Document zbxgrpz3Nz2YzDLXMKo82dVE0

The Ottawa trytescnta and certifies as pan of hu offer that: rCM arompia* ait appikabit bam at hJmbt.J T (ALL BUSINESS ffer>er. 14 so SP 3S-A.J (3 0 * uiufl bnintu concern. If offeror a snail hwiaai concern and r net the monufactufer of the wppliea offered, he alio rtrnnmi dot >plie* to be furnished hereonder Q will. Q will not, be manotaennud or produced by a small buamcaa concern in the United Scam, its poasewons. or t Rico, n/* 2. REGULAR DEALER--MANUFACTURER (Applkabh aafj e tappij twairatU tamdiag SMUHO.J He is a Q regular dealer in, Q manufacturer of. the supplies offetvd. n/g 3. CONTINGENT FES (Smpmr. UamSP SP-A.) (a) He Q has. Q has not, employed or retained any company or person fttbtr (hen e fali-tima. Mao jUt implant narking mitij fir tit tfirarj to solicit or scute this contract. and (b) he Q has, Q haa not, paid or agreed to pay any company or person fsrtar Ikam a fail-umt Mae fkk tmpitrytt waring mUj fir dm affmari any lee. commkawu. percentage, or brokerage fee contingent upon or resuirinf /tom the award of thia contract; and agrees ao furnish information retir ing to (a) and (b) show, aa tenuested by the Contracting Officer. (far mmtprmatiaa af tka rtprtmtuaina, tatimdimg tka farm "Mae/dr n^iajag," jar Cmhaf Mmi JUgeformu. Tuk 41. impart 4. TTFE OF BUSINESS ORGANIZATION He operates aa Q an individual, Q a partnership. Q a nonprofit orpnirariim. Q a corporation. incurp Jiarnl wader the lews of the Scare of Mirylffnd. 5. AFFILIATION AND IDENTIFYING DATA fAppikMt taij ta adamtimd mtiatatiam.) Each oBlflfceTrWori swhfafilil ceowmmpfrletnte* (a) mana*dw ^(Wb)| ihf najprpprlimcaMbmle,t maeneedo \(Hc)f mbealorw"<: __ . (a) He (S is, Q is not. owned or controlled by a parent company. (Sat par. 16 an Jr 33-A-y (b) If the offeror if owned or controlled by a parent company, be shall enter in the Modta below the name and main office address of the .........RamgaYi S^rlett & Co.. Inc.. 810_Kvser Building.^ (includeZIFf-t-i Baltimore. Maryland 21202 (<> (3m par. ITaaSP JJ-H.JL 52 045 4370 (Offmar'i BJ. Sa.J 52 045 4370 (Paraat Camjamft BJ. Ha.) 4 EQUAL OPPORTUNITY He Q has. haa not. participated in a pervious contract or subcontract subiacc either to the Equal Opportunity daoee herein or the dauae oeigmsDr con, tamed in section 301 of Executive Order No. 10923, or the clause contamed in lection 201 of Executive Order No. 11114; that he Q has. Q haa not. filed all required compliance reports; tnd that leprescntattoos indicating submmmn at required compliance reports, signed by proposed subcontractors. wdl be obtamid prior to subcontract awards. (Tka abart nprutatattaa and aataa tabmitmt an tmamtma witk taatmttt ar tabtaattattt amd am aaaatpt fiam tbr titan ) T. BUY AMERICAN CERTIFICATE The offeror hereby certifies that each cod product, except the tnd products Uand below, la a domestic source cod product (as defined in the tiamm entitled "Buy American Act ); and (hat components of unknown origin hate been considered to hate been mined, produced, or manufactured outside the United Stata. couwm or ostom-- g. CERTIFICATION OF INDEPENDENT PRICE DETERMINATION (3m par. it aa SP 3P*tJ - (at By aubmiaaion of this offer, the offeror certifies, and in the case of a joint that in with this procurement: (t) The prices in this offer hast been atrised at independently, wkhmtt oonan or agreement. Mr the of itjuicting comps- tkion. aa to any matter relating such peseta with any ether offeror or with any a ., (I) Unless otherwise required by taw. the prices which haw been quoted m due offrr have not been knowingly dtacioaedby the offeror and will not hnowtagiy be dkdoied by the offeror prior to opening in the case of an adremsod procurement or prior to award io the case of a negotmted