TPSU_-_Nutrition_Svcs_-_SOL.doc

NUTRITION SERVICES – TAOS-PICURIS SU

OF

PURPOSE:

To provide Nutrition Services under a non-personal services contract at the Taos-Picuris Service unit. Contractor is responsible for providing nutrition services for Native American patients who reside within the Taos/Picuris Service Unit area.

SCOPE OF WORK:

The Contractor shall conduct a nutritional and physical activity assessment, and shall provide appropriate education and nutritional counseling to patients, individuals, and/or groups.

The Contractor shall establish long term goals with patients, including individualized plans for meals and snacks, along with goals for life style changes regarding nutrition and exercise. These goals and the patient’s progress will be reviewed with the patient on an agreed upon periodic basis.

The Contractor shall provide the patient with written instructions regarding exercise and nutritional goals.

The Contractor shall provide consultation and/or in-service training on nutrition to health center staff, community programs, families, and others.

The Contractor shall document patient appointment in individual health records via the Electronic Health Record (EHR) within 48 hours of the patient contact.

Contractor maintains health record in accordance with established Policy and Protocols in compliance with Privacy Act, HIPAA and other IHS Standards.

PERIOD OF PERFORMANCE :

The period of performance shall commence on June 1, 2016, and shall not extend beyond the contract completion date of April 30, 2017, unless changed by a written amendment to the contract and approved by the Contracting Officer.

If the Government exercises its option to renew pursuit to FAR Clause: 52-217-9, Option to Extend the Term of this Contract, the following schedule shall prevail:

First Year Option: June 1, 2017 through April 30, 2018

Second Year Option: June 1, 2018 through April 30, 2019

Third Year Option: June 1, 2019 through April 30, 2020

Fourth Year Option: June 1, 2020 through April 30, 2021

Total contract award shall not exceed five years. Option year renewals will be on the basis of satisfactory services provided availability of funds for the appropriate fiscal year, and on the basis of existing requirements.

SCHEDULE OF DELIVERABLES OR REPORTING REQUIREMENTS:

Delivery and accountability of work shall be documented by the Contracting Officer’s Representative (COR).

The Contractor shall document all patient contacts that must be completed within 48 hours of the patients visit using the Resource and Patient Management System (RPMS) and Electronic Health Record (EHR).

The Contractor shall complete a quarterly narrative of the number of patients seen, types of services rendered to these patients and hours worked.

The Contractor shall send invoices to the Healthy Heart Project Director for certification that satisfactory services have been received in accordance with the Scope of Work of the contract then forwarded to the COR. Upon the COR’s certification, the invoice shall be forwarded to the Area Finance for payment.

The Contractor shall call in if unable to work due to illness or unanticipated events, as soon as possible in order to make necessary changes in the provider's schedule.

CONTRACTOR RESPONSIBILITY FACTORS

The Contractor shall possess a valid state license in one or more states as a Registered Dietitian.

The Contractor shall have at least three years of experience in providing nutrition assessments, counseling, and patient education.

The Contractor shall have documentation of past three years of employment and training history and two written verifiable reference letters addressing applicant's reliability, interpersonal interaction and suitability of position.

The Contractor shall have previous experience working in community based settings to provide group and individual nutrition counseling services.

The Contractor shall possess an advance level of knowledge of current scientific information regarding nutrition, diet, and health with regards to diabetes. The Contractor shall have the ability to translate this knowledge into patient nutrition plans and communicate these plans effectively to clinicians and patients.

The Contractor shall have a full range of skills in presenting ideas orally, visually and in writing in a clear, concise and persuasive manner.

The Contractor shall have the ability to adapt principles or nutrition management to prepare culturally appropriate educational materials for dissemination.

The Contractor shall be responsible for reporting all taxes from wages earned under the contract to the appropriate Federal, State and local agencies.

The Contractor shall be responsible for his/her own transportation, travel and per diem expenses in the performance of this contract.

The Contractor shall be responsible for maintaining satisfactory standards of competence, conduct, appearance and integrity. The quality of work performance of the Contractor shall be subject to review.

