(b) On the basis of information from such sources as are available to the supplier and to the best of his information and belief, meets the requirements of § 201.11(b) of AID Regulation 1 as to source, country where mined, grown, or produced and limitation on components. 9. If the supplier is the producer, manufacturer, or processor of the commodity, said contract is not a cost-plus-percentageof-cost contract. 10. The supplier will for a period of not less than three (3) years after the date hereof maintain all business records and other documents which bear on his compliance with any of the undertakings and certifications herein and will at any time requested by AID make such records and documents available to AID for examination and promptly furnish to AID such additional information in such form as AID may request concerning the pruchase price, the cost to the supplier of the commodities and/ or commodity-related services involved, and/or any other facts, data, or business records relating to the supplier's compliance with his undertakings and certifications in this certificate and agreement. 11. The supplier has complied with the provisions contained and referred to in Subpart D of AID Regulation 1. 12. The supplier has not been informed of his ineligibility to act as a supplier or otherwise participate in AID financed transactions. If the supplier has been advised to submit proposed sales to AID for prior review under the provisions of § 201.33 of AID Regulation 1, the supplier has made such submission for said contract, has been notified by AID of the results of such review and has complied with all conditions and requirements specified in such notification. 13. The commodity supplier certified that he has submitted a copy of every ocean bill of lading, applicable to the commodities and transactions described on the reserve hereof, to the Maritime Administration, Cargo Preference Control Center, Commerce Building, Washington, D.C. 20523 and that such bill(s) of lading state all of the carrier's charges including the basis for calculation such as weight or cubic measurement. 14. The supplier has filled in all applicable portions of the Invoice-and-Contract Abstract on the reverse hereof and certifies to the correctness of the information shown therein. PERSONAL CERTIFICATION BY NATURAL PERSON SIGNING THIS CERTIFICATE AND AGREEMENT The natural person who signs this Certificate and Agreement hereby certifies either that he is the supplier or that he has actual authority to sign in behalf of the supplier and to bind the supplier with regard to all certifications and agreement contained in this Certificate and Agreement. He further certifies, if he is not personally the supplier, that either he is an employee of the supplier or he has a written power of attorney to sign for, and bind the supplier. He acknowledges that he is signing and submitting this Certificate and Agreement for the purpose of receiving payment from AID funds and that AID in making funds available for such payment will rely upon the truth and accuracy of this Personal Certification as well as all other representations in this Certificate and Agreement. The Supplier's Certificate and Agreement and the Personal Certification herein shall be governed by and construed in accordance with the laws of the United States of America. Type or print name and title of official authorized to sign. Signature of official authorized to sign for (check one). Date. Commodity Supplier Carrier Insurer Place executed (city, state, country). NOTES: (a) Any amendments of, or additions to, the printed provisions of this Supplier's Certificate and Agreement are improper and will not be considered a part thereof. (b) False statements herein are punishable by United States law. (c) The word "Copy" must be written on all signed copies other than the original. INSTRUCTIONS FOR COMPLETING FORM AID 282 Execution of Form. This form is designed for use with the U.S. Standard Master for International Trade. An original and one copy of this form, completed by the following suppliers of commodities or services, as appropriate, must accompany each invoice for which payment is requested. (a) Commodity Supplier-executed by the commodity supplier covering the cost of the commodity, including the cost of any commodity-related service paid by the commodity supplier for his own or the buyer's account; (b) Transportation Supplier (Carrier)—executed by each transportation supplier (carrier) or, in the case of a through Bill of Lading, the issuing carrier, for the cost of ocean or air transportation financed by AID; (c) Insurance Supplier (Insurer)-executed by the insurance supplier (insurer) or, under the circumstances set forth in § 201.52(b)(2) of AID Regulation 1, by an insurance broker or the commodity supplier for the cost of marine insurance financed by AID when such cost exceeds $50. The original must be signed by a person authorized by the supplier who shall indicate his title and certify to his authority. Submission in English Language. The form must be completed in the English language only and all amounts of money must be shown in U.S. dollars. Obtaining Forms. The form (as well as copies of AID Regulation 1 referenced in this form) may be obtained in limited quantities from banks holding AID Letters of Commitment, from district offices of the Department of Commerce, the AID office in the supplier's country or the Distribution Branch, Agency for International Development, Washington, D.C. 20523. The forms may be reproduced, providing the reproduction is identical in size, color and format. INSTRUCTIONS FOR COMPLETING ENTRIES ON INVOICE-AND-CONTRACT ABSTRACT GENERAL IN STRUCTIONS Except as provided in the instructions for specific blocks, suppliers must complete all blocks or enter the letters "NA" (Not Applicable), as follows: Commodity Supplier-Complete all blocks except 12 and 13; however, if the commodity supplier has paid for the transportation and/or insurance for his own or the buyer's account block 12 and 13 will also be completed by the commodity suppliers. The blocks for item 11 are to be completed only when the address in