SRC27957_vendor_BABA_form.pdf
PDF 209 KB Posted
- Attached to
- Conservation/WL/D2/Jackson County WMA-Culverts-BABA State and local contract opportunity
- Solicitation number
- SRC0000027957
- Issued by
- Jefferson County, Alabama
About this file
The document is a Vendor Certificate of Compliance form for the Build America, Buy America (BABA) Act, issued by the Alabama Department of Conservation and Natural Resources (DCNR) for a culvert infrastructure project located in Jackson County WMA. The form is specifically for procuring Corrugated Double Wall Plastic or Poly Culverts, with the purpose of certifying that the materials being purchased comply with the Infrastructure and Investment Jobs Act (Public Law 117-58) requirements for domestic manufacturing.
The form provides two certification options for vendors: a Certificate of Compliance, where the vendor attests that the steel, manufactured products, and construction materials are produced in the United States as defined by §70912 of the IIJA, or a Certificate of Non-Compliance, where the vendor indicates the materials do not meet the domestic manufacturing requirements. The document is designed to be completed by both DCNR representatives and vendors, with sections for detailing the infrastructure project, grant award information, and specific items being purchased, though the quantity and specific item details are left blank in this instance.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Quick_Quote_Standard_Boilerplate_updated_12.18.2024.pdf | ||
| BABA_Requirement_info.pdf | ||
| SRC27957._specs.pdf |
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Text version
VENDOR CERTIFICATE of COMPLIANCE with BUILD AMERICA, BUY AMERICA ACT Procurement of Steel, Iron, or Manufactured Products, and Construction Materials
1) To be completed by the Alabama Department of Conservation and Natural Resources (DCNR). Instructions: DCNR representative/employee must submit this completed form with Purchase Order Requests and Materials Receipts.
FOR DCNR USE ONLY:
TITLE OF INFRASTRUCTURE PROJECT: _________________________________________________________
GRANT AWARD (FAIN) NUMBER: ______________________________________________________ _____
LOCATION OF INFRASTRUCTURE PROJECT: ____________________________________________________
ITEMS REQUESTED FOR PURCHASE: __________________________________________________________
2) To be completed by the VENDOR. Instructions: VENDOR shall complete the information below and submit it to DCNR representative/employee.
Items Supplied for Purchase by Vendor Under This Certificate
Item Description Quantity
Steel
Manufactured Product
Construction Material
Certificate of Compliance with Build America, Buy America Requirements I hereby certify that, to the best of my knowledge, the iron, steel, manufactured products, and/or construction materials itemized above to be furnished to the Alabama Department of Conservation and Natural Resources for the construction of the above referenced infrastructure project are compliant with the Build America Buy America Act as having been produced or manufactured in the United States of America as defined by §70912 “Definitions” of the Infrastructure and Investment Jobs Act (IIJA) (Public Law 117-58 - Nov.
15, 2021) and applicable laws and policies pursuant to: “Buy America” - DOI Financial Assistance.
Signature________________________________________________________________ Date:___________________
Company________________________________________________________________ ________________________
Name___________________________________________________________________ ________________________
Title____________________________________________________________________ ________________________
Certificate of Non-Compliance with Build America, Buy America Requirements
I hereby certify that, to the best of my knowledge, the iron, steel, manufactured products, and/or construction materials itemized above to be furnished to the Alabama Department of Conservation and Natural Resources for the construction of the above referenced infrastructure project ARE NOT compliant with the requirements of Public Law 117-58 and applicable laws and policies pursuant to:
“Buy America” - DOI Financial Assistance.
Signature_______________________________________________________________ Date:____________________
Company_______________________________________________________________ ________________________
Name__________________________________________________________________ ________________________
Title___________________________________________________________________ ________________________
| TITLE OF INFRASTRUCTURE PROJECT: Culverts |
| LOCATION OF INFRASTRUCTURE PROJECT: Jackson County WMA |
| ITEMS REQUESTED FOR PURCHASE 1: Corrugated Double Wall Plastic or Poly Culverts |
| ITEMS REQUESTED FOR PURCHASE 2: |
| Items Supplied for Purchase by Vendor Under This Certificate: |
| Item DescriptionSteel: |
| QuantitySteel: |
| Item DescriptionManufactured Product: |
| QuantityManufactured Product: |
| Item DescriptionConstruction Material: |
| QuantityConstruction Material: |
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| Title: |
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File details come from the government source that posted it. Updated .