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FEDERAL Washington Metropolitan Area Transit Authority (Washington Metropolitan Area Transport Authority)

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Ver: 05/18/2020
FEDERAL
REPRESENTATION
and
CERTIFICATIONS
Washington Metropolitan Area Transit Authority
2 | Page
Ver: 02/11/2020
1. TYPE OF BUSINESS ORGANIZATION
By submission of this offer, the offeror represents that it operates as [ ] an individual, [ ] a
partnership, [ ] a limited liability company, [ ] a joint venture, [ ] a nonprofit organization,
or [ ] a corporation, incorporated under the laws of _________________.
Name
Signature
Title
Company
Date
2. AFFILIA
TION AND IDENTIFYING DATA
Each offeror shall complete a, b if applicable, and c below, representing that:
a. It [ ] is, [ ] is not, owned or controlled by a parent company. For this purpose, a
parent company is defined as one that either owns or controls the activities and
basic business policies of the offeror. To own another company means that the
parent company must own at least a majority, i.e., more than fifty percent (50%),
of the voting rights in that company. To control another company, such ownership
is not required. If another company is able to formulate, determine or veto the
offeror's basic business policy decisions, such other company is considered the
parent of the offeror. This control may be exercised through the use of dominant
minority voting rights, use of proxy voting, Contractual arrangements or otherwise.
b. If the offeror is owned or controlled by a parent company, it shall insert in the space
below the name and main office address of the parent company:
___________________________________________
Name of Parent Company
___________________________________________
Main Office Address (including ZIP Code)
c. If the offeror has no parent company, it shall provide in the applicable space below
its own employer's identification number (E.I.N.), (i.e., number used on Federal tax
returns or, if it has a parent company, the E.I. N. of its parent company). Offeror
E.I. N.: ____________ or, Parent Company's E.I. N.: ______
Name
Signature
Title
Company
Date
3 | Page
Ver: 02/11/2020
3. COVENANT AGAINST GRATUITIES
By submission of this offer, the offeror certifies, and in the case of a joint offer, each party
thereto certifies as to its own organization, that in connection with this procurement:
Neither it nor any of its employees, representatives or agents have offered or given
gratuities (in the form of entertainment, gifts or otherwise) to any Board member, employee
or agent of the Authority with the view toward securing favorable treatment in the awarding
or administration of this Contract.
Name
Signature
Title
Company
Date
4. CONTINGENT FEES
By submission of this offer, the offeror certifies, and in the case of a joint offer, each party
thereto certifies as to its own organization, that in connection with this procurement:
a. It [ ] has, [ ] has not, employed or retained any company or persons (other than
a full-time, bona fide employee working solely for the offeror) to solicit or secure
this Contract, and
b. It [ ] has, [ ] has not, paid or agreed to pay any company or person (other than a
full-time, bona fide employee working solely for the offeror) any fee, commission,
percentage, or brokerage fee contingent upon or resulting from the award of this
Contract.
Name
Signature
Title
Company
Date
4 | Page
Ver: 02/11/2020
5. CERTIFICATION OF INDEPENDENT PRICE DETERMINATION
a. By submission of its offer, the offeror certifies, and in the case of a joint offer, each
party thereto certifies as to its own organization, that in connection with this
procurement:
i. The prices in this offer have been arrived at independently, without, for
the purpose of restricting competition, any consultation, communication,
or agreement with any other offeror or with any other competitor;
ii. Unless otherwise required by law, the prices that are quoted in this offer
have not been knowingly disclosed by the offeror and will not be
knowingly disclosed by the offeror prior to award (in the case of a
negotiated procurement), directly or indirectly, to any other offeror or to
any competitor; and
iii. No attempt has been made or will be made by the offeror to induce any
other person or firm to submit or not to submit an offer for the purpose
of restricting competition.
b. Each person signing this offer certifies that:
i. He or she is the person in the offeror's organization responsible for the
decision regarding the prices being offered herein and that he/she has
not participated, and will not participate, in any action contrary to 1) a)
through 1) c) above; or
ii. He or she is not the person in the offeror's organization responsible for
the decision regarding the prices being offered herein, but that he/she
has been authorized in writing to act as agent for the persons
responsible for such decision in certifying that such persons have not
participated; and will not participate, in any action contrary to 1) a)
through 1) c) above, or and as their agent he or she does hereby so
certify.