block 1 is a U.S. address. Transportation Supplier (Carrier)-Complete blocks 1 through 8 as well as blocks 13, 14, and 16. Insurance Supplier (Insurer)-Complete blocks 1 through 8a as well as blocks 12, 14, and 16. INSTRUCTIONS FOR INDIVIDUAL BLOCKS BLOCK 1: Enter the commodity supplier's name and address. Caution: If the form is executed by the carrier or the insurer, enter the commodity supplier's name and address in block 1 and complete block 16. BLOCK 2: For AID use only. BLOCK 3: Enter AID implementing document number furnished in the Letter of Credit or Importer's Instructions. This number will normally be the Loan or Grant Agreement number, Letter of Commitment number or the Project Implementation Order number. BLOCK 4: Enter the importer's name and address. Caution: On other documents prepared from the Standard Master, such as the Bill of Lading, the corresponding block may call for the name and address of the party to whom the carrier is to give notice of arrival When such party is not the importer, be sure to enter the importer's name and address. BLOCK 5: Enter the name of the vessel. BLOCK 6: Enter the flag of registry. BLOCK 7: Enter the port shown on the Bill of Lading. BLOCK 8: Commodity Information. a: Enter the description of each commodity and its U.S. Department of Commerce Schedule B number, if available. For multiitem invoices, enter a summary description of the group of items and the appropriate Schedule B number(s), if available. b: Enter the Bill of Lading weight. c: Enter the Bill of Lading measurement. BLOCK 9: Invoice Information. a: Enter the invoice number of the accompanying invoice to which this abstract relates. b: Enter the invoice date. c: Enter the net amount for which the supplier seeks payment. (See paragraphs 5 and 6 of the Supplier's Certificate.) BLOCK 10: Contract Information. c: Enter the country of source as defined in § 201.01 of AID Regulation 1. BLOCK 11: Supplier Information. This section must be completed when a U.S. address is indicated in Block 1. The information is required to enable AID to compile reports requested by Congress. a: Indicate whether the supplier is a small business as defined in FPR Subpart 1-1.7 (CFR Title 41). A small business is an enterprise which (1) is independently owned and operated for profit, is not dominant in its field of operation, and, with its affiliates, has no more than 500 employees (or the higher number of employees designated for specific industry groups in FPR 1-1.701-1 (CFR Title 41)), or (2) is certified as a small business by the Small Business Administration. If the supplier is unsure of his classification, he may obtain guidance from the nearest field or regional office of the Small Business Administration. b: If the supplier is not a small business, enter the best estimate of the percentage of the total invoice amount paid or to be paid to subcontractors or suppliers of components who are small business concerns. c: Indicate whether the supplier is a minority business as defined in FPR 1-1.1303 (CFR Title 41). A minority business is an enterprise which is at least 50 percent owned by minority group members. For the purpose of this definition, minority group members are Negroes, Spanish-speaking Americans, American-Orientals, American Indians, American Eskimos and American Aleuts. d: If the supplier is not a minority business, enter the best estimate of the percentage of the total invoice amount paid or to be paid to subcontractors or suppliers of components who are minority business concerns. BLOCK 12: Insurance Information. Complete block 12 only if the insurance premimum exceeds $50. a: Enter the insured value of the shipment. b: Enter the total premimum. c: Enter the type of coverage and the insurance rate. If "Other" is checked, explain below or in block 15. BLOCK 13: Transportation Information. a: Check appropriate vessel type. b: Enter the Bill of Lading or air waybill number. c: Enter the Bill of Lading or air waybill date. d. Enter freight rate, other freight charges and the total dollar amount of freight charges after discount. BLOCK 14: Information as to Commissions, Credits, Allowances, Similar Payments and Side Payments. Enter in blocks 14 a, b and c pertinent information with reference to (a) all commissions and other payments, credits, allowances or benefits of any kind, paid or to be paid by the supplier to or for the benefit of his agent, the importer or the importer's agent as required by § 201.65(k) of AID Regulation 1; and (b) any side payments, not shown on the invoice, made or to be made by the importer to the supplier, in connection with the transaction, as required by $201.66 of AID Regulation 1. If there is insufficient space to furnish the required information in block 14 continue the listing into block 15 or enter "Continued" or "See attached" listing in block 14a and attach a separate sheet to the form. If no commissions or other payments, credits, allowances, benefits, or side payments are involved, enter "NONE" in block 14. BLOCK 16: Check the appropriate box and print or type carrier's or insurer's name and address. APPENDIX D-APPLICATION FOR APPROVAL OF COMMODITY ELIGIBILITY A.I.D 11 (10-16-70) BUDGET BUREAU NO. 24-R0056 APPROVAL EXPIRES 5-31-74 TRANSACTION NO. (Assigned by A.I.D.) TRANSACTION IDENTIFICATION 1. A.I.D. No. 2. Payment Terms: Letter of Credit No. Date Name and Address of U.S. Bank c. Estimated Value Furnished from Each Plant(s) 16. Remarks and Additional Information 17.: SUPPLIER'S CERTIFICATION As a condition for securing a determination of commodity eligibility preparatory to the receipt by the supplier of funds made available by the United States under the Foreign Assistance Act of 1961, as amended, in payment in whole or in part in the transaction described and for the commodity identified on this form, the undersigned, acting on behalf of the supplier whose name appears in block 5 above and authorized to bind the supplier, agrees with and certifies to A.I.D. as follows: 1. The supplier has contracted for the sale of the commodity described on this form to the importer whose name appears in block 6, and the supplier has either attached to this form a copy of such contract or has furnished in block 2 information concerning a letter of credit confirmed or advised in his favor under a payment obligation assumed by the importer in the sales contract. 