S02 Attachment 2 Attestation AI Template.docx
DOCX document 19 KB Posted
- Solicitation number
- 36C10B26Q0557
About this file
This file is a certification template for artificial intelligence (AI) and large language model (LLM) compliance attestation. The template requires contractors to certify that any AI or LLM used in performance under the contract will comply with Office of Management and Budget Memorandum M-26-04, "Increasing Public Trust in Artificial Intelligence Through Unbiased AI Principles." Signatories must attest that their AI/LLM systems adhere to the two core Unbiased AI Principles—Truth-seeking and Ideological Neutrality—and meet required AI/LLM development and operation documentation standards if any AI/LLM is to be delivered to the Government.
The template includes fields for the signee's printed name and title, company information (name, addresses, city, state, and zip code), and identification of any AI systems or LLMs to be used or delivered during contract performance. The certification applies to the referenced Hill-Rom Voalte Nurse Call System solicitation (36C10B26Q0557) issued by the Department of Veterans Affairs Technology Acquisition Center Austin. This attestation document serves as a compliance mechanism to ensure contractor transparency and adherence to federal AI governance standards throughout contract execution.
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CERTIFICATION
☐ Not Applicable.
☐ I hereby certify that any use of Artificial Intelligence (AI) and/or Large Language Models (LLM) in association with performance under Contract To Be Determined, Order To Be Determined will be compliant with the required Unbiased AI Principles as identified in the Office of Management and Budget Memorandum M-26-04, “Increasing Public Trust in Artificial Intelligence Through Unbiased AI Principles,” will meet the required transparency threshold and align with the two Unbiased AI Principles, i.e., Truth-seeking and Ideological Neutrality, and will meet the required AI/LLM Development and Operation Documentation requirements specified therein if any AI/LLM is to be delivered to the Government.
I further certify that I am authorized to execute this certification on behalf of To Be Determined (Name of Offeror).
Signee Printed Name:
Signee Printed Title:
Name (and version) of any AI System/LLM to be used and/or delivered during performance on Contract To Be Determined, Order To Be Determined:
Company Name:
Company Address 1:
Company Address 2:
Company City, State, Zip code:
File details come from the government source that posted it. Updated .