Attachment 03 - 889 Representation Form.pdf

This is a Micro-Purchase National Defense Authorization Act (NDAA) Section 889 Representation form for merchants participating in federal contracting through the GSA Government Purchase Card (GPC) program.

The form serves as a compliance certification requiring merchants to represent their adherence to NDAA Section 889 restrictions on covered telecommunications equipment and services. Merchants must complete company identification information (name, address, contact details, SAM registration status, CAGE code, and Unique Entity ID) and certify whether they provide covered telecommunications equipment or services as part of their offered products or contract performance. Additionally, merchants must represent whether they use covered telecommunications equipment or services in their operations. The representation requires merchant signature and expires on either the SAM registration expiration date listed in Block 13 or one year from the representation date in Block 3, whichever is sooner. Merchants must update any modifications or changes to their representation within 30 days. If merchants indicate they provide or use covered telecommunications equipment or services, they must provide additional disclosures referencing FAR 52.204-24 and submit supplementary documentation identifying specific equipment, services, or supply chain details to the contracting officer.