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(b) Page 2 of Standard Form 19-A.

program and apprentices as well as the appropriate ratios and wage rates (expressed in percentages of the journeymen hourly rates) for the area of construction, prior to using any apprentices on the contract work. The wage rate paid apprentices shall be not less than the appropriate percentage of the journeymen's rate contained in the applicable wage determination.

(b) Trainees shall be permitted to work at less than the predetermined rate for the work performed when they are employed pursuant to and individually registered in a program which has received prior approval, evidenced by formal certification, by the U.S. Department of Labor, Employment and Training Administration, Bureau of Apprenticeship and Training. The term "trainee" means a person registered and receiving on-the-job training in a construction occupation under a program which been approved in advance by the U.S. Department of Employment and Training Administration, Bureau of Apprentice ship and Training, as meeting its standards for on-the-job training programs and which has been so certified by the Bureau. The ratio of trainees to journeymen on this contract shall not be greater than the ratio permitted under the plan approved by the Bureau of Apprenticeship and Training. Every trainee must be paid at not less than the rate specified in the approved progra for his level of progress. Any employee listed on the payroll at trainee rate who is not registered and participating in a training plan approved by the Bureau of Apprenticeship and Training shall be paid not less than the wage rate determined by the retary of Labor for the classification of work he actually formed. The Contractor or subcontractor shall furnish the tracting Officer written evidence of the certification of his program, the registration of the trainces, and the ratios and wage rates prescribed in that program. In the event the Bureau of Apprenticeship and Training withdraws approval of a training program, the Contractor shall no longer utiline trainees at less than the applicable predetermined rate for work performed until in acceptable program is approved.

(c) The utilization of apprentices, trainces, and journeymen under this clause shall be in conformity with the equal employment opportunity requirements of this contract.

(d) If at any time the Bureau of Apprentices determines, after opportunity for a hearing a training program have not been complic program fails to provide adequate training Contractor shall not utilize trainees at les rate for the classification of work act acceptable program is approved. If appeal pursuant to 29 CFR 5.17 within 3 certified letter withdrawing the Bureau Training's approval, the effect of the

the program will be delayed until a decision appeal pursuant to 29 CFR 5.17.

4. PAYROLLS AND BASIC RECORDS

Training

(a) The Contractor shall maintain payrolls and relating thereto during the course of the work and them for a period of 3 years thereafter for all mechanica, including apprentices, trainees, watche guards working at the site of the work. Such records shall the name and address of each such employee, his corn cation, rate of pay (including rates of contributing for o assumed to provide, fringe benefits), daily and weekly n of hours worked, deductions made, and actual wages paid. Wh ever the Contractor has obtained approval from the Secretary Labor as provided in paragraph (c) of the clause entitled Bacon Act", he shall maintain records which show the c ment, its approval, written communication of the plan or program to the laborers or mechanics affected, and the costs anticipated or incurred under the plan or program.

(b) The Contractor shall submit weekly a copy of all payrolls to the Contracting Officer. The Government Prime Contractor shall be responsible for the submission of copies of payrolls of all subcontractors. The copy shall be accompanied by a statement signed by the Contractor indicating that the payrolls are correct and complete, that the wage rates contained therein are not less than those determined by the Secretary of Labor, and that the classifications set forth for each laborer or mechanic, including

apprentices and trainees conform with the work he performed. Submission of the "Weekly Statement of Compliance" required under this contract and the Copeland Regulations of the Secretary of Labor (29 CFR Part 3) shall satisfy the requirement for submission of the above statement. The Contractor shall submit also a copy of any approval by the Secretary of Labor with respect to fringe benefits which is required by paragraph (c) of the clause entitled "Davis-Bacon Act". Contractors employing apprentices or trainces under approved programs shall include a notation of the first weekly certifed payrolls submitted to the contracting agencies that their employment is pursuant to an approved program and shall identify the program.

(c) The Contractor shall make the records required under this clause available for inspection by authorized representatives of the Contracting Officer and the Department of Labor, and shall permit such representatives to interview employees during working hours on the job.

