2. FAR 52.204-3 TAXPAYER IDENTIFICATION NUMBER (TIN) (continued) Common Parent. Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision Name and TIN of common parent: Name: TIN: 3. FOREIGN OWNED, CONTROLLED, OR INFLUENCED (FOCI) (Whether Offeror, its intermediate or ultimate parent is subject to FOCI) YES NO IF YES, ARE YOU INCORPORATED IN THE US? YES NO If No, NCAGE # ADDRESS: DESCRIPTION OF INTEREST: 4. 52.203-11 and FAR 52.203-12 - CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS Is/Are Proposal(s) expected to exceed $150,000: Yes No. If no, proceed to paragraph 5. Yes No By Checking Yes, Offeror certifies to the best of its knowledge and belief that: No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence 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 on its behalf in connection with the awarding of a subcontract or Purchase Order, or the prime contract it is awarded under. If any registrants under the Lobbying Disclosure Act of 1995 have made or will make a lobbying contact on behalf of the Offeror with respect to the award of a subcontract or Purchase Order, or the prime contract it is awarded under, the Offeror shall notify in writing immediately of such contact and also complete and submit, as directed, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of registrants. Offeror need not report contacts made by individuals described in FAR A copy of each subcontractor disclosure form (but not certifications) shall be forwarded from tier to tier until received by Curtiss-Wright. Penalty: As imposed by 31, U.S.C. 1352, the submission of this certification and disclosure is a prerequisite for making or entering into an applicable subcontract. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
2. FAR 52.204-3 TAXPAYER IDENTIFICATION NUMBER (TIN) (continued) Common Parent. Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision Name and TIN of common parent: Name: TIN: 3. FOREIGN OWNED, CONTROLLED, OR INFLUENCED (FOCI) (Whether Offeror, its intermediate or ultimate parent is subject to FOCI) YES NO IF YES, ARE YOU INCORPORATED IN THE US? YES NO If No, NCAGE # ADDRESS: DESCRIPTION OF INTEREST: 4. 52.203-11 and FAR 52.203-12 - CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS Is/Are Proposal(s) expected to exceed $150,000: Yes No. If no, proceed to paragraph 5. Yes No By Checking Yes, Offeror certifies to the best of its knowledge and belief that: No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence 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 on its behalf in connection with the awarding of a subcontract or Purchase Order, or the prime contract it is awarded under. If any registrants under the Lobbying Disclosure Act of 1995 have made or will make a lobbying contact on behalf of the Offeror with respect to the award of a subcontract or Purchase Order, or the prime contract it is awarded under, the Offeror shall notify in writing immediately of such contact and also complete and submit, as directed, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of registrants. Offeror need not report contacts made by individuals described in FAR A copy of each subcontractor disclosure form (but not certifications) shall be forwarded from tier to tier until received by Curtiss-Wright. Penalty: As imposed by 31, U.S.C. 1352, the submission of this certification and disclosure is a prerequisite for making or entering into an applicable subcontract. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
sm-fm-15-05-rev-0-tac-289-representations-and-certifications.docx