Contractor Responsibility Cert.pdf

REPRESENTATIONS AND CERTIFICATIONS

Contractor Responsibility Certification

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Solicitation No. Project Title.

Contractor Name. UEI No.

By submitting an offer in response to this solicitation, the contractor hereby represents and certifies the following statements as true and accurate to the best of its knowledge.

A. Financial Resources (FAR 9.104-1(a))

1. The contractor ☐ does / ☐ does not have adequate financial resources to perform this contract, or the ability to obtain them.

2. The contractor ☐ can / ☐ cannot provide financial statements if requested by the Government.

3. Financial capacity, working capital, or other resources available to support contract performance (optional):

B. Ability to Meet Performance Schedule (FAR 9.104-1(b)) The contractor ☐ can / ☐ cannot comply with the required performance schedule, considering all existing commercial and governmental commitments.

C. Performance Record (FAR 9.104-1(c)) The contractor ☐ has / ☐ does not have a satisfactory performance record.

□ Not Applicable — Contractor has no relevant past performance.

D. Integrity and Business Ethics (FAR 9.104-1(d)) The contractor ☐ has / ☐ does not have a satisfactory record of integrity and business ethics.

E. Organization, Experience, Controls & Technical Capability (FAR 9.104-1(e)) The contractor ☐ has / ☐ does not have the necessary organization, experience, accounting and operational controls, and technical skills to perform this contract, or the ability to obtain them.

F. Equipment and Facilities (FAR 9.104-1(f)) The contractor ☐ has / ☐ does not have the necessary production, construction, or technical equipment and facilities to perform, or the ability to obtain them.

REPRESENTATIONS AND CERTIFICATIONS

Contractor Responsibility Certification

Solicitation No. Project Title

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G. Eligibility Under Applicable Laws and Regulations (FAR 9.104-1(g)) The contractor ☐ is / ☐ is not otherwise qualified and eligible to receive an award under applicable laws and regulations.

H. Excluded Parties / SAM.gov Status The contractor ☐ is / ☐ is not listed on the System for Award Management (SAM.gov) Exclusions List.

Optional Explanation Section (Complete only if any “does not,” “cannot,” “is not otherwise qualified,” or “is listed on the Exclusions List” response was selected. Additional supporting documentation is not required unless the Government requests it.)

Provide clarifications, context, or planned mitigation if applicable:

Disclaimer. A “does not” or “cannot” response does not automatically render a contractor non-responsible.

The Contracting Officer may request additional information or clarification as needed and will make the final responsibility determination in accordance with FAR Subpart 9.1.

Contractors are not required to submit supporting documentation unless specifically requested by the Government.

Contractor Certification I certify that the information provided in this form is complete and accurate. I understand that knowingly providing false information may result in remedies under applicable federal law.

Company Name:

Authorized Representative Name:

Authorized Representative Title:

Signature:

Date: