Download:
pdf |
pdfBUY AMERICA CERTIFICATION
Instructions:
Bidder to complete the Buy America Certification listed below. Bidder shall certify EITHER
COMPLIANCE OR NON-COMPLIANCE (not both). This Certification MUST BE submitted
with the Bidder’s bid response.
Certification requirement for procurement of steel, iron, or manufactured products.
Certificate of Compliance with 49 U.S.C. 5323(j)(1)
The bidder or offeror hereby certifies that it will meet the requirements of 49 U.S.C. 5323(j)(1) and the applicable
regulations in 49 CFR Part 661 and any amendments thereto.
Signature______________________________________________________
Company Name_______________________________________________________
Title _____________________________________________________________
Date ____________________________________________________________
Certificate of Non-Compliance with 49 U.S.C. 5323(j)(1)
The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j)(1) and 49
C.F.R. 661.5, but it may qualify for an exception pursuant to 49 U.S.C. 5323(j)(2)(A), 5323(j)(2)(B), or
5323(j)(2)(D), and 49 C.F.R. 661.7.
Signature ___________________________________________________________
Company Name _______________________________________________________
Title _______________________________________________________________
Date _________________________________________________________________
Special Note: Make sure you have signed only one of the above statements -- either
Compliance OR Non-Compliance (not both).
File Type | application/pdf |
File Title | Microsoft Word - Buy America Certificate 04-10.doc |
Author | ccrawfor |
File Modified | 2010-04-22 |
File Created | 2010-04-22 |