Attachment No. 5 - Antimafia Self-Certification.pdf

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Amendment 0001 to INDOOR FIRING RANGE MAINTENANCE AND LEAD/HAZMAT ABATEMENT SERVICES, AVIANO AB, ITALY
Solicitation number
FA568222Q0004
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This document contains a federal contract solicitation and related antimafia self-certification form. The solicitation is for indoor firing range maintenance and lead/hazardous materials abatement services at Aviano Air Base in Italy. The contractor must provide all necessary management, tools, equipment, transportation, and qualified personnel to maintain the firing range in a satisfactory condition to support mission-critical firing operations. The contractor must have current Italian certification to perform maintenance services on firing ranges within Italian territory for the entire period of performance. A mandatory site visit and pre-quotation conference is scheduled for April 8, 2022 at the air base, with requests to attend due by April 6. Interested offerors must have valid identification and a green health pass or recent negative COVID-19 test. The self-certification form requires the contractor to attest that they are not prohibited, decertified, or suspended from contracting per Italian law and acknowledges that submitted personal data will be handled according to privacy regulations.

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Other files

File Type Posted
FA568222Q0004-Exhibit No.1-PriceSchedule-02 May 2022.xlsx XLSX spreadsheet
FA568222Q0004-Exhibit No.1-PriceSchedule-02 May 2022.xlsx XLSX spreadsheet
Solicitation Amendment FA568222Q00040001 SF 30.pdf PDF
Q and A to Request for Quotation FA568222Q0004.pdf PDF
Attachment No. 4 - Prohibition Covered Telecommunication Equipment.pdf PDF
Attachment No.1-IFR Performance Work Statement-07 mar 2022 .pdf PDF
Attachment No. 3 - Prior Experience.pdf PDF
Solicitation - FA568222Q0004.pdf PDF
Attachment No. 2 - FAR 52.212-3_Alternate I Offeror Representations and Certifications- Commercial Items.pdf PDF
FA568222Q0004-Exhibit No. 1 Price Schedule-1 apr 2022.xlsx XLSX spreadsheet

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Self-certification for Antimafia communication

Autocertificazione della comunicazione antimafia

Dichiarazione sostitutiva di certificazione (D.P.R. n. 445 del 28.12.2000)

Il/la sottoscritto/a (nome e cognome) _______________________________ C.F._________________ nato/a _______________________________ Prov. _________ il ______________ residente a

________________________ Prov. _____ in via/piazza ____________________

_______________________________ n. ____, in qualità di (carica ricoperta) ___________ dell’impresa (indicare la denominazione) _______________________________________________ C.F. __________________ avente la sede in _________________________ Prov. di __________ Via ___________________________ n. ______ consapevole delle sanzioni penali in caso di dichiarazioni false e della conseguente decadenza dai benefici eventualmente conseguiti (ai sensi degli artt. 75 e 76 D.P.R. 445/2000) sotto la propria responsabilità

DICHIARA

che nei propri confronti non sussistono le cause di divieto, di decadenza o di sospensione di cui all’art. 67 del D.lgs. n. 159 del 06/09/2011.

Il/la sottoscritto/a dichiara inoltre di essere informato/a, ai sensi del D.Lgs. n. 196/2003 (codice in materia di protezione di dati personali) che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nell’ambito del procedimento per il quale la presente dichiarazione viene resa.

data firma leggibile del dichiarante (2)

File details come from the government source that posted it. Updated .