SUPPLIER EXPORT COMPLIANCE AND DDTC REGISTRATION CERTIFICATION
Company Name
Address
City, State, Zip Code
Name of Company
Representative
Phone
Fax
E-mail Address
Product provided to MEC:
Specify product(s)
_
Provide description, part number(s), or NSN
Check relevant box(es):
ITAR-Controlled
EAR-Controlled
COTS*
*Commercial Off the Shelf
Service provided to MEC
Manufacturer
Processing
R&D
Distributor
Other
The Marvin Group requires that its suppliers/contractors provide and/or certify the following information to
ensure compliance with the U.S. Government export/import laws and regulations including the U.S. Department of
State, Directorate of Defense Trade Controls (DDTC), International Traffic in Arms Regulations (ITAR) and the U.S.
Department of Commerce, Bureau of Industry and Security (BIS), Export Administration Regulations (EAR). This
form must be signed by a duly authorized officer of your company.
SECTION I: CERTIFICATION:
Supplier understands that the Marvin Group may provide it with technical data, hardware, or other technical
tooling (e.g. documentation, software, drawings and specifications) as defined and regulated by the U.S.
International Traffic in Arms Regulations (ITAR) in 22 CFR Parts 120-130.
Supplier understands that its employees, agents or representatives may not transfer such technical data,
hardware, or other technical tooling by any means to a foreign person, whether in the United States or another
country, without prior written approval from The Marvin Group and the U.S. Government. Additionally, any
employee of the Supplier who is a foreign person will not have access to such technical data, hardware, or other
technical tooling supplied to it by the Marvin Group.
Supplier understands that written permission from the Marvin Group must be obtained prior to transferring
such technical data, hardware, or other technical tooling to any other company in the United States or any other
country.
Supplier certifies that all employees or representatives of our company that will interact with the Marvin
Group are not debarred or otherwise restricted from participation in government contracting or international
transactions conducted under the jurisdiction of the EAR and ITAR.
Supplier understands that it is obligated to review all information provided and in the event of any ambiguity,
contact the Marvin Group immediately to obtain any export control determination in cases where export control
jurisdiction has not been clearly marked or otherwise identified by the Marvin Group.
FORM F-043 REV B
MEC PROPRIETARY
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SUPPLIER EXPORT COMPLIANCE AND DDTC REGISTRATION CERTIFICATION
Supplier understands that it is responsible for ensuring that the requirements to this certification are
conveyed to all sub-tier suppliers that will receive Marvin Group technical data, or equipment or technology. If the
Supplier provides documentation or information containing controlled Technical Data to subcontractors, it will
mark such documents, emails, etc. with the following statement (or a similarly worded export control warning):
“This document contains technical data whose export is restricted by The Arms Export Control Act (Title 22 USC Sec.
2751 et seq.) Access to this document is restricted to U.S. citizens and lawful permanent residents (US “green card”
holders).” It may not be transferred to any foreign person, whether in the United States or abroad, without an
export license or other approval from the U.S. Department of State (under the ITAR) or U.S. Department of
Commerce (under the EAR). By accepting this data, the consignee agrees to honor the requirements of the U.S.
International Traffic in Arms Regulations (ITAR).”
Supplier certifies that it will, within 30 days of the close of the RFQ or contract, return to MEC or destroy all
information and documents containing ITAR-controlled Technical Data, and all copies in its possession. If
destroyed, our company will provide a written certification to the Marvin Group that such information and/or
documents have been destroyed.
SECTION II: U.S. REGISTRATION REQUIREMENTS (22 CFR § 122.1):
All Marvin Group suppliers must comply with the U.S. regulatory requirements contained in the U.S. International
Traffic in Arms Regulations (ITAR); 22 CFR §122.1 (a):
Any person who engages in the United States in the business of either manufacturing or exporting defense
articles or furnishing defense services is required to register with the Directorate of Defense Trade Controls.
