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15B21621Q00000020/0001 Page 1 of 30

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1 1. CONTRACT ID CODE

I

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 15. PROJECT NUMBER w,_,.,.J

0001 04/08/2021

6. ISSUED BY CODE 15B216 7. ADMINISTERED BY (If other than Item 6) CODE I

Federal Bureau of Prisons Heidi Bourne FCI Elkton (0) 330-420-6476 8730 Scroggs Road hbourne@bop.gov Lisbon, OH 44432

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Coda) (X) 9A. AMENDMENT OF SOLICITATION NUMBER --l 5B2 I 621O00000020

X 9B. DATED (SEE ITEM 11)

04/08/2021

10A. MODIFICATION OF CONTRACT/ORDER

NUMBER

10B. DATED (SEE ITEM 13)

CODE I FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

~ The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers • is extended, (KJ is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing items 8 and 15. and returning __ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic commun ication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified .

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

ORDER NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor • is not, • is required to sign this document and return __ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

THIS SOLICITATION IS AMENDED DUE TO A SPECIFICATION CHANGE FOR COMMERCIAL DRYERS. PLEASE SEE ITEMIZED LINE AND ATTACHED AMENDED STATEMENT OF WORK, SECTION D, PAGE 2, NUMBER 2 & 3 FOR DETArLS. ALL OTHER

REQUIREMENTS REMAIN UNCHANGED.

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 1 OA, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED

(Signature of person authorized to sign)

Prev,ous ed1t1on unusable

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

Heidi Bourne

16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

By (Signature of Contracting Officer) 04/08/2021

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

I

15B21621 Q00000020/0001 Page 2 of 30

Table of Contents

Description Page Number

Solicitation/Contract Form Commodity or Services Schedule Contract Clauses

52 .239-101 DOJ Residency Requirement - Information Technology (NOV 2008) 52 .212-5 Alt I Contract Tenns and Conditions Required to Implement Statutes or Executive Orders- Commercial Items (Jan 202 1) - Alternate I (Feb 2000) BOP 2852.239-70 DOJ Residency Requirement - Information Technology (NOV 2008) 52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment (Aug 2020)

List of Attachments Solicitation Provisions

52 .204-24 Representation Regarding Certain Telecommunications and Video Survei llance Services or Equipment (Oct 2020) .................. .. ........ .......... .......... .. ....... ..... ......... ......... ... .. .. ... ........ .. ................ .. ..... ... I 5 52 .212-3 Offeror Representations and Certifications-Commercial Items (Feb 2021 )

52.2 12- 1 Instructions to Offerors-Commercial Items (Jun 2020) 52.204-16 Commercial and Government Entity Code Reporting (Aug 2020)

52.2 14-22 Evaluation of Bids for Multiple Awards (Mar l 990) .................... .. .................. .. .................. . l 7 52.212-2 Evaluation-Commercial Items (Oct 2014)

15821621Q00000020/0001 Page 3 of 30

Section 2 - Commodity or Services Schedule

REMOVE AND REPLACE 6 COMMERCIAL DRYERS PER THE SOW. BRAND NAME OR EQUAL TO SOLICITATION. COPY OF CURRENT INSURANCE MUST BE PROVIDED WITH QUOTE. DOL WAGE DETERMINATION ATTACHED FOR REFERENCE.

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 REMOVE AND REPLACE FIVE 200 LB COMMERCIAL DRYERS Previous : 6 EA $ $

PER THE ATTACHED SOW. THIS IS A BRAND NAME OR

EQUAL TO SOLICITATION . ALL QUOTES MUST PROVIDE

Change: -1 DETAILED SPECIFICATIONS TO INCLUDE ANY WARRANTIES

OFFERED. A COPY OF CURRENT INSURANCE CERT

REQUIRED WITH QUOTE. Current : 5

CURRENT DOL WAGE DETERMINATION IS ATTACHED FOR

REFERENCE.

Firm Fixed Price

PSC: 3510

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0002 REMOVE AND REPLACE ONE 75 LB COMMERCIAL DRYER Previous : 0 EA $ $

PER THE ATTACHED SOW. THIS IS A BRAND NAME OR

EQUAL TO SOLICITATION. ALL QUOTES MUST PROVIDE

Change: 1 DETAILED SPECIFICATIONS TO INCLUDE ANY WARRANTIES

OFFERED. A COPY OF CURRENT INSURANCE CERT

REQUIRED WITH QUOTE. Current : 1

CURRENT DOL WAGE DETERMINATION IS ATTACHED FOR

REFERENCE.

