Attachment 2 Affirmation_of_Business_Status_Certification.pdf
PDF 129 KB Posted
- Attached to
- Area of Interest (AOI) for User Activity Monitoring (UAM) Centralization Prototype Other Transaction (OT)
- Solicitation number
- DISA-OTA-27-R-UAM
- Issued by
-
Defense Information Systems Agency
About this file
This is a template form for the Affirmation of Business Status Certification (ABSC), required to be completed by every significant participating entity in a Department of Defense prototype project solicitation.
The form requires entities to provide complete organizational information including legal entity name, proposed NAICS code, industry size standard classification (Small/Large/Foreign), DUNS number, CAGE code, tax identification number, and SAM registration status with expiration date. Contact information must include a point of contact name, title, phone number, and email address. The form notes that DUNS number, CAGE code, tax identification, and active SAM registration information are mandatory for the Prime/Lead entity and applicable for all other participating entities. Entities must then certify their contractor status by selecting one of three categories: Nontraditional Defense Contractor (NDC)—defined as an entity with no DoD contracts subject to full cost accounting standards coverage in the preceding one-year period; Nonprofit Research Institution—an organization operated exclusively for scientific or educational purposes with no private earnings; or Traditional Defense Contractor—any entity not meeting the NDC definition. The signatory must certify that all representations are accurate and authorize electronic signature with legal equivalence to written signature, and must provide name, title, and date alongside the signature.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 2 Affirmation_of_Business_Status_Certification.pdf | ||
| AOI - UAM AMD 02.pdf | ||
| Attachment 2 Affirmation_of_Business_Status_Certification.pdf | ||
| AOI - UAM - AMD01.pdf | ||
| AOI - UAM.pdf | ||
| AOI - UAM.docx | DOCX document |
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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)
*DUNS No.
*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. 2302(9)).
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 Scientific 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
| 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: |
| Check Box3: Off |
| Check Box4: Off |
File details come from the government source that posted it. Updated .