Caution:

A practice disclosed in a Disclosure Btatement shall not, by virtue

ey 63Ch disclosure, be deemed to be a proper, approved, or agreed to practice for
3 racing proposals or accumulating and reporting contract performance cost data.

Check the appropriate box below:
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I-

CERTIFICATE OF CONCURRENT SUBMISSION OF DISCLOSURE STATEMENT(S)

The offeror hereby certifies that he has submitted, as a part pf his
proposal under this solicitation, copies of the Disclosure Statement(s) as follows:
(i) original and one copy to the cognizant Contracting Officer and (ii) one copy
i: the cognizant contract auditor.

Date of Disclosure Statement(s):

Name(s) and Address(es) of Cognizant Contracting Officer(s) where filed:

The offeror further certifies that practices used in estimating costs in
v.icing this proposal are consistent with the cost accounting practices cisclosed

.r te Disclosure Statement(s).

i:

II.

CERTIFICATE OF MONETARY EXEMPTION

The offeror hereby certifies that he, together with all divisions,
..'.idiaries, and affiliates under common control, did not receive net awards of
uccotiated national defense prime contracts subject to cost accounting standards
tetaiing more than $10,000,000 in either Federal Fiscal Year 1974 or 1975 or net
a-ards of negotiated national defense prime contracts and subcontracts totaling
tore than $10,000,000 in Federal Fiscal Year 1976 or in any subsequent Federal

7 .+7al Year preceding the year in which this proposal was submitted.

Caution:
Offerors who submitted or who currently are obligated to submit
« tisclosure Statement under the filing requirements previously established by
176 Cost Accounting Standards Board are not eligible to claim this exemption

.7tess they have received notification of final acceptance of all deliverable
dreams on all of their prime contracts and subcontracts containing the Cost

we.

Accounting Standards clause (FPR 1-3.1204-1).
i_| III.

CERTIFICATE OF INTERIM EXEMPTION

The offeror hereby certifies that (i) he first exceeded the monetary
exemption for disclosure, as defined in (II) above, in the Federal Fiscal Year
immediately preceding the year in which this proposal was submitted, and (ii) in
accordance with the regulations of the Cost Accounting Standards Board [4 CFR
351.40(£)), he is not yet required to submit a Disclosure Statement. The offeror
further certifies that if an award resulting from this proposal has not been made
by March 31 of the current Federal Fiscal Year, he will immediately submit a
revised certificate to the Contracting Officer,

in the form specified under (I)

above, or (IV): below, as appropriate, to verify his submission of a completed
Disclosure Statement.
Caution:

Cffercrs may net claim this exemption if they are currently

‘

required to disclose because they exceeded monetary thresholds in Federal Fiscal
Years prior to Fiscal year 1976. Further, the exemption applies only in connection
with proposals submitted prior to March 31 of the year immediately following the
Federal Fiscal Year in which monetary exemption was exceeded.

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