Firm Fixed Price

PSC: 35 10

Section 3 - Contract Clauses

A.1 ADDENDUM TO FAR 52.212-4, Commercial and Government Entity Code Reporting (Aug 2020)

The terms and conditions for the fo llowing clauses are hereby incorporated into this solicitation and resulting contract as an addendum to FAR clause 52.212-4.

Clauses By Reference

2.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

is contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full ext. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed lectronically at this/these address(es): www.acquisition.gov

Clause itle Fill-ins (if applicable)

15821621Q00000020/0001 Page 4 of 30

Clause Title Fill-ins (if applicable)

52.212-4 Contract Terms and Conditions-Commercial Items (Oct 2018)

Clauses By Full Text

52.239-10 I DOJ Residency Requirement - Information Technology (NOV 2008)

Department of Justice (DOJ) Order 2640.2F prohibits the use of non-U.S. citizens in the performance of this contract or commitment for any position that involves access to or assisting in the development, operation, management, or maintenance of any DOJ Information Technology System. By signing this contract or by beginning performance, the contractor agrees to this restriction .

[End of Clause]

BOP 2852.239-70 DOJ Residency Requirement - Information Technology (NOV 2008)

Department of Justice (DOJ) Order 2640.2F prohibits the use of non-U.S. citizens in the performance of this contract or commitment for any position that involves access to or assisting in the development, operation , management, or maintenance of any DOJ Information Technology System. By signing this contract or by beginning performance, the contractor agrees to this restriction.

[End of Clause)

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment (Aug 2020)

(a) Definitions. As used in this clause--

Backhaul means intennediate links between the core network, or backbone network, and the small subnetworks at the edge of the network (e.g., connecting cell phones/towers to the core telephone network). Backhaul can be wireless (e.g., microwave) or wired (e.g., fiber optic, coaxial cable, Ethernet).

Covered foreign country means The People's Republic of China.

Covered telecommunications equipment or services means--

(I) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affi liate of such entities);

(2) For the purpose of public safety, security of Government faci lities, physical securi ty surveillance of critical infrastructure, and other national securi ty purposes, video survei llance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities) ;

(3) Telecommunications or video surveillance services provided by such entities or using such equipment; or

(4) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Director of National Intell igence or the Director of the Federal Bureau oflnvestigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country.

Critical technology means--

( I) Defense articles or defense services included on the United States Munitions List set forth in the International Traffic in Arms Regulations under subchapter M of chapter I of title 22, Code of Federal Regulations;

(2) Items included on the Commerce Control List set forth in Supplement No. I to part 774 of the Export Administration Regulations under subchapter C of chapter VII of title 15, Code of Federal Regulations, and controlled--

15821621 Q00000020/0001 Page 5 of 30

(i) Pursuant to multilateral regimes, including for reasons relating to national security, chemical and biological weapons proliferation, nuclear nonproliferation, or missile technology; or

(ii) For reasons relating to regional stability or surreptitious listening;

(3) Specially designed and prepared nuclear equipment, parts and components, materials, software, and technology covered by part 810 of title 10, Code of Federal Regulations (relating to assistance to foreign atomic energy activities);

(4) Nuclear facilities, equipment, and material covered by part 110 of title 10, Code of Federal Regulations (relating to export and import of nuclear equipment and material);

(5) Select agents and toxins covered by part 331 of title 7, Code of Federal Regulations, part 121 of title 9 of such Code, or part 73 of title 42 of such Code; or

(6) Emerging and foundational technologies controlled pursuant to section 1758 of the Export Control Reform Act of 2018 (50 U.S.C.

4817) .

Interconnection arrangements means arrangements governing the physical connection of two or more networks to allow the use of another's network to hand off traffic where it is ultimately delivered (e .g. , connection ofa customer of telephone provider A to a customer of telephone company B) or sharing data and other information resources.

Reasonable inquiry means an inquiry designed to uncover any infonnation in the entity's possession about the identity of the producer or provider of covered telecommunications equipment or services used by the entity that excludes the need to include an internal or third-party audit.

Roaming means cellular communications services (e.g., voice, video, data) received from a visited network when unable to connect to the facilities of the home network either because signal coverage is too weak or because traffic is too high.

