Representations and Certifications

Forms and Documents

Document Name	Status
Form Reps and Certs Annual Representations and Certification Form and Instruction	New
Supporting Statement annual reps and certs.docx Supporting Statement A	2015-08-19

IC Document Collections

IC ID	Document Title	Status
217811	Annual Representations and Certification Form and Instruction	New

ICR Details

OMB Control No: 3037-0013	ICR Reference No: 201505-3037-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: CPBSD	Agency Tracking No: 0013
Title: Representations and Certifications
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/05/2015
	Date Received in OIRA: 08/19/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2018	36 Months From Approved
Responses	559	0	0
Time Burden (Hours)	4,472	0	0
Cost Burden (Dollars)	178,880	0	0

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Abstract: The U.S. AbilityOne Commission® has required participating nonprofit agencies (NPAs) to submit an Annual Certification, through their respective Central Nonprofit Agency (CNA) for more than 30 years. This certification has two purposes, (1) to assure that the NPAs are complying with the Commission's regulations for maintaining qualification to participate in the AbilityOne® Program, and (2) to gather Program level data that the Commission can use to analyze, report on and further grow the Program. The Representations and Certifications (hereafter "Reps and Certs") being proposed for use beginning in 2015 are an expansion of the current certification (Forms 403/404) to more closely match the Commission's regulatory requirements and gather additional information on Federal procurement requirements that could affect a nonprofit agency's eligibility to hold AbilityOne contracts. The requirement of Reps and Certs is drawn from the Federal Acquisition Regulation (FAR) and introduces a well-established Federal practice to the AbilityOne® Program. By aligning ourselves with other Federal requirements and adapting proven business practices, we increase the AbilityOne Program's credibility, accountability and stability. The use of Reps and Certs for AbilityOne information reporting is the result of a collaborative and robust effort to improve the Program's critical business processes.

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Authorizing Statute(s): US Code: 41 USC Chapter 85 Name of Law: JWOD Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 27930	05/15/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 46248	08/04/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Representations and Certification	Reps and Certs	Annual Reps and Certs

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	559	0	0	559	0	0
Annual Time Burden (Hours)	4,472	0	0	4,472	0	0
Annual Cost Burden (Dollars)	178,880	0	0	178,880	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new form requiring the submittal of new information and thus requires more time to complete. In addition, the number of participating nonprofits has decreased since 2012 when the previous annual certifications were approved

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  Yes

Description/Changes for Common Form Usage:  This single form will replace the two current annual certifications and be used by the Committee to ensure compliance with the Act and the implementing regulations. Without this information the Committee would be unable to assure that the participating nonprofit agencies meet the requirements of the JWOD Act and the implementing regulations. The data on the form is also used to collect information so that the Committee can report on the status and changes in the AbilityOne Program to the President as required in the Act. Section 6 of the form contains 17 questions that are directly related to the requirements that the nonprofit agencies must meet to maintain their qualification to participate in the Program (41 CFR 51-4.3). Section 7 contains seven questions that deal with ensuring that the participating nonprofit agencies are meeting general stewardship requirements and that the Committee is aware of management changes. Section 8 contains 5 questions that are identical with questions asked of all Federal contractors via the System Award Management to ensure that the Committee is aware of any potential issues that would prevent contracts being issued to nonprofits.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/19/2015

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