PPON_Attch_0002_GCSS-Army_Affirmation-Busin-Status-Cert_2021_03_23.docx

Attachment 0002 Affirmation of Business Status Certification (ABSC) for Prototype Project Opportunity Notice:

Global Combat Support System – Army Disconnected Operations (GCSS-Army DISCOPS)

Solicitation Number: W15QKN-20-R-0G91

Army Contracting Command – New Jersey (CCNJ) Innovative Concepts Division (CCNJ-IC) Attn: Mr. Christopher W. Fotiadis Agreements Officer Building 10, Phipps Road, Picatinny Arsenal, NJ 07806-5000

Version 1.0, 23 March 2021

Attachment 0002 – Affirmation-Business-Status-Cert

AFFIRMATION OF BUSINESS STATUS CERTIFICATION (ABSC)

Every significant participating entity shall complete the following table and provide a signature representing its certification.

*Legal Entity Name

Industry Size Standard

☐ Large ☐ Small Socio Economic Status:

NAICS Code: 541690 - Other Scientific and Technical Consulting Services

*DUNS No.

*CAGE Code

*Tax Identification No.

Address 1

Address 2

City/State/Zip

POC Name/Title

POC Phone/e-mail

* This information is required for the entity serving as the Prime/Lead for the prototype project and as applicable for all other legal entities. Submit one (1) Form per entity.

The Entity named above represents that it is (check one of the following boxes):

☐ A Nontraditional Defense Contractor (NDC) – A Nontraditional Defense Contractor is an entity that is not currently performing and has not performed, for at least the one-year period preceding the solicitation of sources by DoD for the procurement or transaction, any contract or subcontract for the DoD that is subject to full coverage under the cost accounting standards prescribed pursuant to section 1502 of title 41 and the regulations implementing such section (see 10 U.S.C. 2302(9)).

☐ A Nonprofit Research Institution (NRI) – means a ”Nonprofit Institution,” as defined in 15 U.S.C. 3703, and includes federally funded research and development centers, as identified by the National Scientific Foundation in accordance with the Government wide Federal Acquisition Regulation issued in accordance with section 1303(a)(1) of title 41 (or any successor regulation thereto).

☐ A Traditional Defense Contractor – A Traditional Defense Contractor is an entity that does not meet the definition of a Nontraditional Defense Contractor (NDC).

The undersigned hereby certifies that the representations made herein are accurate and true regarding the entity identified above. I authorize my electronic signature to carry the same weight and legal effect as my written signature.

Signature

Printed Name

Title

Date

In addition to submitting the Affirmation of Business Status for all significant participants, the Prime Offeror shall submit an explanation on how the Prime is satisfying the requirements under 10 USC 2371(b)(d) appropriate use of Authority.

The Prime Offer explanation provided below (text box) contains language supporting one of the following three areas (check one of the following boxes):

☐ At least one Nontraditional Defense Contractor (NDC) or Nonprofit Research Institution (NRI) is participating to a significant extent in the prototype project. If checked:

Describe the effort and the significance of the NDC or NRI’s contribution that supports at least one of the following factors:

a) Supplying a new key technology, product or process.

b) Supplying a novel application or approach to an existing technology, product or process.

c) Provides a material increase in the performance, efficiency, quality or versatility of a key technology, product or process.

d) Accomplishes a significant amount of the prototype project.

e) Causes a material reduction in the cost or schedule of the prototype project.

f) Provides for a material increase in performance of the prototype project.

g) Provides additional capability beyond those described above necessary for this effort.

Provide a total estimated cost and percentage of the NDC or NRI associated with the proposal. (Note: While cost is an indicator for the level of NDC or NRI participation, there is no specific cost threshold required.)

☐ All significant participants in the transaction other than the Federal Government are small businesses (including small businesses participating in a program described under section 9 of the Small Business Act (15 U.S.C. 638)) or nontraditional defense contractors.

☐ At least one third of the total cost of the prototype project is to be paid out of funds provided by sources other than other than the Federal Government. If selected, the Cost Share details shall be provided in Volume III Cost/Price. Information provided below clearly indicates how the Offeror is meeting the Cost Share requirements.Prime Offeror - Explanation for 10 USC 2371(b)(d) eligibility:

Attachment 0002 – Affirmation-of-Business-Status-Cert

Procurement Sensitive / For Official Use Only (When Completed) image1.png image2.jpg