CERTIFICATIONS AND REPRESENTATIONS
(CONTRACTS AWARDED UNDER DOE GRANTS)
The procurement of material, supplies, services, or construction for use on a U.S. Department of Energy grant requires compliance by contractors,
subcontractors, and suppliers (Seller/Offeror) with socioeconomic programs and other requirements enacted into law, implemented by Executive order
and/or promulgated by Federal Regulations. Certifications on the specific requirements and your present state of compliance and eligibility are
contained in sections 1 through 6 (sections 1 through 9 for Construction Contracts ONLY). Please signify your status by checking the appropriate
boxes. All sections need to be completely filled out to be valid. Seller/Offeror agrees to provide additional representations or
certifications that Allison, from time to time, reasonably requests.
CERTIFICATION:
The Seller/Offeror acknowledges by signing the ‘Received and Acknowledged’ section on AT-10198, an understanding of the U. S.
Government’s grant, contracting and subcontracting programs, and confirms the accuracy of the statements made below. This certification
shall apply to Requests for Quotations, Purchase Orders or Subcontracts received from Allison Transmission.
1.
AFFIRMATIVE ACTION COMPLIANCE
41 CFR 60-1 and 60-2
THRESHOLD APV$10,000
The offeror represents that it –
a)
HAS and has on file at each establishment
HAS NOT
developed an affirmative action program as required by the rules and regulation of the Secretary of Labor (41 CFR 60-1 and 60-2)
b)
2.
N/A Suppliers with Foreign Manufacturing address or less than 50 employees are exempt .
CERTIFICATION REGARDING CLEAN AIR ACT
42 U.S.C. 7401 and 33 U.S.C. 1251
THRESHOLD APV$100,000
The offeror represents that it –
IS
IS NOT
in compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (41 U.S.C. 7401 et seq.) and the
Federal Water Pollution control act as amended (33 U.S.C. 1251 et seq.). Violations must be reported to the responsible DOE contracting
officer and the Regional Office of the Environmental Protection Agency (EPA).
3.
CERTIFICATION REGARDING DEBARMENT, SUSPENSION
PROPOSED DEBARMENT
E.O. 12549 and E.O. 12689
THRESHOLD APV$25,000
(a) The offeror certifies that it
IS
IS NOT
debarred, suspended, or declared ineligible in any aspect from entering into contracts, grants, or other assistance instruments with the
Federal Government, or in receipt of notice of proposed debarment from any department of the Federal Government.
(b) The offeror certifies that its principals
ARE
ARE NOT
debarred, suspended, or declared ineligible in any aspect from entering into contracts, grants, or other assistance instruments with the
Federal Government, or in receipt of notice of proposed debarment from any department of the Federal Government.
(c)The Seller shall provide the Buyer immediate notice in the event of being suspended debarred, in receipt of notice of proposed debarment,
or declared ineligible to receive awards from “any” Federal Agency
Submit completed form to e-mail address of certsandreps@allisontransmission.com
Subject line should be: CERTS [your company name].
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CERTIFICATIONS AND REPRESENTATIONS
(CONTRACTS AWARDED UNDER DOE GRANTS)
4.
EQUAL OPPORTUNITY AND COMPLIANCE WITH VETERANS
EMPLOYMENT REPORTING REQUIREMENTS
3 CFR 1964-1965 Comp. p.339 and 3 CFR 1966-1970 Comp p. 684
THRESHOLD APV> $100,000
(a) The offeror certifies that it
IS
IS NOT
in compliance with special reporting requirements pertaining to Employment Reports on Special Disabled Veterans, Veterans of the
Vietnam Era, and other eligible veterans
(b)
5.
N/A - Suppliers with Foreign Manufacturing address or less than 50 employees are exempt .
CERTIFICATION AND DISCLOSURE REGARDING
PAYMENT TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS
31 U.S.C. 1352
THRESHOLD APV$100,000
(a) The offeror certifies by signing that to the best of his or her knowledge and belief, Federal appropriated funds
HAVE OR WILL BE PAID
HAVE NOT OR WILL NOT BE PAID
to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, and officer or
employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan, or cooperative agreement:
(b) If any funds other than Federal appropriated funds ( including profit or fee received under a covered Federal transaction) have been
paid, or will be paid, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with this
solicitation , the seller shall complete and submit with its offer, OMB standard form LLL, Disclosure of Lobbying Activities, to the
Buyer and
(c) The seller will include the language of this certification in all subcontract awards at any tier and require that all recipients of subcontract
awards in excess of $100,000 shall certify and disclose accordingly
6.
CERTIFICATION REGARDING RECOVERY ACT WHISTLEBLOWER PROTECTION PROVISIONS
Section 1553 of American Recovery and Reinvestment Act of 2009, Pub. L. 111-5 (“Recovery Act”)
If the offeror is a non-Federal employer receiving covered funds under the Recovery Act, the offeror represents that it –
IS
IS NOT
in compliance with Section 1553 of the Recovery Act.
The following Certifications and Representations are applicable ONLY to Contracts for construction, alteration,
maintenance or repair, as identified by the Buyer.
7.
CERTIFICATION RELATED TO ANTI-KICKBACK ACT
18 U.S.C 874 and 40 U.S.C. 276c
The offeror represents that it –
IS
IS NOT
in compliance with the federal Anti-Kickback Act.
Submit completed form to e-mail address of certsandreps@allisontransmission.com
Subject line should be: CERTS [your company name].
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THRESHOLD APV$2,000 for
construction, alteration,
maintenance & repair ONLY
CERTIFICATIONS AND REPRESENTATIONS
(CONTRACTS AWARDED UNDER DOE GRANTS)
8.
CERTIFICATION REGARDING CONTRACT WORK HOURS
AND SAFETY STANDARDS
40 U.S.C. 327-333
THRESHOLD APV$100,000
for construction and other
purposes involving laborers and
mechanics ONLY
The offeror represents that it –
IS
IS NOT
in compliance with Sections 102 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327–333), as
supplemented by Department of Labor regulations (29 CFR part 5).
9.
CERTIFICATION REGARDING DAVIS-BACON ACT ELIGIBILITY
THRESHOLD APV$2,000
for 40 U.S.C. 276a
construction, alteration,
maintenance or
repair at site of work
ONLY
The offeror represents that it
IS
IS NOT
in compliance with Davis-Bacon Act requirements and that it will provide to Buyer applicable wage determination data and reports in a
timely manner and as directed by Buyer as detailed in Buyer’s Davis-Bacon clause z_GCDOECON.
The offeror
DOES
DOES NOT
(i) certify that neither it (nor he or she) nor any person or firm who has an interest in the Contractor's firm is a person or firm
ineligible to be awarded Government contracts by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).
(ii) certify that no part of this Contract is or has been subcontracted to any person or firm ineligible for award of a Government
contract by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).
The penalty for making false statements regarding the above is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001.
Form completed by (print):
Company Name: _____________________________
Name: ______________________________
Signature: _______________________________
Date: ______________________________
Submit completed form to e-mail address of certsandreps@allisontransmission.com
Subject line should be: CERTS [your company name].
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