NOTE: Watchmen and guards appear on payroll records only for purposes of the Contract Work Hours and Safety Standards Act.

5. COMPLIANCE WITH COPELAND REGULATIONS The Contractor shall comply with the Copeland Regulations of the Secretary of Labor (29 CFR Part 3) which are incorporated herein by reference.

6. WITHHOLDING OF FUNDS

(4) The Contracting Officer may withhold or cause to be withheld from the Government Prime Contractor so much of the accrued payments or advances as may be considered necessary (1) to pay laborers and mechanics, including apprentices, trainees, watchmen, and guards employed by the Contractor or any subcontractor on the work the full amount of wages required by the contract, and (2) to satisfy any liability of the Contractor and any subcontrac ated damages under paragraph (b) of the clause ntract Work Hours and Safety Standards sation."

any subcontractor fails to pay any trainer, watchman, or guard en

site of work, all or part of the wages

fract, the Contracting Officer may, after writGovernment Prime Contractor, take such action necessary to cause suspension of any further payments nces until such violations have ceased.

7. SUBCONTRACTS

The Contractor agrees to insert the clauses hereof entitled "Davis-Bacon Act" Contract Work Hours and Safety Standards Ad-Overtime Compensation," "Apprentices and Trainees," "Payrolls and ic Records," "Compliance with Copeland Regulations," "Withholding of Funds," "Subcontracts," and "ConDebarment" in all subcontracts. The term tract Term "Contractor" as used in such clauses in any subcontract shall be deemed to refer to the subcontractor except in the phrase "Gov. ernment Prime Contractor."

& CONTRACT TERMINATION-DEBARMENT

A breach of the clauses hereof entitled "Davis-Bacon Act," "Contract Work Hours and Safety Standards Act-Overtime Compensation," "Apprentices and Trainees," "Payrolls and Basic Records," "Compliance with Copeland Regulations," "Withholdand "Subcontracts" may be grounds for terminathe contract, and for debarment as provided in 29 CFR

3.6

9. DISPUTES CONCERNING LABOR STANDARDS Disputes arising out of the labor standards provisions of this contract shall be subject to the Disputes clause except to the extent such disputes involve the meaning of classifications or wage rates contained in the wage determination decisions of the Secretary of Labor or the applicability of the labor provisions of this contract which questions shall be referred to the Secretary of Labor in accordance with the procedures of the Department of Labor.

19-209

[44 FR 20689, Apr. 6, 1979]

STANDARD FORM 19-A (Rev. 1–78)

EFFECTIVE DATE Note: This section becomes effective July 16, 1979. For the con

venience of the reader the superseded text appears below.

§ 1-16.901-19A Standard Form 19-A: Labor Standards Provisions Applicable to Contracts in Excess of $2,000.

(a)

Page 1 of Standard Form 19-A.

LABOR STANDARDS PROVISIONS
APPLICABLE TO CONTRACTS IN EXCESS OF $2,000

1. DAVIS-BACON ACT (40 U.S.C. 276a-276a-7)

() Ail mechanics and laborers, including apprentices and trainees. employed or working directly upon the site of the work shall be paid unicond. Boazily and not less often than once a week, and without subsequest deduction or rebate on any account (except such payroll deductions as 2.6 52rmitted by the Copeland Regulations, 29 CFR Part 3), the full atan is due at time of payment computed at wage rates not less than the aggregate of the basic hourly rates and the rates of payments, contribu tions, or costs for any fringe benefits contained in the wige determination drusion of the Secretary of Labor which is attached hereto and made a part hereof, regardless of any contractual relationship which may be alined to exist between the Contractor or subcontractor and such laborers and mechanics. A copy of such wage determination decision shall be kept posted by the Contractor at the site of the work in a prominent place here it can be easily seen by the workers.

