Certification_Statement__2___1___2_.pdf
PDF 50 KB Posted
- Attached to
- GT Uni Mac Industrial Washer installed
- Solicitation number
- SRC0000035573
- Issued by
- Butler County, Ohio
About this file
This is a Certification Statement form issued by the Ohio Department of Veterans Services for bidders on a Uni Mac Industrial Washer purchase and installation project at Ohio Veterans Home Georgetown. The document requires bidders to complete certifications to claim eligibility for domestic preference, Ohio preference, and Veteran Friendly Business Enterprise (VBE) preferences. Bidders must attest to the origin of products and services being offered, with options to certify domestic manufacturing in the United States, production with at least 50 percent domestic components, or manufacturing outside the United States. The form includes sections for bidders to document compliance with Ohio Buy America requirements, including whether products are raised, grown, produced, mined, or manufactured in Ohio and whether the bidder maintains significant economic presence within the state.
The certification statement addresses three primary preference categories available to eligible bidders. For Ohio preference eligibility, bidders must demonstrate paid state taxes, registration with the Ohio Secretary of State, and employment thresholds of either ten or more employees in Ohio or border states (Kentucky, Michigan, New York, Pennsylvania, or Indiana) or seventy-five percent or more employees in Ohio or border states. Bidders may also certify Veteran Friendly Business Enterprise status and E.D.G.E. (Encouraging Diversity, Growth, and Equity) business certification. The form requires bidders to acknowledge their status as a business entity as defined by Ohio Revised Code Section 145.037. Intentional submission of false or misleading information to obtain bid preferences results in immediate disqualification and potential legal action including debarment.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| GT SOW Washer.pdf | ||
| State_of_Ohio_Terms_and_Conditions__5___1_ (1).pdf | ||
| 01_Model_Contract_2025__2_ (1).doc | DOC document | |
| Affirmation_and_Disclosure_Form__1_ (1).pdf |
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
CERTIFICATION STATEMENTS
Bidders claiming preference for Domestic Source End Products, the Ohio preference, and/or the Veteran Friendly Business Enterprise (VBE) must complete the following information. Any bidder who intentionally submits false or misleading information in an attempt to receive a bid preference will be immediately disqualified and may be subject to legal action up to and including debarment. The state reserves the right to clarify any information during the evaluation process.
***BIDDERS MUST COMPLETE THE APPROPRIATE CERTIFICATION BELOW TO RECEIVE THE PREFERENCE.***
A. DOMESTIC PREFERENCE (BUY AMERICAN): Revised Code 125:11 and Administrative Code 123:5-1(K) [Not applicable to “Excepted Products”]
1. Where is each product/services being offered mined, raised, grown, produced or manufactured?
United States: (State) Canada Mexico (Go to B-1) Other: (Specify Country) (Go to A-2)
2. End product is manufactured outside the United States and at least 50% of the cost of its components are produced, mined, raised, grown or manufactured within the United States. The cost of components may include transportation costs to the place of manufacture and, in the case of components of foreign origin, duty whether or not a duty free entry certificate is issued. Yes (Go to Section B-1) No (Go to Section A-
3. The Bidder hereby certifies that each end product, except the products listed below, is a domestic source end product as defined in the Buy American Act and that components of unknown origin have been considered to have been mined, produced, grown or manufactured outside the United States.
(Item) (Country of Origin)
(Item) (Country of Origin)
B. OHIO PREFERENCE (BUY OHIO): Revised Code 125:09 and Administrative Code 123:5-1-06
1. The products/services being offered are raised, grown, produced, mined or manufactured in Ohio.
Yes No (Go to B-2)
2. Bidder has significant economic presence within the state of Ohio. Yes (Answer a, b, c, d below) No (Go to B-3)
a) Bidder has paid the required taxes due the state of Ohio Yes No
b) Bidder is registered with the Ohio Secretary of State Yes (Charter/Registration No.: ) No
Questions regarding registration should be directed to (614) 466-3910 or visit their web site at:
http://sos.state.oh.us/
c) Bidder has ten or more employees based in Ohio or border state. Yes No (Go to B-2d)
d) Bidder has seventy-five percent or more employees based in Ohio or border state. Yes No (Go to B-3)
3. Border state bidder:
Yes (Specify which state then go to B-2c): KY MI NY PA IN No (Go to B-4)
4. Border state bidder: mined products mined in respective border state Yes No Not Applicable
C. VETERANS PREFERENCE (BUY VETERAN): Revised Code 9.318 and Administrative Code 123:5-1-16
Is the bidder a certified Veteran Friendly Business Enterprise as defined in Administrative Code 123:5-1-01(KK)
Yes No
II. E.D.G.E DESIGNATION: Is the bidder a certified E.D.G.E business
Yes No
For information on E.D.G.E designation, please visit the DAS Equal Opportunity Division website at:
http://www.das.ohio.gov/Divisions/EqualOpportunity/tabid/80/Default.aspx http://procure.ohio.gov/pdf/exprod.pdf http://sos.state.oh.us/ http://www.das.ohio.gov/Divisions/EqualOpportunity/tabid/80/Default.aspx
III. INDEPENDENT CONTRACTOR ACKNOWLEDGEMENT: Contractor certifies that Contractor is a “business entity” as that term is defined in O.R.C Section 145.037. Independent Contractor Acknowledgement.
Bidder is defined as a business entity Yes No
File details come from the government source that posted it. Updated .