01. BAA_Certification_08.29.2023_(D5) (1).pdf
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- Custom vacuum chamber
- Solicitation number
- SLAC_360953_Customvacuumchamber
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Department of Energy Office of Science
About this file
This document is a Buy America Act Certification form from the National Accelerator Laboratory's Supply Chain Management department. The form requires a bidder/offeror to certify whether their end product qualifies as a U.S. domestic commercial product. If the product is not fully domestic, the offeror must disclose the percentage of foreign content (with accuracy within plus or minus 5 percent) and the country of origin. The certification requires the offeror to confirm that no components of unknown origin have been mined, produced, or manufactured outside the United States, in accordance with Federal Acquisition Regulation (FAR) Part 25.104. The form must be signed and dated by an authorized representative of the offeror's company, making these representations part of their quotation.
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BUY AMERICA ACT CERTIFICATION (REV. 08.29.2023) Page 1 of 1
SUPPLY CHAIN MANAGEMENT
BUY AMERICAN ACT CERTIFICATION
Solicitation Number
The bidder/offeror hereby certifies that each end product qualifies as a U.S. domestic commercial product.
Yes No
If the answer above is Yes, skip to Section (C). If the answer above is No, fill out Sections (A), (B) and
(C) Below:
A. Excluded end products, in accordance with FAR Part 25.104. (Mark "N/A" if not-applicable)
B. The bidder/offeror hereby certifies that each end product, except the end products listed below, is a domestic source end product (as defined in the Buy American Act provisions); and that NO components of unknown origin have been mined, produced, or manufactured outside the United States.
The bidder/offeror will represent (as an estimate), herein, before the award of a purchase order or subcontract, the percent of the foreign content of the item or service being procured expressed as a percent of the total purchase order/subcontract award price (accuracy within plus or minus 5 percent is acceptable).
Percent (%) of Foreign Content:
Country of Origin:
c. THE OFFEROR’S SIGNATURE MAKE THE ABOVE REPRESENTATIONS AND
CERTIFICATIONS PART OF THEIR QUOTATION
Offeror’s Signature: Date:
Printed Name:
Title:
Company Name:
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