5100-136 Buy American Content Percentage Calculation Worksheet

U.S. Department
of Transportation
Federal
Aviation
Administration

FAA Form 5100-136, Buy American Project/Product
Content Percentage Calculation – Worksheet
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to,
nor shall a person be subject to a penalty for failure to comply with a collection of
information subject to the requirements of the Paperwork Reduction Act unless that
collection of information displays a currently valid OMB Control Number. The OMB Control
Number for this information collection is 2120-0569. Public reporting for this collection of
information is estimated to be approximately 8 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, completing and reviewing the collection of information. All responses to this
collection of information are required under 49 U.S.C. Section 47105 to retain a benefit and
to meet the reporting requirements of 2 CFR 200. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to: Information Collection Clearance Officer, Federal Aviation
Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.

Instructions for FAA Form 5100-136, Buy American
Preference - Content Percentage Worksheet
General Instructions/Information
This form is intended for use by applicants (manufacturers, contractors, suppliers) for an
FAA Buy American Preference waiver of the requirements of section 70914 of the Build
America, Buy America (BABA) Act included in the Infrastructure Investment and Jobs
Act (IIJA) (Pub. L. No. 117-58). This form and the Final Assembly Questionnaire (FAA
form 137) must be submitted together for all waiver requests. Complete the below
sections.
Applicant Information Section
Enter applicant and point-of-contact information.

FAA Form 5100-136 (5/2023)

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Project/Product Information Section (The Final Project)
Enter summary information about the specific FAA eligible project for which this waiver
is requested, including the calculated costs and percentage information from the project
material structure worksheet.
FAA Buy American Preference Compliance Section (“Construction Materials”)
Enter summary cost and percentage information about the presence of non-domestic
portions of iron, steel, or other singular “construction materials” that consist primarily of
non-ferrous metals; plastic and polymer-based products (including polyvinylchloride,
composite building materials, and polymers used in fiber optic cables); glass (including
optic glass); lumber; or drywall which are not combined with any of other materials
through a manufacturing process.
Use of Non-Domestic Construction Materials Justification Section
Enter a description of your good faith efforts made to locate and secure domestic
materials that are not 100% domestically produced in the United States, including the
use of the Supplier Scouting by the Manufacturing Extension Partnership (MEP) or
market research. This information is required for any non-U.S. portions of structural
steel and or iron.
Project Material Structure Worksheet (Manufactured Goods)
Enter onto the worksheet the final project and manufactured component/subcomponent
items, prices and total costs, excluding labor and retail markup through level 2 only.
Eligible materials below level two should be included with its associated component or
subcomponent. Price multiplied by quantity equals costs.
For additional information on how to complete this form, contact the FAA regional or
airport district office associated with the airport worksite, or for assistance for other
waivers, contact FAA headquarters via the AIP Buy American Preference Requirements
webpage.
Level. Enter material level 0, 1, or 2. Level 0 is the final product, Level 1 is a
component, and Level 2 is a sub-component.
Part Number. Enter a reference number used to track the item.
Item Description. Enter a concise but clear description of the item.
Quantity. Enter the quantity of the item described in the product/project.
Unit of Measure. Enter the unit of measure used for the item. Examples: Each, Ton, or
Sq. Ft.
Price/Unit of Measure. Enter the price for each unit of the item.
FAA Form 5100-136 (5/2023)

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U.S. Origin Price/Unit of Measure. Enter the price for each unit of U.S. origin.
U.S. Origin Cost. Enter the total cost.
Non-U.S. Price/Unit of Measure. Enter the price for each unit not of U.S. origin.
Non-U.S. Cost. Enter the total cost of the item not of U.S. origin.
Country of Non-U.S. Materials. Enter the country or countries of origin for all non-U.S.
materials. Enter “Not applicable” if only U.S. materials are used for the item.
Example A – Completed Material Structure Worksheet

On the next page is an illustration of a Project Material Structure Worksheet. In this
illustration, the final project and each manufactured component/subcomponent costs,
excluding labor and retail mark-up, are listed. The total cost of materials, excluding labor
and retail mark-up is $720,000 ($565,000 of U.S. costs and $155,000 Non-U.S. costs).
Items [materials] combined through a manufacturing process may be indicated as a
manufactured component/subcomponent.
Unit of measure prices are multiplied by the quantity to identify costs. The sum of each
component/subcomponents is equal to the amounts in the final project. Eligible
materials below level 2 may be included within a manufactured good in levels 1 or 2.
Ineligible or excluded materials should be omitted.
The country of origin of all non-U.S. material are listed by each component and the final
product. Other variations of the project components/subcomponents are possible as
each manufacturer may produce or apply components/subcomponents differently.

