S02_Attachment 0004_RFP 36C79126R0011_FAR Provision 52.225-2_Buy American Certificate_Fillable.docx
FAR Clause DOCX document 49 KB Posted
- Solicitation number
- 36C79126R0011
About this file
This is a fillable Buy American Certificate form, which is a federal compliance document required under FAR Provision 52.225-2 for the ETMPM - TENS Procurement Program (Solicitation 36C79126R0011). The form serves as a template for offerors to certify their compliance with Buy American Act requirements when submitting proposals to the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 19. The certificate is a standard attestation document rather than a substantive solicitation requirement document, and does not contain specific product specifications, pricing terms, or delivery requirements related to the electromedical therapeutic equipment being procured.
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ATTACHMENT 0004 – FAR PROVISION 52.225-2
ATTACHMENT 0004 – FAR PROVISION 52.225-2
DEPARTMENT OF VETERANS AFFAIRS (VA)
VA’S FY26 ETMPM-TENS Procurement Program Recompete Solicitation Number 36C79126R0011
FAR Provision 52.225-2, Buy American Certificate.
Instructions to Offerors: Attachment 0004, FAR Provision 52.225‑2, Buy American Certificate, is a mandatory submission for all Offerors, it’s a fillable PDF document that each Offeror must fully complete, sign, and submit with its proposal package. Submission of a properly completed certificate is a material condition of responsiveness. Any proposal that does not include a fully completed, signed, and dated Attachment 0005 will be considered non‑responsive and eliminated from further consideration. Complete Attachment 0004 as follows:
1. General Completion Requirements: Offerors must complete the fillable PDF in its entirety. The following actions are required:
· Check marks must be placed in all provided boxes where the Offeror is required to certify or indicate responses.
· All fill‑in fields requiring Offeror information, including company details, product listings, country‑of‑origin data, critical component status, and domestic content percentages, must be completed.
· The form must include a valid digital signature of an authorized representative of the Offeror.
· The date signed must be entered in the space provided.
· All content must be truthful, complete, and consistent with FAR 52.212‑3 Offeror Representations and Certifications and SAM.gov registration information.
2. Required Offeror Representations & Certifying Selections: Attachment 0006 requires multiple certifications relating to compliance with the Buy American Act. Offerors must complete each applicable table and listing as follows:
a. Domestic End Product Certification: Offerors must certify that each end product offered (unless separately listed as foreign) is a domestic end product, including identification of any critical components.
b. Listing of Foreign End Products: Offerors must fill out the “Foreign End Products” table by listing:
· Contract Line Item Number (CLIN) or Sub‑Line Item Number (SLIN)
· Country of origin
· Whether the product contains more than 55% domestic content (“Yes/No”)
c. Listing of Domestic End Products Containing Critical Components: A Critical component is defined as: A component that is mined, produced, or manufactured in the United States and identified as critical to the U.S. supply chain, based on the list maintained at FAR 25.105. For goods not consisting wholly or predominantly of iron or steel, a Domestic End Product is defined as: An unmanufactured end item mined or produced in the United States; or A manufactured end item in the United States, where the cost of its U.S.-origin components exceeds 65% of all component costs. Offerors must separately identify domestic end products containing critical components, using the fillable table provided:
· CLIN or SLIN being offered;
· Country of Origin;
· Whether the item exceeds 55% domestic content (“Yes/No”). A foreign end product (e.g., not wholly or predominantly iron or steel, and not a COTS item) must indicate “Yes” in the certificate if more than 55% of the cost of all its components is attributable to materials mined, produced, or manufactured in the United States, including associated transportation and duty costs. How to Apply This Definition:
(1) Calculate:
(2) If over 55%, mark “Yes” in the foreign end products table.
(3) If 55% or less (or unknown), mark “No.”
d. Definitions and Applicability: These terms are defined via reference to the solicitation clause Buy American - Supplies, which governs evaluation of domestic content and origin. Offerors should review the definitions embedded in the attachment:
· “Commercially available off‑the‑shelf (COTS) item”: CLINs/SLINs X001 - X004 are determined by the VA to be designated as COTS items. Definition:
An item of supply (including construction material) that is:
(1) A “commercial product” per FAR 2.101 and FAR 12.103;
(2) Sold in substantial quantities in the commercial marketplace;
(3)
(4) Offered to the Government in its unmodified form (same as to the general public); and
(5) Not classified as bulk cargo (e.g., petroleum, agricultural commodities).