(1) The Contractor may discharge his obligation under this clause to workers in any classification for winch the wage determination decision

Contains:

(1) Only a basic hourly rate of pay, by making payment at not less than such basic hourly rate, except as otherwise provided in the Copeland Regulations. (29 CFR Part 3); or

(2) Both a basic hourly rate of pay and fringe benefits payments. by making payment in cash, by irrevocably making contributions pursuant to a fund, plan, or program fur, and/or by assuming an enforceable com mitment to bear the cost of, bona fide fringe benefits contemplated by the Davis Bacon Act, or by any combination thereof. Contributions made. or costs assumed, on other than a weekly basis shall be considered as hav ing been constructively made or assumed during a weekly period to the extert that they apply to such period. Where a fringe benefit is expressed in a wage determination in any manner other than as an hourly rate and the Contractor pays a cash equivalent or provides an alternative fringe benefit, he shall furnish information with his payrolls showing how he determined that the cost incurred to make the cash payment or to provide the alternative fringe benefit is equal to the cost of the wage determination funge benefit. In any case where the Contractor provides a fringe bene. fit different from any contained in the wage determination, he shall similarly show how he arrived at the hourly rate shown therefor. In the event of disagreement between or among the interested parties as to an equivalent of any fringe benefit, the Contracting Officer shall submit the question, together with his recommendation, to the Secretary of Labor for final determination.

(c) The assumption of an enforceable commitment to bear the cost of fringe benefits, or the provision of any fringe benefits not expressly listed in section 1(b) (2) of the Davis Bacon Act or in the wage deter tination decision forming a part of the contract, may be considered as payment of wages only with the approval of the Secretary of Labor ur suant to a written request by the Contractor. The Secretary of Laber any require the Contractor to set aside assets, in a separate account to his obligations under any unfunded plan or program.

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(d) The Contracting Officer shall require that any clas or bore or mechanics, including apprentices and trainees, which it sted in the wage determination decision and which is to be employed the contract shall be classified or reclassified conformably determination decision, and shall report the action taken to the detry of Labor. If the interested parties cannot agree on the proper clasificanon or reclassification of a particular class of laborers or mechanics to be used. the Contracting Officer shall submit the question, together with his recom. mendation, to the Secretary of Labor for final determination. Apprentices and trainees may be added under this clause only where they are employed pursuant to an apprenticeship or trainee program meeting the requirements of the Apprentices and Trainees clause below.

(e) In the event it is found by the Contracting Officer that any laborer or mechanic, including apprentices and trainees, employed by the Con tractor or any subcontractor directly on the site of the work covered by this contract has been or is being paid at a rate of wages less than the rate of wages required by paragraph (a) of this clause, the Contracting Officer may (1) by written notice to the Government Prime Contractor terminate his right to proceed with the work, or such part of the work as to which there has been a failure to pay said required wages, and (2) prosecute the work to completion by contract or otherwise, whereupon such Contractor and Subcontractor and his sureties shall be liable to the Government for any excess costs occasioned the Government thereby.

(f) Paragraphs (a) through (e) of the clause shall apply to this contract to the extent that it is (1) a prime contract with the Govern ment subject to the Davis Bacon Act, or (2) a subcontract also subject to the Davis-Bacon Act under such prime contract.

2. CONTRACT WORK HOURS AND SAFETY STANDARDS ACTOVERTIME COMPENSATION (40 U.S.C. 327–333).

This contract is subject to the Contract Work Hours and Safety Standards Act and to the applicable rules, regulations, and interpretations of the Secretary of Labor.

(a) The Contractor shall not require or permit any laborer or mechanic. including apprentices, trainees, watchmen, and guards, in any workweek in which he is employed on any work under this contract to work in excess of 8 hours in any calendar day or in excess of 40 hours in such workweek on work subject to the provisions of the Contract Work Hours and Safety Standards Act unless such laborer or mechanic, including ap prentices, trainees, watchmen, and guards, receives compensation at a rate not less than 11⁄2 times his basic rate of pay for all such hours worked in excess of 8 hours in any calendar day or in excess of 40 hours in such workweek, whichever is the greater number of overtime hours. The "basic rate of pay," as used in this clause, shall be the amount paid per hour exclusive of the Contractor's contribution or cost for fringe benefits, and any cash payment made in lieu of providing fringe benefits, or the basic hourly rate contained in the wage determination, whichever is greater.

