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Document Creation Date: 
June 22, 2015
Document Release Date: 
September 29, 2008
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Publication Date: 
September 1, 2004
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'19/01/2004 14:13 FAX 650 823 6719 0006LE Google FACSIMILE TRANSMITTAL SHEET FROM: Sharon Levy September 1, 2004 TOTAL NO. OF PAGES INCLUDING COVER: 16 ^ FOR REVIEW ^ PLEASE COMMENT El PLEASE REPLY Thanks for your patience. Attached please find the following. ? Electronic Funds Transfer Infonnation Sheet (b) (3) (b) (6) ^ PLEASE RECYCLE ? Completed Reps and Cents (note that no response was provided for K-17, as it should be inapplicable for the products we're providing). ? Update to K-12, regarding 52223-13 (Certification of Toxic Chemical Release Reporting) Please let me know if you have any questions. Regards, Sharon THIS TRANSMISSION MAY BE PRiVilEGFD AND MAY CONf.AE1 CONFIDENiTAL JNPORMATION MENDED ONLY FOR THE PERSON(S) NAMED ABOVE. ANY OTHER DIS17tIDUfION, RE-TRANsM SS1QN, COF 1NG OR DLSCL091RE LS SIRtCILY PROHIBITED, IF YOU HAVE RECEIVED THIS TRANSMISSION IN ERROR PLEASE NOTIFY ME iM MPDIATELY BY TELEPHONE OR FACSIMI B, AND RETURN THIS BY U.S. NQJL fa 001/016 09/01/2004 14:13 FAX 650 623 6719 GOOGLE 08/01/2004 13:38 FAX 19002/016 IQJ 00[/002 Pb, 40S P.?Ji5 ILBCTRONIC FUNDS TAAE4SFER (IRE) NOT!: ALL PAYMENTS ARA MADE VIA !LBOTRONIC FUNDS TRANSFER (EP) - FAILURE TO PROVIDE GFT INFORMATION MAY RG8ULT IN SERE D!LAY8 IN INVOICE PAYMENT. ' NAME OF THE FINANCIAL INSTITUTION TO RNCEIVE PAYMENT FOR YOUR COMPANY: COMPLETE ADORES$.OF THE FINANCIAL, INQTITuTIQN, FINANCIAL INSTITUTIONS NIN!-DIGIT ABA ROUTING NUMBER: C6NTRACTOR9,ACCOUNT NUMBER TO BE CR! t !D WITH FUNDS; TYPE OF ACCOUNT AT THE FINANCIAL INSTITUTION; CHECKING SAVIN?3 NAME, TITLE AND T$LEPHCNE NUMBER OF COMPANY CONTRACT PERSON; (fie .r=~i3cal 16 0041016 AUG.30.2004 111142AM NU. 4105 r.gr1D Oob& Section K - Rips d?. Caste. Page 2 of 13 (d) Taxpayer Ider0cation Number (TIN), TIN bas been plied flir. TDQ is not reauimd because; Oipaor is a nonresident alias, foreign eorporedM or fereida prsblp that does not have Ineame effectively connected with the conduct of a redo or busiaws iatbe United States and does not have gn affix or place of busine9a or a flaoal paying agent in the United States! [ ] O Fcror is an agony or Wm ity of a fbreiga govran MM; ] 00M is eat agency or inatrumentalty of the Federal Gov nmmt. (e) Type of organization. [ W o propriatonship; [ ] Pet= hip; [ Corporate etidty (not tax-exen s); Corporate entity (tax-Oq empt); [ ] ovaroment entity (Pedoanl, State, or local); [ a Pooeign govmrDme* [] Iato?naecnal orgw ixetion per 26 CPR 1.6O49.4; []0dw (t) Common parent. /` ("Iftor is not owned or controlled by a common parent as defined is paragraph (a) of thin provision. [ ] Name and TIN of common pates Name TIN KA $.20" Cectibeatlon Regarding Debarment, Suspension! Proposed Debarment; and Other Responsibthty Matters MAR 1996 (a)(1) The Oflrerer certifies, m the best of its lonow1edgo and belief that - (1) The Of[bror and/or arty of Us Princjpab - (A) Are L ] are not ?,/ ently debarred, rnepaided, proposed for debermeat, or doolsred inaligiblezu the awoO of coutraoe by any Fod%4 Wncy (9) Have ( ] have not within is thanayear period preceding this offer, been ooavlc ed of or bad a evil jud t rendered Against t m for. commission of Saud or It criminal o se in oamaeetion with obtsb*'g, aetemptlag to obtain, or performing a public (Federal, state, or loos]) conlte t or subontracM violption of Federal or state ao*uat statutes relating to the submission of ors or