18-235-SOL-00015_FBO.pdf

17-235-SOL-00023

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

08/07/2017

1 32

John E Moss Federal Bldg 650 Capitol Mall, Suite 7-100 Sacramento CA 95814

California Office of the Director Multiple

CORDELL BAILEY

08/24/2017 1200 PT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1 Provide Alcohol Counselor Certification Training for Mental/Behavioral Health and Substance Use Disorder Staff

SEE ATTACHED STATEMENT OF WORK

Quotes packages must be submitted to the Contracting Officer via email Cordell.Bailey@ihs.gov and in the Subject Line insert, Response to Solicitation 17-235-SOL-00023.

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

PRICE SCHEDULE

The contractor shall survey California Tribal and Urban Substance Abuse/Mental Health programs to determine number of certified/uncertified counselors and training needs. Necessary training shall be provided. The contractor shall arrange for certification testing and certification.

Proposed Prices:

Unit Price Total Price

Survey $ $_______

Trainings

One five day training $ $________

(1 each)

Three two-day trainings $ $ _______

(3 each)

Reports $__________ $_________

(4 each)

Reimburse programs for participant travel/per diem $ 71,610

Certification testing and re-certification fees. Costs securing

Continuing Education Units for licensed providers.

Reimbursed on an actual cost basis. $ 12,000

TOTAL $_________

PERFORMANCE WORK STATEMENT

ALCOHOL COUNSELOR CERTIFICATION TRAINING

SECTION 1 GENERAL INFORMATION

This Performance Work Statement (PWS) defines the requirements for Alcohol Counselor Certification Training for the California Area Indian Health Services (CAIHS) on behalf of the Tribal and Urban Indians health programs of the California Area.

1.1 The Overall Purpose

To train, educate, certify and re-certify alcohol and substance abuse counselors at California Tribal and Urban Substance Abuse/Mental Health programs throughout California. Training will be based upon a survey of the needs of these programs.

Training shall consist of one (1) five-day training and three (3) two-day trainings.

1.2 SCOPE

The Contractor will provide Alcohol Counselor Certification Training a described herein.

1.2.1 Period of Performance: September 1, 2018 to August 31, 2019.

1.2.2 Place of Performance: The Contractor shall perform the training sessions in the Sacramento area, at a local hotel or training center that can facilitate 40 - 50 people.

SECTION 2 DEFINITIONS

The language in this section is suggested for use only as appropriate and necessary.

2.1 Area

A defined geographical region for Indian Health Service administrative purposes.

2.2 Contracting Officer (CO)

A government employee authorized and warranted to issue contracts, and to make subsequent modification(s). The CO has full authority to make determinations on all changes and disputes regarding the contract.

2.3 Contractor

The individual awarded a legal binding contract to provide supplies and/or services.

2.4 Defective Service

A service output that does not meet the standard of performance requirement specified in the contract for that service.

2.5 Inspector

A government employee authorized to provide verbal and written performance direction to the Contractor that the Contractor must follow without exception.

2.6 Performance Requirement

The point that divides acceptable and unacceptable performance of a task according to the PRS and the Inspection of Services Clause.

2.7 Performance Requirements Summary

A listing of the service outputs under the contract that are to be evaluated by the project officer on a regular basis, the surveillance methods to be sued for these outputs, and the performance requirements of the listed outputs.

2.8 Project Officer

A government representative appointed by the CAIHS to assist in the management of the contract. The project officer will work cooperatively under the direction of the contracting officer.

2.9 Quality Assurance

A planned and systematic pattern of all government actions necessary to provide confidence that adequate technical requirements are established; products and services conform to established technical requirements; and satisfactory performance is achieved.

Quality assurance refers to actions by the government assurance functions for a contracted service.

2.10 Quality Control

Those actions taken by a contractor to control the production of outputs to ensure that they conform to the contract requirements.

SECITON 3 GOVERNMENT FURNISHED INFORMATION AND

PROPERTY

None

SECTION 4 CONTRACTOR FURNISHED PROPERTY

The contractor shall provide all equipment, material, and supplies necessary to provide Alcohol Counselor Certification training described herein.

