Attachment 003 Pre-Award Survey Form.docx
DOCX document 33 KB Posted
- Solicitation number
- 12805B24R0043
About this file
This document is an Attachment 003 Pre-Award Survey form related to a federal contract opportunity for Necropsy Coolers Cove Base Repairs in Manhattan, KS. The form includes representations and statements required from the offeror, such as confirmation of compliance with the Biobased Products Requirements clause and the Insurance Coverage clause. The offeror must complete and submit this form along with their proposal. The related federal contract opportunity is Solicitation Number 12805B24R0043, issued by the Department of Agriculture Agricultural Research Service (Plains Area). The solicitation is for the repair of necropsy coolers and cove base, with a site visit requirement. The solicitation has an offer due date and any amendments will be posted on SAM.gov. The procurement requires the use of biobased products and the contracting office will gather data on the timeliness of definitization of change order equitable adjustments.
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ATTACHMENT 003 PRE-AWARD SURVEY
PRE-AWARD SURVEY INFORMATION – Instructions, please complete, save document as a PDF and submit with business entity representative signature. If a check box is required, delete the box and put a text “X” in that space.
Solicitation Representations – For FAR References see Acquisition.gov for full context.
1.0. FAR 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment.
The Offeror represents that—
(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and
(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—
It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.
1.1. FAR 52.222-22 Previous Contracts and Compliance Reports.
The offeror represents that-
It □ has, □ has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation;
It □ has, □ has not filed all required compliance reports; and
Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained before subcontract awards.
1.2. Statement confirming review of Section H.15 BIOBASED PRODUCTS REQUIREMENTS. [insert business entity name] has reviewed solicitation section H.15 BIOBASED PRODUCTS REQUIREMENTS.”
1.3. Statement confirming compliance with the clause at AGAR 452.228-71 Insurance Coverage, see section H.1. [insert business entity name] can present evidence to show, as a minimum, the amounts of insurance coverage indicated by the clause at AGAR 452.228-71 Insurance Coverage.
Signature/Date of Business Entity Representative
File details come from the government source that posted it. Updated .