The Contractor shall be familiar and Knowledgeable of the "Privacy Act of 1996", the Health Insurance Portability and Accountability Act "HIPAA", and the use of confidential information as an integral part of the everyday duties. The privacy of individuals must be protected to the fullest extent possible.

CONTRACTOR RESPONSIBILITY:

The contractor is responsible for ensuring the following health requirements are met prior to performance of service; if a medical provider under personal service contract:

1. Evidence of current immunization for tetanus, rubella, rubeola and hepatitis B (O positive titer)

2. Evidence of negative PPD or chest x-ray if history of positive PPD must be provided within one (1) month of assignment

3. Complete and return the form "Addendum to Declaration for Federal Employment. Completed document shall be returned to the Contracting Officer. Failure to respond may be cause for termination.

4. Is subject to character investigation in the performance of the contract in accordance with P.L. 101-0630, "Indian Child Protection and Family Violence Act of 1990".

IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES:

The Contractor is not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service.

All patient related data are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR 352.224-70).

Upon completion/termination of the contract, all information, statistical or analytical material or Reports; and other data generated by the Contractor shall become the property of the Indian Health Service.

The Contractor is prohibited from gathering data, statistics, or use of material for publication and/or research for its own benefits. Dissemination of Information, prior approval shall be obtained from the Government Contracting Officer for the release or dissemination of information related to this contract. Information includes, but is not limited to: news releases, articles, manuscripts, advertisements, reports, still and motion pictures, speeches, trade association meetings, symposia, brochures, etc.

IHS CONTRACTING OFFICER:

The authority to negotiate a change in terms, conditions, or amounts cited is reserved for the HIS Contracting Officer. The COR designated holds no such authority.

CONTRACT OFFICER’S REPRESENTATIVE:

Connie Loretto, Taos-Picuris Service Unit, 1090 Goat Springs Road, Taos, NM 87571, Telephone No. (575) 758-6966, is hereby designated as Contract Officer’s Representative for this service. The Contract Officer’s Representative’s responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer’s Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

REVIEW, APPROVAL AND EVALUATION:

Review and approval of the work hereunder shall be performed by the Contracting Officer or his duly authorized representative.

Evaluation of services performed under this contract will be made jointly by the Contractor and the Government COR during the term of this contract and results of such evaluation made a part of the contract file. The evaluation report will be directed toward the progress made in meeting the contract objectives. Evaluation will be conducted on a date mutually agreed between the Contractor and Government COR.

QUALITY ASSURANCE:

The work of the contractor is subject review as part of the Albuquerque Indian Health Centers Quality Assurance Program. Review will consist of assignments accomplished, and COR’s review of work. The contractor is required to correct any deficiencies identified. Failure to take corrective action may result in termination of the contract. The contract may also be terminated for cause if facilities are endangered or harmed as a result of the contractor's action.

HOURS OF SERVICE

The hours of business and clinical operation for most IHS facilities are normally from 8:00 AM to 4:30 PM, Monday through Friday, except all federal holidays.

IHS clinics are usually closed for lunch break from 12:00 Noon to 1:00 PM, the Contractor may take a lunch break during this time. If the Contractor chooses not to take a lunch break, it cannot be claimed or invoiced as time worked.

Travel to and from the facility/office site are not included in the tour of duty and cannot be invoiced as part of the tour of duty day.

If this contract requires services to be provided at an IHS facility/Clinic located on any one of the Indian Reservations, and the Contractor is unable to provide services due the closure of the community for religious observation, the services will be rescheduled by mutual agreement between the Project Office and the Contractor.

INVOICE SUBMISSION

PROPER INVOICE: Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule,progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice,must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on eachinvoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visithttp://fedgov.dnb.com/webform.

The Contractor shall submit invoices once per training IN ARREARS. A proper invoice with all required back-updocumentation shall be sent electronically via e-mail to the following:

1.Buyer: Patricia Trujillo, patricia.trujillo@ihs.gov

2.Contracting Officer’s Representative (COR): Bernadine Letcher, bernadine.letcher@ihs.gov

3.Albuquerque Finance: alb_aoapinvoices@ihs.gov

Do not send non-invoice related documents (i.e. deliverables, reports, balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract/order number, and invoice number (e.g. Company Name, Contract HHSI2422014XXXXXX, Invoice #123). The Contractor shall send one email per contract/order. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

PROPER INVOICE: Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule,progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice,must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on eachinvoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visithttp://fedgov.dnb.com/webform.