FORM APPROVED O.M.B. NO. 29-RO121

(b) In the event of any violation of the provisions of paragraph (a). the Contractor shall be liable to any affected employee for any amounts due, and to the United States for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including an apprentice, trainee, watchman, or guard, employed in violation of the provisions of paragraph (a) in the sum of $10 for each calendar day on which such employee was required or permitted to be employed on such work in excess of 8 hours or in excess of the standard workweek of 40 hours without payment of the overtime wages required by paragraph (a),

3. APPRENTICES AND TRAINEES

(a) Apprentices shall be permitted to work as such only when they are registered, individually, under a bona fide apprenticeship program registered with a State apprenticeship agency which is recognized by the Bureau of Apprenticeship and Training, U.S. Department of Labor; or if no such recognized agency exists in a State, under a program registered with the aforesaid Bureau of Apprenticeship and Training. The allowable ratio of apprentices to journeymen in any craft classification shall not be greater than the ratio permitted to the Contractor as to his entire work force under the registered program. Any employee listed on a payroll at an apprentice wage rate who is not a trainee as defined in pragraph (b) of this clause, and who is not registered as above, shall be paid the wage rate determined by the Secretary of Labor for the classification of work he actually performed. The Contractor shall furnish to the Contracting Officer written evidence of the registration of his program and apprentices, as well as of the appropriate ratios allowed and the wage rates required to be paid thereunder for the area of construction, prior to using any apprentices in the contract work. The term "apprentice" means (1) a person employed and individually registered in a bona fide apprenticeship program registered with the U.S. Department of Labor, Bureau of Appren ticeship and Training or with a State apprenticeship agency recognized by the Bureau, or (2 person in his first 90 days of probationary employ ment as an apprentice in such an apprenticeship program, who is not individually reed in the program, but who has been certified by the Bureau of Appre cechi and Training, or a State Apprenticeship Council (where appropriate ible for probationary employment as an

apprentice

fide

(b) Tainehan be permitted to work as such when they are bond es emoyed pursuant to a program approved by the U.S. Departmen& Llanpower Administration, Bureau of Apprenticend Traing. The term "trainee" means a person receiving on the construction occupation under a program which is Aot necessarily sponsored) by the U.S. Department of power Administration, Bureau of Apprenticeship and Traindich is reviewed from time to time by the Manpower Adminis on ensure that the training meets adequate standards.

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In connection with contracts in excess of $10,000, the Contractor grees as follows:

(1) The Contractor shall make a diligent effort to hire for perform ce of work under this contract a number of apprentices or trainees, of both, in each occupation, which bears to the average number of the journeymen in that occupation to be employed in the performance of the contract the applicable ratio as set forth in paragraph (c)(7) of this clause. (2) The Contractor shall insure that 25 percent of such apprentices or trainees in each occupation are in their first year of training, where feasible. Feasibility here involves a consideration of (i) the availability of training opportunities for first year apprentices, (ii) the hazardous nature of the work for beginning workers, and (iii) excessive unemploy ment of apprentices in their second and subsequent years of training.

(3) The Contractor shall, during the performance of the contract, to the greatest extent possible, employ the number of apprentices or trainees necessary to meet currently the requirements of paragraph (c) (1) and (c) (2) of this clause.

(4) The Contractor shall maintain records of employment on this contract by trade of the number of apprentices and trainees, apprentices and trainees in first year of training, and of journeymen, and wages paid and hours of work of such apprentices, trainees, and journeymen. In addi tion, the Contractor who claims compliance based on the criterion set forth in paragraph (c) (6) (ii) of this clause shall maintain such records of employment on all his construction work in the same labor market area, both public and private, during the performance of this contract. In each of the above cases the Contractor shall make such records avail able for inspection upon request of the Department of Labor or the Contracting Officer.

