Attch__13_GTSS_Technical_Data_Certification.docx

DATA CERTIFICATION

1. QUALIFIED U.S. CONTRACTOR NAME AND ADDRESS: (Physical address, including P.O. Box if applicable)

a. NAME OF SUBSIDIARY/DIVISION/DEPARTMENT:

b. CAGE CODE:

2. DATA CUSTODIAN:

a. NAME:

b. TELEPHONE NUMBER: (Include Area Code)

c. TITLE:

d. E-MAIL ADDRESS:

3. DESCRIPTION OF RELEVANT BUSINESS ACTIVITY:

By providing the information above in 1 through 3 and signing below, you are certifying the following:

1. The individual who will act as recipient of the export-controlled technical data on behalf of the U.S. contractor is a U.S. citizen or a person admitted lawfully into the United States for permanent residence and is located in the United States.

2. Such data are needed to bid or perform on a contract with the Department of Defense. The purpose for which the data are needed shall be described sufficiently in such certification to permit an evaluation of whether subsequent requests for data are related properly to such business purpose.

3. The U.S. contractor acknowledges its responsibilities under U.S. export control laws and regulations (including the obligation, under certain circumstances, to obtain an export license prior to the release of technical data within the United States) and agrees that it will not disseminate any export-controlled technical data subject to this certification in a manner that would violate applicable export control laws and regulations. Any Qualified U.S. Contractor seeking access to the Technical Data for the GTSS effort must complete, sign, and return the following pages to erik.halverson@usmc.mil. The Government will not grant access until the following information has been completed and verified.

4. The U.S. contractor also agrees that, unless dissemination is permitted in accordance with DoD 5230.55, it will not provide access to export-controlled technical data to persons other than its employees or persons acting on its behalf, without the permission of the DoD Component that provided the technical data.

5. To the best of its knowledge and belief, the U.S. contractor knows of no person employed by it, or acting on its behalf, who will have access to such data, who is debarred, suspended, or otherwise ineligible from performing on U.S. Government contracts; or has violated U.S. export control laws or a certification previously made to the Department of Defense under the provisions of this Directive.

6. The U.S. contractor itself is not debarred, suspended, or otherwise determined ineligible by any Agency of the U.S. Government to perform on U.S. Government contracts, has not been convicted of export control law violations, and has not been disqualified under the provisions of this Directive.

When the certifications required by paragraphs 5 and 6 above, cannot be made truthfully, the U.S. contractor may request the certification be accepted based on its description of extenuating circumstances.

7. This certification may not be used as a basis for the release of "limited rights" or "restricted rights" data as defined in subsections 9-201(c) and 9-601(j) of the DoD Federal Acquisition Regulation Supplement or that is authorized to be withheld from public disclosure under the Freedom of Information Act (FOIA).

8. This certification may not be used to provide protection for technical data that should be classified in accordance with E.O. 12356 and DoD 5200.1-R.

9. I represent a Qualified U.S. Contractor that, in accordance with procedures established by the Under Secretary of Defense for Research and Engineering, certifies, as a condition of obtaining export-controlled technical data subject to this Directive from the Department of Defense, the above is true and complete

Signature

Date

Company and Title

Phone Number and E-mail