Name
Signature
Title
Company
Date
6. NONDISCRIMINATION ASSURANCE
a. By submission of this offer, the offeror certifies, and in the case of a joint offer,
each party thereto certifies as to its own organization, in connection with this
procurement, that it will not discriminate on the basis of race, color, creed, religion,
national origin, sex, age, disability, sexual preference and/or gender identity in the
5 | Page
Ver: 02/11/2020
performance of this Contract. The offeror is required to insert the substance of this
clause in all subcontracts and purchase orders. The Contractor's failure to carry
out these requirements is a material breach of this Contract that may result in the
termination of this Contract or such other remedy as the Authority deems
appropriate. The offeror further agrees by submitting this offer that it will include
this certification, without modification, in all subcontracts and purchase orders.
Name
Signature
Title
Company
Date
7. DISCLOSURES OF INTERESTS OF WMATA BOARD MEMBERS
For purposes of this disclosure, terms in bold are defined by the Code of Ethics for
Members of the WMATA Board of Directors, a copy of which is available at
www.wmata.com. Financial interests include ownership interests and prospective and
actual income. Firm includes parents, subsidiaries and affiliates.
By submission of this offer, the offeror certifies, and in the case of a joint offer, each party
thereto certifies as to its own organization, that to the best of its knowledge, information
and belief in connection with this procurement:
Name
Signature
Title
Company
Date
8. CRIMINAL BACKGROUND SCREENING CERTIFICATION (QUARTERLY)
By submission of this offer, the offeror certifies that:
a. It will contract with or engage a reputable third-party vendor to conduct criminal
background screenings of all Contractor personnel who will have access to
WMATA's customers, WMATA's property, or WMATA's information in connection
with this Contract. This requirement also applies to Contractors who engage with
the general public on WMATA's behalf.
b. It will screen for criminal convictions all Contractor personnel who will have access
to WMATA's customers, the general public, WMATA's property, or WMATA's
information and who work on this Contract during each calendar year within this
Contract's period of performance, taking into consideration: (1) the nature of the
services or work being performed under the contract with particular regard for the
6 | Page
Ver: 02/11/2020
individual's access to, and interaction with, WMATA's customers, property, and
confidential information; (2) the nature or gravity of the offense or conduct resulting
in a criminal conviction; and (3) the time that has lapsed since the conviction and/or
completion of the sentence . The Offeror will provide certification that it conducted
these screenings to the Contracting Officer's Technical Representative (COTR) on
a quarterly basis, on a form provided.
c. The Contractor shall submit to the COTR a list of all employees and agents who
will require Contractor access badges not less than 7 days prior to the date on
which access will be required.
d. The Offeror will determine that all Contractor personnel working on this Contract
during the calendar year passed the Contractor's criminal background screening
and will be in good standing and otherwise fit to work on this Contract.
e. The Offeror has not obtained or otherwise been made aware of any information
about any Contractor personnel working on this Contract that contradicts or
otherwise impacts the Contractor's determination that such persons passed the
Contractor's criminal background screening and/or are fit to work on this Contract.
f. The Contractor will flow this requirement down to all of its subcontractors who will
have access to WMATA's customers, the general public, WMATA's property, or
WMATA's information within this Contract's period of performance.