coin UsIon of ember, tires, 09/01/2004 14:14 FAX 650 823 6719 8006LE -UG.30.2004 11143RM Ooogle Beotioa K - Reps & C. Page 3 of 13 [aj 005/016 Qdt~ fwgwy, bnbery} +a1si$cgdiou or deeovcbon of nawrdm. tRldag iii1se ststeaatmts taut evasion, or receiving stolen property; and 03/01/2004 14:16 FAX 650 623 6713 GOOGLE la 012/016 AUG. 313.8Cee4 11:45AM NO.405 P.12/15 Googia sootion K - Reps & Came. Palo 10 of 13 (b) The Con=tor abaA is any case m which it behaves that %roign afteooe satiate or Is being saugl * 1* be obtelaed over its al tiia, or the afaauv of a Suboontraow, psvuptly- not* the C,ontactiag OMcor of sU the QWfinenc ?ots, even if euoh Influence is not esertod to the degree speclfed is the NISPOM, (o) The C u*o'tor shill promptly disclose to the OontictIn OflSoer aW btft :ta ion pertaining to any iaweet of a FOCI nature in the Contractor or Suboont actor that bas dcvo1opod at nay situ dortq the coaAaot'e duration er h99 subaequmtty come to the Cantraet0a atta3goL 409/01/2004 14:.17 FAX 650 623 6719 8000LE 52.223-13 Certification of Toxic Chemical Release Reporting. As prescribed in 23.906(a), insert the following provision: Certification of Toxic Chemical Release Reporting (Aug 2003) (a) Executive Order 13148, of April 21, 2000, Greening the Government through Leadership in Environmental Management, requires submission of this certification as a prerequisite for contract award. (b) By signing this offer, the offeror certifies that- (1) As the owner or operator of facilities that will be used in the performance of this contract that are subject to the filing and reporting requirements described in section 313 of the Emergency Planning and Community Right-to-Know Act of 1986 (EPCRA) (42 U.S.C. 11023) and section 6607 of the Pollution Prevention Act of 1990 (PPA) (42 U.S.C. 13106), the offeror will file and continue to file for such facilities for the life of the contract the Toxic Chemical Release Inventory Form (Form R) as described in sections 313(a) and (g) of EPCRA and section 6607 ofPPA; or (2) None of its owned or operated facilities to be used in the performance of this contract is subject to the Form R filing and reporting requirements because each such facility is exempt for at least one of the following reasons: [Check each block that is appl~able.] i) The facility does not manufacture, process, or otherwise use any toxic chemicals listed in 40 CFR 372.65; [ ] (ii) The facility does not have 10 or more full-time employees as specified in section 313(b)(1)(A) of EPCRA, 42 U.S.C. 11023(b)(1)(A); [ ] (iii) The facility does not meet the reporting thresholds of toxic chemicals established under section 313(f) of EPCRA, 42 U.S.C. 11023(f) (including the alternate thresholds at 40 CFR 372.27, provided an appropriate certification form has been filed with EPA); iv) The facility does not fall within the following Standard Industrial Classification (SIC) codes or their corresponding North American Industry Classification System sectors; (A) Major group code 10 (except 1011, 1081, and 1094. (B) Major group code 12 (except 1241). (C) Major group codes 20 through 39. (D) Industry code 4911, 4931, or 4939 (limited to facilities that combust coal and/or oil for the purpose of generating power for distribution in commerce),, (E) Industry code 4953 (limited to facilities regulated under the Resource Conservation and Recovery Act, Subtitle C (42 U.S.C. 6921, et seq.), or 5169, or 5171, or 7389 (limited to facilities primarily engaged in solvent recovery services on a contract or fee basis); or [ ] (v) The facility is not located in the United States or its outlying areas.. (End of provision) [a 016/016