(5) The Contractor shall supply one copy of each of the written. notices required in accordance with paragraph (c) (6) (ii) of this clause at the request of the Contracting Officer. The Contractor also agrees to supply at 3-month intervals during the performance of the contract and after completion of contract performance a statement describing steps taken toward making a diligent effort and containing a breakdown by craft, of hours worked and wages paid for first year apprentices and trainees, other apprentices and trainees, and journeymen. One copy of the statement will be sent to the Contracting Officer and one copy to the Secretary of Labor.

(6) The Contractor will be deemed to have made a "diligent effort" as required by paragraph (c) (1) if during the performance of this contract, he accomplishes at least one of the following three objectives: (i) The Contractor employs under this contract a number of apprentices and trainees by craft, at least equal to the ratios established in accordance with paragraph (c) (7) of this clause, or (ii) the Contractor employs. on all his construction work, both public and private, in the same labor

STANDARD FORM 19-A NOVEMBER 1972 EDITION GENERAL SERVICES ADMINISTRATION FPR (41 CFR) 1-16.401

(b) Page 2 of Standard Form 19-A.

market area, an average number of apprentices and trainees by craft at least equal to the ratios established in accordance with paragraph (c) (7) of this clause, or (ii) the Contractor (A) if covered by a collective bargaining agreement, before commencement of any work on the project, has given written notice to all joint apprenticeship committees, the local U.S. Employment Security Office, local chapter of the Urban League, Workers Defense League, or other local organizations concerned with minority employment, and the Bureau of Apprenticeship and Training Representa tive, U.S. Department of Labor, for the locality of the work; (B) if not covered by a collective bargaining agreement, has given written notice to all of the groups stated above, except joint apprenticeship committees, and will in addition notify all non-joint apprenticeship sponsors in the labor market area; (C) has employed all qualified applicants referred to him through normal channels (such as the Employment Service, the Joint Apprenticeship Committees and where applicable, minority organizations and apprentice outreach programs who have been delegated this function) at least up to the number of such apprentices and trainees required by paragraph (c) (7) of this clause. The notice, as referred to herein, will include at least the Contractor's name and address, the agency designation, the contract number, job site address, value of the contract, expected starting and completion dates, the estimated average number of employees in each occupation to be employed over the duration of the contract work, and a statement of his willingness to employ a number of apprentices and trainees at least equal to the ratios established in accordance with paragraph (c) (7) of this clause.

(7) The Contractor recognizes that the Secretary of Labor has determined that the applicable ratios of apprentices and trainees to journey. men in any occupation for the purpose of this clause shall be as follows: (i) In any occupation the applicable ratio of apprentices and trainees to journeymen shall be equal to the predominant ratio for the occupation in the area where the construction is being undertaken, set forth in collective bargaining agreements, or other employment agreements, and avail. able through the Bureau of Apprenticeship and Training Representative, U.S. Department of Labor, for the applicable area; (i) for any occupa tion for which no ratio is found, the ratio of apprentices and trainees to journeymen shall be determined by the Contractor in accordance with the recommendations set forth in the Standards of the National Joint Apprentice Committee for the occupation, which are on file at offices of the U.S. Department of Labor's Bureau of Apprenticeship and Training: and (iii) for any occupation for which no such recommendations are found, the ratio of apprentices and trainees to journeymen shall be at least one apprentice or trainee for every five journeymen.

4. PAYROLLS AND BASIC RECORDS

(a) The Contractor shall maintain payrolls and basic records relating thereto during the course of the work and shall preserve them for a period of 3 years thereafter for all laborers and mechanics, including apprentices. trainees, watchmen, and guards working at the site of the work. Such records shall contain the name and address of each such employee, his correct classification, rate of pay (including rates of contributions for, or costs assumed to provide, fringe benefits), daily and weekly number of hours worked, deductions made and actual wages paid. Whenever the Contractor has obtained approval from the Secretary of Labor as provided in paragraph (c) the clause entitled "Davis-Bacon Act," he shall maintain records which show the commitment, its approval, written communication of the plan or program to the laborers or mechanics affected, and the costs anticipated or incurred under the plan or program. (b) The Contractor shall submit weekly a copy of all payrolls to the Contracting Officer. The Government Prime Contractor shall be responside for the submission of copies of payrolls of all subcontractors. The op shall be accompanied by a statement signed by the Contractor indicating that the payrolls are correct and complete, that the wage rates contained

