Buy_America_CMO_Utility.xls

XLS spreadsheet 70 KB Posted

Attached to
RFP_MID_ODOT_Uility_Relocation
Solicitation number
S-Q10026-00018175
Issued by
Oregon

About this file

This is a Certificate of Materials Origin form required by the Oregon Department of Transportation (ODOT) for the RFP MID ODOT Utility Relocation project, established under CFR 635.410 to certify compliance with Buy America provisions. The form requires contractors, subcontractors, or suppliers to document the domestic sourcing of iron and steel materials used on the project. Bidders must identify the project name, contract number, and bid item number, then provide detailed information about both domestic materials sources and any foreign materials or materials of unknown origin. The certificate serves as official documentation that all iron or steel manufacturing processes, including protective coatings, occurred within the United States of America, with manufacturers' certificates to be retained for three years following final payment and made available to the Engineer upon request.

The authorized representative of the submitting company must sign the certificate under penalty of perjury under Oregon and Federal laws, certifying the accuracy of the materials documentation. A new certificate must be submitted for any subsequent shipments if the documented information changes. This certification requirement ensures compliance with domestic content preferences for federally-funded infrastructure projects and establishes a clear audit trail for materials verification throughout the contract performance period.

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Text version

PROJECT NAME (SECTION)CONTRACT NO.
BID ITEM NO.BID ITEM NAME
DOMESTIC MATERIALS SOURCE (NAME AND ADDRESS)
DOMESTIC MATERIALS DESCRIPTION
FOREIGN MATERIALS SOURCE INCLUDING MATERIAL OF UNKNOWN ORIGIN (NAME AND ADDRESS)
FOREIGN MATERIALS (OR OF UNKNOWN ORIGIN) DESCRIPTION AND VALUE OF IRON OR STEEL PRODUCT AS IT IS DELIVERED TO THE PROJECT
This certification is made for the purpose of establishing materials acceptance under CFR 635.410. All iron or steel manufacturing processes, including protective coatings, for the domestic materials described above occurred within the United States of America.
Manufacturers' certificates verifying the origin of the above described domestic materials will be kept on file for three years following final payment. Copies will be furnished to the Engineer upon request.
I declare under penalty of perjury under Oregon and Federal laws that the foregoing is true and correct.
AUTHORIZED REPRESENTATIVE*COMPANY* NAME AND ADDRESS:
NAME:
TITLE:
SIGNATURE:
DATE:
Submit a new certificate for subsequent shipments if any of the above information changes.*May be Contractor, Sub-Contractor or supplier

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CERTIFICATE OF MATERIALS ORIGIN

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