FAA Form 5100-136 (5/2023)

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Level (0,
1, 2)

Part
Number

Item Description

Quantity

Unit of
Measure

Price/Unit
of Measure

U.S. Origin
Price/Unit
of Measure

U.S. Origin
Cost

Non-U.S
Price/Unit
of Measure

Non-U.S.
Cost

Country of
Non U.S.
Materials

0

Ref #

Final Project

1

Each

Country A,
$720,000 $425,000 $565,000 $72,500 $155,000 Country B,
Country C

1

Ref #

Manufactured
Component

4

Ton

$320,000 $70,000 $210,000 $27,500 $110,000

Non-U.S.
Country A

1

Ref #

Manufactured
Component

1

Each

$100,000 $100,000 $100,000

$0

$0

Not
Applicable

1

Ref #

Manufactured
Component

1

Each

$25,000

1

Ref #

Manufactured
Component

1

2

Ref #

Manufactured
Subcomponent

1

Each

$25,000

1

Ref #

Manufactured
Component

1

Each

$50,000

1

Ref #

Structural Steel
Material

1

Tons

FAA Form 5100-136 (5/2023)

$25,000

$25,000

$0

$0

Not
Applicable

Sq. Ft. $100,000 $60,000

$60,000

$40,000

$40,000

Non-U.S.
Country B

$20,000

$20,000

$5,000

$5,000

Non-U.S.
Country C

$50,000

$50,000

$0

$0

Not
Applicable

$100,000 $100,000 $100,000

$0

$0

Not
Applicable

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OMB CONTROL NUMBER: 2120-0569
EXPIRATION DATE: 6/30/2023

U.S. Department of Transportation
Federal Aviation Administration

Buy American Project/Product
Content Percentage Calculation – Worksheet
Applicant Information
Date of Application:
Applicant Name:
Applicant Type (choose one):
Prime Contractor

Manufacturer

Supplier

Point of Contact (First and Last Name):
Applicant Business Address:
Email address:
Telephone:

Extension:

Project/Product Information
FAA Eligible Project:
Airport Sponsor:
Airport LOCID:
FAA Award Number:
FAA Item Number (FAA Advisory Circular reference, if applicable):
Total Material Cost:
Total U.S. Material Content Cost:

Percentage:

%

Total Non-U.S. Material Content Cost:

Percentage:

%

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

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FAA Buy American Preference (including Buy American Build American) Compliance
Does this project include any iron, steel or any of the following construction materials, not 100%
produced in the United States?
Yes

No

If “Yes,” indicate the cost and percentage of the project below.
Steel (e.g., structural steel, rebar)

Cost:

Percentage:

%

Iron

Cost:

Percentage:

%

Non-ferrous metals

Cost:

Percentage:

%

Plastic and polymer-based products

Cost:

Percentage:

%

Glass (including optic glass)

Cost:

Percentage:

%

Lumber

Cost:

Percentage:

%

Drywall

Cost:

Percentage:

%

Use of Non-Domestic Construction Materials Justification
Provide a description of your efforts to locate and secure a domestic source for those “construction
materials” or final manufactured goods that are not 100% produced in the U.S., including use of
the Manufacturing Extension Partnership (MEP) and market research.

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

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– CONFIDENTIAL –
NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT

Project Material Structure Worksheet
Level
(0, 1, 2)

0

Part
Number

Item Description

Quantity

Unit of
Measure

1

Each

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

Price/Unit
of Measure

U.S. Origin
Price/Unit
of Measure

U.S. Origin
Cost (Each)

Non-U.S.
Price/Unit
of Measure

Non-U.S.
Cost (Each)

Country of
Non-U.S.
Materials

Page 3 of 7

– CONFIDENTIAL –
NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT
Level
(0, 1, 2)

Part
Number

Item Description

Quantity

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

Unit of
Measure

Price/Unit
of Measure

U.S. Origin
Price/Unit
of Measure

U.S. Origin
Cost (Each)

Non-U.S.
Price/Unit
of Measure

Non-U.S.
Cost (Each)

Country of
Non-U.S.
Materials

Page 4 of 7

– CONFIDENTIAL –
NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT
Level
(0, 1, 2)

Part
Number

Item Description

Quantity

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

Unit of
Measure

Price/Unit
of Measure

U.S. Origin
Price/Unit
of Measure

U.S. Origin
Cost (Each)

Non-U.S.
Price/Unit
of Measure

Non-U.S.
Cost (Each)

Country of
Non-U.S.
Materials

Page 5 of 7

– CONFIDENTIAL –
NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF INFORMATION ACT
Level
(0, 1, 2)

Part
Number

Item Description

Quantity

FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

Unit of
Measure

Price/Unit
of Measure

U.S. Origin
Price/Unit
of Measure

U.S. Origin
Cost (Each)

Non-U.S.
Price/Unit
of Measure

Non-U.S.
Cost (Each)

Country of
Non-U.S.
Materials

Page 6 of 7

– CONFIDENTIAL –
NOT SUBJECT TO DISCLOSURE UNDER EXEMPTION # 4 OF THE FREEDOM OF
INFORMATION ACT

Certification
The undersigned certifies that this information is true and accurate to the best of their knowledge. A
false certification represents a violation of 18 U.S.C § 1001 and 49 U.S.C § 47126. Signatory has
the burden of proof to establish compliance.

Date:

Signature:

Name:
Title:

Submit by Email

FOR FAA USE ONLY
(Mark the appropriate Waiver Type & Scope)
Applicable FAA Waiver Type
Type I Public Interest (HQ Only)
Type II Nonavailability (HQ Only)
Type III More than 60% and Final Assembly within the U.S.
Type IV Unreasonable Cost (Requires MEP/requires HQ coordination)
BABA Iron, Steel, or Construction Material (requires justification) (Apply BABA Flag)
Applicable FAA Waiver Scope
Project Specific
Nationwide – (General Applicability) (For HQ Only)
Justifications
Manufacturing Extension Partnership (MEP) Coordinated

FAA Official’s Signature:
End of FAA-Use Only Section
FAA Form 5100-136 (5/2023) SUPERSEDES PREVIOUS EDITION

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