.09 Domestic Workforce Utilization Certification Form-Multiple Award.pdf
PDF 155 KB Posted
- Attached to
- Greene County Uniform Services -
- Solicitation number
- 6100066303
- Issued by
- Fulton County, Pennsylvania
About this file
This is a Domestic Workforce Utilization Certification Form for Multiple Award Contracts issued by the Commonwealth of Pennsylvania, specifically applicable to the Greene County Uniform Services contract for the Pennsylvania Department of Transportation (PennDOT) Engineering District 12-2. The form establishes certification requirements that contractors must complete and sign to receive consideration in the agency's best value selection process for each assignment under the contract. Contractors must certify their commitment to utilizing domestic workforce in fulfilling contracted direct labor, with maximum consideration given to suppliers performing all direct labor exclusively within the United States or within countries that are parties to the World Trade Organization Government Procurement Agreement, including the United Kingdom, Canada, Japan, and numerous European nations.
The certification requires contractors to elect one of two options: either commit that all direct labor will be performed within the United States or eligible WTO member countries, or specify the percentage of direct labor to be performed within these geographical boundaries and identify which countries will host any work performed outside approved jurisdictions. Failure to complete and sign the certification results in no consideration for this evaluation criterion. Upon contract execution, this certification becomes a contractual obligation, and any misstatement is treated as fraudulent concealment punishable under Section 4904 of the Pennsylvania Crimes Code. The form requires authorized signatures from both the contractor and a witness, with attestation of the corporate or legal entity name and printed names and titles of all signatories.
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Text version
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], 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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