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Click ‘Get Form’ to open the DOT ADM-0077 in the editor.
Begin with Option #1 if your company has not engaged in business outside the U.S. Fill in the Company/Vendor Name and Federal ID Number, then provide the Printed Name and Title of the person signing. Ensure you sign under penalty of perjury.
If your company has had business activities outside the U.S., select Option #2. Enter your Company/Vendor Name and Federal ID Number, followed by the Printed Name and Title of the signer. Confirm that you are not a scrutinized company as per Public Contract Code Section 10476.
For Option #3, if you are a scrutinized company with DGS permission, complete the required fields including Company/Vendor Name and Federal ID Number. Attach a copy of the written permission from DGS with your submission.
Finally, review all entries for accuracy before applying your electronic signature to confirm your intent to be bound by this certification.
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