|
<br />'.
<br />
<br />.
<br />
<br />(Coldr.efioll anet Architect..E.,ineer Contract)
<br />(For ItS& with St..daret ForMs 19. 21 and 25ZJ
<br />
<br />REFERENCE (Enter sa"" No.(s) as on SF 19. 21 ana 2'2)
<br />Inv. No.
<br />
<br />(Bidder to complete Inv. No.)
<br />
<br />REPRESENTATIONS AND CERTIFICATIONS
<br />
<br />l'oAME :.NO ll.OORlSSOF BIODER(No., SJT'~1. Cit), 5t.1I~. 4nti ZlPCod,~
<br />
<br />DATE OF BID
<br />
<br />..
<br />
<br />In negotiated procurements, "bid" and "bidder" shall be cons/rued 10 "/tan "offer" and "offeror."
<br />The bidder makes the following represent.3rions and certifications as a part of the bid identified
<br />above. (Ched, appropriate boxes.)
<br />
<br />I. SMALL BUSINESS
<br />He 0 is? 0 is not. a small business concern. (A sman business concern for the purpose of Government procurement
<br />is 3' concern, including its affiliates, which is independendy owned and operated. is not dominant in the field of opera-
<br />tions in which it is bidding on Government contracts? and can further qualify under the criteria concerning number of
<br />employees? average annual receipts, or other criteria as prescribed by the Small Business Administration. For additionaJ
<br />information see governing regulations of the Small Business Adminh.tration (13 CFR Part 121)).
<br />
<br />.
<br />
<br />2. MINORITY BUSINESS ENTERPRISE
<br />He 0 is? 0 is not a minority b1Js.iness enterprise. A minority business enterprise is defined as a "business, at least 50
<br />percent of which is owned by minority group ~embers or, in case of (lublicly owned businesses? at least 51 percent of
<br />the srock of which is owned by minority group members." For the purpose of this definition, minority group members
<br />are Negroes, SPanish-speaking American persons, American~Orientals, American-Indians, American-Eskimos, and American-
<br />Aleuts."
<br />
<br />3. CONTINGENT FEE
<br />
<br />(a) He- 0 has. 0 has not, employed or retained any company or person (other than a full.time bona fide employee
<br />working solely for the bidder) to solicit or secure this contract, and (b) he 0 has. 0 has nor, paid or agreed to pay
<br />any company or person (other than a full.time bona fide employee working solely for the bidder) any fee, commission,
<br />percentage or brokerage f~, contingent upon or resulting from the award of this contract; and agrees to furnish informa.
<br />tion relating to (a) and (6) above as requested by the Contracting Officer, (For i"lerpretalioll of Ih~ r~pr~st"talio", i"clud-
<br />i"g Ih~ Ur", "holl. fid~ ~",pl()y~~," su CoJ~ o.f F~dtral R~gulat;o"J. Till~ 41. Subpart 1-I.S.)
<br />
<br />4. TYPE OF ORGANIZATION
<br />He operates u an 0 individual, 0 partnership, 0 joint venture. 0 corporation, incorporated in Scate of
<br />
<br />.
<br />
<br />~. INDEPENDENT PRICE DETERMINATION
<br />
<br />(a) By submission of this bid. each bidder cenlfies, .and in the case of a joint bid each parn' thereto certifies as to his
<br />own organization. that in connection with this procurement: .
<br />(1) The prices in this bid have been arrived at independently, without con~uhation, communication, or agree-
<br />ment. for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with
<br />any competitor;
<br />(2) Unllt'ss otherwise required by law, the prices which have been quoted in this bid have not ~t'n knowingl}'
<br />disclo!ted by the bidder and will not knowingl)' be discJosed by the bidder prior to opening, in the case of a bid, or
<br />prior to award, in the case of a proposal, directly or indirectly to any other bidder or to any competitor; and
<br />(3) No attempt has been made or will be made by the bidder to induce any other person or _firm to submit or
<br />not to submit a bid for the purpose of restricting competition.
<br />(b) Each person signing this bid certifies that:
<br />(I) He is the person in the bidder's organization responsible within that organization for the decision as to the
<br />price) being bid herein and that he has not participated. and will not participate. in any action contrary to (~) (1)
<br />through (a) (3) above; or
<br />(2) (i) He is not the person in the bidder's organization responsible within that organization for rhe decision
<br />as to the price~ being bid herein but that he has been authorized in wriring to act as agent for the p~rsons rcspan-
<br />~ible for such decision in certifying that suc.:h persons have not panicipated. and will not participate, in any action
<br />connary to (a) (1) through (0:1) (3) above, and u their ag:enr does hereby so cenify; and (ii) he has nor participated.
<br />and will not panicipate, in any action contrary to (d) ( I) through (ll) ( 3) above.
<br />(e) This ccnincation i~ not 3pplicable to a foreign bidder ~ubmining a bid for a conrracr which requires performanct"
<br />or delivery outside the United States, its possessions. and Puerto Rico.
<br />rd) A bid will nor be considert'd for award where (",)fl), (...)(~). or (b) above. has b<t:n del~ted or modified.
<br />Where (a) (2) above, has been deleted or modified. the bid .will not be considued for award unles~ the bidder furnishes
<br />with the bid a signed statement which sets forth in detail the circumstances of the disclosure and the head of the agency.
<br />or his designee, determines that such disclosure was not made for the purpose of restrICting competition.
<br />
<br />,
<br />
<br />.
<br />
<br />,"Ol'f..-8ids musl ul /O,I!J filII, auu'.sle, '''lfJ ,'omp/dc.' illlfJIIII.lliOIl .IS '~'qllirlt,l by Ibis illl il,llioll lor bids (;'ldu,Jing
<br />tr/l4c-bments). Tbe pitH_lily /or mi1Jiug Id/Sf.' st,lIo'uu/J hi bids jJ presalb<'tJ ill JI; {',S.L 1 (JII I ,
<br />
<br />19-304
<br />
<br />SF-19B-Page 1 STANOARD FORM 19-8. JUNE 1976 EOITION
<br />GENERAL SERVICES ADMINISTRATION
<br />FED. PAOC. REG. 141 CFA) 1-16.401 AND 1-16701
<br />
|