therein are not less than those determined by the Secretary of Labor, and that the classifications set forth for each laborer or mechanic, including apprentices and trainees, conform with the work he performed. Submis sion of the Weekly Statement of Compliance" required under this contract and the Copeland Regulations of the Secretary of Labor (29 CFR Part 3) shall satisfy the requirement for submission of the above statement. The Contractor shall submit also a copy of any approval by the Secretary of Labor with respect to fringe benefits which is required Ly paragraph (c) of the clause entitled "Davis-Bacon Act."

(c) The Contractor shall make the records required under this clause available for inspection by authorized representatives of the Contracting Officer and the Department of Labor, and shall permit such representa tives to interview employees during working hours on the job.

5. COMPLIANCE WITH COPELAND REGULATIONS

The Contractor shall comply with the Copeland Regulations of the Secretary of Labor (29 CFR Part 3) which are incorporated herein by reference.

6. WITHHOLDING OF FUNDS

(a) The Contracting Officer may withhold or cause to be withheld from the Government Prime Contractor so much of the accrued payments or advances as may be considered necessary (1) to pay laborers and mechanics, including apprentices, trainees, watchmen, and guards employed by the Contractor or any subcontractor on the work the full amount of wages required by the contract, and (2) to satisfy any liability of any Contractor and Subcontractor for liquidated damages under paragraph (b) of the clause entitled "Contract Work Hours and Safety Standards ActOvertime Compensation."

(b) If any Contractor or subcontractor fails to pay any laborer, mechanic, apprentice, trainee, watchman, or guard employed or working on the site of work, all or part of the wages required by the contract, the Contracting Officer may, after written notice to the Government Prime Contractor, take such action as may be necessary to cause suspension of any further payments or advances until such violations have ceased.

7. SUBCONTRACTS

The Contractor agrees to insert the clauses hereof entitled "Davis-Bacon Act," "Contract Work Hours and Safety Standards Act-Overtime Compen: sation," Apprentices and Trainees." "Payrolls and Basic Records," Compliance with Copeland Regulations." Withholding of Funds," "Subcontracts," and "Contract Termination-Debarment" in all subcontracts. The term "Contractor" as used in such clauses in any subcontract shall be deemed to refer to the subcontractor except in the phrase "Government Prime Contractor."

8. CONTRACT TERMINATION-DEBARMENT

A breach of the clauses hereof entitled "Davis-Bacon Act," "Contract Work Hours And Safety Standards Act-Overtime Compensation," Apprentices and Trainees." "Payrolls and Basic Records," "Compliance with Copeland Regulations," "Withholding of Funds," and "Subcontracts" may bounds or termination of the contract, and for debarment as provided in 29 CFR 1.6.

DISPUTES &NCERNING LABOR STANDARDS

Dispute arising out of the labor standards provisions of this contract shall subieco the Disputes clause except to the extent such disputes vlve e meaning of classifications or wage rates contained in the wage determinen decision of the Secretary of Labor or the applicability of the borovisions of this contract which questions shall be referred to the ary of Labor in accordance with the procedures of the Department obor.

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SPECIME

STANDARD FORM 19-A (Rev. 11-72) (Back)

[39 FR 11268, Mar. 27, 1974]

§ 1-16.901-19-B Standard Form 19-B, Representations and Certifications
struction and Architect-Engineer Contract).
(a) Page 1 of Standard Form 19-B.

NAME

REPRESENTATIONS AND CERTIFICATIONS
(Construction and Architect-Engineer Contract)
(For use with Standard Forms 19, 21 and 252)

NO ADDRESS OF BIDDER (No, Street, City, State, and ZIP Code)

REFERENCE (Enter same No. (s) as on SF 19. 21 and 252)

DATE OF BID

(Con

In negotiated procurements, "bid" and "bidder" shall be construed to mean "offer" and "offeror." The bidder makes the following representations and certifications as a part of the bid identified above. (Check appropriate boxes.)