SECTION 5 SPECIFIC REQUIREMENTS

The Contractor shall assess the training needs of the Tribal and Urban Indian alcohol and substance abuse counselors in the California area. This assessment will be based on the results of a survey of these programs the Contractor will perform, described below. Then, the Contractor will perform one (1) five-day training and three (3) two-day trainings which target the needs that were elucidated through the survey. The contractor will also make logistical arrangements for the meetings including conference facility costs for meeting space, securing lodging, and processing travel vouchers for the participants.

Additionally, the contractor will arrange and fund certification training for at least 10 alcohol and substance abuse counselors.

The contractor shall ensure that the performance standards of the contract are met. The contractor shall provide the required services during Federal government business days.

5.1 Survey of the Tribal & Urban Health Clinics

The contractor shall survey a minimum of 52 Tribal and Urban Indian health programs (see attached Directory of Health Programs), within 30 days of the start of the contract to determine the following:

5.1.1 The number of certified and non-certified alcohol and substance abuse counselors in each program.

5.1.2 The training required by the alcohol and substance abuse counselors for initial certification.

5.1.3 The training required by the alcohol and substance abuse counselors for re-certification.

5.1.4 The training desired by the alcohol and substance abuse counselors for further professional development.

5.1.5 The Contractor shall provide a copy of the survey results and report, to the Project Officer, by 45 days of the start of the contract.

5.2 Training of alcohol and substance abuse counselors

The Contractor shall provide pertinent training of alcohol and substance abuse counselors, on an approximately quarterly basis, in the following manner:

5.2.1 The Contractor shall provide one 5-day training session for Tribal and Urban Indian alcohol and substance abuse counselors in the California Area. The training content shall be dependent on the survey described in 5.1.

5.2.2 The Contractor shall provide three 2-day training sessions for Tribal and Urban Indian alcohol and substance abuse counselors in the California Area. The training content shall be dependent on the survey described in 5.1.

5.2.3 The Contractor shall provide reports of the above training, to the Project Officer, within 30 days of the end of the training sessions.

5.3 Arranging the logistics of training and participant travel The Contractor shall make logistical arrangements for training and participant travel in the following manner:

5.3.1 The Contractor shall secure a meeting space of adequate size to accommodate the alcohol and substance abuse counselors who will be attending the training session.

5.3.2 The Contractor shall secure lodging for participants of the training sessions at a hotel in close proximity, preferable in walking distance.

5.3.3 The Contractor shall process travel vouchers for training session participants, which will include reimbursement for transportation costs, lodging and meals, at the Federal per diem rate.

5.3.4 The Contractor shall set aside $71,610 to reimburse Tribal and Urban Indian health programs for the travel costs incurred by the participants of the training from their programs.

5.4 Arranging and funding of alcohol counselor certification testing The Contractor shall arrange and fund alcohol counselor certification testing for at least fifteen (10) counselors.

5.4.1 The Contractor shall arrange alcohol counselor certification testing with a certifying body which emphasizes the practice of substance abuse counseling and disorders for at least five (5) alcohol and substance abuse counselors and/or mental health professionals from Tribal and Urban Indian programs. One type of certifying agency is the California Certification Board of Alcohol and Drug Counseling (CCBADC),

5.4.2 The Contractor shall pay the certification, re-certification and associated testing fees for the counselors, as well as, associated travel costs for the examinees. Priority will be given to those counselors testing for initial certification. Re-certification fees will be provided if funds are available.

5.4.3 The Contractor will set aside $12,000 to be used for paying the testing certification fees.

5.5 Reports

The Contractor is responsible for providing reports to the Project Officer within 30 days of the completion of the survey and each training sessions.

SECTION 6 ADMINISTRATIVE

Billing will be fixed price for the survey, each report, and each training session. Contractors are required to fill the price schedule for payment calculation (see technical exhibit #2).