Substantial or essential component means any component necessary for the proper function or perfonnance of a piece of equipment, system, or service.

(b) Prohibition.

(I) Section 889(a)(l )(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 extend ing 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. The Contractor is prohibited from providing to the Government 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, unless an exception at paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described in FAR 4.2 104.

(2) Section 889(a)(l)(B) 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, 2020, from entering into a contract, or extending or renewing a contract, with an entity that uses 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, unless an exception at paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described in FAR 4.2104. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract.

(c) Exceptions. This clause does not prohibit contractors from providing--

(I) A service that connects to the faci lities ofa 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 .

( d) Reporting requirement.

(I) In the event the Contractor identifies covered telecommunications equipment or services used as a substantial or essential component of any system, or as critical technology as part of any system, during contract perfonnance, or the Contractor is notified of

15821621Q00000020/0001 Page 6 of 30 such by a subcontractor at any tier or by any other source, the Contractor shall report the information in paragraph ( d)(2) of this clause to the Contracting Officer, unless elsewhere in this contract are established procedures for reporting the information; in the case of the Department of Defense, the Contractor shall report to the website at https://dibnet.dod.mil. For indefinite delivery contracts, the Contractor shall report to the Contracting Officer for the indefinite delivery contract and the Contracting Officer(s) for any affected order or, in the case of the Department of Defense, identify both the indefinite delivery contract and any affected orders in the report provided at https://dibnet.dod. mil.

(2) The Contractor shall report the following information pursuant to paragraph (d)(l) of this clause

(i) Within one business day from the date of such identification or notification: the contract number; the order number(s), if applicable; supplier name; supplier unique entity identifier (if known) ; supplier Commercial and Government Entity (CAGE) code (if known); brand; model number (original equipment manufacturer number, manufacturer part number, or wholesaler number) ; item description; and any readily available information about mitigation actions undertaken or recommended.

(ii) Within 10 business days of submitting the information in paragraph (d)(2)(i) of this clause: any further available information about mitigation actions undertaken or recommended. In addition, the Contractor shall describe the efforts it undertook to prevent use or submission of covered telecommunications equipment or services, and any additional efforts that will be incorporated to prevent future use or submission of covered telecommunications equipment or services.

(e) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (e) and excluding paragraph (b)(2), in all subcontracts and other contractual instruments, including subcontracts for the acquisition of commercial items.

(End of clause)

[END OF ADDENDUM TO FAR 52.212-4]

52.2 12-5 Alt I Contract Terms and Conditions Required to Implement Statutes or Executive Orders Commercial Items (Jan 2021) - Alternate I (Feb 2000)

(a) The Contractor shall comply with the fo llowing Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(I) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)) .

(2) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 20 18) (Section 1634 of Pub. L. 115-91).

(3) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Survei llance Services or Equipment. (Aug 2020) (Section 889(a)(l)(A) of Pub. L. 115-232).

(4) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 20 15).

(5) 52.233-3, Protest After Award (Aug 1996) (3 1 U.S.C. 3553).

(6) 52.233-4, Applicable Law for Breach of Contract Claim (Oct 2004)(Public Laws I 08-77 and I 08-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.]

_ (I) 52.203-6, Restrictions on Subcontractor Sales to the Government (Jun 2020), with Alternate I (Oct 1995) ( 4 I U .S.C. 4 704 and 10 u.s.c. 2402).

_ (2) 52 .203-13, Contractor Code of Business Ethics and Conduct (Jun 2020) (4 1 U.S.C. 3509)).

15821621Q00000020/0001 Page 7 of 30

_ (3) 52 .203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (Jun 20 I 0) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of2009.)

_ (4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Jun 2020) (Pub. L. 109-282) (31 U.S.C.

610 1 note).

_ (5) [Reserved] .

_ (6) 52.204-14, Service Contract Reporting Requirements (Oct 20 16) (Pub. L. 111-11 7, section 743 of Div. C).

_ (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) (Pub. L. 111-11 7, section 743 of Div. C).

_ (8) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. (Jun 2020) (31 U.S.C. 6 101 note).

_ (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Oct 2018) ( 41 U.S.C. 2313).

_ (I 0) [Reserved].

_ (1 l)(i) 52.2 19-3, Notice of HUBZone Set-Aside or Sole-Source Award (Mar 2020) (15 U.S.C. 657a) .

