The bidder shall complete, sign, and return with his/her bid, the certificate as contained in this invitation. No award will be made or sale consummated until after this agency has obtained from the Drug Enforcement Administration, Department of Justice, verification that the bidder is registered to manufacture, distribute, or dispense those controlled substances which are the subject of the award.
The undersigned bidder certifies that he/she is Registered with the Drug Enforcement Administration, Department of Justice, as a manufacturer, distributor, or dispenser of the controlled substances for which a bid is submitted and the registration number is: __.
This certification is made in accordance with and subject to the penalties of Title 18, Section 1001, United States Code, Crime and Criminal procedures.
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Name of bidder (print or type)
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Signature of bidder
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Address of bidder (print or type)
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City, State, Zip code
We, the undersigned, have witnessed the destruction of the (controlled substance(s)) described herein and in the manner of destruction and on the date stated herein:
Certification of destruction of: ___
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Manner in which destruction was performed
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Date
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Witness
_______________________________
Date
_______________________________
Witness
_______________________________
Date
41 C.F.R. §102-40.160