Attachment 2 Affirmation_of_Business_Status_Certification.pdf
PDF 259 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 document is a template form for the Affirmation of Business Status Certification (ABSC), used to certify the status of entities participating in federal defense procurement opportunities.
The form requires all significant participating entities to complete a standardized information table and provide authorized signature certification. Required data fields include Legal Entity Name, Proposed NAICS Code, Industry Size Standard designation (Small/Large/Foreign), Unique Entity Identifier, CAGE Code, Tax Identification number, active SAM registration status with expiration date, business address, and Point of Contact information. The form specifies that Unique Entity Identifier, CAGE Code, Tax Identification, and active SAM Registration information are mandatory for the Prime/Lead entity and applicable for all other participating entities. The certification portion requires the entity to declare its status under one of three mutually exclusive 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—as defined in 15 U.S.C. 3703, including federally funded research and development centers; or Traditional Defense Contractor—any entity not meeting NDC criteria. The signatory must certify the accuracy and truthfulness of all representations and acknowledges that electronic signatures carry the same legal weight as written signatures. The form requires signature, printed name, title, and date fields for authorization.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 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 | |
| Attachment 2 Affirmation_of_Business_Status_Certification.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
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 |
File details come from the government source that posted it. Updated .