SECTION 7 ATTACHMENT/TECHNICAL EXHIBITS

7.1 Technical Exhibit # 1, Performance Requirements Summary

7.2 Technical Exhibit # 2, Directory of Health Programs

Performance Requirements Summary

Technical Exhibit # 1

Required Service Performance Indicator Standard Method of Surveillance Maximum Payment

5.1 Survey Tribal/Urban (T/U) Report results of survey (52) Report to Project Officer (PO) 12% sites in California Tribal/Urban Indian health progwithin 45 days start of contract

5.2 Train Alcohol/Substance One training each quarter Evaluations complete 30% Use Disorder staff after each training

5.3 Arrange for training Training site costs & Evaluations & review invoices 25% & participants travel individual travel costs quarterly

5.4 Arrange funding for Obtain the number of Quarterly reports & review 8% certification and re-cert. certified and un-certified budget submitted with report counselors

5.5 Write Quarterly Reports Obtain number of Number of testing fees reported 25% counselors and behavioral health staff trained

CALIFORNIA HEALTH PROGRAMS Last Updated: 7/26/2018 YELLOW for URBAN Offices

American Indian & Alaska Native Healthcare Jolene Lono, LCSW 1505 Dillingham Blvd., Ste. 205 Honolulu, HI 96817-4822 Voice: (808) 848-8000 Fax: (808) 848-8001

American Indian Health & Services Scott Black, Director 4141 State Street, Ste. B-11 Santa Barbara, CA 93110-2829 Voice: (805) 681-7356 Fax: (805) 681-7358

Bakersfield American Indian Health Project Dan Tatum, Director 1617 30th Street Bakersfield, CA 93301-1907 Voice: (661) 327-4030 Fax: (661) 327-0145

Cabazon Band of Mission Indians Nancy Markwardt, Office Manager 84-245 Indio Springs Parkway Indio, CA 92203-3499 Voice: (760) 342-2593 Fax: (760) 347-7880

California Rural Indian Health Board, Inc.

Mark Lebeau, Director (CRIHB) 1020 Sundown Way Roseville, CA 95661-4473 Voice: (916) 929-9761 Fax: (916) 929-7246

Central Valley Indian Health Chuck Fowler, Director 2740 Herndon Avenue Clovis, CA 93611-6813 Voice: (559) 299-2578 Fax: (559) 299-0245

Chapa-De Indian Health Program, Inc Lisa Davies, Director 11670 Atwood Road Auburn, CA 95603-9522 Voice: (530) 887-2800 Fax: (530) 887-2819

Cold Springs Rancheria Carol Bill, Chairperson 32861 Sycamore Road, Ste. 300, POB 209 Tollhouse, CA 93667-9513 Voice: (559) 855-2451 Fax: (559) 855-4443

Colusa Indian Community Council Catrina Ross, Director 3710 Hwy 45, Ste. A Colusa, CA 95932-4026 Voice: (530) 458-5501 Fax: (530) 458-8660

Consolidated Tribal Health Project Inc.

Richard Matens, Exec. Director P.O. Box 387 Calpella, CA 95418-0387 Voice: (707) 485-5115 Fax (707) 467-5650

Coyote Valley Tribal Council Melinda Hunter, Director 7601 North State Street, P.O. Box 39 Redwood Valley, CA 95470 -9663 Voice: (707) 485-8723 Fax: (707) 485-1247

Desert Sage Youth Regional Treatment Center Mark Espinosa, Director 39990 Faure Road (Physical) Hemet, CA. 92544-9408, P.O.Box 2748 Hemet, CA 92546-9408 Voice: 951-708-4019 Fax: 951-767-9520

Elem Indian Coloney Hiram Campbell, Tribal Admin.

P.O. Box 757 Lower Lake, CA 95457-0757 Voice: (707) 994-3400 Fax: (707) 994-3408

Feather River Tribal Health Inc.