Name
Signature
Title
Company
Date
9. CERTIFICATION REQUIRED FOR ALL SAFETY-SENSITIVE CONTRACTS.
a. By submission of this offer, the offeror represents and certifies that it will comply
with the Federal Transit Administration (FTA) regulations, "Prevention of Alcohol
Misuse and Prohibited Drug Use in Transit Operations," 49 C.F.R. Part 655, and
applicable provisions of the U.S. Department of Transportation (DOT) regulations,
"Procedures for Transportation Workplace Drug and Alcohol Testing Programs,"
49 C.F.R. Part 40.
b. Offeror agrees that its employees and agents, including but not limited to safety-
sensitive subcontractors, will be enrolled in a drug and alcohol testing program that
7 | Page
Ver: 02/11/2020
meets the policy and procedural requirements listed in Appendix A of this
document.
c. Offeror understands that Washington Metropolitan Area Transit Authority
(WMATA) will perform oversight during the contract's period of performance to
ensure that the successful offeror complies with the DOT/FTA regulations.
d. Failure to comply with this certification may result in WMATA issuing sanctions and
pursuing available contractual remedies.
Name
Signature
Title
Company
Date
10. PREVIOUS CONTRACTS AND COMPLIANCE REPORTS
a. It [ ] has, [ ] has not, participated in a previous contract or subcontract subject to
either the Equal Opportunity Clause of this solicitation, or the clause contained in
Parts II and IV of Executive Order 11246, as amended that prohibits discrimination
on the basis of race, color, creed, national origin, sex, age; and
b. It [ ] has, [ ] has not, filed all required compliance reports; and
c. Representations indicating submittal of required compliance reports signed by
proposed subcontractors will be obtained prior to subcontract awards.
Name
Signature
Title
Company
Date
11. DISADVANTAGED BUSINESS ENTERPRISE
a. It [ ] is, [ ] is not, a disadvantaged business enterprise.
'Disadvantaged Business Enterprise' means a for-profit small business concern
that is at least fifty one percent (51%) owned by one or more individuals who are
both socially and economically disadvantaged individuals or, in the case of a
corporation, in which fifty one percent (51%) of the stock is owned by one or more
8 | Page
Ver: 02/11/2020
such individuals and whose management and daily business operations are
controlled by one or more socially and economically disadvantaged individuals
who own it.
'Socially and Economically Disadvantaged Individual' is defined in Appendix B.,
Notice of Requirements for Disadvantaged Business Enterprise (DBE). By
submission of this offer, the offeror represents that:
b. It [ ] is, [ ] is not, currently certified by Metropolitan Washington Unified
Certification Program (MWUCP) as a disadvantaged business enterprise.
c. Special Certification Requirements for Transit Vehicle Manufacturers. Each transit
vehicle manufacturer, as a condition of being authorized to bid or propose on FTA
funded transit vehicle procurements, must certify that it has complied with the DBE
requirements of 49 C.F.R. Part 26.
d. The offeror represents that it [ ] is or [ ] is not a transit vehicle manufacturer and
[ ] has or [ ] has not complied with the DBE requirements of 49 C.F.R Part 26.
Name
Signature
Title
Company
Date
12. SMALL BUSINESS ENTERPRISE (MAY 2015)
"Small Business Enterprise" means a for-profit small business concern that is at least fifty
one percent (51%) owned by one (1) or more individual(s) who are economically
disadvantaged. "Economically Disadvantaged Individual" is defined in Appendix B-1,
Definitions, in Notice of Requirements for Small Business Enterprise (SBE) Program.
By submission of this offer, offeror certifies that:
a. It [ ] is, [ ] is not, a small business enterprise. A firm must be a small business
as defined by the U.S. Small Business Administration (SBA) by applying current
SBA business size standards found in 13 C.F.R. Part 121 that are applicable to
the type of work the firm seeks to perform in USDOT-assisted contracts. The fifty
one percent (51%) owner must be a U.S. citizen or permanent resident. A firm
must be organized for profit in order to be eligible for SBE certification. The firm's
average gross receipts cannot exceed the overall USDOT size standard for a small
business set forth in 49 C.F.R. § 26.65. Also, at least fifty one percent (51%) of
9 | Page
Ver: 02/11/2020
the firm's ownership must be held by individuals who meet the personal net worth
(PNW) cap prescribed by 49 C.F.R. § 26.67.
b. It [ ] is, [ ] is not, currently certified by WMATA as a small business enterprise.
