forms to return with proposal 140P8320R0002.docx

SECTION B: Price Schedule

INSTRUCTIONS. On lump-sum-priced line items, provide the total price only. If no specific line item exists for a portion of the work, include the costs in a related item. In case of errors in summations, the total of the corrected amounts govern. Round totals and extended prices to whole dollars. Complete this page and return with other documents described in Section L.

All work shall be performed in accordance with the attached specifications, drawings, and wage determination. Refer to Definition of Line Items in specifications for details.

CONTRACT PRICE SCHEDULE

Repair/replace sewer collection pipes, Big Hole National Battlefield.

Item 1: Project Preliminaries

Item 2: Mobilization and demobilization

Item 3: Temporary Traffic Control

Item 4: Temporary Stormwater Pollution Prevention

Item 10: Project Closeout

Point of contact name: ______________________________ and e-mail: __________________________

This business’ registration is active in SAM __yes __no (check one).

The representations and certifications in SAM apply to this proposal (see FAR provision 52.204-8(b)(2)): __yes __no.

52.209-13 Violation of Arms Control Treaties or Agreements-Certification (JUN 2018)

(a) This provision does not apply to acquisitions below the simplified acquisition threshold or to acquisitions of commercial items as defined at FAR 2.101.

(b) Certification. [Offeror shall check either (1) or (2).] ___ (1) The Offeror certifies that–

(i) It does not engage and has not engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act (22 U.S.C. 2593a). The report is available via the Internet at https://www.state.gov/t/avc/rls/rpt/; and

(ii) No entity owned or controlled by the Offeror has engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act (22 U.S.C. 2593a). The report is available via the Internet at https://www.state.gov/t/avc/rls/rpt/; or ___ (2) The Offeror is providing separate information with its offer in accordance with paragraph (d)(2) of this provision.

(c) Procedures for reviewing the annual unclassified report (see paragraph (b)(1) of this provision). For clarity, references to the report in this section refer to the entirety of the annual unclassified report, including any separate reports that are incorporated by reference into the annual unclassified report.

(1) Check the table of contents of the annual unclassified report and the country section headings of the reports incorporated by reference to identify the foreign countries listed there. Determine whether the Offeror or any person owned or controlled by the Offeror may have engaged in any activity related to one or more of such foreign countries.

(2) If there may have been such activity, review all findings in the report associated with those foreign countries to determine whether or not each such foreign country was determined to be in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or to be not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. For clarity, in the annual report an explicit certification of non-compliance is equivalent to a determination of violation. However, the following statements in the annual report are not equivalent to a determination of violation:

(i) An inability to certify compliance.

(ii) An inability to conclude compliance.

(iii) A statement about compliance concerns.

(3) If so, determine whether the Offeror or any person owned or controlled by the Offeror has engaged in any activity that contributed to or is a significant factor in the determination in the report that one or more of these foreign countries is in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. Review the narrative for any such findings reflecting a determination of violation or non-adherence related to those foreign countries in the report, including the finding itself, and to the extent necessary, the conduct giving rise to the compliance or adherence concerns, the analysis of compliance or adherence concerns, and efforts to resolve compliance or adherence concerns.

(4) The Offeror may submit any questions with regard to this report by email to NDAA1290Cert@state.gov. To the extent feasible, the Department of State will respond to such email inquiries within 3 business days.

(d) Do not submit an offer unless—

(1) A certification is provided in paragraph (b)(1) of this provision and submitted with the offer; or

(2) In accordance with paragraph (b)(2) of this provision, the Offeror provides with its offer information that the President of the United States has

(i) Waived application under 22 U.S.C. 2593e(d) or (e); or

(ii) Determined under 22 U.S.C. 2593e(g)(2) that the entity has ceased all activities for which measures were imposed under 22 U.S.C. 2593e(b).

(e) Remedies. The certification in paragraph (b)(1) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly submitted a false certification, in addition to other remedies available to the Government, such as suspension or debarment, the Contracting Officer may terminate any contract resulting from the false certification.

