Material Submittal for Buy American Compliance
Federal-Aid Airport Contracts

PART 1: 	
Project Name and Number	
Supplier Company Name	
Supplied to: Contractor or Subcontractor Company Name	
Materials: Bid Item No. / Bid Item Description	Quantity	
Description of Steel and Manufactured Goods (attach material documentation and mill certifications):	
Steel or Manufactured Good is (check one box): 
Produced in the United States                                          
FAA has issued a Type 1, 2, or 3 Waiver (type) ___    
FAA lists it as an Excepted Article, Material or Supply    
FAA has issued a Nationwide Waiver                             	
I certify under penalty of law that the steel and manufactured goods listed on this form (or attachment), comply with the requirements of 49 USC § 50101 and Contract subsection GCP 60-09 Buy American Preference. 
Steel and manufactured goods submittals may be approved when: 
(1)	They are produced in the United States;
(2)	The FAA has issued a waiver for the product; 
(3)	The product is listed as an Excepted Article, Material or Supply in Federal Acquisition Regulation subpart 25.108; or
(4)	The product is included in the FAA Nationwide Buy American Waivers Issued list. 

I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.	

Authorized Corporate Signature		Date	
Printed Name		Supplier’s Company Name	
Position Title