I understand that the information submitted may be given to Federal, State and local agencies for determining violations of law and other purposes. All the statements and information provided in this form and any documents submitted are true, accurate and complete. If assistance was obtained in completing this form and the supporting documentation, I have personally reviewed the information and it is true and accurate. I understand that, in general, these statements are made for the purpose of determining eligibility for an SBIR funding agreement and continuing eligibility. I understand that the certifications in this document are continuing in nature. Each SBIR funding agreement for which the small business submits an offer or application or receives an award constitutes a restatement and reaffirmation of these certifications. I understand that I may not misrepresent status as small business to: 1) obtain a contract under the Small Business Act; or 2) obtain any benefit under a provision of Federal law that references the SBIR Program. I am an officer of the business concern authorized to represent it and sign this certification on its behalf. By signing this certification, I am representing on my own behalf, and on behalf of the SBIR applicant or awardee, that the information provided in this certification, the application, and all other information submitted in connection with this application, is true and correct as of the date of submission. I acknowledge that any intentional or negligent misrepresentation of the information contained in this certification may result in criminal, civil or administrative sanctions, including but not limited to: restitution and/or imprisonment under 18 U.S.C. §1001; treble damages and civil penalties under the False Claims Act (31 U.S.C. §3729 et seq.); double damages and civil penalties under the Program Fraud Civil Remedies Act (31 U.S.C. §3801 et seq.); civil recovery of award funds, suspension and/or debarment from all Federal procurement and nonprocurement transactions (FAR Subpart 9.4 or 2 C.F.R. part 180); and other administrative penalties including termination of SBIR/STTR awards. My signature is verification that the statements checked () above are true and complete. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. Date Signature Printed Name (First, Middle, Last)
I understand that the information submitted may be given to Federal, State and local agencies for determining violations of law and other purposes. All the statements and information provided in this form and any documents submitted are true, accurate and complete. If assistance was obtained in completing this form and the supporting documentation, I have personally reviewed the information and it is true and accurate. I understand that, in general, these statements are made for the purpose of determining eligibility for an SBIR funding agreement and continuing eligibility. I understand that the certifications in this document are continuing in nature. Each SBIR funding agreement for which the small business submits an offer or application or receives an award constitutes a restatement and reaffirmation of these certifications. I understand that I may not misrepresent status as small business to: 1) obtain a contract under the Small Business Act; or 2) obtain any benefit under a provision of Federal law that references the SBIR Program. I am an officer of the business concern authorized to represent it and sign this certification on its behalf. By signing this certification, I am representing on my own behalf, and on behalf of the SBIR applicant or awardee, that the information provided in this certification, the application, and all other information submitted in connection with this application, is true and correct as of the date of submission. I acknowledge that any intentional or negligent misrepresentation of the information contained in this certification may result in criminal, civil or administrative sanctions, including but not limited to: restitution and/or imprisonment under 18 U.S.C. §1001; treble damages and civil penalties under the False Claims Act (31 U.S.C. §3729 et seq.); double damages and civil penalties under the Program Fraud Civil Remedies Act (31 U.S.C. §3801 et seq.); civil recovery of award funds, suspension and/or debarment from all Federal procurement and nonprocurement transactions (FAR Subpart 9.4 or 2 C.F.R. part 180); and other administrative penalties including termination of SBIR/STTR awards. My signature is verification that the statements checked () above are true and complete. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. Date Signature Printed Name (First, Middle, Last)
SBIR%20Application%20VCOC%20Certification.docx