FY20_Buy_America_-_Ohio_Certification_v2.0__U.S..pdf
PDF 1 MB Posted
- Attached to
- Competitive Selection OH|DOT31825-1
- Contract number
- DOT31825-1
- Issued by
- Ohio
About this file
The document is a Certification Statements form completed by 214 Veteran, LLC, addressing domestic, Ohio, and veterans' business preferences for a state procurement process. The form relates to Ohio state government procurement regulations, specifically covering Buy American, Buy Ohio, and Buy Veteran preferences as outlined in Ohio Revised Codes and Administrative Codes. The vendor 214 Veteran, LLC has indicated compliance with various state-level business certification requirements.
The vendor has certified that its products/services are domestically sourced from within the United States and has significant economic presence in Ohio, including having paid state taxes and being registered with the Ohio Secretary of State. Additionally, 214 Veteran, LLC is certified as a Veteran Friendly Business Enterprise. The form allows the bidder to claim potential procurement preferences by demonstrating compliance with state-specific sourcing, economic, and veteran-owned business criteria. The certification is signed by Michael Lackey, who completed the form and attests to the accuracy of the information provided.
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Other files
| File | Type | Posted |
|---|---|---|
| 3430_3440_Plus.pdf | ||
| RFQ_22768_214VET.pdf | ||
| Affirmation_and_Disclosure_Form_ODOT_1600_W._Broad_St..pdf | ||
| Signature.pdf |
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Text version
Vendor Name: ______________________________________________________________
CERTIFICATION STATEMENTS
Bidders claiming preference for Domestic Source End Products, the Ohio preference, and/or the Veteran Friendly Business Enterprise (VBE) must complete the following information. Any bidder who intentionally submits false or misleading information in an attempt to receive a bid preference will be immediately disqualified and may be subject to legal action up to and including debarment. The Department reserves the right to clarify any information during the evaluation process.
***BIDDERS MUST COMPLETE THIS CERTIFICATION TO RECEIVE ANY PREFERENCES***
A. DOMESTIC PREFERENCE (BUY AMERICAN): Revised Code 125:11 and Administrative Code 123:5-1(K) [Not applicable to "Excepted Products"]
1. Where is each product/services being offered mined, raised, grown, produced or manufactured?
United States: (State) (Go to B-1)
Other: ________________________________ (Specify Country) (Go to A-2)
2. End product is manufactured outside the United States and at least 50% of the cost of its components are produced, mined, raised, grown or manufactured within the United States. The cost of components may include transportation costs to the place of manufacture and, in the case of components of foreign origin, duty whether or not a duty free entry certificate is issued.
Yes (Go to Section B-1) No (Go to Section A-3)
3. The Bidder hereby certifies that each end product, except the products listed below, is a domestic source end product as defined in the Buy American Act and that components of unknown origin have been considered to have been mined, produced, grown or manufactured outside the United States.
(Item) _____________________________ (Country of Origin) __________________________
(Item) _____________________________ (Country of Origin) __________________________
214 Veteran, LLC
B. OHIO PREFERENCE (BUY OHIO): Revised Code 125:09 and Administrative Code 123:5-1-06
1. The products/services being offered are raised, grown, produced, mined or manufactured in Ohio.
Yes No (Go to B-2)
2. Bidder has significant economic presence within the state of Ohio.
Yes (Answer a, b, c, d below) No (Go to B-3)
a) Bidder has paid the required taxes due the State of Ohio
Yes No
b) Bidder is registered with the Ohio Secretary of State
Yes (Charter/Registration No: _______________)
c) Bidder has ten or more employees based in Ohio or border state.
Yes No (Go to B-2d)
d) Bidder has seventy-five percent or more employees based in Ohio or border state Yes No (Go to B-3)
3. Border state bidder?
Yes (Specify which state then go to B-2c): KY MI NY PA IN No (Go to B-4 below)
4. Border state bidder: mined products mined in respective border state Yes No Not Applicable
Name of person completing form (printed): __________________________________________________
Signature of person completing form: _______________________________________________________
C. VETERANS PREFERENCE (BUY VETERAN): Revised Code 9.318 and Administrative Code 123:5-1-16
Is the bidder a certified Veteran Friendly Business Enterprise as defined in Administrative Code 123:5-1-01(KK)
Yes No
5144139
Michael Lackey
File details come from the government source that posted it. Updated .