Contractor_Certification_Statements.pdf
PDF 122 KB Posted
- Attached to
- GDC FY26 Outdoor Rubber Surfacing Area State and local contract opportunity
- Solicitation number
- SRC0000036295
- Issued by
- Gallia County, Ohio
About this file
This is a Contractor Certification Statements form used by the State of Ohio to evaluate bidder eligibility for various procurement preferences. The document requires bidders to complete certifications to claim preferences for Domestic Source End Products under the Buy American Act, Ohio preference under Buy Ohio, and Veteran Friendly Business Enterprise (VBE) status. Bidders must disclose where products and services are mined, raised, grown, produced, or manufactured, and certify the origin of components. The form applies to state and local contract opportunities in Ohio and requires bidders to provide specific information about product sourcing and manufacturing locations to qualify for applicable preferences.
The certification process includes three primary preference categories with detailed eligibility criteria. For Domestic Preference, bidders must confirm U.S. manufacturing or demonstrate that at least 50 percent of component costs originate within the United States. For Ohio Preference, bidders must verify that products are produced in Ohio or demonstrate significant economic presence within the state through tax compliance, Ohio Secretary of State registration, and employee location requirements. For VBE status, bidders must provide certification from the state. The State of Ohio reserves the right to clarify information during evaluation and warns that intentional submission of false or misleading information to obtain bid preferences will result in immediate disqualification and potential legal action including debarment. Bidders must complete the appropriate certification sections corresponding to the preferences they are claiming.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| STANDARD_AFFIRMATION_AND_DISCLOSURE_FORM__EO_2019-12D___2022-02D_.pdf | ||
| GDC - Rubber Surfacing RFQ.docx | DOCX document | |
| Contractor_Information_Form__rev._5.24_.pdf |
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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)
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: (Except products mined in Michigan) 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 (Except for products mined in Michigan)
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 http://procure.ohio.gov/pdf/exprod.pdf http://sos.state.oh.us/
| Where is each productservices being offered mined raised grown produced or manufactured: |
| United States: Off |
| Canada: Off |
| Mexico: Off |
| Other Specify Country: Off |
| State: |
| Yes: Off |
| No Go to Section A3: Off |
| produced grown or manufactured outside the United States 1: |
| produced grown or manufactured outside the United States 2: |
| Country of Origin: |
| Country of Origin_2: |
| Item: |
| No Go to B2: Off |
| Yes Answer a b c d below: Off |
| No Go to B3: Off |
| Yes_2: Off |
| Yes CharterRegistration No: Off |
| undefined: Off |
| Yes_3: Off |
| No Go to B2d: Off |
| Yes_4: Off |
| No Go to B3_2: Off |
| Yes Specify which state then go to B2c: Off |
| KY: Off |
| MI: Off |
| NY: Off |
| PA: Off |
| IN: Off |
| No Go to B4: Off |
| Border state bidder mined products mined in respective border state Except for products mined in Michigan: Off |
| Is the bidder a certified Veteran Friendly Business Enterprise as defined in Administrative Code 1235101KK: Off |
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