Name
Signature
Title
Company
Date
13. AFFIRMATIVE ACTION COMPLIANCE
This representation is applicable to federally assisted contracts of $50,000 or more that are
awarded to contractors with fifty (50) or more employees. By submission of this offer, the
offeror represents that:
a. It has a workforce of employees.
b. It [ ] has developed and has on file, or [ ] has not developed and does not have
on file, at each establishment, affirmative action programs required by the rules
and regulations of the Secretary of Labor (41 C.F.R. §§ 60.1 and 60.2), or
c. It [ ] has not previously had contracts subject to the written affirmative action
program requirements of the rules and regulations of the U.S. Secretary of Labor.
Name
Signature
Title
Company
Date
14. CLEAN AIR ACT AND CLEAN WATER ACT CERTIFICATION
This certification is applicable if the Contract will be federally assisted and the offer exceeds
$150,000, or the Contracting Officer believes that orders under an indefinite type Contract
in any year will exceed $150,000 or a facility to be used has been the subject of a conviction
under the Clean Air Act [42 U.S.C. § 7413(c)(1)] or the Clean Water Act [33 U.S.C.§
1319(c)], is listed by the U.S. Environmental Protection Agency (EPA) as a violating facility,
and the acquisition is not otherwise exempt:
10 | Page
Ver: 02/11/2020
a. Any facility to be utilized in the performance of this Contract [ ] is, or [ ] is not listed
on the EPA's List of Violating Facilities;
b. Offeror will immediately notify the Contracting Officer, before award, of the receipt
of any communications from the Administrator, or a designee of the EPA, indicating
that any facility that it proposes to use in the performance of this Contract is under
consideration to be listed on the EPA's List of Violating Facilities; and
c. Offeror will include a certification substantially the same as this certification,
including this paragraph, in every non-exempt subcontract.
Name
Signature
Title
Company
Date
15. DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION
This certification is applicable to federally assisted contracts over $25,000.
a. Primary Covered Transactions. This certification applies to the offer submitted in
response to this solicitation and will be a continuing requirement throughout the
term of any resultant Contract.
i. In accordance with the provisions of 2 C.F.R. Part 1200 and 2 C.F.R.
Part 180, Subpart C, the offeror certifies to the best of its knowledge and
belief that it and its principals:
1) are not currently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded
from covered transactions by any Federal or state
department or agency;
2) have not, within a three (3) year period preceding this offer,
been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or
performing a public (Federal, state, or local) transaction or
contract under a public transaction; violation of Federal or
state antitrust statutes, or commission of embezzlement,
theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen
property;
3) are not currently indicted for or otherwise criminally or
civilly charged by a governmental entity (Federal, state, or
local) with commission of any of the offenses enumerated
11 | Page
Ver: 02/11/2020
in paragraph (1)(ii) of this certification; and have not, within
a three (3) year period preceding this offer, had one (1) or
more public transactions (Federal, state, or local)
terminated for cause or default.
ii. Where the offeror is unable to certify to any of the statements in this
certification, the offeror shall attach an explanation to this offer.
b. Lower Tier Covered Transactions. This certification applies to a subcontract at any
tier expected to equal or exceed $25,000 and will be a continuing requirement
throughout the term of this Contract.
i. The prospective lower tier subcontractor certifies, by submission of this
offer, that neither it nor its principals is currently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded
from participation in this transaction by any Federal or state department
or agency.
ii. Where the prospective lower tier subcontractor is unable to certify to any
of the statements in this certification, such prospective participant shall
attach an explanation to this proposal.
c. The Certification required by 10.2, above, shall be included in all applicable
subcontracts and the Contractor shall keep a copy on file. The Contractor shall
be required to furnish copies of certifications to the Contracting Officer upon his or
her request.
