LOS CERTIFICATION DOCUMENT.doc

Compliance with 13 C.F.R. 125.6

DATE: ______________

Contractor Point of Contact: _____________________________ Business Name: _______________________________________

DUNS #: ____________________

Solicitation Number: ________________________ Offerors are required to comply with 13 C.F.R. 125.6. Offerors are to check which applies block applies:

[ ] I certify that no subcontractors are anticipated in performing services under this contract. My Company receives 100% of the cost of this contract.

[ ] I certify that my company and those subcontractors that are similarly situated are estimated to receive at least 50% of the value of this contract. I understand that a similarly situated subcontractor must meet the size standard for NAICS assigned by the prime and must be in certified in VIP. Please provide the following information to identify and calculate the cost of the work self-performed and what is subcontracted.

For each subcontractor provide the flowing: business name, DUNs number, description of work, Percentage COST of Contract.

Value of work in % Contractor DUNs Number Description of Work Contract Services _ Total % of value of contract by Prime Contractor %__________ Total % of value of contract by similarly situated subcontractors %_________

WARNING: Severe Penalties for Contractors that violate the Limitations on Subcontracting Rule: If caught during the performance violating the FAR government subcontracting rules or limitations on subcontracting clause under the Code of Federal Regulations 13 C.F.R. 125.6(g), there can be stiff penalties: “Whoever violates the requirements set forth in paragraph (a) of this section shall be subject to the penalties prescribed in 15 U.S.C. 645(d), except that the fine shall be treated as the greater of $500,000 or the dollar amount spent, in excess of permitted levels, by the entity on subcontractors. A party's failure to comply with the spirit and intent of a subcontract with a similarly situated entity may be considered a basis for debarment on the grounds, including but not limited to, that the parties have violated the terms of a Government contract or subcontract pursuant to FAR 9.406-2(b)(1)(i) (48 CFR 9.406-2(b)(1)(i)).” Contracting Officers may require the contractor to demonstrate its compliance with the limitations on subcontracting at any time during the performance of the contract by having the Contractor provide invoices, copies of subcontracts, or a list of the value of tasks performed.

I certify the above representations are true and correct to the best of my knowledge.

(Contractor Name)

Date

Return this certification via email to: CO NAME & Email Address