Maria Hunzeker, Director 2145 5th Avenue Oroville, CA 95965-5870 Voice: (530) 534-5394 Fax: (530) 534-3820

Fresno American Indian Health Project Selina De La Pena, Director 1551 E. Shaw Avenue, Suite 139 Fresno, CA 93710-8012 Voice: (559) 320-0490 Fax: (559) 320-0494

Friendship House Assoc. of Amer. Inds.

Helen Waukazoo, Director 56 Julian Avenue San Francisco, CA 94103-3547 Voice: (415) 865-0964 Fax: (415) 865- 5428

Greenville Rancheria Lucretia Fletcher, CEO Director 410 Main Street, P.O. Box 279 Greenville, CA 95947-0279 Voice: (530) 528-8600 Fax: (530) 284-6612

Guidiville Indian Rancheria Ed Kimberly Dufour, Director P.O. Box 339 Talmage, CA 95481-0339 Voice: (707) 462-3682 Fax: (707) 462-9183

Hoopa Valley Tribe (Kima:w) Keith Dobbs, CEO 535 Airport Road, P.O. Box 1288 Hoopa, CA 95546-1288 Voice: (530) 625-4261 Fax: (530) 625-4842

Hopland Band of Pomo Indians Joseph San Diego, Director 3000 Shanel Road Hopland, CA 95449-9809 Voice: (707) 472-2100 Fax: (707) 744-1506

Indian Health Center of Santa Clara Valley Sonya Tetnowski, Director 1333 Meridian Avenue San Jose, CA 95125-5212 Voice: (408) 445-3400 Fax: (408) 448-1727

Indian Health Council, Inc.

Orvin Hanson, Acting Director P.O. Box 406 Pauma Valley, CA 92061-0406 Voice: (760) 749-1410 Fax: (760) 749-2151

Karuk Tribe of California Velda Williams, CEO 64236 2nd Avenue, P.O. Box 1016 Happy Camp, CA 96039-1016 Voice: (530) 493-1600 Fax: (530) 493-5322

KOI Nation of Northern California Darin Beltrans, Chairperson 705 College Avenue Santa Rosa, CA 95404-4106 Voice: (707) 331-9788 Fax: (707) 575-5506

Lake County Tribal Health Consortium Ernesto Padilla, Exec. Director 925 Bevins Court, P.O. Box 1950 Lakeport, CA 95453-1950 Voice: (707) 263-8382 Fax: (707) 263-0329

Mathiesen Memorial Health Clinic (CRIHB) John Vass, Executive Director 18144 Seco Street, POB 535 Jamestown, CA 95327-9710 Voice: (209) 984-4820 Fax: (209) 984-4825

M.A.C.T. Health Board, Inc.

John Alexander, Director 52 South Main St., PO Box 939 Angels Camp, CA 95222 -0939 Voice: (209) 754-6255 Fax: (209) 736-1813

Strong Family Health Center (Modoc) Candace Carlson, Exec. Director 1203 Oak Street Alturas, CA 96101-3225 Voice: (530) 233-4591 Fax: (530) 233-3055

Native American Health Center Martin Waukazoo, Director 1151 Harbor Bay Parkway, Suite 203 Alameda, CA 94502 -6533 Voice: (510) 747-3030 Fax: (510) 748-0116

Native Directions Inc.

Ramona Valadez, Director 13505 Union Road Manteca, CA 95336-9258 Voice: (209) 858-2421 Fax: (209) 858-4692

CALIFORNIA HEALTH PROGRAMS Last Updated: 7/26/2018 YELLOW for URBAN Offices

Northern Valley Indian Health Inder Wadhwa, Director 207 N. Butte Street Willows, CA 95988-2803 Voice: (530) 934-4641 Fax: (530) 934-3285

Pinoleville Pomo Nation Lenora Steele, Tribal Admin.

500 Pinoleville Dr., Ste. B Ukiah, CA 95482-7121 Voice: (707) 463-1454 Fax: (707) 463-6601

Pit River Health Services, Inc. (CRIHB) Glenna Moore, Director 36977 Park Avenue Burney, CA 96013-4067 Voice: (530) 335-0333 Fax: (530) 335-5241

Quartz Valley Indian Reservation (CRIHB) Kyle Nelson, Director 9024 Sniktaw Lane Fort Jones, CA 96032-9408 Voice: (530) 468-4470 Fax: (530) 468-4478

Redding Rancheria Tribal Health Center Glen Hayward, Director 1441 Liberty St.

