Domestic Utilization Form (1).pdf
PDF 155 KB Posted
- Attached to
- Interstate Secondary Herbicide Services State and local contract opportunity
- Solicitation number
- 6100065044
- Issued by
- Lackawanna County, Pennsylvania
About this file
This is a Domestic Workforce Utilization Certification form required by the Commonwealth of Pennsylvania for state and local contract opportunities, specifically for Interstate Secondary Herbicide Services involving roadside pesticide and herbicide spraying on interstate roads within PennDOT's operational guidelines. The certification establishes scoring criteria based on contractors' commitment to employing domestic labor, with maximum consideration awarded to offerors performing all direct labor exclusively within the United States or within countries party to the World Trade Organization Government Procurement Agreement. Contractors must complete and sign the certification to receive any consideration under this criterion, and failure to do so results in automatic disqualification from scoring on this measure. The form allows offerors to declare either that 100 percent of direct labor will be performed domestically or to specify a percentage to be performed domestically, with remaining labor identified by country of origin.
The certification becomes a contractual obligation upon contract execution and creates a legal obligation for accuracy, with any misstatement treated as fraudulent concealment punishable under Section 4904 of the Pennsylvania Crimes Code. The form requires the contractor to provide corporate identification including legal entity name, place of incorporation, business address, and Social Security or Federal Identification Number. Approved countries for preferred consideration include Armenia, Austria, Belgium, Canada, France, Germany, Hong Kong, Israel, Japan, Korea, Singapore, Switzerland, the United Kingdom, and numerous other nations party to the WTO Government Procurement Agreement. The list of acceptable countries is extensive and specifically enumerated within the certification document.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| OS-501 (1) (4).pdf | ||
| Trade Secret Form (2).pdf | ||
| 2026 Interstate Herbicide Contract Specs_FINAL PDF.pdf | ||
| Terms and Conditions.pdf | ||
| Worker Protection and Investment Cert Form (BOP 2201).docx | DOCX document |
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Text version
APPENDIX B
DOMESTIC WORKFORCE UTILIZATION CERTIFICATION
To the extent permitted by the laws and treaties of the United States, each proposal will be scored for its commitment to use the domestic workforce in the fulfillment of the contract. Maximum consideration will be given to those offerors who will perform the contracted direct labor exclusively within the geographical boundaries of the United States or within the geographical boundaries of a country that is a party to the World Trade Organization Government Procurement Agreement. Those who propose to perform a portion of the direct labor outside of the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement will receive a correspondingly smaller score for this criterion. In order to be eligible for any consideration for this criterion, offerors must complete and sign the following certification. This certification will be included as a contractual obligation when the contract is executed. Failure to complete and sign this certification will result in no consideration being given to the offeror for this criterion.
I, ______________________[title] of ____________________________________[name of Contractor] a _______________ [place of incorporation] corporation or other legal entity, (“Contractor”) located at __________________________________________________________ [address], having a Social Security or Federal Identification Number of ________________________, do hereby certify and represent to the Commonwealth of Pennsylvania ("Commonwealth") (Check one of the boxes below):
All of the direct labor performed within the scope of services under the contract will be performed exclusively within the geographical boundaries of the United States or one of the following countries that is a party to the World Trade Organization Government Procurement Agreement: Armenia, Aruba, Austria, Belgium, Bulgaria, Canada, Chinese Taipei, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Liechtenstein, Lithuania, Luxemburg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, and the United Kingdom
OR
________________ percent (_____%) [Contractor must specify the percentage] of the direct labor performed within the scope of services under the contract will be performed within the geographical boundaries of the United States or within the geographical boundaries of one of the countries listed above that is a party to the World Trade Organization Government Procurement Agreement. Please identify the direct labor performed under the contract that will be performed outside the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement and identify the country where the direct labor will be performed: ____________________________________________
[Use additional sheets if necessary]
The Department of General Services [or other purchasing agency] shall treat any misstatement as fraudulent concealment of the true facts punishable under Section 4904 of the Pennsylvania Crimes Code, Title 18, of Pa. Consolidated Statutes.
Attest or Witness: ______________________________ Corporate or Legal Entity's Name
Signature/Date Signature/Date
Printed Name/Title Printed Name/Title
Printed Name/Title Printed Name/Title
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