SECTION 889 COMPLIANCE FORM-KAS112020.pdf

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Attached to
FY21-21527/FY21-21621 VME I/O INPUT CCAs
Solicitation number
N63394-21-Q-0123
Issued by

About this file

This document contains a federal contract opportunity solicitation and a related compliance form. The solicitation from the Naval Sea Systems Command seeks quotes for 26 VME I/O input circuit card assemblies with part number A159427 and 33 assemblies with part number A159432 from GDCA, Inc. The assemblies are to isolate and interface digital input and output signals. The compliance form requires the vendor to represent whether it provides covered telecommunications equipment or services and to conduct a reasonable inquiry to determine if it uses such equipment in its products and services.

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Text version

Merchant Name

Merchant’s Authorized Representative

Authorized Representative Signature and Date

If vendor indicates WILL or DOES, then review will be required by a Contracting Officer prior to purchase.

Contracting Officer Approval

I have reviewed and determined procurement through this vendor is authorized.

Contracting Officers Name

Signature

Solicitation or PRT #:

Buyer Name: Rachel T. Smith

Representation.

The Merchant represents that—

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (OCT 2020)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(c) Representations.

(1) The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

(End of provision)

Section 889 Form Compliance Form

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