Name
Signature
Title
Company
Date
16. CERTIFICATION OF NONSEGREGATED FACILITIES
This certification is applicable to federally assisted contracts over $10,000.
a. By submission of this offer, the offeror certifies, and in the case of a joint offer,
each party thereto certifies as to its own organization, that in connection with this
procurement:
i. It does not and will not maintain or provide for its employees any
segregated facilities at any of its establishments, and that it does not
12 | Page
Ver: 02/11/2020
and will not permit its employees to perform their services at any location
under its control where segregated facilities are maintained.
ii. The offeror agrees that a breach of this certification is a violation of the
Equal Opportunity clause in this Contract.
iii. As used in this certification, the term 'segregated facilities' means any
waiting rooms, work areas, rest rooms and wash rooms, restaurants and
other eating areas, time clocks, locker rooms and other storage or
dressing areas, parking lots, drinking fountains, recreation or
entertainment areas, transportation, and housing facilities provided for
employees that are segregated by explicit directive or are in fact
segregated on the basis of race, color, religion or national origin,
because of habit, local custom or otherwise.
iv. It further agrees that (except where it has obtained identical
certifications from proposed subcontractors for specific time periods) it
will:
b. Obtain identical certifications from proposed subcontractors before the award of
subcontracts under which the subcontractor will be subject to the Equal
Opportunity clause;
c. Retain such certifications in its files; and
d. Forward the following notice to such subcontractors (except if the proposed
subcontractors have submitted identical certifications for specific time periods):
e. NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENTS FOR
CERTIFICATIONS
f. OF NONSEGREGATED FACILITIES
g. A Certification of Non-segregated Facilities must be submitted prior to award of a
subcontract exceeding $10,000 that is not exempt from the provisions of the Equal
Opportunity clause. The certification may be submitted either for such subcontract
or for all subcontracts during a period (i.e., quarterly, semiannually or annually).
Name
Signature
Title
Company
Date
17. CERTIFICATION OF RESTRICTIONS ON LOBBYING
This certification is applicable to federally assisted contracts if the offer exceeds $150,000.
13 | Page
Ver: 02/11/2020
a. By submission of this offer, the offeror certifies, and in the case of a joint offer,
each party thereto certifies as to its own organization, that to the best of his or her
knowledge or belief:
i. No federally appropriated funds have been paid or will be paid, by or on
behalf of the undersigned, to any person for influencing or attempting to
influence an officer or employee of an agency, a member of Congress,
an officer or employee of Congress, or an employee of a member of
Congress 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.
ii. If any funds other than federally appropriated funds have been paid or
will be paid to any person for making lobbying contacts to 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 in connection
with this Contract, the undersigned shall complete and submit Standard
Form--LLL, 'Disclosure of Lobbying Activities.
iii. The undersigned shall require that the language of this certification be
included in all sub-awards (including subcontracts, sub-grants and
contracts under grants, loans and cooperative agreements) at all tiers
and that all sub-recipients shall certify and disclose accordingly.
b. This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered. Submission of this certification
is a prerequisite for making or entering into this transaction imposed by 31 U.S.C.
§ 1352, as amended. Any person who fails to file the required certification shall
be subject to a civil penalty of not less than $10,000 and not more than $150,000
for each such failure.
c. The Contractor certifies or affirms the truthfulness and accuracy of each statement
of its certification and disclosure, if any. In addition, the Contractor understands
and agrees that the provisions of 31 U.S.C.A. § 3801, et.seq. apply to this
certification and disclosure, if any.
Name
Signature
Title
Company
Date
18. BUY AMERICA ACT CERTIFICATION
The Buy America Act requirements apply to federally-assisted construction contracts, and
acquisition of goods or rolling stock contracts valued at more than $150,000.
