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CERTIFICATE OF PROCUREMENT <br /> INTEGRITY--MODIFICATION (NOV 1990) <br /> am the officer or employee responsible <br /> IName of certifier) <br /> the preparation of this modification proposal and hereby certify that, to the best of my <br /> knowledge and belief, with the exception of any information described in this certification, I <br /> have no information concerning a violation or possible violation of subsection 27(a), (b), (d), <br /> or (f) of the Office of Federal Procurement Policy Act, as amended* (41 U.S.C. 423), <br /> (hereinafter referred to as "the Act"), as implemented in the FAR, occurring during the <br /> conduct of this procurement <br /> (contract and modification number) <br /> (2) As required by subsection 27(e)(1)(B) of the Act, I further certify that to the <br /> best of my knowledge and belief, each officer, employee, agent, representative, and <br /> consultant of <br /> [Name of Offeror) <br /> who has participated personally and substantially in the preparation or submission of this <br /> proposal has certified that he or she is familiar with, and will comply with, the requirements <br /> of subsection 27(a) of the Act, as implemented in the FAR, and will report immediately to me <br /> any information concerning a violation or possible violation of subsections 27(a), (b), (d), or <br /> (f) of the Act, as implemented in the FAR, pertaining to this procurement.. <br /> (3) Violations or possible violations: (Continue on plain bond paper If necessary <br /> and label Certificate of Procurement Integrity--Modification (Continuation Sheet), ENTER <br /> "NONE" IF NONE EXISTS) <br /> Date <br /> (Signature of the officer [Typed name of the officer <br /> or employee responsible for or employee responsible for <br /> the offer and date] the offer) <br /> "Subsections 27(a), (b), and (d) are effective on December 1, 1990. Subsection 27(f) is <br /> effective on June 1, 1991. <br /> THIS CERTIFICATION CONCERNS A MATTER WITHIN THE JURISDICTION OF AN AGENCY <br /> OF THE UNITED STATES AND THE MAKING OF A FALSE, FICTITIOUS, OR FRAUDULENT <br /> CERTIFICATION MAY RENDER THE MAKER SUBJECT TO PROSECUTION UNDER TITLE 18, <br /> UNITED STATES CODE, SECTION 1001. <br /> (End of certification) <br /> 1-3 <br />