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

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Ver: 05/18/2020
NON-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. AFFILIATION 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
3 | Page
Ver: 02/11/2020
Title
Company
Date
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. SMALL BUSINESS & LOCAL PREFERENCE PROGRAM (SBLPP)
This representation is applicable to non-federally assisted contracts. By submission of this
offer, the offeror represents that:
a. It [ ] is, [ ] is not, a small business and local preference program enterprise certified
firm. "Small Business and Local Preference Program" enterprise means a for profit
small business concern that is located in the District of Columbia, Maryland, or
Virginia and meets the U.S. Small Business Administration small business size
standards.
Name
Signature
Title
Company
Date
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Completed 27 June 2021

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