Manufacturers of defense articles who do not engage in exporting must nevertheless register.
1.
Is your company registered with the Directorate of Defense Trade Controls, U.S. Department of State?
Yes
Expiration Date:
(MM/DD/YY)
(If expiring within current calendar year, please remember to start Renewal Activities)
2.
New Application In Process
Application Date:
(MM/DD/YY)
Renewal Application In Process
Application Date:
(MM/DD/YY)
No
If “No”, please complete section 2 below before continuing to
sections 3 and 4
Our business is not required to be registered with the U.S. Department of State for the following reason:
(Check only one box):
We supply/manufacture products that are subject exclusively to the controls of the Export Administration
Regulation (EAR) and they are classified as
(provide the Export Control
Classification Number/ECCN).
Our pertinent business activity is confined exclusively to the production of unclassified technical data
only. Therefore, 22 CFR § 122.1(b)(2) applies. (Note: only one occasion of manufacturing a defense article
is needed to effect the manufacturer registration requirement.)
Our business engages only in the fabrication of articles for experimental or scientific purpose, including
research and development. Therefore, 22 CFR § 122.1(b)(4) applies.
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MEC PROPRIETARY
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SUPPLIER EXPORT COMPLIANCE AND DDTC REGISTRATION CERTIFICATION
Our activities as a distributor/reseller have not and do not involve the manufacture or export of defense
articles.
We are a consultant to the Marvin Group, providing other business services. None of the aforementioned
options apply to our service agreement with the Marvin Group.
Other (please explain):
3.
Is Supplier a U.S. company or other U.S. legal entity?
Answering “YES” means you ARE a corporation, business association, partnership, society, trust, or any other
entity, organization or group that is incorporated to do business in the United States. Answering “NO” means
that your company or legal entity is NOT a corporation, business association, partnership, society, trust, or any
other entity, organization or group that is incorporated to do business in the United States.
YES
NO (if no, please provide the requested information and acknowledge the following conditions, and
proceed to question 7.
Supplier is registered for business in
(country)
Supplier hereby acknowledges notification of the requirement to disclose to the Marvin Group
any employees, by country, who hold dual-citizenship status with a country other than the U.S.
(e.g., they are citizens of your country and a third country, other than the U.S.).
4.
Does Supplier employ non-U.S. persons or use non-U.S persons as contract labor or consultants at any of its
U.S. locations? A non-U.S. person is someone who is NOT a U.S. citizen or U.S. permanent resident alien (also
referred to as a “green card holder”).
YES
NO
5.
Does Supplier perform work at non-U.S. facilities, affiliates, or subsidiaries?
YES
NO
6.
Will any third party who is a non-U.S. company or, who will utilize non-U.S. facilities or non-U.S. persons be
involved in any way on Marvin Group transactions?
YES
NO
7.
Does Supplier have an export compliance program in place and understand its responsibilities under U.S.
export laws?
YES
NO
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MEC PROPRIETARY
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SUPPLIER EXPORT COMPLIANCE AND DDTC REGISTRATION CERTIFICATION
SECTION III: AUTHORIZED SIGNATURE:
Please certify understanding and compliance to the preceding conditions by signing below:
I hereby certify that the information entered on this document is accurate and complete, and undertake to inform
the Marvin Group immediately of any subsequent change(s) hereto:
Company name
Authorized Representative:
NAME / TITLE (PLEASE PRINT)
Signature:
Date:
(PRINTED)
Signer is authorized to discuss/verify/confirm the export compliance requirements associated with this
certification.
Signer is an Empowered Official as defined by ITAR 22 CFR 120.25
Please return completed form to export@marvineng.com. Contact Margrette Francisco at e-mail
margrettef@marvineng.com or telephone number (310) 674-5030 ext. 451 with any questions concerning
the content of this form.
FORM F-043 REV B
MEC PROPRIETARY
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ISSUE DATE: 05-12-14