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UTC CERTS & REPS SURVEY GUIDANCE
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UTC
Completing the Electronic Annual Certifications & Representations
Survey: Supplier Guidance
Name: Supplier Guidance: Completing the Electronic Annual Certifications &
Representations Survey
Owner: UTC Compliance
Revision: #3
Date: January 23, 2017
UTC CERTS & REPS SURVEY GUIDANCE
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Table of Contents
1) Introduction
2) UTC Supplier Portal Survey Application
3) List of referenced regulatory, FAR & DFARS
4) Advance preparation required uploads
5) Section by section form information
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1) Introduction:
The Annual Certifications and Representations is collected annually from all UTC
suppliers in compliance with regulatory, public law, FAR and DFAR requirements.
All Suppliers are required to respond to all the required fields of this certification as the
regulatory, public laws, FAR and DFARS apply to their business. This document is your
company certification that specific obligations under individual purchase orders will be
met. Certain of these requirements are invoked by dollar thresholds, contract type, or
other conditions of the purchase order. All regulatory, FAR and DFARS references are
provided below. It is recommended that your company understand the requirements
prior to completing this electronic form.
The electronic collection of this information will allow for consistency of the process for
all Quality Approved US Domestic Suppliers. The electronic collection will allow all UTC
business units to access the document which will be retained centrally.
This means that the supplier will only need to complete their Certifications and
Representations once annually.
Suppliers who have specific questions should contact their UTC Business Unit Buyers
IT IS RECOMMENDED THAT ALL SUPPLIERS REVIEW THIS GUIDANCE TO
ENSURE SUCCESSFUL SUBMISSION.
It is further recommended that this Certifications & Representations be completed by an
individual of the company who is familiar with the completion of the company annual
representations and certification to the United States Government electronically via the
System for Award Management (SAM) Web site accessed through
http://www.acquisition.gov as required under FAR 4.12 Representations and
Certifications and 52.212-3 -- Offeror Representations and Certifications -- Commercial
Items. Please note that our form includes additional elements as required by United
Technologies and its operating units.
The full Federal Acquisition Regulation (FAR) and Defense Federal Acquisition
Regulation Supplement (DFARS) clause sections can be accessed from
http://farsite.hill.af.mil/vffara.htm
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2) UTC Supplier Portal Survey Application
A) Registration Process:
The process begins when the supplier Location Administrator receives an e-mail
invitation to complete their Certs & Reps Survey on the UTC Supplier Portal.
Need Support?
Please email suppliersurveyssuppt@utc.com. Please provide your SL ID (Supplier Location ID
see page 12). Please specify that your issue is related to the Certs & Reps application for the
new Supplier Portal at Suppliers.utc.com
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The Supplier Location Administrator will review the Terms and Conditions Step 1
Read
Acknowledge
Continue
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Location Administrator Registration: 2
Name , Contact Information
User Preferences
Continue
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Location Registration: 3
Password
Challenge questions
Continue
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Registration Confirmation
Continue to Supplier Portal Log In Screen
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B) Login screen after registration:
Need Support?
Please email suppliersurveyssuppt@utc.com. Please provide your SL ID (Supplier Location ID
see page 12). Please specify that your issue is related to the Certs & Reps application for the
new Supplier Portal at Suppliers.utc.com
Location: http://suppliers.utc.com
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Certs and Reps Survey Site
Location Home Page
Edit your supplier location properties
Entry for Certs & Reps application
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Complete each Step
Need Support? Please email suppliersurveyssuppt@utc.com. Please provide your SL ID
(Supplier Location ID see page 12). Please specify that your issue is related to the Certs &
Reps application for the new Supplier Portal at Suppliers.utc.com
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Advance Preparation/ Required Uploads
In advance of completing the survey the supplier will need to prepare in advance to
ensure that all of the required uploads are available prior to the submission.
If your business is located in a HUB Zone: The HUB Zone Certification received
from the SBA is a required upload.
If your business is certified as Minority Owned and Controlled: A NMSDC
(National Minority Supplier Development Council) Certification is a required
upload.
A. List of Supplier Information
Type of Business
Country of Legal Entity Incorporation
US owned Yes/No
If Yes Incorporated under the laws of which state
Year Founded
Congressional District
Fiscal Year End
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List of Referenced Regulatory, FAR and DFARS referenced on survey:
B. Business Size: 18 U.S.C. 1001
Under 15 U.S.C. 645 (D), any person who misrepresents a firm's status as established pursuant to Sections 8(a), 8(d), 9 or 15 of the Small Business Act or any other provision of the Federal Law that specifically references Section 8(d) for a definition of program eligibility, shall (1) be punished by the imposition of fine, imprisonment, or be ineligible for participation in programs conducted under the authority of the act.
Upload for State and NMSDC Certifications / please have PDF copy available
Upload for HUB Zone Certification Letter / please have PDF copy available
C. Certificate of Independent Price Determination (FAR 52.203-2)
No entry required, your signature on this certification indicates that your company is
compliant with this clause.
D. Federal Funding Accountability and Transparency Act of 2006 (Pub L 109-282)
(FAR 52 204-10)
If No is selected for Question 1, no other information is required.
If Yes is selected for Question 1, question 2 will appear.
If Yes is selected for Question 2 no other information is required.
If No is selected for Question 2 a drop down will appear and completion of information
is required.