1. SMALL BUSINESS

He is, is not, a small business concern. (A small business concern for the purpose of Government procurement is a concern, including its affiliates, which is independently owned and operated, is not dominant in the field of opera tions in which it is bidding on Government contracts, and can further qualify under the criteria concerning number of employees, average annual receipts, or other criteria as prescribed by the Small Business Administration. For additional information see governing regulations of the Small Business Administration (13 CFR Part 121)).

2. MINORITY BUSINESS ENTERPRISE

He is, is not a minority business enterprise. A minority business enterprise is defined as a "business, at least 50 percent of which is owned by minority group members or, in case of publicly owned businesses, at least 51 percent of the stock of which is owned by minority group members." For the purpose of this definition, minority group members are Negroes, Spanish-speaking American persons, American-Orientals, American-Indians, American-Eskimos, and AmericanAleuts."

3. CONTINGENT FEE (a) He

has, has not, employed or retained any company or person (other than a full-time bona fide employee working solely for the bidder) to solicitecure this contract, and (b) he has, has not, paid or agreed to pay any company or person (other than a full- bona fide employee working solely for the bidder) any fee, commission, percentage or brokerage fee, contingent upon sulting from the award of this contract; and agrees to furnish information relating to (a) and (b) above as requested he Contracting Officer. (For interpretation of the representation, including the term "bona ɲde employee." see Code of Feder Regulations. Title 41. Subpart 1-1.5.)

4. TYPE OF ORGANIZATION

SPECIMEN

He operates as an individual,☐ partnership, joint

5. INDEPENDENT PRICE DETERMINATION

ture, corporation, incorporated in State of..

(a) By submission of this bid, each bidder certifies, and in the case of a joint bid each party thereto certifies as to his own organization, that in connection with this procurement:

(1) The prices in this bid have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor;

(2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, in the case of a bid, or prior to award, in the case of a proposal, directly or indirectly to any other bidder or to any competitor; and

(3) No attempt has been made or will be made by the bidder to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition.

(b) Each person signing this bid certifies that:

(1) He is the person in the bidder's organization responsible within that organization for the decision as to the prices being bid herein and that he has not participated, and will not participate, in any action contrary to (#)(1) through (a)(3) above; or

(2) (i) He is not the person in the bidder's organization responsible within that organization for the decision as to the prices being bid herein but that he 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 (a)(1) through (a) (3) above, and as their agent does hereby so certify; and (ii) he has not participated. and will not participate, in any action contrary to (a)(1) through (w) (3) above.

(c) This certification is not applicable to a foreign hidder submitting a bid for a contract which requires performance or delivery outside the United States, its possessions, and Puerto Rico.

(d) A bid will not be considered for award where (w) (1), (a)(3), or (b) above, has been deleted or modified. Where (a) (2) above, has been deleted or modified, the bid will not be considered for award unless the bidder furnishes with the bid a signed statement which sets forth in detail the circumstances of the disclosure and the head of the agency, or his designee, determines that such disclosure was not made for the purpose of restricting competition.

NOTE.- Bids must set forth full, accurate, and complete information as required by this invitation for bids (including attachments). The penalty for making false statements in hids is prescribed in 18 U.S.C, 1001,

19-303

STANDARD FORM 19-8, JUNE 1976 EDITION
GENERAL SERVICES ADMINISTRATION
FED. PROC. REG (41 (FR) 1-16.401 AND 1-18.701

(b) Page 2 of Standard Form 19-B.

THE FOLLOWING NEED BE CHECKED ONLY IF BID EXCEEDS $10,000 IN AMOUNT.

6. EQUAL OPPORTUNITY

He has, has not, participated in a previous contract or subcontract subject to the Equal Opportunity Clause herein, the clause originally contained in Section 301 of Executive Order No. 10925, or the clause contained in Section 201 of Executive Order No. 11114; he has, has not, filed all required compliance reports; and representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained prior to subcontract awards.

