Exhibit N - IFB - BUY AMERICAN FORM.docx

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Attached to
Wash Bay Equipment
Solicitation number
300000278027593
Issued by
Missouri

About this file

This is a Buy American certification form (Exhibit N) required by the Missouri Department of Transportation Southeast District for the Wash Bay Equipment procurement. The form implements Missouri's Domestic Products Procurement Act (sections 34.350-34.359, RSMo) and requires bidders to certify the manufacturing origin of all products being bid for the vehicle wash system equipment installation project at four locations. Bidders must complete applicable certification tables indicating whether products are manufactured or produced in the United States, outside the United States, covered by applicable trade treaties or agreements, or qualify as single-source U.S. manufacturer products. The form accommodates mixed sourcing scenarios through item-by-item certification when not all products fall into the all-domestic or all-foreign categories.

Bidders are responsible for providing accurate information regarding the point of manufacture for finished products and may be required to submit supporting documentation to prove compliance. Misrepresentation on the certification constitutes a Class A misdemeanor under Missouri law. The bidder must sign the form certifying that all information provided is true, correct, and complies with Missouri statutory requirements. This domestic preference form is a mandatory component of bid submission for this one-time purchase project and applies the state's preference for products manufactured or produced domestically or those imported under applicable U.S. trade treaties, laws, agreements, or regulations that afford them equivalent status to domestically-manufactured products.

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File Type Posted
MODOT SE 0000000026SL_SUPPLIER.pdf PDF
Scope of Work - Wash Equipment.docx DOCX document
Affidavits - Exhibit A and B.pdf PDF

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EXHIBIT N

DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

In accordance with sections 34.350-34.359, RSMo, the bidder is instructed to provide information regarding the point of manufacture for each of the products being bid so that the product’s eligibility for the Domestic Products Procurement Act (Buy American) Preference can be determined. This information is requested for the finished product only, not for components of the finished product. The bidder may be required to provide supporting documentation indicating proof of compliance.

Qualifying for the Domestic Products Preference:

A product qualifies for the preference if one of the following circumstances exist:

· if manufactured or produced in the U.S.; or

· if the product is imported into the U.S. but is covered by an existing international trade treaty, law, agreement, or regulation that affords the specific product the same status as a product manufactured or produced in the U.S.; or

· if only one line of products is manufactured or produced in the U.S.

Non-Domestic Product:

If the product is not manufactured or produced in the U.S. and does not otherwise qualify as domestic, then it will be considered non-domestic and not eligible for the preference.

THE BIDDER MUST COMPLETE THE FOLLOWING APPLICABLE TABLES TO CERTIFY WHETHER:

(Table 1)ALL products bid are manufactured or produced in the U.S. and qualify for the Domestic Products Procurement Act Preference; OR
(Table 2)ALL products bid are manufactured or produced outside the U.S. and do not otherwise qualify for the Domestic Products Procurement Act Preference; OR
(Tables 3-6)Not all products bid fall into the prior two categories so an item-by-item certification is necessary.

The bidder is responsible for certifying the information provided on the exhibit is accurate by signing where indicated at the end of the exhibit.

TABLE 1 – ALL PRODUCTS MANUFACTURED OR PRODUCED IN U.S. (eligible for preference) Check the box to the right if ALL products bid are MANUFACTURED OR PRODUCED IN THE U.S.:

TABLE 2 – ALL PRODUCTS MANUFACTURED OR PRODUCED OUTSIDE U.S. AND DON’T QUALIFY FOR PREFERENCE (ineligible for preference) Check the box to the right if ALL products bid are MANUFACTURED OR PRODUCED OUTSIDE THE U.S. and DO NOT OTHERWISE QUALIFY for the Domestic Products Procurement Act Preference:

TABLES 3 THROUGH 6 – ITEM BY ITEM CERTIFICATION (NOT ALL PRODUCTS BID FALL INTO PRIOR TWO TABLES)

· For those line items for which a U.S.-manufactured or produced product is bid, complete Table 3.

· For those line items which are manufactured or produced outside the U.S. that do not qualify for the Domestic Products Procurement Act Preference, complete Table 4.

· For those line items which are not manufactured or produced in the U.S., but for which there is a U.S. trade treaty, law, agreement, or regulation in compliance with section 34.359, RSMo, complete Table 5.

· For those line items which are not manufactured or produced in the U.S., but for which there is only one U.S. Manufacturer of that product or line of products, complete Table 6.

TABLE 3 – U.S.-MANUFACTURED OR PRODUCED PRODUCTS (Eligible for Preference)

· List item numbers of products bid that are U.S.-manufactured or produced and therefore qualify for the Domestic Products Procurement Act Preference.

· List U.S. city and state where products bid are manufactured or produced.

Item #
U.S. City/State Where Manufactured/Produced
Item #
U.S. City/State Where Manufactured/Produced

TABLE 4 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS (Not Eligible for Preference)

· List item numbers of products bid that are foreign manufactured or produced and do not otherwise qualify for the Domestic Products Procurement Act Preference.

· List country where product bid is manufactured or produced.

Item #
Country Where Manufactured/Produced
Item #
Country Where Manufactured/Produced

(Exhibit continues on next page)

EXHIBIT N, continued: DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT U.S. TRADE TREATY, LAW, AGREEMENT, OR REGULATION APPLIES (Eligible for Preference)

· List item numbers of products bid that are foreign manufactured or produced but qualify for the Domestic Products Procurement Act Preference because a U.S. Trade Treaty, Law, Agreement, or Regulation applies.

· Identify country where proposed foreign-made product is manufactured or produced.

· Identify name of applicable U.S. Trade Treaty, Law, Agreement, or Regulation that allows product to be brought into the U.S. duty/tariff-free.

· Identify website URL for the U.S. Trade Treaty, Law, Agreement, or Regulation.

· NOTE: As an imported product, if an import tariff is applied to the item, it does not qualify for the preference. In addition, “Most Favored Nation” status does not allow application of the preference unless the product enters the U.S. duty/tariff-free.

Item #
Country Where Proposed Foreign-Made Product is Manufactured/Produced
Name of Applicable U.S. Trade Treaty, Law, Agreement, or Regulation
Official Website URL for the U.S. Treaty, Law, Agreement, or Regulation

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD (Eligible for Preference)

· List item numbers of products bid that are foreign manufactured or produced but qualify for the Domestic Products Procurement Act Preference because only one US Manufacturer produces the product or line of a particular good.

· Identify country where proposed foreign-made product is manufactured or produced.

· Identify sole US manufacturer name.

· Identify name of sole US manufactured product/line of particular good.

Item #
Country Where Proposed Foreign-Made Product is Manufactured/Produced
Sole US Manufacturer Name
Name of Sole U.S. Manufactured Product or Line of Particular Good

The bidder is responsible for certifying the information provided on this exhibit is accurate by signing below:

I hereby certify that the information provided herein is true and correct, and complies with all provisions of sections 34.350 to 34.359, RSMo. I understand that any misrepresentation herein constitutes the commission of a class A misdemeanor.

SIGNATURE (If submitting bid electronically, scanned or typed signature is acceptable)

COMPANY NAME

MO 300-1102N (1-16)

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