DomesticWorkforceUtilizationCertificationForm_MultipleAward.pdf

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Attached to
Hamburg Center Grounds Maintenance
Solicitation number
6100066013
Issued by
Berks County, Pennsylvania

About this file

This is a Domestic Workforce Utilization Certification Form for Multiple Award Contracts issued by the Commonwealth of Pennsylvania, Department of General Services. The form serves as an evaluation criterion in the best value selection process for multiple award contracts, with maximum consideration given to suppliers committing to perform all direct labor exclusively within the United States or within countries that are parties to the World Trade Organization Government Procurement Agreement. The certification must be completed and signed by contractors to be eligible for consideration under this criterion, and the form becomes a contractual obligation upon contract execution. Failure to complete and sign the certification results in no consideration for this evaluation criterion.

Contractors must certify either that all direct labor will be performed within approved geographical boundaries, or specify the percentage of direct labor that will be performed in such locations. For any direct labor performed outside the United States and outside WTO Government Procurement Agreement countries, contractors must identify the specific countries where such work will occur. Misstatements on the certification are treated as fraudulent concealment punishable under Section 4904 of the Pennsylvania Crimes Code. The form requires attestation from both the contractor and a corporate or legal entity representative, with signatures and dates required from each party.

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Text version

BOP-1301.Multiple Award

Revised 02/23/2018

DOMESTIC WORKFORCE UTILIZATION CERTIFICATION FOR MULTIPLE AWARD

CONTRACTS

To the extent permitted by the laws and treaties of the United States, this certification will be used by the Agency in making a best value selection for each particular assignment. Each quote will be evaluated for its commitment to use the domestic workforce in the fulfillment of the contract. Maximum consideration will be given to those suppliers 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, suppliers 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 supplier for this criterion.

I, ______________________[title] of ____________________________________[name of Contractor] a

_______________ [place of incorporation] corporation or other legal entity, (“Contractor”) located at

[address], 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, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Latvia, Liechtenstein, Lithuania, Luxemburg, Malta, Moldovia, Montenegro, New Zealand, the Netherlands, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Ukraine 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

BOP-1301.Multiple Award

Revised 02/23/2018

Printed Name/Title Printed Name/Title

File details come from the government source that posted it. Updated .