses and specifies that only new OEM equipment is acceptable, with no refurbished, remanufactured, or gray market items permitted. Delivery terms are FOB Destination with specific delivery locations and dates to be identified in individual orders issued under the resulting contract. Offerors must complete all fields in the certification form, including their Company Unique Entity Identifier (UEI), authorized representative information, and signature, with instructions to ensure proper authorization before submission.
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Attachment H Certification of Recall or Safety Issues Instructions to Offerors:
1. Complete all fields in the certification form.
2. Ensure that the form is signed by an authorized representative of the company.
3. Submit the completed form along with your proposal.
Certification of No Outstanding Recalls or Safety Issues Solicitation Number: 36C10X27R0004 Requirement for: NX EQ Image-Guided Surgical Navigation System
Company Unique Entity Identifier (UEI): __________________________________________
Certification:
By signing below, I, the undersigned, certify on behalf of the company identified by the UEI above, the medical equipment quoted in response to the above-referenced solicitation:
1. Does not have any outstanding recalls.
2. Does not have any known safety issues.
3. Complies with all relevant regulations and standards for medical equipment.
4. Has been thoroughly checked for compliance with safety and performance standards.
I understand that any false or misleading information provided in this certification may result in disqualification from the solicitation process and other penalties as permitted by law.
Authorized Representative:
Name: __________________________________________ Title: __________________________________________ Signature: __________________________________________ Date: __________________________________________
File details come from the government source that posted it. Updated .