Attachment (C) Patent Certification.pdf

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Attached to
NSLS-II SIX Ultrahigh Energy Resolution Spectrometer Grating
Solicitation number
PB431913-1
Issued by

About this file

This document is a Patent Certification form related to Contract Number 431913. The contractor certifies that all procedures for identifying and disclosing subject inventions have been followed, and lists any inventions or discoveries made under the contract. The contract completion date and the certification period are also provided.

The related federal contract opportunity is a Request for Quote (RFQ) from Brookhaven Science Associates (BSA) for the NSLS-II SIX Ultrahigh Energy Resolution Spectrometer Grating and all related hardware for the Ari & SXN Beamlines at Brookhaven National Laboratory. The solicitation number is PB431913-1, and the proposal due date is May 6, 2024. The contract is being awarded by the Department of Energy Office of Science.

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Text version

Date Printed 11/28/2023 1 of 1 Date Approved 07/19/17

PROCUREMENT AND PROPERTY MANAGEMENT DIVISION

BROOKHAVEN NATIONAL LABORATORY

Managed by Brookhaven Science Associates, LLC under contract to the U.S. Department of Energy

ACQUISITION MANAGEMENT SYSTEM FORM

Form No. AMS-Form-032

Revision No. 1.0

APPROVED BY:

Anthony Guadagni / 7/19/17

PPM Manager/Date

Patent Certification

Interim Certification

Final Certification

Contractor:

Contract Number: 431913

Contractor hereby certifies that :

1. All procedures for identifying and disclosing subject inventions as required by the patent clause of the contract have been followed thought the reporting period.

2. There were no subcontracts or purchase orders involving research, development, and demonstration except as follows:

3. No inventions or discoveries were made or conceived in the course of or under this contract other than the following (Certification includes , does not include all subcontracts):

TITLE INVENTOR DATE REPORTED DOE “S” NO.

4. The completion date of this contract is as follows:

5. The following period is covered by this certification:

To

Month Day Year Month Day Year

To

Contractor Signature

To

Title

To

Address Date of Certification

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