The Contractor shall submit invoices once per training IN ARREARS. A proper invoice with all required back-updocumentation shall be sent electronically via e-mail to the following:

1.Buyer: Patricia Trujillo, patricia.trujillo@ihs.gov 2.Contracting Officer’s Representative (COR): Connie Loretto, connie.loretto@ihs.gov 3.Albuquerque Finance: alb_aoapinvoices@ihs.gov Do not send non-invoice related documents (i.e. deliverables, reports, balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract/order number, and invoice number (e.g. Company Name, Contract HHSI2422014XXXXXX, Invoice #123). The Contractor shall send one email per contract/order. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word). Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).The Contractor shall submit invoices and narrative reports with the following information on each invoice.

The Contractor shall submit invoices directly to the following address:

E-INVOICE ADDRESS: alb_aoapinvoices@ihs.gov (for electronic invoices) or to address (If paper invoices):

Albuquerque Area Office

Indian Health Service

Division of Accounting Services

5300 Homestead Road, NE

Albuquerque, NM 87110

NVOICE: Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule,progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice,must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on eachinvoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visithttp://fedgov.dnb.com/webform.

The Contractor shall submit invoices once per training IN ARREARS. A proper invoice with all required back-updocumentation shall be sent electronically via e-mail to the following:

1.Buyer: Patricia Trujillo, patricia.trujillo@ihs.gov

2.Contracting Officer’s Representative (COR): Bernadine Letcher, bernadine.letcher@ihs.gov

3.Albuquerque Finance: alb_aoapinvoices@ihs.gov

Do not send non-invoice related documents (i.e. deliverables, reports, balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract/order number, and invoice number (e.g. Company Name, Contract HHSI2422014XXXXXX, Invoice #123). The Contractor shall send one email per contract/order. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

PROPER INVOICE: Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule,progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice,must be included in all invoices for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on eachinvoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visithttp://fedgov.dnb.com/webform.

The Contractor shall submit invoices once per training IN ARREARS. A proper invoice with all required back-updocumentation shall be sent electronically via e-mail to the following:

1.Buyer: Patricia Trujillo, patricia.trujillo@ihs.gov

2.Contracting Officer’s Representative (COR): Bernadine Letcher, bernadine.letcher@ihs.gov

3.Albuquerque Finance: alb_aoapinvoices@ihs.gov

Do not send non-invoice related documents (i.e. deliverables, reports, balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract/order number, and invoice number (e.g. Company Name, Contract HHSI2422014XXXXXX, Invoice #123). The Contractor shall send one email per contract/order. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

Training and training expenses are not covered by this contract, unless it is included as; training required by IHS for new technology or as requirement of the IHS and IHS itself has not had the required training to carry out its mission.

Per mandate by the U. S. Department of Treasury and effective July 1996, payments by Electronic Funds Transfer System will be made to the Contractors designated financial institute.

PAYMENT OFFICE:

The payment office is:

Albuquerque Indian Health Service

Division of Accounting Services

5300 Homestead Road, NE

Albuquerque, New Mexico 87110

Electronic Funds Transfer (EFT) Disbursed by:

U. S. Department of Treasury

Office of Disbursements

Austin, TX 73301

COMPENSATION

The contractor shall be compensated at the agreed contract amount based on invoices submitted and only for services in direct performance of this contract.

Overtime compensation is not authorized unless specifically included in the scope of work and approved.

DESIGNATION OF CONTRACTING OFFICER’S REPRESENTATIVE

Connie Loretto, Medical Records/Business Officer Manager, Taos/Picuris Health Center, 1090 Goat Springs Road, Taos, New Mexico 87571, telephone number (575) 758-4224 ext. 314, is hereby designated the COR to monitor the performance of this order on behalf of the Government COR will provide no supervisory or instructional assistance to Contractor personnel. The COR’s function is primarily to provide the contractor with working data. The COR is not empowered to make any commitments, nor authorized to make any changes which affect prices, terms, or delivery as specified on this order. Any such proposed changes shall be brought to the immediate attention of the ordering officer for action. The acceptance of any changes by the Contractor without specific approval and written consent of the order officer will be at the Contractor’s own risk.

IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES

The Contractor is not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service.

All patient related data are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR 352.224-70)

Upon completion/termination of the contract, all information, statistical or analytical material or Reports; and other data generated by the Contractor shall become the property of the Indian Health Service.

The Contractor is prohibited form gathering data, statistics, or use of material for publication and/or research for its own benefits. Dissemination of Information, prior approval shall be obtained from the Government Contracting Officer for the release or dissemination of information related to this contract. Information includes, but is not limited to: news releases, articles, manuscripts, advertisements, reports, still and motion pictures, speeches, trade association meetings, symposia, brochures, etc.

GOVERNMENT FURNISHED MATERIALS AND SUPPLIES/OFFICE FACILITEIS/EQUIPMENT

The Government may provide limited use of office space, office supplies & materials, computer, and routine office equipment i.e. fax machine, copy machine, etc.

CONTRACTOR FURNISHED MATERIALS AND SUPPLIES/OFFICE SUPPLIES/OFFICE/FACILITIES/EQUIPMENT

The Contractor may use his/her supplies, materials, and other equipment not available through the Government; but is not required.

FAR CLAUSES:

FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

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

FAR

TITLE DATE

52.212-1 Instructions to Offerors—Commercial Items (OCT 2015)

52.212-4 Contract Terms and Conditions—Commercial Items (MAY 2015)

52.212-2 Evaluation—Commercial Items (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers: Best Value in descending order of importance (i) past performance;

(ii) technical capability of the item offered to meet the Government requirement; (iii) price. Technical and past performance, when combined, are more important than price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

52.212-3 Offeror Representations and Certifications—Commercial Items (Apr 2016)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

(a) Definitions. As used in this provision-

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“Forced or indentured child labor” means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation”, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except-

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

“Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

“Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate-

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

“Sensitive technology”-

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically-

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

“Service-disabled veteran-owned small business concern”-

(1) Means a small business concern-

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

“Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

“Small disadvantaged business concern”, consistent with 13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that-

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-

(i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

“Subsidiary” means an entity in which more than 50 percent of the entity is owned-

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

“Veteran-owned small business concern” means a small business concern-

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

“Women-owned business concern” means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

“Women-owned small business concern” means a small business concern-

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program” (in accordance with 13 CFR part 127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States.

(b)

(1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the SAM website.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through http://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications-Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ______________.

[Offeror to identify the applicable paragraphs at (c) through (p) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it □ is, □ is not a small business concern.

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it o is, o is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it o is, o is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, that it □ is, □ is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is, □ is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that-

(i) It □ is,□ is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: __________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that-

(i) It □ is, □ is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: __________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:____________________________________

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that-

(i) It □ is, □ is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It □ is, □ is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) Representations required to implement provisions of Executive Order 11246-

(1) Previous contracts and compliance. The offeror represents that-

(i) It □ has, □ has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(ii) It □ has, □ has not filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that-

(i) It □ has developed and has on file, □ has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 cfr parts 60-1 and 60-2), or

(ii) It □ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American-Supplies, is included in this solicitation.)

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American-Supplies.”

(2) Foreign End Products:

Line Item No.

Country of Origin

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals-

(1) □ Are, □ are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) □ Have, □ have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property;

(3) □ Are, □ are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) □ Have, □ have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples.

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. §362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at .]

(1) Listed end products.

Listed End Product Listed Countries of Origin

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

□ (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

□ (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly-

(1) □ In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) □ Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards(Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.]

□ (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror □ does □ does not certify that-

(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

□ (2) Certain services as described in FAR 22.1003-4(d)(1). The offeror □ does □ does not certify that-

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and

(iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers.

(3) If paragraph (k)(1) or (k)(2) of this clause applies-

(i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Labor Standards wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and

(ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this provision to comply with debt collection…