Reps and Certs International Rider.pdf

This is a Representations and Certifications form for the SLAC National Accelerator Laboratory, operated for the U.S. Department of Energy by Stanford University under Contract DE-AC02-76-SF00515. The form applies to offerors whose performance is outside the United States or who do not recruit employees in the United States for work on a subcontract.

The document requires offerors to complete and sign multiple certifications prior to proposal submission, including: (1) Type of Organization, identifying the organizational structure; (2) Certification Regarding Debarment, Suspension, and Proposed Debarment, confirming the offeror and principals are not debarred or suspended and have not been convicted of fraud or criminal offenses within three years, nor terminated for default; (3) Payments to Influence Certain Federal Transactions (applicable if offer exceeds $100,000), certifying no appropriated funds have been paid to influence federal officers or Congress members; (4) Anti-Kickback Certification (applicable if offer exceeds $100,000), certifying no kickbacks have been provided or solicited; (5) Buy American Certificate, requiring identification of foreign end products and their countries of origin; and (6) Employee-Vendor Relationship Certification, requiring disclosure of any Stanford University employees, former employees, or near relatives with ownership, control, or significant financial interests in the offeror's organization. The form includes signature blocks and requires provision of company name, offeror name, address, title, date, telephone number, and email address.