ST-3 75% U.S. MANUFACTURE CERTIFICATION
The Steel Products Procurement Act (73 P.S. § 1881, et seq.) allows the use of steel products with both foreign and
domestic steel if at least 75 percent of the cost of the materials (including steel, rubber, wood, plastic, etc.) in the product
are manufactured or produced, as the case may be, in the United States.
This form must be executed by a Fabricator of any item containing BOTH U.S. AND FOREIGN STEEL. The
Fabricator shall hereby be defined as the firm that assembles the component parts of the product to be purchased. The
Department of General Services will accept the certification of firms that are earlier in the chain of purchase (i.e.,
manufacturers of components, steel suppliers) in lieu of the Fabricator.
This form must be submitted to the CIS within 30 days from the date the Professional approves a GSC-23
listing a "steel product". No steel product may be delivered on-site unless DGS has received an ST form.
A. TO BE COMPLETED BY THE PRIME CONTRACTOR (PURCHASER):
1. Name of Contractor:___________________________________________________________________
2. Address of Contractor:_________________________________________________________________
3. Phone Number:_________________________ 4. Date submitted to Fabricator:_____/_______/_____
5. Contract No. DGS_______________________ 6. Contract Title:______________________________
7. Steel Product Certified:___________________________________________ 8. GSC-23#_______________
Model: ___________________________________________
B. TO BE COMPLETED BY THE FABRICATOR/MANUFACTURER:
9. Name of Firm:________________________________________________________________________
10. Address of Firm: _____________________________________________________________________
11. Firm's Phone number: (______)_____________________ 12. Date Received:_____/______/______ 13.
Fed. Employer ID. No.: ________________________________________
14. Percentage of the cost of the articles, materials and supplies which have been mined,
produced or manufactured in the U. S. for the product listed above on Line 7: ___________
CERTIFICATION: I, the undersigned Officer of the Fabricator/Manufacturer, do certify that our firm
assembled/manufactured the components to the steel product listed in Section 7, that the steel in said product is both
foreign and domestically manufactured, and that all the facts contained in this document are true. I agree to provide
documentation supporting these facts if requested by the Commonwealth. I further understand that this document is subject
to the provisions of the Unsworn Falsification to Authorities Act (18 P.S. § 4904) and the Steel Products Procurement Act
(73 P.S. § 1881, et seq.) which provide penalties including, but not limited to, debarment from supplying any products for
Commonwealth of Pennsylvania public works projects for a period of five (5) years for violations therein. The
Commonwealth reserves the right to pursue any action deemed necessary to protect the Commonwealth's interest and
ensure compliance with the laws of the Commonwealth.
Witness:
__________________________________ _________________________________(Seal)
Name: Name:
Secretary or Treasurer President or Vice President
(Rev. 6/1/99)
