Attachment 2 Affirmation_of_Business_Status_Certification.pdf
PDF 259 KB Posted
- Solicitation number
- DISA-OTA-27-R-ICAM
- Issued by
-
Defense Information Systems Agency
About this file
This is an Affirmation of Business Status Certification (ABSC) form required for entities participating in a federal contract opportunity. Every significant participating entity must complete the form and provide a signature certifying their business status.
The form requires entities to provide company information including legal entity name, proposed NAICS code, industry size standard classification (Small/Large/Foreign), unique entity identifier, CAGE code, tax identification number, and confirmation of active SAM registration with expiration date. Additional information required includes business address and point of contact details with name, title, phone, and email. The form specifies that unique entity identifier, CAGE code, and tax identification are required for the entity serving as Prime/Lead for the prototype project and as applicable for all other entities.
Entities must certify their contractor status by selecting one of three categories: Nontraditional Defense Contractor (NDC)—defined as an entity not currently performing and not having performed any DoD contract or subcontract subject to full cost accounting standards coverage for at least one year preceding the solicitation; Nonprofit Research Institution—defined as an organization owned and operated exclusively for scientific or educational purposes with no net earnings benefiting private shareholders or individuals, including federally funded research and development centers; or Traditional Defense Contractor—defined as an entity not meeting the NDC definition. An authorized representative must sign the certification, affirming that all representations are accurate and authorizing electronic signature to carry legal weight equivalent to written signature.
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Other files
| File | Type | Posted |
|---|---|---|
| AOI - NG E-ICAM.pdf | ||
| Appendix B - DoD_Enterprise_ICAM_Reference_Design.pdf | ||
| Appendix A - DoW ICAM Governing Authorities List.pdf |
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Text version
AFFIRMATION OF BUSINESS STATUS CERTIFICATION (ABSC)
Every significant participating entity shall complete the following table and provide a signature representing its certification.
Legal Entity Name Proposed NAICS Code Industry Size Standard (Small/Large/Foreign) *Unique Entity Identifier *CAGE Code *Tax Identification *Active SAM Registration Yes No Expiration Date:
Address 1 Address 2 City/State/Zip POC Name/Title POC Phone/e-mail
* This information is required for the entity serving as the Prime/Lead for the prototype project and as applicable for all other entities.
The Entity named above represents that it is (check one of the following boxes):
A Nontraditional Defense Contractor (NDC) – A Nontraditional Defense Contractor is an entity that is not currently performing and has not performed, for at least the one-year period preceding the solicitation of sources by DoD for the procurement or transaction, any contract or subcontract for the DoD that is subject to full coverage under the cost accounting standards prescribed pursuant to section 1502 of title 41 and the regulations implementing such section (see 10 U.S.C. 3014).
A Nonprofit Research Institution – As defined in 15 U.S.C. 3703 a nonprofit institution means an organization owned and operated exclusively for scientific or educational purposes, no part of the net earnings of which inures to the benefit of any private shareholder or individual; and includes federally funded research and development centers, as identified by the National Science Foundation in accordance with the government wide Federal Acquisition Regulation issued in accordance with section 1303(a)(1) of title 41 (or any successor regulation thereto).
A Traditional Defense Contractor – A Traditional Defense Contractor is an entity that does not meet the definition of a Nontraditional Defense Contractor (NDC).
The undersigned hereby certifies that the representations made herein are accurate and true regarding the entity identified above. I authorize my electronic signature to carry the same weight and legal effect as my written signature.
Signature
Name
Title
Date
Pending Approval
| Legal Entity Name: |
| Proposed NAICS Code: |
| Industry Size Standard SmallLargeForeign: |
| DUNS No: |
| CAGE Code: |
| Tax Identification: |
| Yes No Expiration DateAddress 1: |
| Yes No Expiration DateAddress 2: |
| Yes No Expiration DateCityStateZip: |
| Yes No Expiration DatePOC NameTitle: |
| Yes No Expiration DatePOC Phoneemail: |
| A Nontraditional Defense Contractor NDC A Nontraditional Defense Contractor is an entity that is not currently: Off |
| A Nonprofit Research Institution As defined in 15 USC 3703 a nonprofit institution means an organization: Off |
| A Traditional Defense Contractor A Traditional Defense Contractor is an entity that does not meet the definition: Off |
| Name: |
| Title: |
| Date: |
| Expiration Date: |
| Pending Approval: Off |
| Yes: Off |
| No: Off |
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