Tax_and_Felony_Representation_Form_(Use_with_Assistance_Proposals).docx
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- Solicitation number
- W911NF-17-S-0002
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This document contains a representation form and details of a federal contract opportunity notice issued by the U.S. Army Combat Capabilities Development Command Army Research Laboratory Army Research Office.
The representation form requires any corporate applicants to disclose whether they have any unpaid federal tax liability or have been convicted of a criminal violation under federal law within the past 24 months. Applicants must respond affirmatively or negatively to these representations and provide additional information to the agency suspension and debarment official if needed.
The federal contract opportunity notice is a Broad Agency Announcement seeking research proposals in mechanical sciences, mathematical sciences, electronics, computing science, physics, chemistry, life sciences, materials science, network science, and environmental sciences. Proposals submitted in response to this announcement and selected for award will be considered the result of full and open competition in compliance with public law. Eligible applicants include institutions of higher education, nonprofit organizations, state and local governments, foreign organizations, and for-profit organizations. This BAA is continuously open from the date of issuance through March 31, 2022. The attached Army Research Office BAA document provides further details on the basic and applied scientific research sought.
Tax and Felony Representation Form (Use with Assistance Proposals)
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Representations under DoD Assistance Agreements: Appropriations Provisions on Tax Delinquency and Felony Convictions
The applicant is ( ) is not ( ) a “Corporation” meaning any entity, including any institution of higher education, other nonprofit organization, or for-profit entity that has filed articles of incorporation.
If the applicant is a “Corporation” please complete the following representations:
(1) The applicant represents that it is ( ) is not ( ) a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.
(2) The applicant represents that it is ( ) is not ( ) is not a corporation that was convicted of a criminal violation under any Federal law within the preceding 24 months.
NOTE: If an applicant responds in the affirmative to either of the above representations, the applicant is ineligible to receive an award unless the agency suspension and debarment official (SDO) has considered suspension or debarment and determined that further action is not required to protect the Government’s interests. The applicant therefore should provide information about its tax liability or conviction to the agency’s SDO as soon as it can do so, to facilitate completion of the required considerations before award decisions are made.
Sign:___________________________________
Date:____________________________________
Print Name and Position:______________________________________________
File details come from the government source that posted it. Updated .