2. The supplier has filled in the applicable portions of this form and certifies to the correctness of the information shown herein. 3. The supplier agrees that the commodity will be shipped and invoiced in accordance with the information shown herein; that if any change in commodity identification takes place after A.I.D. has approved this transaction, the supplier will resubmit this form to A.I.D. for review and further approval for financing in light of the changed commodity; and that this Commodity Approval Application which the supplier proposes to use as a basis for securing payment from A.I.D. funds, is in every respect the original or true copy of the original application approved by A.I.D. The supplier acknowledges that any commodity, other than a commodity described on this form from any supplier approved by A.I.D. below, is ineligible for A.I.D. financing with respect to the sale transaction for which this form must be submitted as a condition for payment. 4. The supplier certifies that he is an individual resident in a country included in the authorized source code; a nonresident citizen of a country included in the authorized source code; a corporation or partnership organized under the laws of a country inIcluded in the authorized source code; or a controlled foreign corporation (within the meaning of section 957 et seq. of the Internation Revenue Code) as attested by current information on file with the Internal Revenue Service of the United States (on IRS Form 959,2952,3646, or any substitute or successor forms) submitted by shareholders of the corporation. If the supplier is a controlled foreign corporation without a regular place of business in the United States, the supplier appoints any shareholder or officer thereof agent for the supplier to receive service of process in the United States in connection with any dispute arising between the supplier and A.I.D. and relating to the commodity sale financed by A.I.D. 5. The supplier has not received notice directly by mail or indirectly by publication in the FEDERAL REGISTER or otherwise that A.I.D. has suspended or debarred him pursuant to A.I.D. Regulation 8 (22 CFR Part 208) or that the Treasury Department has placed his name on the Consolidated List of Designated Nations and thereby rendered him ineligible to receive A.I.D. funds. To the best of his knowledge, the supplier has not acquired, and in any event will not acquire, for resale under A.I.D. financing the goods described is of a description, condition, and suspended or debarred by A.I.D. or included on the Treasury List of Designated Nationals or from any affiliate of such a person. 6. The supplier acknowledges that this application, when approved, is not valid for shipments having a delivery date on or after the expiration date shown below. Typed or Printed Name and Title Signature of Authorized Representative of 18.: A.I.D. APPROVAL By the signature and seal which appear below, A.I.D. has given limited approval to the sale described on this form. This approval is limited strictly to a determination that the commodity which the supplier has described is of a description, condition, and source eligible for A.I.D. financing. This approval and determination of commodity eligibility does not represent an approval of the sale price and does not in any way preclude an A.I.D. refund claim based upon a detailed analysis of the transaction upon postaudit in accordance with the provisions of A.I.D. Regulation 1 (22 CFR Part 201). A.I.D. expressly reserves to itself such rights as it may have under that regulation and under such other A.I.D. forms as the supplier may be required to submit by the terms of financing documents and by the terms of Regulation 1. Expiration Date Approved for A.I.D. Authorized Signature Date Expiration Date Approved for A.I.D. Authorized Signature Date 19.: CERTIFICATE FOR PARTIAL SHIPMENT I hereby certify that the partial shipment 'for which payment is being requested from A.I.D. funds is being made under the contract covered by the original validated form AID-11 of which this is a true copy. Typed or Printed Name and Title Signature of Authorized Representative of Supplier Date Typed or Printed Name and Title GENERAL INSTRUCTIONS Requirement for payment: Section 201.11(k) of A.I.D. Regulation 1 declares that a commodity sale transaction is eligible for A.I.D. financing only if A.I.D. provides a determination of the commodity eligibility on the Commodity Approval Application. Section 201.52(a)(8) of the regulation states that to secure payment in connection with any sale governed by the regulation, a supplier must submit to the paying bank the signed original of this form, countersigned by A.I.D. As appropriate, a reproduced copy of the validated form, certified as provided in the second paragraph below, is required with each subsequent claim for partial shipments made under the original validated form AID-11. Approval by A.I.D.: To secure A.I.D. approval, a supplier must submit signed and properly executed original and one copy of the form, addressed to the Agency for International Development, Office of the Controller, Washington, D.C. 20523, or to the alternative direct mail address published in A.I.D. Small Business Memorandums. A.I.D. will indicate its approval in Block 18 of the form if the form is properly executed and if A.I.D. has no objection to financing the described commodity. If A.I.D. refuses approval, the Agency will return the form to the supplier with an explanation for the refusal. In either case, an identification number will be assigned by A.I.D. in the upper righthand corner of the form. Any followup correspondence between the supplier and A.I.D. should refer to this number. Partial shipments: In the event a supplier expects to make more than one shipment under a single contract, letter or credit, or collection document, he may either submit a separate form AID-11 covering each ship |