14 | Page
Ver: 02/11/2020
a. By submission of this offer, the offeror certifies, and in the case of a joint offer,
each party thereto certifies as to its own organization, that in connection with this
procurement it will comply with 49 U.S.C. § 5323(j) and 49 C.F.R. Part 661, which
provide that Federal funds may not be obligated unless steel, iron, and
manufactured products used in FTA-funded projects are produced in the United
States, unless a waiver has been granted by FTA or the product is subject to a
general waiver. General waivers are listed in 49 C.F.R. § 661.7. Separate
requirements for rolling stock are set out at 49 U.S.C. § 5323(j)(2)(C) and 49 C.F.R.
§ 661.11.
b. An offeror must submit to the Authority the appropriate Buy America Act
certification (below) with all offers on FTA funded contracts, except those subject
to a general waiver. Offers that are not accompanied by a completed Buy America
Act certification must be rejected as nonresponsive. This requirement does not
apply to lower tier subcontractors. Mark the applicable certifications below:
i. Certification requirement for procurement of steel, iron, or
manufactured products:
[ ] Certificate of Compliance with 49 U.S.C. § 5323(j)(1)
The offeror hereby certifies that it will meet the requirements of 49
U.S.C. § 5323(j)(1) and the applicable regulations in 49 C.F.R. § 661.5.
[ ] Certificate of Non-Compliance with 49 U.S.C. § 5323(j)(1)
The offeror hereby certifies that it cannot comply with the requirements
of 49 U.S.C. § 5323(j)(1) and 49 C.F.R. § 661.5, but it may qualify for
an exception pursuant to 49 U.S.C. §§ 5323(j)(2)(A), 5323(j)(2)(B), or
5323(j)(2)(D), and 49 C.F.R. § 661.7.
ii. Certification requirement for procurement of buses, other rolling
stock and associated equipment:
[ ] Certificate of Compliance with 49 U.S.C. § 5323(j)(2)(C)
The offeror hereby certifies that it will comply with the requirements of
49 U.S.C. § 5323(j)(2)(C) and the regulations at 49 C.F.R. § 661.11.
[ ] Certificate of Non-Compliance with 49 U.S.C. 5323§ (j)(2)(C)
The offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. §
5323(j)(2)(C) and 49 C.F.R. § 661.11, but may qualify for an exception pursuant to 49
U.S.C. §§ 5323(j)(2)(A), 5323(j)(2)(B), or 5323(j)(2)(D), and 49 C.F.R. § 661.7.
15 | Page
Ver: 02/11/2020
Name
Signature
Title
Company
Date
19. CERTIFICATION OF NON-DELINQUENT TAXES
This certification is applicable to federally-assisted contracts.
a. By submission of this offer, the offeror certifies, and in the case of a joint offer,
each party thereto certifies as to its own organization, that in connection with this
procurement:
i. It has not been convicted over the past three (3) years of violating any
Federal criminal tax law or failed to pay any tax.
ii. It has certified if it has been notified of an unresolved tax lien or any
unsatisfied Federal tax delinquency in excess of $3,000 and that it is
paying tax debts through an installment agreement or has requested a
collections due process hearing.
iii. [omitted]
iv. As used in this certification, the term 'tax delinquency' means an
outstanding debt for which a notice of lien has been filed in public
records.
v. It further agrees that (except where it has obtained identical
certifications from proposed subcontractors for specific time periods) it
will:
b. Obtain identical certifications from proposed subcontractors before the award of
subcontracts;
c. Retain such certifications in its files; and
d. Forward the following notice to such subcontractors (except if the proposed
subcontractors have submitted identical certifications for specific time periods):
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENTS FOR
CERTIFICATION OF NON-DELINQUENT TAXES
16 | Page
Ver: 02/11/2020
A Certification of Non-Delinquent Taxes must be submitted prior to award of a subcontract
exceeding $150,000. The certification may be submitted either for such subcontract or for
all subcontracts during a period (i.e., quarterly, semiannually or annually).
Name
Signature
Title
Company
Date
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Completed 27 June 2021

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