Procurement-Related Forms

The following procurement-related forms are provided in PDF fillable and/or Word format.

Form No.      Title/Description
Construction Labor Agreement,  

(May, 2023)
UCN-13816B Request for Waiver or Deviation,  

(January 2016)
UCN-13816C Request for Waiver or Deviation (Continuation),  

(January 2016)
UCN-20087A Suspect/Counterfeit Part Headmark List,  

(April 2012)
UCN-20856 Security Requirements for Non-Possessing Facilities,  

(February 2018)
UCN-21329 Subcontract Technical Representative (STR) Change Notice,  

(July 2022)
UCN-21364 Subcontractor Request for Y-12 National Security Complex Training,  

(July 2014)
UCN-21380 Monthly Subcontract Summary Report
UCN-21439 Subcontract Safety Performance Report,  

(June 2017)
UCN-21445 Subcontractor Hazardous Materials Inventory Report,  

(September 2020)
UCN-21519 Badge Request Form,  

(October 2014)
UCN-21681 CNS Subcontractor Submittal Status Sheet,  

(July 2014)
UCN-21709 Subcontract Badge/Clearance Status Report,  

(January 2014)
UCN-21752 Seller Safety Qualification Questionnaire,  

(January 2015)
UCN-22179 Certification Special Provisions American Recovery and Reinvestment Act of 2009
UCN-22212 Submittal Checklist,  

(June 2021)
UCN-22327 International Traffic in Arms Regulations (ITAR) Notice and Acknowledgement,  

(July 2014)
UCN-22338 Representations and Certifications,  

(December 2022)
UCN-22345 Workplace Substance Abuse Program,  

(January 2021)
UCN-22346 Request for Inspection of Completed Work,  

(July 2014)
UCN-22347 Daily Summary of Backcharge Work,  

(July 2014)
UCN-22348 Indemnification and Medical Liability Insurance,  

(July 2014)
UCN-22349 Representations Regarding Subcontracting Plans,  

(March 2018)
UCN-22350 Request for Information (RFI),  

(March, 2023)
UCN-22351 Subcontract Request for Travel, Pre-Approval,  

(August 2021)
UCN-22353 Exemption from Application of the Service Contract Act — Certain Services — Requirements,  

(July 2014)
UCN-22354 Exemption from Application of the Service Contract Act — Maintenance, Calibration or Repair of Certain Equipment — Requirements,  

(July 2014)
UCN-22355 Exemption from Application of the Service Contract Act — Maintenance, Calibration or Repair of Certain Equipment — Certification,  

(June 2020)
UCN-22361 Exemption from Application of the Service Contract Act — Certain Services — Certification,  

(July 2014)
UCN-22371 Release and Certificate of Final Payment,  

(January 2018)
UCN-22372 Release and Certificate of Interim Payment,  

(March 2015)
UCN-22373 Subcontract Overtime Request,  

(July, 2014)
UCN-22376 Motor Vehicle Leases,  

(July 2014)
UCN-22377 Personal Property Taxes,  

(July 2014)
UCN-22379 Seller's Assignment of Refunds, Rebates, Credits, and Other Amounts,  

(July 2014)
UCN-22380 Cost Accounting Standards—Clauses,  

(February 2019)
UCN-22381 Civil Penalties for Classified-Information Security Violations,  

(July 2014)
UCN-22382 Subcontract Pricing Proposal (Cost or Pricing Data Required),  

(March 2015)
UCN-22384 Progress Payments,  

July 2022
UCN-22398 Cost Accounting Standards Notices and Certification,  

(February 2019)
UCN-22399 Milestone Payments,  

(July 2014)
UCN-22400 Continuity of Services,  

(July 2014)
UCN-22401 Organizational Conflicts of Interest,  

(July 2014)
UCN-22402 Facility Clearance,  

(July 2014)
UCN-22403 Organizational Conflicts of Interest Disclosure—Advisory and Assistance Services,  

(July 2014)
UCN-22405 Procurement of Quality or Risk Significant Products or Services,  

(July 2014)
UCN-22406 Government Property—Research and Development,  

(July 2014)
UCN-22407 Reporting Requirements,  

(July 2014)
UCN-22409 Environment, Safety and Health
UCN-22410 Payment Bond — Construction Contracts,  

(January 2015)
UCN-22411 Payment Bond — Other Than Construction Contracts,  

(January 2015)
UCN-22412 Performance Bond — Construction Contracts,  

(January 2015)
UCN-22413 Performance Bond — Other Than Construction Contracts,  

(January 2015)
UCN-22414 Identification and Protection of UCNI/OUO Information,  

(April 2018)
UCN-22417 Special Tooling,  

(July 2014)
UCN-22418 Statement of Equivalent Rates for Federal Hires,  

(July 2014)
UCN-22423 Proposal Bond,  

(July 2014)
UCN-22427 Travel Reimbursement Policy,  

(September, 2022)
UCN-22428 Acknowledgement Intent to Participate in the Bidding Event,  

