Special Articles and Forms

Special Articles and Forms are company provisions, clauses and forms referenced in procurement documents. Current Procurement and Construction articles and forms are linked below as PDF files unless otherwise noted.

Title/Description Form No.        
Access to Pantex Plant,  

(October 2019)

PX-200STC-1B
Access to Y-12,  

(Sept 2019)

UCN-26303
Acknowledgement Intent to Participate in the Bidding Event,  

(July 2014)

UCN-22428
Agreement Regarding Company Workplace Substance Abuse Program,  

(July 2014)

UCN-22429
Agreement to Company Solicitation Provisions,  

(July 2014)

UCN-22516
Assignee's Assignment of Refunds, Rebates, Credits and Other Amounts,  

(July 2014)

UCN-22484
Assignee's Release,  

(July 2014)

UCN-22483
Background Investigation of Non-Cleared Personnel,  

(August 2018)

UCN-22922
Badge Request Form,  

(October 2014)

UCN-21519
Bid Escrow Documents,  

(July 2018)

UCN-22526
Cargo Configuration for Trailers Entering Y-12 National Security Complex,  

(July 2014)

UCN-22522
Certificate of Background Investigation,  

(October 2012)

UCN-22916
Certificate of Current Cost or Pricing Data,  

(July 2014)

UCN-22437
Certification as a United States Citizen in Order to Handle UCNI/OUO,  

(April 2018)

UCN-22435
Certification of Most Favored Customer Pricing,  

(July 2014)

UCN-22478
Civil Penalties for Classified-Information Security Violations,  

(July 2014)

UCN-22381
CNS Subcontractor Personnel Exit Checklist,  

(August 2018)

UCN-4452S
CNS Subcontractor Submittal Status Sheet,  

(July 2014)

UCN-21681
Company Holiday Schedule 2019 N/A
Construction Labor Agreement,  

(May 2019)

N/A
Continuity of Services,  

(July 2014)

UCN-22400
Contractor's Request for Progress Payment,  

SF1443 (expires August 31, 2018) (legal-sized form from gsa.gov web site)

N/A
Cost Accounting Standards Notices and Certification,  

(February 2019)

UCN-22398
Cost Accounting Standards—Clauses,  

(February 2019)

UCN-22380
Daily Summary of Backcharge Work,  

(July 2014)

UCN-22347
EEO Preaward Clearance Request,  

(July 2014)

UCN-22482
Environment, Safety and Health Compliance—Alternative II,  

(July 2014)

UCN-22476
Environment, Safety and Health Compliance—Alternative III,  

(July 2014)

UCN-22479
Environment, Safety and Health into Work Planning and Execution, Integration of, Alternative I,  

(July 2014)

UCN-22481
Equipment List,  

(August 2019)

UCN-22826
Exemption from Application of the Service Contract Act — Certain Services — Certification,  

(July 2014)

UCN-22361
Exemption from Application of the Service Contract Act — Certain Services — Requirements,  

(July 2014)

UCN-22353
Exemption from Application of the Service Contract Act — Maintenance, Calibration or Repair of Certain Equipment — Certification,  

(July 2014)

UCN-22355
Exemption from Application of the Service Contract Act — Maintenance, Calibration or Repair of Certain Equipment — Requirements,  

(July 2014)

UCN-22354
Exhibit 11, Limited Rights in Proprietary Data,  

(July 2014)

UCN-22510
Exhibit 12, Restricted Rights Notice,  

(July 2014)

UCN-22504
Exhibit 13, Seller Licensing,  

(July 2014)

UCN-22505
Exhibit 15, Rights in Data — Special Works,  

(July 2014)

UCN-22506
Exhibit 1B, Patent Rights — Acquisition by the Government,  

(July 2014)

UCN-22511
Exhibit 1C, Patent Rights — Retention by the Seller (Short Form),  

(July 2014)

UCN-22512
Exhibit 2, Representation of Limited Rights Data and Restricted Computer Software,  

(July 2014)

UCN-22513
Exhibit 21, Rights in Data — Facilities,  

(October 2016)

UCN-22502
Exhibit 2B, Questionnaire (Petition for Advance Waiver of Patent Rights under 41 CFR Sect. 9-9.109-6),  

(May 2017)

UCN-22514
Exhibit 2D, Refund of Royalties,  

(July 2014)

UCN-22515
Exhibit 4, Authorization and Consent,  

(May 2017)

UCN-22507
Exhibit 7, Classified Inventions,  

(May 2017)

UCN-22508
Exhibit 9, Technical Data,  

(July 2014)

UCN-22509
Exhibit CCS, Commercial Computer Software — Restricted Rights,  

(July 2014)

UCN-22503
Export Compliance,  

(July 2014)

UCN-22523
Export Compliance (MPO),  

(July 2014)

UCN-22524
Facilities Capital Cost of Money Factors Computation,  

CASB-CMF

N/A
Facility Clearance,  

(July 2014)

UCN-22402
Fair Labor Standards Act and Service Contract Act—Price Adjustment,  

(July 2014)

UCN-22362
Fair Labor Standards Act and Service Contract Act—Price Adjustment (Multiple Year and Option Contracts),  

(July 2014)

UCN-22363
Government Property—Research and Development,  

(July 2014)

UCN-22406
Hazardous Materials Identification and Material Safety Data,  

(July 2014)

UCN-22480
Identification and Protection of UCNI/OUO Information,  

(April 2018)

