UNITED STATES DEPARTMENT OF THE INTERIOR ao. > RITACHMENT SHALT, BE EXECUTED BY AN OFFICIAL AUTHORIZED TO BIND TEE OFFEROR, .itACRED AND MADE A PART OF HIS BUSINESS MANAGEMENT PROPOSAL REPRESENTATIONS AND CERTIFICATIONS ..£ czferor makes the following representations and certifications as part of his ui n-esal (check or complete all appropriate boxes or blanks). SMALL BUSINESS REPRESENTATION He Ti is, Li is not, a small business concern. If the offeror is a small ““¢SS8 concern and is not the manufacturer of the supplies offered, he also “nts that all supplies to be furnished hereunder || will, Li will not, be -ivi stured or produced by a small business concern in the United States, its .. . .. + 7i0ns, Or Puerto Rico. A small business concern for the purpose of Government . €ment is a concern, including its affiliates, which is independently owned ., cated, is not dominant in the field of operation in which it is quoting on -.'\xmrent contracts, and can further qualify under the criteria concerning number "t e€vployees, average annual receipts, or other criteria, as prescribed by the o°.... Fusiness Administration. (See Code of Federal Regulations, Title 13, Part ‘24, &s amended, which contains detailed industry definitions and related ures). FEGULAR DEALER = MANUFACTURER REPRESENTATION ..2TéCtB exceeding $10,000) He is a | | regular dealer in, ZYPE OF ORGANIZATION | (Applicable only to supply | manufacturer of, the supplies offered. . we He operates as | {| an INDIVIDUAL, |] | @ PARTNERSHIP, sonsisting of | | a JOINT VENTURE and ’ !_| a CORPORATION incorporated under the laws of the State of jii an EDUCATIONAL INSTITUTION, LI a NON-PROFIT ORGANIZATION organized and existing under the laws of the State of , oF Ll a STATE or LOCAL, AGENCY organized and existing under the laws of the State of - 4. DUNS CONTRACTOR ESTABLISHMENT NUMBER Following is the Contractor Establishment Identification number issued to wi. offeror by Dun and Bradstreet, Inc.: '