Representations & Certifications

Contractor's Certificate of Current Cost or Pricing Data

Workplace Substance Abuse Programs at DOE Sites Certification

Annual Representations and Certifications must be completed, and be on file, for any and all businesses that wish to deal with Brookhaven National Laboratory. These Representations and Certifications deal with supplier specific information and are not related to any individual purchase order or contract.

If you have the ability to utilize Microsoft Word Templates please download the following files. These are self-extracting Zip files and will allow you to save the files to your desktop by using the Browse button on the extraction form.

A test file called FormsText.exe can be downloaded to test your macro settings on Word. If you are unsure of your settings please download this file and follow the instructions.

The other two files are: AMS-Form-010.exe and Instr_for_Reps&Certs.exe. The first file is the actual form you will be completing and the second file is the instructions for completing the form.

If you do not have the ability to utilize Microsoft Word Templates please download the AMS-Form-010.PDF file. Print out the form, complete it and mail it to the BNL PPM Department.

Thank you.

Last Modified: April 7, 2021
Please forward all questions about this site to: John Collins

One of ten national laboratories overseen and primarily funded by the Office of Science of the U.S. Department of Energy (DOE), Brookhaven National Laboratory conducts research in the physical, biomedical, and environmental sciences, as well as in energy technologies and national security. Brookhaven Lab also builds and operates major scientific facilities available to university, industry and government researchers. Brookhaven is operated and managed for DOE's Office of Science by Brookhaven Science Associates, a limited-liability company founded by the Research Foundation for the State University of New York on behalf of Stony Brook University, the largest academic user of Laboratory facilities, and Battelle, a nonprofit, applied science and technology organization.

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