FY21-21560-SECTION 889 COMPLIANCE FORM.pdf

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Attached to
FY21-21560-NI Circuit Card Assemblies and Chassis
Solicitation number
N63394-21-Q-0055
Issued by

About this file

This solicitation seeks commercial off-the-shelf circuit card assemblies and chassis from National Instruments Corporation. The Naval Surface Warfare Center Port Hueneme Division requires various circuit card assemblies, chassis, modules, and cables to be delivered within one to two weeks of order receipt. Products sought include PXI and PXIe chassis, oscilloscopes, interfaces, digital I/O modules, and multiplexers from National Instruments. The total small business set-aside has a North American Industry Classification System code of 334418 with up to 750 employees. Responses are requested as a request for quotes under solicitation number N63394-21-Q-0055.

The solicitation seeks a total of over 200 units of various National Instruments modular hardware products including PXI and PXIe chassis, oscilloscopes, interfaces, digital I/O modules, multiplexers, and cables for use by the Naval Surface Warfare Center Port Hueneme Division of the Department of the Navy. Products must be new and unused from National Instruments and delivered within one to two weeks of order receipt. The requirement is set aside for small businesses with fewer than 750 employees under NAICS code 334418 for circuit card assembly manufacturing.

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Text version

Merchant Name

Merchant’s Authorized Representative

Authorized Representative Signature and Date

If vendor indicates WILL or DOES, then review will be required by a Contracting Officer prior to purchase.

Contracting Officer Approval

I have reviewed and determined procurement through this vendor is authorized.

Contracting Officers Name

Signature

Solicitation or PRT #: N63394-21-Q-0055 / PRT #FY21-21560

Buyer Name: Rachel T. Smith

Representation.

The Merchant represents that—

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (OCT 2020)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(c) Representations.

(1) The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

(End of provision)

Section 889 Form Compliance Form

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