Redding, CA 96001-0848 Voice: (530) 224-2700 Fax: (530) 224-2742

Riverside/San Bernardino County IHC Jess Montoya, Director 11555 1/2 Potrero Road Banning, CA 92220 -6946 Voice: (951) 849-4761 Fax: (951) 849-5612

Rolling Hills Clinic Lona Marioneaux-Ibanitoru, Director 740 Solono Street Corning, CA 96021-3352 Voice: (530) 690-2827 Fax: (530) 838-9026

Round Valley Indian Health Center, Inc.

James Russ, Exec. Director Corner of Hwy 162 & Bigger Ln., POB 247 Covelo, CA 95428-0247 Voice: (707) 983-6404 Fax: (707) 983-6184

Sacramento Native American Health Center Britta Guerrero, Director 2020 J Street Sacramento, CA 95811-3120 Voice: (916) 341-0575 Fax: (916) 341-0574

San Diego American Indian Health Cntr.

Joseph Bulfer, CEO 2602 First Avenue, Suite 105 San Diego, CA 92103-6599 Voice: (619) 234-1525 Fax: (619) 234-0505

Santa Ynez Band of Chumash Indians Ron Sisson, Director 90 Via Juana Lane Santa Ynez, CA 93460-9679 Voice: (805) 688-7070 Fax: (805) 686-2060

Scotts Valley Band of Pomo Indians Wally Lighthouse, Chief Financial Officer 1005 Parallel Dr.

Lakeport, CA 95453 -5643 Voice: (707) 263-4220 Fax: (707) 533-2873

Sherwood Valley Band of Pomo Indians Sherol McDade, Director 190 Sherwood Hill Drive Willits, CA 95490-4666 Voice: (707) 459-9690 Fax: (707) 459- 6936

Shingle Springs Tribal Health Programs Kasey Lonbaken, Director 5168 Honpie Road Placerville, CA. 95667-8635 Voice: (530) 387-4975 Fax: (530) 387- 8006

Sierra Tribal Consortium Yolanda Herrera, Director 610 West McKinley Ave.

Fresno, CA 93728-1425 Voice: (559) 445-2691 Fax: (559) 445-3125

Sonoma County Indian Health (CRIHB) Betty Arterberry, CEO 144 Stony Point Road Santa Rosa, CA 95401-4122 Voice: (707) 521-4545 Fax: (707) 526-1016

Southern Indian Health Council, Inc.

Carolina Manzano, CEO 4058 Willows Road Alpine, CA 91901-1668 Voice: (619) 445-1188 Fax: (619) 659-3144

Susanville Indian Rancheria Health Center Lassen Indian Health Center Kristofer Green, COO 795 Joaquin Street Susanville, CA 96130 -3628 Voice: (530) 257-2542 Fax: (530) 251-5208

Sycuan Band of Mission Indians Dan Barbara, Director 5442 Sycuan Road El Cajon, CA 92019-1816 Voice: (619) 445-0707 Fax: (619) 445-9764

Table Mountain Rancheria Dr. Marilyn Benck, Director 23736 Sky Harbor Road, P.O.B. 410 Friant, CA 93626-9733 Voice: (559) 822-3785 Fax: (559) 822-2928

Tejon Indian Tribe Octavio Escobedo, Chairperson 1731 Hasti-Acres Dr. #108 Bakersfield, CA 93309-4888 Voice: (661) 834-8566 Fax: (661) 834-8564

Toiyabe Indian Health Project (CRIHB) Amber Curley, Director 250 N. See Vee Lane Bishop, CA 93514-8058 Voice: (760) 873-8464 Fax: (760) 873-3935