_ (ii) Alternate I (Mar 2020) of 52.2 19-3 .

_ (l 2)(i) 52.2 I 9-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Mar 2020) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a).

_ (ii) Alternate I (Mar 2020) of 52 .2 19-4.

_ (13) [Reserved]

X ( 14)(i) 52.219-6, Notice of Total Small Business Set-Aside (Nov 2020) ( 15 U.S.C. 644) .

_ (ii) Alternate I (Mar 2020) of 52.219-6.

_ (15)(i) 52.219-7, Notice of Partial Small Business Set-Aside (Nov 2020) (15 U.S .C. 644) .

_ (ii) Alternate I (Mar 2020) of 52.2 19-7.

_ (16) 52.219-8, Utilization of Small Business Concerns (Oct 20 I 8) (15 U.S .C. 637(d)(2) and (3)).

_ (17)(i) 52.219-9, Small Business Subcontracting Plan (Jun 2020) ( 15 U.S.C. 637(d)(4)) .

_ (ii) Alternate I (Nov 2016) of 52.2 19-9.

_ (iii) Alternate II (Nov 2016) of 52.219-9.

_ (iv) Alternate III (Jun 2020) of 52.219-9.

_ (v) Alternate IV (Jun 2020) of52.219-9.

_ ( l 8)(i) 52.219- 13 , Notice of Set-Aside of Orders (Mar 2020) ( 15 U.S.C. 644(r)) .

_ (ii) Alternate I (Mar 2020) of 52.2 19-13 .

_ (19) 52.219-14, Limitations on Subcontracting (Mar 2020) (15 U.S.C. 637(a)( 14)).

_ (20) 52.2 19-16, Liquidated Damages--Subcon-tracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)).

_ (2 1) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (Mar 2020) (15 U.S.C. 657f).

15B21621Q00000020/0001 Page 8 of 30

_ (22)(i) 52.2 I 9-28, Post Award Small Business Program Rerepresentation (Nov 2020) ( I 5 U.S.C. 632(a)(2)).

_ (ii) Alternate I (Mar 2020) of 52.219-28.

_ (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (Mar 2020) ( 15 U.S.C. 637(m)).

_ (24) 52.2 I 9-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (Mar 2020) {15 U.S.C. 637(m)) .

_ (25) 52 .219-32, Orders Issued Directly Under Small Business Reserves (Mar 2020) (15 U.S.C. 644(r)).

_ (26) 52 .219-33, Nonmanufacturer Rule (Mar 2020) (15 U.S.C. 637(a){l 7)) .

X (27) 52.222-3, Convict Labor (June 2003) (E.O. 11755).

X (28) 52.222-19, Child Labor--Cooperation with Authorities and Remedies (Jan 2020) (E.O. 13126).

_ (29) 52.222-21, Prohibition of Segregated Faci lities (Apr 20 J 5).

X (30)(i) 52.222-26, Equal Opportunity (Sept 2016) (E.O. 11246).

_ (ii) Alternate I (Feb 1999) of 52.222-26.

_ {3l)(i) 52.222-35, Equal Opportunity for Veterans (Jun 2020) (38 U.S.C. 4212) .

_ (ii) Alternate 1 (July 2014) of52.222-35.

_ (32)(i) 52.222-36, Equal Opportunity for Workers with Disabilities (Jun 2020) (29 U.S.C. 793).

_ (ii) Alternate I (July 2014) of 52.222-36.

_ (33) 52.222-37, Employment Reports on Veterans (Jun 2020) (38 U.S.C. 4212).

_ (34) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 20 I 0) (E.O. 13496).

X (35)(i) 52 .222-50, Combating Trafficking in Persons (Oct 2020) (22 U.S.C. chapter 78 and E.O. 13627).

_ (ii) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627).

_ (36) 52.222-54, Employment Eligibility Verification (Oct 2015). (Executive Order 12989). (Not applicable to the acquisition of commercially avai lable off-the-shelf items or certain other types of commercial items as prescribed in 22. 1803.)

_ (37)(i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S .C. 6962(c) (3)(A)(ii)) . (Not applicable to the acquisition of commercially available off-the-shelf items.)

_ (ii) Alternate I (May 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off the-shelf items.)

_ (38) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydro fluorocarbons (Jun 2016) (E.O. 13693).

_ (39) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Jun 20 16) (E.O.

13693).

