B08 - Attachment 3 Tax-and-Felony-Representation-Form.pdf
PDF 83 KB Posted
- Opportunity number
- W911SR-24-S-0001
About this file
This document is a Representations under DoD Assistance Agreements form, which requires the applicant to provide information about any unpaid federal tax liabilities or criminal convictions. The applicant must indicate whether it is a corporation and, if so, whether it has any unpaid federal tax liabilities or criminal convictions within the past 24 months. If the applicant responds affirmatively to either of these representations, they are ineligible to receive an award unless the agency suspension and debarment official determines that further action is not required to protect the government's interests.
The related federal grant opportunity is for the Minority Serving Institutions (MSIs) and Historically Black Colleges and Universities (HBCUs) Science, Technology, Engineering and Mathematics (STEM) Consortium, funded by the Department of the Army Materiel Command Army Contracting Command Aberdeen Proving Ground. The funding instrument is a cooperative agreement, and the program is under the Basic, Applied, and Advanced Research in Science and Engineering federal grant program (CFDA 12.630). The opportunity seeks innovative applications to cooperatively partner with eligible entities in the implementation, execution, development, and administration of the consortium to conduct research and development efforts at educational institutions.
Attachment 3 Tax-and-Felony-Representation-Form
View the file
Other files
| File | Type | Posted |
|---|---|---|
| B08 - Amendment 3 FOA update to remove PPQ 09 SEP 2024.pdf | ||
| B08 - Amendment 3 Q_A as of 10 SEP 2024.pdf | ||
| B08-Amendment 2_QA as of 21 AUG2024.pdf | ||
| B08 - Attachment 3 Tax-and-Felony-Representation-Form.pdf | ||
| B08 - Amendment 2 FOA update to Factor 1 technical plan_Date of submission_Attachment 3.pdf | ||
| B08-AM~1.PPT | PPT presentation | |
| B08-AM~1.PDF | ||
| B08-AM~2.PPT | PPT presentation | |
| B08 -FOA Amendment 1_Incorporates QA asked during the Opportunity Day and After 06AUG2024.xlsx | XLSX spreadsheet | |
| B08-FO~1.XLS | XLS spreadsheet | |
| W911SR-24-S-0001.pdf | ||
| W911SR-24-S-0001.pdf |
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Representations under DoD Assistance Agreements: Appropriations Provisions on Tax Delinquency and Felony Convictions
The applicant is ( ) is not ( ) a “Corporation” meaning any entity, including any institution of higher education, other nonprofit organization, or for-profit entity that has filed articles of incorporation.
If the applicant is a “Corporation” please complete the following representations:
(1) The applicant represents that it is ( ) is not ( ) a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.
(2) The applicant represents that it is ( ) is not ( ) is not a corporation that was convicted of a criminal violation under any Federal law within the preceding 24 months.
NOTE: If an applicant responds in the affirmative to either of the above representations, the applicant is ineligible to receive an award unless the agency suspension and debarment official (SDO) has considered suspension or debarment and determined that further action is not required to protect the Government’s interests. The applicant therefore should provide information about its tax liability or conviction to the agency’s SDO as soon as it can do so, to facilitate completion of the required considerations before award decisions are made.
Sign:___________________________________
Date:____________________________________
Print Name and Position:______________________________________________
File details come from the government source that posted it. Updated .