5152.204-4032.pdf

5152.204-4032 REPRESENTATIONS AND CERTIFICATIONS

(a) SUBCONTRACTING:

If the offeror contemplates subcontracting, it must obtain prior written approval of subcontractor from the PCO or

ACO, and list below: (1) the names and addresses of the subcontractor(s), (2) the type of subcontracting, and (3) the estimated price for each subcontract.

(b) AFFILIATED OFFERORS:

(1) Business concerns are affiliates of each other when, either directly or indirectly, one concern controls or has the power to control the other, or a third party controls or has the power to control both.

(2) Each offeror shall furnish, below, the following information:

(i) Whether the offeror has any affiliates;

(ii) The names and addresses of all affiliates of the offeror; and

(iii) The names and addresses of all persons and concerns exercising control or ownership of the offeror and any or all of its affiliates, and whether they are common officers, directors, stockholders holding controlling interest, or otherwise.

AFFILIATED CONCERNS. : (Name, location and, in detail, controlling interest in each)

(c) PRINCIPAL OWNER(S) OR STOCKHOLDER(S):

Each offeror shall list below the name(s) and address(es) of the principal owner(s) or stockholder(s) of the company and percentage of ownership. If a major portion is publicly traded and/or otherwise widely distributed, state that, with the percentage so affected.

(d) STANDARDS OF CONDUCT CERTIFICATION:

This is to certify that, to the best of my knowledge and belief, except as described below, no representative of this firm who deals with US Government employees on any aspect of this procurement is a former US Government employee, to include former US military personnel. I understand that this certification is continuing in nature and places a duty on me and my firm to notify the Contracting Officer of any additional individual(s) who fit the above description prior to the individual's assuming duties.

(i) Name ______________________________________________

Former rank/grade ____________________________________

Last US Government position ___________________________

(ii) Name ______________________________________________

(iii) Name ______________________________________________

Firm ____________________________________________________

Name _____________________________________________________

Signature __________________________________________________

Title _____________________________________________________

Date of Execution ____________________________________________

(e) TAXES:

(1) References:

(i) Contract clause entitled "FAR 52.229-06 Taxes—Foreign Fixed-Price Contracts (Jan 1991)."

(ii) US-ROK Status of Forces Agreement (SOFA), Articles IX and XVI.

(iii) ROK Customs Law, Law No. 1976, promulgated on 29 November 1967, as amended.

(iv) ROK Value Added Tax Law, Law No. 2934, promulgated on 22 December 1976 (effective date 1 July 1977), as amended.

(v) ROK Special Excise Tax Law, Law No. 2935, promulgated on 22 December 1976 (effective date 1 July

1977), as amended.

(2) Contractor shall state the types and estimated amount of taxes that would normally apply to such transactions but are excluded from this proposal.

(i) Customs Tax (except for ROK MND-funded contracts or delivery orders):

Name Number Cost/Unit of Item of Units w/o Tax % of Tax Tax/Unit Tax Total

This item will be imported specifically for this contract? Yes _____ No _____

(ii) Special Excise Tax:

Name Number Cost/Unit of Item of Units w/o Tax % of Tax Tax/Unit Tax Total

Name of item manufacturer

(iii) Value Added Tax (VAT):

Input VAT on materials purchased for this contract. 10% _____

Input VAT on transportation leased/rented for this contract.10% _____

Input VAT on equipment leased/rented for this contract. 10% _____

Input VAT on services purchased for this contract. 10% _____

Output VAT on total contract amount. 10% _____

(iv) Special Excise (Petroleum) Tax:

No. of U/P

Liters w/o Tax Tax/Unit Total Tax Amount

Regular Gasoline ________ (L) ________ w________ w_____________

Premium Gasoline ________ (L) ________ w________ w_____________

Diesel ________ (L) ________ w________ w_____________

Other ________ (L) ________ w________ w_____________

(v) Education Tax.

(3) Name of the oil company from which POL products will be purchased:

Oil Company: _________________________________________ (Name only)

(4) I certify by this submission that all supplies and services to be purchased for this contract have been proposed exclusive of Value Added Tax, applicable Customs Tax (except ROK MND-funded contracts and delivery orders), Special Excise Tax, and Education Tax.

Signed (Chop)

(f) CERTIFICATIONS AND REPRESENTATIONS

By submitting an offer, each offeror agrees to be bound by all certifications and representations in this solicitation.

The Government reserves the right to require any and all certifications and representations to be completed and signed in hard copy by the successful offeror prior to contract award. Failure of an offeror to complete the certifications and representations within the time directed by the Contracting Officer may result in a determination that the contractor is not a responsible offeror for this acquisition.