· “Critical Component”: Definition: A component that is mined, produced, or manufactured in the United States and identified by the agency as critical to the U.S. supply chain, per the list in FAR 25.105 and FAR Clause 52.225-1(a).
· “Domestic End Product”: Definition: For end products not consisting wholly or predominantly of iron or steel:
(1) An unmanufactured item mined or produced in the U.S.; or
(2) A manufactured item in the U.S. whose U.S.-sourced components exceed 65% of total component cost, per FAR 25.1101(a)(1)(i) and FAR Clause 52.225-1(a). Also includes COTS items.
· “Foreign End Product”: Definition: Any end product not classified as a “Domestic End Product.” Specifically, it is an end product that does not meet domestic origin or cost thresholds, per FAR Clause 52.225-1(a).
e. Required Offeror Information: The following fields must be completed by the Offeror:
· Legal Business Name;
· Printed Name of Authorized Signee - The individual signing Attachment 0006 must have authority to legally bind the Offeror for purposes of federal contracting.;
· Printed Title of Authorized Signee;
· Authorized Digital Signature;
· Date of Signature; and
· Business Address.
f. Digital Signature Requirements: Typed or handwritten signatures inserted without digital authentication will not be accepted. Attachment 0006 must be signed with a recognized digital or electronic signature, such as:
· Adobe digital signature;
· DocuSign;
· PKI‑based signature; or
· Other compliant electronic authentication recognized by federal acquisition standards.
g. Submission Requirements: Offerors must:
· Submit Attachment 0004 as a standalone PDF file included within the proposal package.
· Label the file: “Attachment 0004 – FAR 52.225‑2 Buy American Certificate – [Offeror Name]”
· Ensure all entries within Attachment 0004 match the Offeror’s representations in its proposal, price matrix, technical submission, and SAM.gov registration.
h. Impact of Non‑Submission: Failure to submit a fully completed and signed Attachment 0006 will result in:
· Immediate rejection of the Offeror’s proposal as non‑responsive;
· No further evaluation under technical or price factors; and
· Ineligibility for award under Solicitation 36C79126R0011.
Policy Note: If any conflict exists between country‑of‑origin (COO) entries in Attachment 0002 - FAR Provision 52.212‑3 Offeror Representations and Certifications and Attachment 0004 - FAR Provision 52.225‑2 Buy American Certificate, Attachment 0004 shall prevails, governs, and controls for the sole purposes of end-product COO eligibility and evaluation under FAR Part 25 procurement restrictions. The VA will rely on the CLIN/SLINs‑level end-product COO declarations in Attachment 0004 when applying the Trade Agreements Act requirements.
As prescribed in 25.601(a)(2), insert the following provision: Buy American Certificate (Oct 2022).
(a)
(1) The Offeror certifies that each end product, except those listed in paragraph (b) of this provision, is a domestic end product and that each domestic end product listed in paragraph (c) of this provision contains a critical component.
(2) The Offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products. For those foreign end products that do not consist wholly or predominantly of iron or steel or a combination of both, the Offeror shall also indicate whether these foreign end products exceed 55 percent domestic content, except for those that are COTS items. If the percentage of the domestic content is unknown, select “no”.
(3) The Offeror shall separately list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).
(4) The terms “commercially available off-the-shelf (COTS) item,” “critical component,” "domestic end product," "end product," and "foreign end product" are defined in the clause of this solicitation entitled "Buy American-Supplies."
(b) Foreign End Products: [List as necessary]
Contract Line Item Number Or Sub-Line Item Number
| Country of Origin |
| Exceeds 55% Domestic Content |
(Yes/No)
(c) Domestic end products containing a critical component: [List as necessary] Contract Line Item Number Or Sub-Line Item Number
| Country of Origin |
| Exceeds 55% Domestic Content |
(Yes/No)
(d) The Government will evaluate offers in accordance with the policies and procedures of part 25 of the Federal Acquisition Regulation.
Certification:
I hereby certify that, if awarded the contract [insert name of Offeror], _____________________ will furnish end-products in accordance with FAR Provision 52.225-2, Buy American Certificate, as completed and submitted with this offer. I further certify that I am authorized to execute this certification on behalf of [insert name of Offeror], ________________________.
Printed Name of Signee: ___________________________________.
Printed Title of Signee: ____________________________________.
Signature: ___________________________.
Date: _______________.
Company Name and Address: __________________________________________________
(End of Provision)
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