NDAA-889-Compliance-form.pdf
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This document is an NDAA (National Defense Authorization Act) Certification form from the United States Department of State, specifically Attachment 1 - Express NDAA Certification. The form implements requirements from Public Law 115-232, which mandates representations regarding Covered Telecommunications Equipment and Services. Vendors must complete this certification to comply with federal acquisition regulations, specifically addressing the use of certain telecommunications equipment or services that may pose potential security risks. The form requires vendors to disclose whether they will provide, use, or have any connection to covered telecommunications equipment or services, with the expectation that they will complete the representation with full transparency and by an authorized representative who can legally bind the merchant.
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United States Department of State
Washington, D.C. 20520 www.state.gov
SENSITIVE BUT UNCLASSIFIED
ATTACHMENT 1 – EXPRESS NDAA CERTIFICATION
Public Law 115-232, also known as the John S. McCain National Defense Authorization Act
(NDAA) for Fiscal Year 2019, requires representations regarding Covered Telecommunications
Equipment and Services. Contracting staff shall use this representation with vendors to determine compliance with NDAA requirements. To comply with this Public Law the Federal Acquisition
Regulation (FAR) in FAR 4.2105 requires two provisions 52.204-24 & 52.204-26 and contract clause 52.204-25 in all procurement actions.
DIRECTIONS FOR THE MERCHANT
1. Read the entire provisions and clause in the FAR at Acquistion.gov.
2. After you have read the provisions, please answer the questions below.
3. Upon completion of Step 2, fill out the representation below. NOTE: This representation is made by a person with the authority to bind the merchant.
4. Return completed form to your Contract Specialist.
52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND
VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (AUG 2020)
(d) Representation. The Offeror represents that—
(1) It □ will, □ will not provide covered telecommunications equipment or services to the
Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds “will” in paragraph (d)(1) of this section; and
(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 use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the
Offeror responds “does” in paragraph (d)(2) of this section.
Merchant Name____________________________________________________________________
Merchant’s Authorized Representative Signature_____________________________________________
(Typed Name)
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BalachandranPT Highlight
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