Attachment 0002 Small Business Certification Form.docx
DOCX document 26 KB Posted
- Solicitation number
- W56HZV-20-R-0101
About this file
This document contains a certification form for small business size and socioeconomic status for proposed subcontractors not registered in the System for Award Management, along with details of a related Request for Proposal from the Department of the Army Materiel Command TACOM Life Cycle Management Command.
The certification form is to be completed by any small businesses listed in a proposal that are not registered in SAM. It requires the business to certify its size status under the listed NAICS code and size standard, and whether it qualifies as a small, small disadvantaged, woman-owned small, veteran-owned small, or service-disabled veteran-owned small business.
The RFP seeks product assurance and test services, logistics management, and industrial base operations support for Army vehicles. It was released on May 21, 2021 by Army Contracting Command-Detroit Arsenal with the RFP and an attachment. The solicitation number is W56HZV-20-R-0101 and responses are due by the date specified in the RFP. The required services are to support the Department of the Army Materiel Command TACOM Life Cycle Management Command.
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Other files
| File | Type | Posted |
|---|---|---|
| W56HZV-20-R-0101 Amendment 0005.pdf | ||
| W56HZV-20-R-0101 Conformed - Amend 0005.pdf | ||
| W56HZV-20-R-0101 Finalized Questions and Answers 1-109.docx | DOCX document | |
| Attachment 0001 Small Business Participation.xlsx | XLSX spreadsheet | |
| W56HZV-20-R-0101_Conformed through Amend 0004.pdf | ||
| W56HZV-20-R-0101_Amend 0004.pdf | ||
| W56HZV-20-R-0101 July 6 2021.pdf | ||
| W56HZV20R0101-0003.pdf | ||
| Questions and Answers June 25 2021.docx | DOCX document | |
| W56HZV-20-R-0101 June 17 2021.pdf | ||
| W56HZV20R0101-0002.pdf | ||
| W56HZV-20-R-0101 June 16 2021.pdf | ||
| W56HZV20R0101-0001.pdf | ||
| Questions and Answers June 11 2021.docx | DOCX document | |
| W56HZV20R0101 RFP.pdf | ||
| W56HZV20R0101 RFP.pdf | ||
| Attachment 001 Small Business Participation.xlsx | XLSX spreadsheet |
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Text version
Certification Form Small Business Size and Socioeconomic Status For Proposed Subcontractors Not Registered in the System for Award Management (SAM) Instructions for Prime Offeror:
1. Obtain this certification from any small business listed in the proposal that is not registered in SAM at https://www.sam.gov.
2. Before sending to a subcontractor to fill in, insert the Solicitation Number, NAICS code associated with the work to be done by the subcontractor, and the size standard for that NAICS code. Insertion of subcontract number or other internal tracking code is optional.
Instructions for Subcontractor:
1. Do not fill in this form if the NAICS code or one of the size standard fields has not been filled in by the prime offeror.
2. Fill in the other fields below. {The fields will expand as you type.}
3. Provide Name, Title, and Signature of official authorized to sign for the company and the date.
Solicitation Number: W56HZV-{ }-{ }-{ } Subcontract Number or Other Internal Tracking Code (Optional): { }
| Company Name: | { } | |
| Address: | { } |
I hereby certify that for the North American Industry Classification System (NAICS) code of { } defined in https://www.census.gov/eos/www/naics/ with a size standard of { } employees / $ { } average annual receipts assigned at https://www.sba.gov/contracting/getting-started-contractor/make-sure-you-meet-sba-size-standards, the above named business is a (check all that apply):
|_| Small Business (SB) |_| Small Disadvantaged Business (SDB) |_| Woman Owned Small Business (WOSB) |_| Veteran Owned Small Business (VOSB) |_| Service Disabled Veteran Owned Small Business (SDVOSB) as defined in Federal Acquisition Regulation (FAR) 2.101, FAR Clause 52.219-8, and taking into consideration the 13 CFR 121.103 “How does SBA determine affiliation” at http://www.ecfr.gov.
The contractor may self-certify in the above categories. A Contractor cannot self-certify as an 8(a) Small Disadvantaged Business or a Historically Underutilized Small Business Zone Small Business (HUBZone SB). These require certification by the Small Business Administration (SBA) and registration in the System for Award Management (SAM) and the SBA’s Dynamic Small Business Search Database.
Official authorized to sign for the company
| Name: | { } |
| Title: | { } |
Electronic Signature: { } or Handwritten Signature: _______________________________________________________________
| Electronic Date: | { } |
| or Handwritten Date: | ___________________ |
Form version: 27 Mar 2019
File details come from the government source that posted it. Updated .