Domestic Utilization Form.pdf
PDF 155 KB Posted
- Attached to
- PA DEP Certified Drinking Water Operator
- Solicitation number
- 6100064177
- Issued by
- Fulton County, Pennsylvania
About this file
This document is a Domestic Workforce Utilization Certification form used by the Commonwealth of Pennsylvania's Department of General Services and other purchasing agencies for contract procurements. The certification requires contractors to specify whether all direct labor will be performed exclusively within the United States or within countries that are parties to the World Trade Organization Government Procurement Agreement (which includes 41 specified countries including Armenia, Canada, Germany, Japan, and the United Kingdom), or to specify what percentage of direct labor will be performed in these approved locations versus other countries. The form must be completed and signed by contractors as part of their proposal submissions, and failure to complete this certification results in no consideration for this evaluation criterion.
Proposals are scored based on their commitment to use domestic workforce, with maximum consideration given to those performing all contracted direct labor within the specified geographical boundaries. Contractors performing portions of direct labor outside the United States and outside WTO Government Procurement Agreement countries receive correspondingly lower scores. The certification becomes a contractual obligation upon contract execution, and any misstatements are treated as fraudulent concealment punishable under Pennsylvania criminal law. The form requires corporate signatures, witness attestation, and detailed identification of any work to be performed outside approved geographical areas.
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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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