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 form requiring offerors to attest to the absence of recalls and safety issues for medical equipment being proposed in response to Solicitation Number 36C10X27R0004.
The certification mandates that an authorized company representative confirm that the NX EQ Image-Guided Surgical Navigation System submitted in response to this VA solicitation: (1) has no outstanding recalls; (2) has no known safety issues; (3) complies with all relevant medical equipment regulations and standards; and (4) has been thoroughly checked for compliance with safety and performance standards. The form requires completion of company identification information, including the Company Unique Entity Identifier (UEI), along with the authorized representative's name, title, signature, and date. Offerors must submit the completed and signed certification as part of their proposal package. The form warns that false or misleading information may result in disqualification from the solicitation process and other legal penalties. This certification applies to the Department of Veterans Affairs Strategic Acquisition Center Frederick's acquisition for new OEM Image-Guided Surgical Navigation Systems, which is set aside for Service-Disabled Veteran-Owned Small Businesses.
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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 .