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TAXPAYER IDENTIFICATION
(FAR 52.204-3) (MAR 1994)
(a) Definitions.
"Common parent" as used in this solicitation provision, means that
corporate entity that owns or controls an affiliated group of corporations that
files its Federal income tax returns on a consolidated basis, and of which the
offeror is a member.
"Corporate status" as used in this solicitation provision, means a
designation as to whether the offeror is a corporate entity, an unincorporated
entity (e.g., sole proprietorship or partnership), or a corporation providing
medical and health care services.
"Taxpayer Identification Number (TIN)" as used in this solicitation
provision, means the number required by the IRS to be used by the offeror in
reporting income tax and other returns.
(b) All offerors are required to submit the information required in
paragraphs (c) through (e) of this solicitation provision in order to comply
with reporting requirements of 26 U.S.C.
6041, 6041A, and 6050M and implementing
regulations issued by the Internal Revenue Service (IRS).
If the resulting
contract is subject to reporting requirements described in 4.903, the failure or
refusal by the offeror to furnish the information may result in a 31 percent
reduction of payments otherwise due under the contract.
(c) Taxpayer Identification Number (TIN).
(/) [TIN: 101556194
( ) TIN has been applied for.
( ) TIN is not required because:
( ) Offeror is a nonresident alien, foreign corporation, or
foreign partnership that does not have income
effectively connected with the conduct of a trade or
business in the U.S. and does not have an office or
place of business or a fiscal paying agent in the U.S.;
( ) Offeror is an agency or instrumentality of a foreign
government;
( ) Offeror is an agency or instrumentality of a Federal,
state, or local government;
( ) Other.
State basis.
______________________________.
(d) Corporate Status.
( ) Corporation providing medical and health care services,
or engaged in the billing and collecting of payments
for such services;
(?)
Other corporate entity;
( ) Not a corporate entity;
( ) Sole proprietorship
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( ) Partnership
( ) Hospital or extended care facility described in 26 CFR
501(c)(3) that is exempt from taxation under 26 CFR 501
(a).
(e) Common Parent.
(/) Offeror is not owned or controlled by a common parent
as defined in paragraph (a) of this clause.
( ) Name and TIN of common parent:
Name
TIN_________________________________
Offerors must complete the following representations when the resulting contract
is to be performed inside the United States its territories or possessions
Puerto Rico, the Trust Territory of the Pacific Islands or the District of
Columbia.
SMALL BUSINESS CONCERN REPRESENTATION
(FAR 52.219-1 ) (FEB 1990)
(a) Representation.
The offeror represents and certifies as part of its
offer that it (/) is, ( ) is not a small business concern and that (/) all, ( )
not all end items to be furnished will be manufactured or produced by a small
business concern in the United States, its territories or possessions, Puerto
Rico, or the Trust Territory of the Pacific Islands.
(b) Definition.
Small business concern, as used in this provision, means a concern,
including its affiliates, that is independently owned and operated, not dominant
in the field of operation in which it is bidding on Government contracts, and
qualified as a small business under the criteria and size standards in this
solicitation.
(c) Notice.
Under 15 U.S.C.
645(d), any person who misrepresents a
firm's status as a small business concern in paragraph (a) of this clause in
order to obtain a contract to be awarded under the preference programs
established pursuant to sections 8(a), 8(d), 9, or 15 of the Small Business Act
or any other provision of Federal law that specifically references section 8(d)
for a definition of program eligibility, shall (1) be punished by imposition of
a fine, imprisonment, or both (2) be subject to administrative remedies; and (3)
be ineligible for participation in programs conducted under the authority of the
Act.
SMALL DISADVANTAGED BUSINESS CONCERN
REPRESENTATION (FAR 52.219-2) (FEB 1990)
(a) Representation.
The offeror represents that it ( ) is, (/) is not a