SRC27975._Vendor_BABA_form.pdf

PDF 209 KB Posted

Attached to
Conservation/WL/FW/Coosa WMA -Culverts-BABA
Solicitation number
SRC0000027975
Issued by
Conecuh County, Alabama

About this file

Written by GovTribe AI ·

This is a Vendor Certificate of Compliance form for the Alabama Department of Conservation and Natural Resources (DCNR) related to the Build America, Buy America (BABA) Act requirements for procurement of materials. The specific project is for Culverts Coosa WMA, located at 143 County Road 15, Rockford, AL 35136, involving the purchase of Solid Corrugated Double Wall Plastic Culverts. The form is designed to certify whether the vendor's supplied materials meet the domestic manufacturing requirements outlined in the Infrastructure and Investment Jobs Act (Public Law 117-58).

The document provides a standardized template for vendors to declare compliance with Buy America provisions, requiring certification that iron, steel, manufactured products, and construction materials are produced or manufactured in the United States. The form allows vendors to either affirm compliance or declare non-compliance with the specific procurement requirements. While no specific quantities or pricing details are provided in this document, it serves as a mandatory certification mechanism for vendors participating in infrastructure projects funded through federal financial assistance programs, specifically those administered by the Department of the Interior.

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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 Coosa WMA
LOCATION OF INFRASTRUCTURE PROJECT: 143 County Road 15, Rockford, AL 35136
ITEMS REQUESTED FOR PURCHASE 1: Solid Corrugated Double Wall Plastic 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:
Company:
Name:
Title:
Date 1:
Date 2:
Date 3:
Date 4:
Company_2:
Name_2:
Title_2:
Date 1_2:
Date 2_2:
Date 3_2:
Date 4_2:

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