Tule River Indian Health Center, Inc. (CRIHB) Zahid Sheikh, Director 380 N. Res. Rd., P.O. Box 768 Porterville, CA 93258-0768 Voice: (559) 784-2316 Fax: (559) 781-6514

Tule River Tribal Council (CRIHB) Neil Peyron, Tribal Chairperson 340 N. Res Rd., P.O. Box 589 Porterville, CA 93258-0589 Voice: (559) 781-4271 Fax: (559) 781-4610

Tuolumne Me-Wuk Indian Health Center LeAnne Piche-Ryan, Interim Director 18880 Cherry Valley Blvd Tuolumne, CA 95379-9506 Voice: (209) 928-5400 Fax: (209) 928-5412

United American Indian Involvement, Inc Jerimy Billy, Exec. Director 1125 West 6th Street, Suite 103 Los Angeles, CA 90017-1879 Voice: (213) 202-3970 Fax: (213) 202-3977

United Indian Health Services, Inc. (CRIHB) David Rosen, Acting CEO 1600 Weeot Way Arcata, CA 95521-4734 Voice: (707) 825-5000 Fax: (707) 825-6747

Warner Mountain Indian Health Project Jana Townsend, Director (CRIHB) 132 Mee Thee-Uh Rd, P.O. Box 247 Fort Bidwell, CA 96112 -0247 Voice: (530) 279-6194 Fax: (530) 279-6288

Wilton Rancheria Elena Tarango, Director 9728 Kent Street Elk Grove, CA 95624-2453 Voice: (916) 683-6000 Fax: (916) 683-6015

Auga Caliente Band Of Cahuilla Indians (S) Jeff Grubbee, Chairperson 5401 Dinah Shore Dr.

Palm Springs, CA 92264-5970 Voice: 760-699-6919 Fax: 760-699-6919

18-235-SOL-00015 Page 1 of 20

Contract Clauses and Provisions

52.212-1 Instructions to Offerors - Commercial Items. (Jan 2017)

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:

Listed in descending order of importance

(i) technical capability

(ii) past performance

(iii) 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 (Nov 2017)

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 located at https://www.sam.gov/portal. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) 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.

“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).

https://www.sam.gov/portal http://uscode.house.gov/ http://uscode.house.gov/

18-235-SOL-00015 Page 2 of 20

“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.

“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.

“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—

18-235-SOL-00015 Page 3 of 20

(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.

“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term “successor” does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

“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.

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(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 (t) 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 □ is, □ 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 □ is, □ 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.

http://www.acquisition.gov/ https://www.acquisition.gov/sites/default/files/current/far/html/52_212_213.html#wp1179194 https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%204_12.html#wp1073667

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(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.

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(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

(3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(g)(1) Buy American—Free Trade Agreements—Israeli Trade Act Certificate. (Applies only if the clause at

FAR 52.225-3, Buy American—Free Trade Agreements—Israeli Trade Act, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) 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 terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements–Israeli Trade Act.”

(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”:

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

https://www.acquisition.gov/sites/default/files/current/far/html/52_223_226.html#wp1192900 https://www.acquisition.gov/sites/default/files/current/far/html/FARTOCP25.html#wp225048 https://www.acquisition.gov/sites/default/files/current/far/html/52_223_226.html#wp1169038

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Line Item No. Country of Origin

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled “Buy American— Free Trade Agreements—Israeli Trade Act.” The offeror shall list as other 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.”

Other Foreign End Products:

Line Item No. Country of Origin

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(iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(2) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”:

Canadian End Products:

Line Item No.

(3) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements— Israeli Trade Act”:

Canadian or Israeli End Products:

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Line Item No. Country of Origin

(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American-Free Trade Agreements-Israeli Trade Act”:

Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country of Origin

(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled “Trade Agreements.”

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products:

Line Item No. Country of Origin

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part

25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer https://www.acquisition.gov/sites/default/files/current/far/html/52_223_226.html#wp1169038 https://www.acquisition.gov/sites/default/files/current/far/html/52_223_226.html#wp1169151

18-235-SOL-00015 Page 9 of 20 determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(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 $3,500 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.