Section_L,_Attachment_5_Declaration_Sheet.docx

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Western Medical Services, Multiple Award Task Order Contract
Solicitation number
N62645-17-R-0014
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Section L, Attachment 5 Declaration Sheet

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Western Medical MATO N62645-17-R-0014

Declaration Sheet – Attachment 5

1. If a subcontractor has been proposed, the Offeror agrees to abide by the terms of FAR 52.219-14, Limitations on Subcontracting.

2. If the Offeror is part of a Mentor-Protégé agreement or Joint Venture, the Offeror shall possess Small Business Administration (SBA) approved Mentor-Protégé agreement and/or Joint Venture certification documentation. The SBA must receive the certification documentation prior to the proposal due date and must approve the documentation before award of any contract.

3. The Offeror agrees to abide by the terms of FAR 52.222-17, Nondisplacement of Qualified Workers.

4. Check one of the following:

_______ I certify that all of the representations and certifications completed in SAM are current, complete and accurate as of the date of my signature below for solicitation # N62645-17-R-0014.

OR

_______ I certify that all of the representations and certifications completed in SAM are current, complete and accurate as of the date of my signature below for solicitation # N62645-17-R-0014 with the exception of the following:

(list any changes)

I certify to the above items 1-4 being accurate and complete.

Signature Date

Title

Organization

E-Mail Address

Phone

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