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment. (AUG 2019)

(a) Definitions. As used in this provision— Covered telecommunications equipment or services, Critical technology, and Substantial or essential component have the meanings provided in clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition. Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Contractors are not prohibited from providing—

(1) A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(2) Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Representation. The Offeror represents that— 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.

(d) Disclosures. If the Offeror has responded affirmatively to the representation in paragraph (c) of this provision, the Offeror shall provide the following information as part of the offer—

(1) All covered telecommunications equipment and services offered (include brand; model number, such as original equipment manufacturer (OEM) number, manufacturer part number, or wholesaler number; and item description, as applicable);

(2) Explanation of the proposed use of covered telecommunications equipment and services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b) of this provision;

(3) For services, the entity providing the covered telecommunications services (include entity name, unique entity identifier, and Commercial and Government Entity (CAGE) code, if known); and

(4) For equipment, the entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known).

Solicitation #140P8320R0002, Replace sewer collection pipes Big Hole NB

Experience and Past Performance READ CAREFULLY: The purpose of this form is for the offeror to list construction projects performed during the past five (5) years that are similar to the work described in this solicitation. The number of projects listed shall not exceed ten (10) and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the capability criteria described in the Request for Proposal. Include area codes with all telephone numbers. Type or print legibly.

It is especially important that the offeror disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record.

Name of Contractor/Offeror:

Project Name:

Project Location:

Name of Owner:

Address of Owner:

Telephone Number:

Project Value:

Dates of Construction:

Description of the Project and Scope of Offeror’s Work

Performance Remarks

Key Personnel Qualifications READ CAREFULLY: The purpose of this form is for the Offeror to list the qualifications of all key personnel as described in the solicitation.

Experience and qualifications include those developed on previous jobs; jobrelated training courses; certificates and licenses; honors; and specialty skills that are relevant to the proposed project. Provide dates, but do not send documents.

Provide the state in which registration or license is held and the registration or license number. Fill in the information by typing or printing legibly.

NAME OF CONTRACTOR/OFFEROR:

PERSONNEL INFORMATION:

Name:

Job Title:

EDUCATION AND PROFESSIONAL REGISTRATION:

Top Educational Level Obtained:

Year:

Area of Specialization:

Professional Registrations:

EXPERIENCE AND QUALIFICATIONS

List of proposed subcontractors

The purpose of this form is for the Offeror to list the proposed subcontractors who will perform on the contract. Include a brief description of the work they will perform. Fill in the information by typing or printing legibly.

NAME OF CONTRACTOR/OFFEROR:

SUBCONTRACTOR NAME:

DUNS:

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

DUNS:

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

DUNS:

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

SUBCONTRACTOR NAME:

DUNS:

Address and website (if applicable):

DESCRIPTION OF PROPOSED SUBCONTRACT WORK:

Subcontractor Reference READ CAREFULLY: The purpose of this form is for the offeror to provide references for key subcontractors identified in the Instructions, Conditions, and Notices to Offerors (Section L) who are considered critical to the successful accomplishment of the project. Use as many sheets as necessary. These subcontractor references should include additional relevant projects similar to the work described in the plans and specifications. Include area codes with all telephone numbers. Fill in the information by typing or printing legibly.

SUBContractor (PROPOSED):

ADDRESS:

Project Name:

Name of Owner:

Location:

Prime Contractor

Telephone Number:

Subcontract $ Value:

Dates of Construction:

Dates of Construction:

Description & Scope of Work specific areas of experience (SEE INSTRUCTIONS FOR THE SUBMISSION OF OFFERS AND OTHER INFORMATION – capability CRITERIA):

General References READ CAREFULLY: The purpose of this form is for the offeror to provide the Government with general references in the spaces provided as described in the Instructions, Conditions, and Notices to Offerors (Section L). Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their relationships with the references may be considered less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record. Provide explanations on separate sheets as necessary.

Name of Contractor/Offeror:

Surety

Name of Surety:

Address of Surety:

Name of Agent:

Telephone Number:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Insurance Company

Name:

Address:

Name of Agent:

Telephone Number:

Types of Policies: