B06_Supplier_commitment_Verification_Form.pdf
PDF 127 KB Posted
- Solicitation number
- 140FS226Q0149
About this file
This is a Subcontractor/Supplier Commitment Verification Form used in federal contract solicitations to establish supplier commitments for material delivery. The form serves as a verification mechanism between the primary offeror, the proposed supplier, and the Government to ensure supplier capability and commitment prior to contract award.
The form requires suppliers to provide organizational information including business name, address, UEI, and primary contact details. In Section II, suppliers must certify discussions with the offeror, intent to supply specified types of gravel/material, review of delivery requirements, and confirmation of sufficient production capacity to meet anticipated contract quantities. The form requires identification of gravel types and source quarry location, along with estimated maximum production capacity during contract performance. Section III addresses pricing verification, requiring suppliers to confirm pricing has been provided to the offeror and specify the validity period or indicate pricing will be available upon contract award following subcontract execution. In Section IV, suppliers certify no known performance impediments exist, that available production capacity has not been committed elsewhere, and intent to negotiate in good faith if award is made. Section V authorizes Government verification contact with a designated supplier representative. Both the supplier and offeror must provide certification signatures and dates. The form includes a Government Use Only section for recording verification methods (telephone, email, or other) and verification results.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FS226Q0149.pdf | ||
| A04_RFQ_SOW_Gravel.pdf | ||
| A04_Map_GravelDropOffLocation.pdf |
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Text version
SUBCONTRACTOR / SUPPLIER COMMITMENT VERIFICATION FORM
Solicitation Number: ______________________
Project Title: _____________________________
Offeror SAM UEI: ___________________________________
Section I – Proposed Supplier Information
Supplier Name:
Business Address:
UEI (if applicable):
Primary Contact:
Title:
Phone:
Email:
Section II – Material Commitment
The Supplier identified above certifies the following:
☐ We have discussed this solicitation with the Offeror.
☐ We intend to supply the gravel/material identified below if the Offeror is awarded the contract.
☐ We have reviewed the anticipated delivery requirements.
☐ We have sufficient production capacity and availability to meet the anticipated contract requirements, subject to execution of a subcontract or purchase agreement.
☐ We understand the estimated quantities are not guaranteed but represent the Government's anticipated requirements.
Type(s) of Gravel to be Furnished:
Source Quarry Location:
Estimated Maximum Production Capacity During Performance:
Section III – Pricing Verification
The Supplier certifies that:
☐ Pricing has been provided to the Offeror.
☐ Pricing remains valid through:
OR
☐ Pricing will remain available upon contract award subject to execution of a subcontract agreement.
Section IV – Performance Commitment
The Supplier understands that the Offeror intends to rely upon this commitment in preparing its proposal.
The Supplier further certifies that, as of the date below:
• There are no known circumstances preventing performance.
• The Supplier has not committed all available production capacity elsewhere.
• The Supplier intends to negotiate in good faith with the Offeror if award is made.
Section V – Government Verification Authorization
The Supplier authorizes the Government to contact the individual listed below solely for the purpose of verifying the information contained in this certification.
Verification Contact:
Phone:
Email:
Supplier Certification
I certify that the information contained herein is accurate and complete.
Supplier Representative:
Name:
Signature:
Date:
Offeror Certification
The Offeror certifies that this supplier is the intended source of material for this solicitation.
Offeror Representative:
Name:
Signature:
Government Use Only
Verification Performed By:
Verification Method:
☐ Telephone
☐ Other
Comments:
File details come from the government source that posted it. Updated .