ATTACHMENT J - CERTIFICATION OF RECALL OR SAFETY ISSUES - NX EQ EEG SYSTEMS.docx
DOCX document 32 KB Posted
- Solicitation number
- 36C10X26R0062
About this file
This is a certification form required for quoters responding to a solicitation for NX EQ EEG Systems from the Department of Veterans Affairs Strategic Acquisition Center Frederick (Solicitation Number 36C10X26R0062). The form serves as an attachment to the solicitation and must be completed and signed by an authorized company representative before submission with the quote.
The certification requires quoters to attest that the medical equipment being quoted meets three key compliance requirements: it has no outstanding recalls, contains no known safety issues, and complies with all relevant regulations and standards for medical equipment. Additionally, quoters must certify that the equipment has been thoroughly checked for compliance with safety and performance standards. The form includes mandatory fields for the company's Unique Entity Identifier (UEI), authorized representative name, title, signature, and date. Quoters are informed that providing false or misleading information in this certification may result in disqualification from the solicitation process and other legal penalties.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10X26R0062_2.pdf | ||
| SF30 36C10X26R0062 0002.pdf | ||
| 36C10X26R0062.pdf | ||
| 36C10X26R0062_1.docx | DOCX document | |
| 36C10X26R0062 Vendor Questions.pdf | ||
| SF30 36C10X26R0062 0001.pdf | ||
| ATTACHMENT A - PRICE COST SCHEDULE - NX EQ EEG SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT H - RFQ QUESTIONS - NX EQ EEG SYSTEMS.xlsx | XLSX spreadsheet | |
| APPENDIX C - NX EQ EEG SYSTEMS.docx | DOCX document | |
| ATTACHMENT D - SOLICITATION PROVISIONS - NX EQ EEG SYSTEMS.docx | DOCX document | |
| 852.219-76 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING-CERTIFICATE OF COMPLIANCE FOR SUPPLIES AND PRODUCTS -DEVIATION.docx | DOCX document | |
| ATTACHMENT E - QUARTERLY SALES REPORT - NX EQ EEG SYSTEMS.xlsx | XLSX spreadsheet | |
| ATTACHMENT F - PAST PERFORMANCE REFERENCES - NX EQ EEG SYSTEMS.pdf | ||
| ATTACHMENT C - CONTRACT CLAUSES - NX EQ EEG SYSTEMS.docx | DOCX document | |
| ATTACHMENT B - CONTRACT ADMINISTRATION - NX EQ EEG SYSTEMS.docx | DOCX document | |
| ATTACHMENT G - PAST PERFORMANCE QUESTIONAIRE - NX EQ EEG SYSTEMS.docx | DOCX document |
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Text version
Attachment J Certification of Recall or Safety Issues Instructions to Quoters:
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 quote.
Certification of No Outstanding Recalls or Safety Issues Solicitation Number: 36C10X26R0062 Requirement for: NX EQ EEG Systems
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 .