(The above representations need not be submitted in connection with contracts or subcontracts which are exempt from the equal opportunity clause.)

7. PARENT COMPANY AND EMPLOYER IDENTIFICATION NUMBER

Each bidder shall furnish the following information by filling in the appropriate blocks:

(a) Is the bidder owned or controlled by a parent company as described below? Yes No. (For the purpose of this bid, a parent company is defined as one which either owns or controls the activities and basic business policies of the bidder. To oun another company means the parent company must own at least a majority (more than 50 percent) 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 basic business policy decisions of the bidder, such other company is considered the parent company of the bidder. This control may be exercised through the use of dominant minority voting rights, use of proxy voting, contractual arrangements, or otherwise.)

(b) If the answer to (4) above is "Yes," bidder shall insert in the space below the name and main office address of the parent company.

NAME OF PARENT COMPANY

MAIN OFFICE ADDRESS (No., Street, City, State, and ZIP Code)

(c) Bidder shall insert in the applicable space below, if he has no parent company, his own Employer's Identification Number (E.I. No.) (Federal Social Security Number used on Employer's Quarterly Federal Tax Return, U.S. Treasury Depart ment Form 941), or, if he has a parent company, the E.I. No. of his parent company.

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PECIME

BIDDER

8. CERTIFICATION OF NONSEGREGATED FACINES (Applicable to (1) contracts, (2) subcontracts, and Agreements with applicants who are themselves performing federally assisted construction contracts, exceeding $10,000 which exempt from the provisions of the Equal Opportunity clause.) By the submission of this bid, the bidder, offeror, ant, or subcontractor certifies that he does not maintain or provide for his employees any segregated facilities at any of establishments, and that he does not permit his employees to perform their services at any location, under his control, were segregated facilities are maintained. He certifies further that he will not maintain or provide for his employees any segregated facilities at any of his establishments, and that he will not permit his employees to perform their services at any location, under his control, where segregated facilities are maintained. The bidder, offeror, applicant, or subcontractor agrees that a breach of this certification is a violation of the Equal Opportunity clause in this contract. 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 which 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. He further agrees that (except where he has obtained identical certifications from proposed subcontractors for specific time periods) he will obtain identical certificatons from proposed subcontractors prior to the award of subcontractors exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity clause; that he will retain such certifications in his files; and that he will forward the following notice to such proposed subcontractors (except where the proposed subcontractors have submitted identical certifications for specific time periods): NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NONSEGREgated faciliTIES

A Certification of Nonsegregated Facilities must be submitted prior to the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Opportunity clause. The certification may be submitted either for each subcon. tract or for all subcontracts during a period (i.e., quarterly, semi annually, or annually).

NOTE: The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.

9. CLEAN AIR AND WATER

(Applicable if the bid or offer exceeds $100,000, or the contracting officer has determined that orders under an indefinite quantity contract in any year will exceed $100,000, or a facility to be used has been the subject of a conviction under the Clean Air Act (42 U.S.C. 1857c-8(c)(1)) or the Federal Water Pollution Control Act (33 U.S.C. 1319(c)) and is listed by EPA, or is not otherwise exempt.)

The bidder or offeror certifies as follows:

(1) Any facility to be utilized in the performance of this proposed contract has □, has not □, been listed on the Environmental Protection Agency List of Violating Facilities.

(b) He will promptly notify the contracting officer, prior to award, of the receipt of any communication from the Director, Office of Federal Activities, Environmental Protection Agency, indicating that any facility which he proposes to use for the performance of the contract is under consideration to be listed on the EPA List of Violating Facilities.

(c) He will include substantially this certification, including this paragraph (c), in every nonexempt subcontract.

STANDARD FORM 19-8 (Back) (REV. 6-76)

[41 FR 27724, July 6, 1976]

☆U.S. GOVERNMENT PRINTING OFFICE: 1175-0-580-450 18-1

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