Sample - BABA Compliant Form.docx

DOCX document 14 KB Posted

Attached to
Conflict Monitors - FHWA Eligible
Solicitation number
RFB 605 2600000250 2
Issued by
Elliott County, Kentucky

About this file

This is a Build America, Buy America (BABA) Act compliance certification form template designed for use on infrastructure projects funded under the Infrastructure Investment and Jobs Act (IIJA), Public Law 117-58, Section 70901-27. The form requires a company representative to certify that specified manufacturing and fabrication processes—including melting, bending, coating, galvanizing, and cutting operations—for listed products and materials have been completed in full compliance with BABA Act requirements. The certification must identify all items, products, and materials subject to compliance, document the geographic location where the specified processes occurred, and include provisions for immediate notification to the prime contractor and engineer if compliance status changes during the course of project performance.

The form serves as documentation of domestic content and manufacturing compliance for federal infrastructure funding. No specific pricing, set-asides, or contract term information is provided within this template document. The form functions as a standardized attestation mechanism to verify that materials and products supplied for BABA-compliant projects meet the statutory requirement that the manufacturing processes take place within the United States, with companies required to maintain ongoing compliance notification protocols throughout project delivery.

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Text version

Company letterhead

Date

Company Name Company Address City, State Zip

Subject: Build America, Buy America Act Step Certification for Project (XXXXXXXXXX)

I, (company representative), certify the (melting, bending, coating, galvanizing, cutting, etc.) process for (manufacturing or fabricating) the following products and/or materials shipped or provided for the subject project is in full compliance with the Build America, Buy America (BABA) Act requirement as mandated in the Infrastructure Investment and Jobs Act (IIJA) Pub. L. No. 117-58, §§ 70901-27.

Item, Products and/or Materials:

1. XXXX

2. XXXX

3. XXXX

Such process took place at the following location: .

If any of the above compliance statements change while providing material to this project, we will immediately notify the prime contractor and the engineer.

Signed by company representative

File details come from the government source that posted it. Updated .