_ ( 40)(i) 52.223-13 , Acquisition ofEPEAT®-Registered Imaging Equipment (Jun 2014) (E.O.s 13423 and 13514).

_ (ii) Alternate I (Oct 2015) of52.223-13 .

_ {41)(i) 52.223-1 4, Acquisition ofEPEAT®-Registered Televisions (Jun 2014) (E.O.s 13423 and 13514).

15B21621 Q00000020/0001 Page 9 of 30

_ (ii) Alternate I (Jun 2014) of 52.223-14.

_ (42) 52.223-15, Energy Efficiency in Energy-Consuming Products (May 2020) (42 U.S.C. 8259b).

_ (43)(i) 52 .223-16, Acquisition of EPEAT®-Registered Personal Computer Products (Oct 2015) (E.O.s 13423 and 13514).

_ (i i) Alternate I (Jun 2014) of52.223-16.

_ ( 44) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (Jun 2020) (E.O. 135 13).

_ (45) 52.223-20, Aerosols (Jun 20 16) (E.O. 13693).

_ (46) 52.223-21, Foams (Jun 2016) (E.O. 13693).

_ (47)(i) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

_ (i i) Alternate I (Jan 20 17) of 52.224-3 .

X (48) 52.225-1, Buy American--Supplies (Jan 2021 ) (4 1 U.S.C. chapter 83).

_ (49)(i) 52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act (Jan 2021) (4 1 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 21 12 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-1 82, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 11 0- 138, 112-41, 11 2-42, and 11 2-43 .

_ (i i) Alternate I (Jan 2021) of 52.225-3.

_ (i ii) Alternate II (Jan 2021) of52.225-3 .

_ (iv) Alternate fII (Jan 2021) of52 .225-3 .

_ (50) 52.225-5, Trade Agreements (Oct 2019) (19 U.S.C. 2501 , et seq., 19 U.S.C. 3301 note) .

_ (5 1) 52.225-13, Restrictions on Certain Foreign Purchases (June 2008) (E.O. 's, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

_ (52) 52.225-26, Contractors Performing Private Securi ty Functions Outside the United States (Oct 20 I 6) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note) .

_ (53) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150).

_ (54) 52.226-5, Restrictions on Subcontracti ng Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150).

_ (55) 52.229-12, Tax on Certain Foreign Procurements (Jun 2020).

_ (56) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C. 4505, IO U.S.C. 2307(t)) .

_ (57) 52 .232-30, Installment Payments for Commercial Items (Jan 2017) (41 U.S.C. 4505, JO U.S.C. 2307(f)) .

X (58) 52.232-33, Payment by Electronic Funds Transfer--System for Award Management (Oct 20 18) (31 U.S.C. 3332).

_ (59) 52.232-34, Payment by Electronic Funds Transfer--Other than System for Award Management (Jul 2013) (3 1 U.S.C. 3332).

_ (60) 52.232-36, Payment by Third Party (May 2014) (31 U.S.C. 3332).

_ (6 1) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a).

_ (62) 52.242-5, Payments to Small Business Subcontractors (Jan 2017)(15 U.S.C. 637(d)(13)) .

15B21621 Q00000020/0001 Page 10 of 30

_ (63)(i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. 124l(b) and JO U.S.C. 2631).

_ (ii) Alternate I (Apr 2003) of 52.247-64.

_ (iii) Alternate II (Feb 2006) of 52.247-64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.]

X (I) 52.222-41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67).

_ (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67) .

_ (3) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards-Price Adjustment (Multiple Year and Option Contracts) (Aug 20 18) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

_ (4) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards--Price Adjustment (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67) .

_ (5) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C. chapter 67) .

_ (6) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services- Requirements (May 2014) (4 1 U.S.C. chapter 67) .

_ (7) 52.222-55, Minimum Wages Under Executive Order 13658 (Nov 2020).

_ (8) 52.222-62, Paid Sick Leave Under Executive Order 13706 (Jan 2017) (E.O. 13706).

_ (9) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (Jun 2020) (42 U.S.C. 1792).

(d)(l) Notwithstanding the requirements of the clauses in paragraphs (a) , (b), and (c) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (d)( l ) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down sha ll be as required by the clause--

(i) 52.203-13, Contractor Code of Business Ethics and Conduct (Jun 2020) (41 U.S.C. 3509).

(ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiali ty Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(iii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 20 18) (Section 1634 of Pub. L. 115-91 ).

(iv) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Survei llance Services or Equipment. (Aug 2020) (Section 889(a)(l )(A) of Pub. L. 115-232).

(v) 52.2 19-8, Utilization of Small Business Concerns (Oct 2018) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds the applicable threshold specified in FAR I 9.702(a) on the date of subcontract award, the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities .

(vi) 52.222-2 1, Prohibition of Segregated Facilities (Apr 2015)

(vii) 52.222-26, Equal Opportunity (Sept 2016) (E.O. 11246).

15B21621 Q00000020/0001 Page 11 of 30

(viii) 52 .222-35, Equal Opportunity for Veterans (Jun 2020) (38 U.S.C. 4212).

(ix) 52.222-36, Equal Opportunity for Workers with Disabilities (Jun 2020) (29 U.S.C. 793).

(x) 52.222-37, Employment Reports on.Veterans (Jun 2020) (38 U.S.C. 4212).

(xi) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 20 I 0) (E.O. 13496). Flow down required in accordance with paragraph (t) of FAR clause 52.222-40.

(xii) 52.222-41 , Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67).

(xiii) (A) 52.222-50, Combating Trafficking in Persons (Oct 2020) (22 U.S.C. chapter 78 and E.O 13627).

(B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O 13627).

(xiv) 52.222-51 , Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment-Requirements (May 2014) (41 U.S.C. chapter 67) .

(xv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Requirements (May 2014) (41 U.S.C. chapter 67) .

(xvi) 52.222-54, Employment Eligibi lity Verification (Oct 20 I 5) (E.O. 12989).

(xvii) 52.222-55, Minimum Wages Under Executive Order 13658 (Nov 2020).

(xviii) 52.222-62, Paid Sick Leave Under Executive Order I 3706 (Jan 2017) (E.O. 13706).

(xix)(A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

(B) Alternate I (Jan 2017) of52.224-3.

(xx) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fisca l Year 2008; JO U.S.C. 2302 Note).

(xxi) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (Jun 2020) (42 U.S.C. 1792). Flow down required in accordance with paragraph (e) of FAR clause 52 .226-6.

(xxii) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx. l24l(b) and 10 U.S.C.

2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

(2) While not required, the Contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

(End of clause)

Section 4 - List of Attachments

No Clauses

No Attachments

15B21621Q00000020/0001 Page 12 of 30

Section 5 - Solicitation Provisions

52.2 I 2-1 Instructions to Offerors-Commercial Items (Jun 2020)

(a) North American Industry Classification System (NA/CS) code and small business size standard. The NAJCS code(s) and small business size standard(s) for this acquisition appear elsewhere in the solicitation. However, the small business size standard for a concern which submits an offer in its own name, but which proposes to furnish an item which it did not itself manufacture, is 500 employees.

(b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show--

(I) The solicitation number;

(2) The time specified in the solicitation for receipt of offers;

(3) The name, address, and telephone number of the offeror;

(4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary;

(5) Terms of any express warranty;

(6) Price and any discount terms;

(7) "Remit to" address, if different than mailing address;

(8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

(9) Acknowledgment of Solicitation Amendments;

( I 0) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and

(11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fa il to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

(c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 30 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation.

(d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples sha ll be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing.

(e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with subpart 4.10 of the Federal Acquisition Regulation), or alternative commercial items for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately.

(t) late submissions, modifications, revisions, and withdrawals of offers.

( 1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due.

15B21621 Q00000020/0001 Page 13 of 30

(2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is "late" and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acqui sition; and--

(A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or

(B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's contro l prior to the time set for receipt of offers; or

(C) If thi s solicitation is a request for proposals, it was the only proposal received.

(ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the Government, wi ll be considered at any time it is received and may be accepted.

(3) Acceptable evidence to estab lish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel.

( 4) If an emergency or unanticipated event interrupts norn1al Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the so lici tation on the first work day on which normal Government processes resume.

(5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers. Oral offers in response to oral solici tations may be withdrawn orally. If the solicitation authorizes facsimi le offers, offers may be withdrawn via facs imile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the so licitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt ofoffers, the identity of the person requesting withdrawal is establi shed and the person signs a receipt for the offer.

(g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received.

(h) Multiple awards. The Government may accept any item or group of items ofan offer, unless the offeror qualifies the offer by specific limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified.