(July 2014)
UCN-22429 Agreement Regarding Company Workplace Substance Abuse Program,  

(July 2014)
UCN-22433 Nuclear Hazards Indemnity and Price-Anderson Amendments Act,  

(July 2017)
UCN-22434 Small Business Subcontracting Plan,  

(November, 2018)
UCN-22435 Certification as a United States Citizen in Order to Handle UCNI/OUO,  

(April 2018)
UCN-22437 Certificate of Current Cost or Pricing Data,  

(July 2014)
UCN-22438 Suspect/Counterfeit Fastener Certification,  

(December 2018)
UCN-22478 Certification of Most Favored Customer Pricing,  

(July 2014)
UCN-22480 Hazardous Materials Identification and Material Safety Data,  

(July 2014)
UCN-22482 EEO Preaward Clearance Request,  

(July 2014)
UCN-22483 Assignee's Release,  

(July 2014)
UCN-22484 Assignee's Assignment of Refunds, Rebates, Credits and Other Amounts,  

(July 2014)
UCN-22485 Seller's Release,  

(July 2014)
UCN-22502 Exhibit 21, Rights in Data — Facilities,  

(October 2016)
UCN-22503 Exhibit CCS, Commercial Computer Software — Restricted Rights,  

(July 2014)
UCN-22504 Exhibit 12, Restricted Rights Notice,  

(July 2014)
UCN-22505 Exhibit 13, Seller Licensing,  

(July 2014)
UCN-22506 Exhibit 15, Rights in Data — Special Works,  

(September 2020)
UCN-22507 Exhibit 4, Authorization and Consent,  

(May 2017)
UCN-22508 Exhibit 7, Classified Inventions,  

(May 2017)
UCN-22509 Exhibit 9, Technical Data,  

(July 2014)
UCN-22510 Exhibit 11, Limited Rights in Proprietary Data,  

(July 2014)
UCN-22511 Exhibit 1B, Patent Rights — Acquisition by the Government,  

(July 2014)
UCN-22512 Exhibit 1C, Patent Rights — Retention by the Seller (Short Form),  

(July 2014)
UCN-22513 Exhibit 2, Representation of Limited Rights Data and Restricted Computer Software,  

(July 2014)
UCN-22514 Exhibit 2B, Questionnaire (Petition for Advance Waiver of Patent Rights under 41 CFR Sect. 9-9.109-6),  

(May 2017)
UCN-22515 Exhibit 2D, Refund of Royalties,  

(July 2014)
UCN-22516 Agreement to Company Solicitation Provisions,  

(December 2020)
UCN-22522 Cargo Configuration for Trailers Entering Y-12 National Security Complex,  

(July 2014)
UCN-22523 Export Compliance,  

(July 2014)
UCN-22524 Export Compliance (MPO),  

(July 2014)
UCN-22525 Letter of Intent to Perform as a Subcontractor/Teaming Partner,  

(July 2014)
UCN-22526 Bid Escrow Documents,  

(July 2018)
UCN-22529 Required Training,  

(September 2018)
UCN-22533 Supplier Information,  

(July 2020)
UCN-22544 Property and Materials Certificate,  

(July 2014)
UCN-22565 Transparency Act — Executive Compensation and Subcontracting Reporting Information (Company),  

(October 2014)
UCN-22645 Sustainable Acquisition Program,  

(December 2018)
UCN-22646 Sustainable Acquisition Program — Construction,  

(December, 2018)
UCN-22825 Subcontractor/Supplier List,  

(January 2015)
UCN-22826 Equipment List,  

(August 2019)
UCN-22827 Supplier’s Experience/Past Performance Statement,  

(March 2016)
UCN-22916 Certificate of Background Investigation,  

(June 2021)
UCN-22922 Background Investigation of Non-Cleared Personnel,  

(June 2021)
UCN-22965 Y-12 Subcontractor Security Clearance Certification,  

(May 2013)
UCN-26030 Request to Work Outside Normal Work Days (Friday, Saturday, Sunday),  

(August 2019)
UCN-26303 Access to Y-12,  

(May 2023)
UCN-26608 UCNI/OUO Information Protection Requirements for CNS Suppliers,  

(October 2021)
UCN-26735 Integration of Environment, Safety, and Health Service Subcontract Specifications for Low Risk Subcontracts,  

(February 2022)
UCN-26736 Integration of Environment, Safety, and Health Service Subcontract Specifications for Moderate/High Risk,  

(March 2023)
UCN-26788 Personal Identity Verification (PIV),  

(July 2020)
UCN-4452S CNS Subcontractor Personnel Exit Checklist,  

(June, 2021)
UCN-6573 Subcontractor's Invoice for Travel and/or Services,  

(July 2014)