E. Affirmative Action Compliance (FAR 52.222-25)
Acknowledgment that your company HAS or DOES NOT HAVE an Affirmative Action
Program.
If NOT, acknowledgment that your company has not had previous contracts subject to
FAR 52.222-25.
F. Equal Opportunity (FAR 52.222-26)
Yes / No response required
G. Equal Opportunity for Disabled Veterans and Veterans of The Vietnam Era (FAR 52.222-35)
Acknowledgment that your company HAS or Does Not Have
Yes / No response required
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H. Affirmative Action for Workers with Disabilities (FAR 52.222-36)
Acknowledgment that your company HAS or Does Not Have
Yes / No response required
I. Previous Contracts and Compliance Reports (FAR 52.222-22)
Acknowledgment that your company HAS or DOES NOT participated in contracts that
are subject to FAR 52.222-22.
If HAS, acknowledgment that your company has filed all required compliance reports.
If NOT Applicable, an Exemption selection is provided.
J. Preference for Domestic Specialty Metals (DFARS 252.225-7008-7009)
Do you comply with DFARS 252.225-7008-7009 Yes or No?
If No a reason drop down is provided.
K. Union Contract information
Acknowledgment that your company HAS or DOES NOT HAVE a Union.
If Yes, Provide Union Name and Contract Expiration Date MM/DD/YY.
L. Report of Performance Outside of the United States (DFARS 252.225.7003)
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
M. Suspended or Debarred Certification (FAR 52.209-6)
Acknowledgment your company IS or IS NOT presently debarred or ineligible for
contract award by US Government Agencies.
N. Certification Regarding Responsibility Matters (FAR 52.209-5)
Acknowledgment that your company HAS or HAS NOT been convicted of or had a
civil judgment.
Acknowledgment that your company IS or IS NOT presently indicted for or criminally or
civilly charged.
Acknowledgment that your company HAS or HAS NOT within a three year period
preceding this certification been notified of Delinquent Federal Taxes.
O. Subcontractor (Supplier) Code of Business Ethics (FAR 52.203-13)
Acknowledgment that your company HAS or DOES NOT HAVE an Ethics Program.
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P. Directorate of Defense Trade Controls Registration; Export Compliance http://www.pmddtc.state.gov/registration/
Acknowledgment that your company manufactures defense articles listed on the United
States Munitions List. YES or NO.
If YES, your company’s registrations start and end dates MM/DD/YYYY are required.
Supplier or its Parent acknowledgment that they ARE or ARE NOT registered with
DDTC.
Acknowledgment that you employ Foreign Nationals: YES or NO.
If YES, Acknowledgment that you have a License in place to authorize access.
Acknowledgment that your company utilizes technical date: YES or NO.
If YES acknowledgment that your company has a Technology Control Plan: YES or NO.
Q. Payments to Influence Certain Federal Transactions (FAR 52.203-11)
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
R. Payments of Fees, Commissions or Political Contributions to Foreign Countries
22 CFR 130.5 AND 130.6
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
S. “Buy American Act-Trade Agreements” (FAR 52.225-1-4, DFARS 252.225.7000-7001)
Acknowledgment that your company DOES or DOES NOT certify compliance with the
FAR.
T. Representation of Transportation by Air or Sea (FAR 52.247-63, DFARS 252.247.7023)
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
U. HS14722 Controlled Materials for Procured Parts (Available on the SCM Portal) Certification of Toxic Chemical Release Reporting (FAR 52.223-13)
Acknowledgment of compliance to the FAR, Or, Acknowledgment of exemption to the
FAR.
V. Customs Administration C-TPAT
Acknowledgment that your company participates in a supply chain security program:
YES or NO.
IF YES, provide the name of the security program.
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W. Aerospace Insurance as per UTC Standard Terms & Conditions Sec. 22.
Supplier must complete the Supplier Limits and Policy Number fields provided. Mark
N/A for the policy number in categories that do not apply.
If your company has a fully executed Long Term Agreement: List the agreement number
in the field provided.
X. Certification Regarding Knowledge of Child Labor for Listed End Products (FAR 52.222-18)
Select One:
WILL NOT SUPPLY
MAY SUPPLY, includes a certification statement of your companies good faith effort
to determine whether forced or indentured child labor was used.
Y. Safeguarding of Covered Defense Information (DFARS 252.204-7012) Nov 2013)
Supplier Understands and is compliant Yes/ No
Z. Prohibition of Segregated Facilities (FAR 52.222-21)
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
AA. Employment Reports on Disabled Veterans and Veterans of the Vietnam Era (FAR 52.222- 37)1
No entry required, your signature on this certification indicates that your company
would be compliant with this clause if it applied to your business.
AB. Certification Regarding Trafficking in Persons (52.222-50)
If applicable per the clause requirements
The supplier will certify that they will not engage in any trafficking of persons
Supplier has hiring policies to protect the rights of its employees
Has notified its employees of the responsibility to report trafficking in persons violations.
AC. Business Specific Questions
All Yes / No questions except where described Does your Company perform any FAA repairs, overhauls, modification or inspections
as defined in CFR Title 14. Part 145 either as a FAA approved repair station or under contract from a FAA approved repair station.
Is your company an FAA approved Repair Station
Please provide the date the certification was issued or renewed
Date entry required Please identify the type of repairs the station is rated to perform
Description of repairs required Do you perform maintenance repairs, overhauls modification