01. BAA_Certification_08.29.2023_(D5) (1).pdf
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- Attached to
- Dispersive Mirror
- Solicitation number
- SLAC_368931_DispersiveMirror
- Issued by
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Department of Energy Office of Science
About this file
This is a Buy American Act Certification form issued by the SLAC National Accelerator Laboratory for federal contract procurement compliance (Revision 08.29.2023).
The form requires bidders/offerors to certify whether each end product qualifies as a U.S. domestic commercial product. If the offeror answers "Yes" to this certification, they may skip to Section (C) for signature. If the answer is "No," the offeror must complete Sections (A), (B), and (C). Section (A) requires listing any excluded end products in accordance with FAR Part 25.104. Section (B) requires the offeror to certify that all end products (except those listed in Section A) are domestic source end products with no components of unknown origin mined, produced, or manufactured outside the United States. The offeror must also provide an estimate of the percent of foreign content in the items or services being procured, expressed as a percentage of the total purchase order or subcontract award price, with accuracy within plus or minus 5 percent deemed acceptable. The offeror must identify the country of origin for any foreign content. Section (C) requires the authorized representative to sign and date the certification, and provide their printed name, title, and company name, making these representations and certifications part of their quotation.
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Text version
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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