procurement, directly or indirectly to any other offerer or to any competitor: and -. . (3) No attempt haa bom mads or will bo made by the offtroe mUndnce my other person or firm to auhnw or not an submit an offrr for the purpose ta tuiming competition. (bl Each person signing this offer certifies char: (1) He is the person in the offeror's organoaoon reipimiais wnhm that organnation for the decision as to the prices being offered herein and tfam be has not petticipeted. and will not participate, in any action contrary to (e) (!) through (e) (3) shorn; or (2) (i> He is not the person in the offerer's organnation responsible within that organisation Mr the decin'on as to the prices being offered herein bat Mat be has been fathomed in waiting to act as agent Mr rbepenona loapuiia Lie far such decision in certifying that such parsons hast not pattitipatHL sne will not porticipara. io any action contrary to (a) (l) through (a) (3) shorn, and aa choir agent does hereby so certify, and tut he h m> --nsoparad. anc will not participetn. in any action contrary o (a) (1) through (a) (3) shorn. ------------------------------------- | BB 0013667 | 9. CERTIFICATION OF NONSEGREGATZD FACILITIES '^ ----------------------------- --* 1__________ czctudieg 310.000 which ate not exempt from the pmeinoni^fMnlqnal Oppoacuoky danat.) mmxuy Be the nabmiaaMn of this bid, the buldcr. offeror, applicant, or subcontractor eamfiea that he does not maintain or prosids Mr his smplnsata any srgreaitti. ficilines at any of his establishmems. and that be does not permit ha tnyM^ti to perform chew icrvinaat any location, under hu rontrol. where atgregatwi btiian irr maintained. He certifies further that he will not maintain or provide for his employees any wgregated facilities ai any ot Mis csaoMtimmis. and that he will nor permit hk emplonrs to perform their services at any locatm, under hu control, where srgrrgired fstilitiea are mamtainad. The bidder, offeror sfptksnc. or subcontractor agrees that a breach of this certification k a notation of the Equal Opportunky dauae io this contract. Aa used m thk certification the term "segregated facilities" means any waiting rooms, work areas, tear rooms aad wash rooms, restaurants and ocher eating areas, time dodo, lodcrt moms and nthcr Borage or dressing areas, parking lota, drinking fountains, recreation or entertainment areas, transportation, and housing tacilttses provide: far employees which are segregated oy explicit directive or are in fact segregated on the bosk of race, color, reiigmo or national origin, because of habit, lorai , or otherwise. H'ei further iagrees tntt (except where be bus obtained...i.d..e..n..t.i.c.a...l..c.e...r.t.i.fications from proposed subcontracts for specific time prnodr) he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding 310.000 which era not exempt from the gwwam of the Equal Opportunky dauae: that be will retain such certifications in hk files; and that be will forward the following notice to such piopowd subrantrac- tots (except where the proposed subcontractors have submitted identical certifionona for specific time periods): Name ta pmipntht ubnatratmt af maammat fir trrtiptatiaai af aauqapM fatiiitm. A Certification of Nonasgrtgated Faoiines muse be submitted prior to the sward of a subcontract exceeding 310.000 which k not exempt from the ptovi- j ns of the Equal Opportunity danse. The certification may be submitted either Mr each subcontract or for all subcpettracta during a period (Le. qnsrteriy lauasnually. ee annually). NOTE: Th* paaalrj fir makmgfain ttstaaimg in *fm itjwtnitd im 11 US.C 1001. , AOmowtiOGMiNr of AMomseotts AMOIOmOIT NO. ~ 0ATI AWCNOMerTNO. i onn wssHumsntm* PfQ IHEJU *>7'HlbVrilMU. L)IQ rnMF LwS,,FiS:E?;Ai??5^!),c[T.!E authenticated smz: