Representation for Tax Delinquency, Felony Conviction, and Internal Confidentiality Agreements.pdf

Proposal Title ___________________________________________________________________________________

Proposal Number and/or Date ____________________________________________________________________

Representation Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under Any Federal Law – DoD Appropriations

(1) The applicant represents that it is ___ is not___ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) The applicant represents that it is__ is not __a corporation that was convicted of a felony criminal violation under any Federal law within the preceding 24 months.

NOTE: If an applicant responds in the affirmative to either of the above representations, the applicant is ineligible to receive an award unless a Federal agency suspension and debarment official (SDO) has considered suspension or debarment and determined that further action is not required to protect the Government’s interests. The applicant therefore should provide information about its tax liability or conviction to the agency’s SDO as soon as it can do so, to facilitate completion of the required consideration before award decisions are made.

Representation Regarding the Prohibition on Using Funds under Grants and Cooperative Agreements with Entities that Require Certain Internal Confidentiality Agreements

By submission of its proposal or application, the applicant represents that it does not require any of its employees, contractors, or subrecipients seeking to report fraud, waste, or abuse to sign or comply with internal confidentiality agreements or statements prohibiting or otherwise restricting those employees, contractors, or subrecipients from lawfully reporting that waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information. Note that, as applicable, the bases for this representation are the prohibition(s) as follow:

a. Section 743 of the Financial Services and General Government Appropriation Act, 2015 (Division E of the Consolidated and Further Continuing Appropriations Act, 2015, Pub. L. 113-235)

b. Section 101(a) of the Continuing Appropriation Act, 2016 (Pub. L. 114-53) and any subsequent FY2016 appropriations act that extends to FY2016 the same restrictions as are contained in section 743 of Division E, title VII of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub L. 113-235)

c. Any successor provision of law on making funds available through grants and cooperative agreements to entities with certain internal confidentiality agreements or statements

The prohibitions stated above do not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

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SIGN HERE_________________________________________

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