BAA_Certification.pdf
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- Solicitation number
- Req-352980
- Issued by
-
Department of Energy Office of Science
About this file
This is a Buy American Act Certification form from SLAC National Accelerator Laboratory's Supply Chain Management department, dated August 29, 2023. The form requires bidders/offerors to certify whether their end products qualify as U.S. domestic commercial products.
The certification is associated with a solicitation for vacuum storage fixtures for 5045 Klystrons, specifically requesting 10 units each of storage fixture body, shoulder ring, rework shell, cover plate, and storage fixture components. The form requires bidders to indicate if products are domestic, and if not, to detail excluded end products per FAR 25.104, certify domestic source components, and specify the percentage of foreign content (with accuracy within ±5%). The form must be signed by the offeror, making these representations part of their quotation. This certification supports SLAC's requirement for U.S. domestic end item sources, with responses due by March 14, 2025.
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BUY AMERICA ACT CERTIFICATION (REV. 08.29.2023) Page 1 of 1
SUPPLY CHAIN MANAGEMENT
BUY AMERICAN ACT CERTIFICATION
Solicitation Number
The bidder/offeror hereby certifies that each end product qualifies as a U.S. domestic commercial product.
Yes No
If the answer above is Yes, skip to Section (C). If the answer above is No, fill out Sections (A), (B) and
(C) Below:
A. Excluded end products, in accordance with FAR Part 25.104. (Mark "N/A" if not-applicable)
B. The bidder/offeror hereby certifies that each end product, except the end products listed below, is a domestic source end product (as defined in the Buy American Act provisions); and that NO components of unknown origin have been mined, produced, or manufactured outside the United States.
The bidder/offeror will represent (as an estimate), herein, before the award of a purchase order or subcontract, the percent of the foreign content of the item or service being procured expressed as a percent of the total purchase order/subcontract award price (accuracy within plus or minus 5 percent is acceptable).
Percent (%) of Foreign Content:
Country of Origin:
c. THE OFFEROR’S SIGNATURE MAKE THE ABOVE REPRESENTATIONS AND
CERTIFICATIONS PART OF THEIR QUOTATION
Offeror’s Signature: Date:
Printed Name:
Title:
Company Name:
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