The Government reserves the right to make an award on any item for a quanti ty less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer.

(i) Availability of requirements documents cited in the solicitation.

(l)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to--

GSA Federal Supply Service Specifications Section Suite 8 I 00 470 East L'Enfant Plaza, SW Washington, DC 20407 Telephone (202) 6 19-8925 Facsimile (202) 619-8978.

(i i) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)( I )(i) of this provision. Additional copies will be issued for a fee.

(2) Most unclassified Defense specifications and standards may be downloaded from the follow ing ASSIST websites:

(i) ASSIST (https ://assist.dla.mil/online/start/).

(ii) Quick Search (http ://quicksearch.dla.mil/).

(iii) ASSISTdocs .com (http ://assistdocs.com).

15B21621Q00000020/0001 Page 14 of 30

(3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by-

(i) Using the ASSIST Shopping Wizard (https://assist.dla.mil/wizardlindex.cfm) ;

(ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone (215) 697-2667/2179, Facsimile (215) 697- 1462.

( 4) Nongovemment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance.

U) Unique entity identifier. (Applies to all offers that exceed the micro-purchase threshold, and offers at or below the micro-purchase threshold if the solicitation requires the Contractor to be registered in the System for Award Management (SAM).) The Offerer shall enter, in the block with its name and address on the cover page of its offer, the annotation "Unique Entity Identifier" followed by the unique entity identifier that identifies the Offerer's name and address . The Offerer also shall enter its Electronic Funds Transfer (EFT) indicator, if applicable. The EFT indicator is a four-character suffix to the unique entity identifier. The suffix is assigned at the discretion of the Offerer to establish additional SAM records for identifying alternative EFT accounts (see FAR subpart 32 .11) for the same entity. If the Offerer does not have a unique entity identifier, it should contact the entity designated at www.sam.gov for unique entity identifier establishment directly to obtain one. The Offerer should indicate that it is an offerer for a Government contract when contacting the entity designated at www.sam.gov for establishing the unique entity identifier.

(k) [Reserved] .

(I) Debriefing. If a post-award debriefing is given to requesting offerers, the Government shall disclose the following information, if applicable:

( I) The agency's evaluation of the significant weak or deficient factors in the debriefed offerer's offer.

(2) The overall evaluated cost or price and technical rating of the successful and the debriefed offerer and past performance infonnation on the debriefed offerer.

(3) The overall ranking of all offerers, when any ranking was developed by the agency during source selection.

(4) A summary of the rationale for award;

(5) For acquisitions of commercial items, the make and model of the item to be delivered by the successfu l offerer.

(6) Reasonable responses to relevant questions posed by the debriefed offerer as to whether source-selection procedures set forth in the soli citation, applicable regulations, and other app licable authorities were followed by the agency.

(End of provision)

A.2 ADDENDUM TO FAR 52.212-1, Commercial and Government Entity Code Reporting (Aug 2020)

The terms and conditions for the following provisions are hereby incorporated into this solicitation as an addendum to FAR provision 52.212-1.

Provisions By Full Text

15B21621 Q00000020/0001 Page 15 of 30

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct 2020)

The Offeror shall not complete the representation at paragraph ( d)( I) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph ( c )(I) in the provision at 52.204-26, Covered Telecommunications Equipment or Services-Representation, or in paragraph (v)(2)(i) of the provision at 52.2 12-3, Offeror Representations and Certifications-Commercial Items. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision--

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(I) Section 889(a)(I )(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. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third party, such as back.haul , roaming, or interconnection arrangements; or

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

(2) Section 889(a)(I )(B) 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, 2020, from entering into a contract or extending or renewing a contract with an entity that uses 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. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third party, such as back.haul, roaming, or interconnection arrangements ; or

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

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https:/1 www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services."

(d) Representations. The Offeror represents that--

( I) It_ wi ll,_ wi ll 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)(I) of this section if the Offeror responds "will" in paragraph (d)( l ) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that--

1t _ 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 infonuation required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

15B21621 Q00000020/0001 Page 16 of 30

()) Disclosure for the representation in paragraph (d)()) of this provision. If the Offeror has responded "wi ll" in the representation in paragraph ( d)( I) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known) ;

(8) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and i!em description, as applicable); and

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

(ii) For covered services--

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(8) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b )( 1) of this provision.

(2) Disclosure for the representation in paragraph…

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