UCN-22414
Indemnification and Medical Liability Insurance,  

(July 2014)

UCN-22348
Individual Accident/incident Report,  

DOE F 5484.3, (May 1998)

N/A
Integrated Safety Management Program,  

(January 2019)

N/A
International Traffic in Arms Regulations (ITAR) Notice and Acknowledgement,  

(July 2014)

UCN-22327
Inventory of Government Property,  

(November 2000)

N/A
Letter of Intent to Perform as a Subcontractor/Teaming Partner,  

(July 2014)

UCN-22525
Milestone Payments,  

(July 2014)

UCN-22399
Motor Vehicle Leases,  

(July 2014)

UCN-22376
Nuclear Hazards Indemnity and Price-Anderson Amendments Act,  

(July 2017)

UCN-22433
Organizational Conflicts of Interest,  

(July 2014)

UCN-22401
Organizational Conflicts of Interest Disclosure—Advisory and Assistance Services,  

(July 2014)

UCN-22403
Payment Bond — Construction Contracts,  

(January 2015)

UCN-22410
Payment Bond — Other Than Construction Contracts,  

(January 2015)

UCN-22411
Performance Bond — Construction Contracts,  

(January 2015)

UCN-22412
Performance Bond — Other Than Construction Contracts,  

(January 2015)

UCN-22413
Personal Property Taxes,  

(July 2014)

UCN-22377
Pre-Employment Certification Letter,  

(January 2011)

UCN-22440
Procurement of Quality or Risk Significant Products or Services,  

(July 2014)

UCN-22405
Progress Payments,  

(May 2015)

UCN-22384
Property and Materials Certificate,  

(July 2014)

UCN-22544
Proposal Bond,  

(July 2014)

UCN-22423
Release and Certificate of Final Payment,  

(January 2018)

UCN-22371
Release and Certificate of Interim Payment,  

(March 2015)

UCN-22372
Reporting Requirements,  

(July 2014)

UCN-22407
Representations and Certifications,  

(November 2016)

UCN-22338
Representations Regarding Subcontracting Plans,  

(March 2018)

UCN-22349
Request for Information (RFI),  

(July 2014)

UCN-22350
Request for Inspection of Completed Work,  

(July 2014)

UCN-22346
Request for Waiver or Deviation,  

(January 2016)

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

(January 2016)

UCN-13816C
Request to Work Outside Normal Work Days (Friday, Saturday, Sunday),  

(August 2019)

UCN-26030
Required Training,  

(September 2018)

UCN-22529
Security Requirements for Non-Possessing Facilities,  

(February 2018)

UCN-20856
Seller Safety Qualification Questionnaire,  

(January 2015)

UCN-21752
Seller's Assignment of Refunds, Rebates, Credits, and Other Amounts,  

(July 2014)

UCN-22379
Seller's Release,  

(July 2014)

UCN-22485
Sensitive Foreign Nations Controls,  

(July 2014)

UCN-22415
Service Contract Act of 1965, As Amended,  

(July 2014)

UCN-22416
Small Business Subcontracting Plan,  

(December 2018)

UCN-22434
Special Tooling,  

(July 2014)

UCN-22417
Stand-Alone Aircraft Insurance Clause,  

(May 2017)

UCN-26544
Statement and Acknowledgement,  

SF1413

N/A
Statement of Equivalent Rates for Federal Hires,  

(July 2014)

UCN-22418
Subcontract Badge/Clearance Status Report UCN-21709
Subcontract Badge/Clearance Status Report,  

(January 2014)

UCN-21709
Subcontract Overtime Request UCN-22373
Subcontract Pricing Proposal (Cost or Pricing Data Required),  

(March 2015)

UCN-22382
Subcontract Request for Travel, Pre-Approval,  

(December 2014)

UCN-22351
Subcontract Safety Performance Report,  

(June 2017)

UCN-21439
Subcontract Technical Representative (STR) Change Notice,  

(July 2014)

UCN-21329
Subcontractor Hazardous Materials Inventory Report,  

(January 2018)

UCN-21445
Subcontractor Request for Y-12 National Security Complex Training,  

(July 2014)

UCN-21364
Subcontractor's Invoice for Travel and/or Services,  

(July 2014)

UCN-6573
Subcontractor/Supplier List,  

(January 2015)

UCN-22825
Submittal Checklist,  

(January 2017)

UCN-22212
Supplemental Conditions, Construction,  

(CON July 2018)

N/A
Supplier Information,  

(July 2016)

UCN-22533
Supplier’s Experience/Past Performance Statement,  

(March 2016)

UCN-22827
Suspect/Counterfeit Fastener Certification,  

(December 2018)

UCN-22438
Suspect/Counterfeit Part Headmark List,  

(April 2012)

UCN-20087A
Sustainable Acquisition Program,  

(August 2018)

UCN-22645
Sustainable Acquisition Program — Construction,  

(August 2018)

UCN-22646
Time Record of Subcontractor’s Employee,  

(January 2017)

UCN-26482
Transparency Act — Executive Compensation and Subcontracting Reporting Information (Company),  

(October 2014)

UCN-22565
Travel Reimbursement Policy,  

(November 2016)

UCN-22427
UCNI/OUO Information Protection Requirements for CNS Suppliers,  

(March 2018)

UCN-26608
Workplace Substance Abuse Program,  

(July 2014)

UCN-22345
Y-12 Subcontractor Security Clearance Certification,  

(May 2013)

UCN-22965