I have read the above agreement for my ... - Alion Science



The following certification is required for each agreeement or subcontract entered into between Alion and its subcontractors or consultants. If there is any change to your status under any of the certifications during the period, you are required to inform Alion Science and Technology Corporation (Alion) in writing promptly within fifteen (15) days of the change in status.

|SECTION A: COMPANY INFORMATION |

|Company Name: |      | |

|Company Address: |      | |

|Telephone Number: |      | |Fax Number: |      | |

| | | | | | |

|SECTION B: SUPPLIER EXPORT COMPLIANCE POINT OF CONTACT |

Alion requires that its subcontractors and consultants certify certain information necessary to ensure compliance with U.S. Government export control laws and regulations. Adherence to this requirement is necessary before Alion will place, or continue to place, any orders, participate in technical discussions or provide any items, data, or assistance. This certification must be signed by a duly authorized officer of the company. The person below is authorized to discuss/verify/confirm the export compliance requirements associated with this certification.

|Export Compliance Point of Contact: | |      |

| | |      |

|Title: | | |

| | |      |

|Phone Number: | | |

| | |      |

|Fax Number: | | |

| | |      |

|E-mail Address: | | |

SECTION C: U.S. REGISTRATION REQUIREMENTS

All Alion’s sucontractors and consultants who are U.S. entities or persons must comply with the U.S. regulatory requirements contained in the U.S. International Traffic in Arms Regulations (ITAR); 22 CFR § 122.1(a):

Any person who engages in the United States in the business of either manufacturing or exporting defense articles or furnishing defense services is required to register with the Direcorate of Defense Trade Controls (DDTC). Manufacturers who do not engage in exporting must neverthless register.

1. Company is / is not incorporated in the United States.

If yes, Company is incorporated in the state of                .

2. Company is / is not registered with the U.S. Department of State, Directorate of Defense Trade Controls in accordance with the International Traffic in Arms Regulations (22 CFR 120-130) Subpart 122.1 as a “person/entity” who engages in the business of either manufacturing or exporting defense articles or furnishing defense services. 

If yes, Company’s registration no. expires on and Company does/does not certify that the DDTC

registration will remain in effect while Company will be involved in Alion’s transactions.

3. Company employs / does not employ Foreign Nationals and/or Foreign Persons. A Foreign National/Person is someone who is NOT a U.S. citizen and/or U.S. permanent resident alien. If “Does” is checked in response to this item, the Company further represents that:

▪ Company does / does not have a Technology/Access Control Plan to prevent the unauthorized export or disclosure of technical data, regardless of whether within the U.S. or abroad, to any foreign concern, foreign interest, foreign national, or their representatives.

▪ The Foreign Nationals and/or Foreign Persons employed by the Company will / will not participate in programs in support of Alion.  If “will” is checked above in response to this item, the Company further represents that:

▪ The foreign nationals and/or Foreign Persons employed by the Company are / are not residents of, a

citizen of, or under the control of Cuba, Iran, North Korea, Sudan, Syria, or any country to which the laws and

regulations of the United States prohibits export transactions.

▪ The foreign Nationals and/or Foreign Persons employed by the Company are / are not dual nationals and/or

third country nationals of other countries.

|SECTION D: CERTIFICATION AND SIGNATURE |

I certify that the information provided above is true and accurate to the best of my knowledge. I further certify that Alion products, data, and services are subject to U.S. laws and regulations, including but not limited to the Export Administration Regulations administered by the U.S. Department of Commerce, Bureau of Industry and Security and the International Traffic In Arms Regulations administered by the U.S. Department of State, Directorate of Defense Trade Controls, and that such products, data, and services may not be exported, reexported, transferred or transshipped without proper, written authorization from the U.S. Government and Alion.

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|Printed Name | |Company Name |

| | |      |

|Signature | |Date |

| | | |

|      | | |

|Title | | |

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Once the form is completed, please send it back to the requester. As an alternative, you may email it to export@ or fax it to 703-714-6511 Attn: Corporate Export Compliance Office.

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