MANUFACTURER CERTIFICATION Form.pdf
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- Solicitation number
- 2137510
- Issued by
- Albany County, Albany City, New York
About this file
This is a Manufacturer's Certification Form issued by the New York State Department of Transportation (NYSDOT) Administrative Services Division – Purchasing Unit for use in conjunction with an Invitation for Bid (IFB) for genuine OEM parts and components for Mack Trucks, John Deere Equipment, and Hydraulic Supplies. The form is designed to be completed by manufacturers of the products being bid and submitted by bidders as part of their bid response. The certification requires manufacturers to confirm their status as an authorized dealer for the bidder, their commitment to supply all quantities of products ordered under any resulting contract with the State, and their attestation that the products meet all IFB requirements. The form includes fields for the bidder's company information and address, a listing of applicable products or components, and the manufacturer's complete contact information including company name, address, telephone, fax, and email.
The Manufacturer's Certification Form serves as a qualification mechanism for bidders and is a mandatory submission requirement as referenced in the "QUALIFICATION OF BIDDER" clause of the IFB. Bidders are responsible for obtaining the completed and signed form directly from their manufacturers prior to submitting their bid proposals. The form contains three yes/no attestation questions that manufacturers must answer under penalty of perjury, with signature and date fields required from an authorized representative. This certification process ensures that NYSDOT can verify the legitimacy of the supply chain and confirm that bidders have direct authorization and commitment from manufacturers to fulfill contract obligations for the full range and quantities of parts needed throughout the contract term.
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Text version
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Administrative Services Division - Purchasing Unit
NEW YORK STATE DEPARTMENT of TRANSPORTATION
MANUFACTURER’S CERTIFICATION FORM
INSTRUCTIONS TO BIDDERS:
This “Manufacturer’s Certification” is to be forwarded to the manufacturer by the bidder (if required by
IFB), completed by the manufacturer and returned to the bidder by the manufacturer, and submitted with the bidder’s offer. (See “QUALIFICATION OF BIDDER” clause).
BIDDER’S COMPANY NAME: ______________________________________________
STREET ADDRESS: _______________________________________________________
CITY, STATE ZIP: ________________________________________________________
List the Products/Components to which this Certificate applies: ___________________________________________
The manufacturer executing this certification by signature below does hereby attest to the accuracy and validity of the responses to the following questions:
1. Is the bidder listed above an authorized dealer? Yes No
2. Do you as a manufacturer agree to supply the bidder/dealer with all quantities of products ordered pursuant to any resulting contract with the State? Yes No
3. Do you as a manufacturer certify that product listed above meets the requirements stated in the IFB? Yes No
MANUFACTURER’S COMPANY NAME:
ADDRESS:
TELEPHONE NUMBER:
FAX NUMBER:
E-MAIL ADDRESS:
PRINTED OR TYPED COPY OF SIGNATURE
SIGNATURE OF AUTHORIZED DATE
MANUFACTURER’S REPRESENTATIVE
TITLE
Contract/Procurement
File details come from the government source that posted it. Updated .