21Q0112 SOL.pdf

SEE ADDENDUM

(No Collect Calls)

N0040621Q0112 03-Feb-2021

b. TELEPHONE NUMBER

360-476-7587

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 10 Feb 2021

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

N004069. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

FERBIEN O. ENCOMIENDA

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

N6275821RCUS725

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

NAVSUP FLC PUGET SOUND

467 W STREET, 2ND FLR

ATTN: FERBIEN ENCOMIENDA

BREMERTON WA 98314

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE N62758 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

N62758 SRF AND JRMC

GOVT REPRESENTATIVE

SEE PAGE 4 OF ORDER FOR

SHIPMENT REQUEST PROCEDURES

. WA 00000

TEL: FAX:

360-476-1947FAX:

TEL: 360-476-7587 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$8,000,000

NAICS:

811310

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF55

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

N0040621Q0112

Section SF 30 - BLOCK 14 CONTINUATION PAGE

NOTICE TO OFFERORS

1. This solicitation is for the procurement of SERVICE TECH DAVIT ASSEMEBLY in support of SRF YOKOSUKA. It is anticipated that this solicitation will result in an award/order of a Firm, Fixed-Price Service type contract.

2. The entire solicitation shall be filled out, signed, and returned as part of your quote. See block 8 on page 1 of the solicitation for the closing date and time.

3. The deadline for submission of questions regarding the solicitation’s terms, conditions, specifications, and/or the statement of work (SOW) / performance work statement (PWS) is 2 days prior to the solicitation’s closing date.

4. The Government will award on the basis of price unless the contracting officer is aware of past performance information related to the low price quote/offer which indicates that quote/offer may not represent best value. In that case, the Government reserves the right to consider the past performance of other quotes/offers, conduct a price, past performance tradeoff, and award to other than the lowest price quote/offer.

5. SINGLE AWARD FOR ALL ITEMS: Due to the interrelationship of supplies and/or services to be provided hereunder, the Government reserves the right to make a single award to the quoter whose quote is considered in the best interest of the government, price and other factors considered. Therefore, quoters who quote less than the entire effort specified herein may be determined to be unacceptable.

6. “EXCEPTIONS: All quoters MUST note all exceptions from the solicitation’s terms conditions, specifications, and/or the statement of work / performance work statement, if any. It will be assumed that any quote without mention of any exceptions will take no exception from all specifications, terms and conditions, clauses, or provisions within the solicitation.”

7. All questions in regards to this solicitation shall be submitted, via email, to the Purchasing Agent / Contract

Specialist (listed below):

Name: FERBIEN O. ENCOMIENDA Email: FERBIEN.ENCOMIENDA@NAVY.MIL

PLEASE PROVIDE:

COMPANY NAME: __________________________________________________________

SAM CAGE CODE NUMBER: ____________________________________________

POC NAME: _______________________________________________

E-MAIL ADDRESS: ________________________________________

PHONE NUMBER: _________________________________________

LIST THE MFG AND COUNTRY OF ORIGIN:_______________________________

LIST YOUR COMPANIES SIZE: LARGE OR SMALL

CLAUSES 52.204-24, 52.204-26 & 52.209-11 MUST BE FILLED OUT

(YOUR COMPANY MUST BE REGISTERED WITH **SAM** (SYSTEM AWARD FOR

MANAGEMENT** IN ORDER TO RECEIVE A GOVERNMENT AWARD) (SAM REGISTRATION IS

FREE)

INTERNET ADDRESS FOR SAM IS: https://www.sam.gov

Government terms and conditions will be followed.

***For large or heavy items: metals, pipe, lumber etc. please ensure the shipment is properly wrapped, strapped, palletized or boxed up for shipment so it can be moved with a forklift.***

NOTE: In accordance with 52.212-4(f), in part, "The contractor will be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the contractor.." The contractor SHALL notify the Contracting Office and/or customer POC in writing immediately, but NO LATER THAN 2 weeks prior to expiration, for any delays, to include delivery dates and periods of performance specified in the schedule.

***NOTICE***

The public health considerations occasioned by the Coronavirus Disease 2019 (COVID-2019) continue to evolve. Every contractor should be mindful of current events, travel warnings, and health advisories, and of the potential impacts on personnel safety and contracted supplies and services. Offerors are responsible for understanding any travel restrictions or medical warnings/advisories that may be in effect for the place of performance and should price their proposal accordingly. Relevant information may be obtained from the U.S. Center for Disease Control at https://www.cdc.gov/coronavirus/2019-ncov/index.html, and from the U.S.

Department of State at:

https://travel.state.gov/content/travel/en/traveladvisories/COVID-19 -Country -Specific-Information.html.

1. At the direction of [insert relevant Command or civilian authority], contractor and subcontractor employees meeting any of the four criteria below are restricted from entering any U.S. Navy Instillation:

(a) Employees who have been in the People's Republic of China, South Korea, Italy, or Iran, or any region that the U.S. Center for Disease Control designates as a Warning Level 3 or higher due to COVID-19 [or other locations identified by the Command or civil authority]. These locations are referred to as "relevant locations." Contractor employees are restricted from entering [name installation or location] for 14 days from the latest date of departure from a relevant location.

(b) Employees who have been in close physical contact for an extended period of time with someone who has returned from a relevant location. Contractor employees are restricted from entering [name installation or location] for 14 days from the last day on which the employee had close physical contact with someone who has returned from a relevant location.

(c) Employees who have been in close physical contact with someone identified as having COVID-19. Contractor employees are restricted from entering [name installation or location] for 14 days from the last day on which the employee had close physical contact with someone identified as having COVID-19.

(d) Employees who have been diagnosed with COVID-19. Contractor employees who have been diagnosed with COVID-19 will not be permitted to access [name installation or location] until they have been cleared to do so by military personnel or by cognizant medical experts for those not serviced by military medical services.

2. Contractors will notify the U.S. Navy's contracting officer if they become aware that any of their employees or subcontractors who would otherwise seek to access [name installation or location] as part of performing contract requirements meet one or more of the four criteria above. The notice will provide the name of the contractor or subcontractor employee, identify the applicable criterion or criteria that applies, and explain (for criteria (a), (b), or (c)) when the 14 day period concludes.

FACE MASK INSTRUCTIONS MUST BE FOLLOWED:

Navy is committed to taking every precaution to ensure the health and wellbeing of our people and the nation in response to the coronavirus disease 2019 (covid-19) pandemic. Navy supports, and will continue to implement, all measures necessary to mitigate risks to the force, to our mission and to the spread of the disease. The center for disease control and prevention (CDC) recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission.

Effective immediately, to the extent practical, ALL individuals, “this includes Navy Contractors,” on DOD property, installations, and facilities are required to wear cloth face coverings when they cannot maintain six feet of social distance.

The below CDC guidance is acceptable. Face coverings will:

a. Fit snugly but comfortably against the side of the face

b. Be from nose to chin full face coverings (like ski masks) are not authorized

c. Be secured with ties or ear loops

d. Preferably include multiple layers of fabric if material is cloth

e. Allow for breathing without restriction

f. Medical or construction type masks, or other cloth covering such as bandanas, scarfs, etc. are acceptable. When in doubt, priority will be compliance with the CDC guidance for function over appearance or preferred date of implementation.

Questions pertaining to this memo or requests for copies of the references should be addressed to the Contracting Officer.

CONTRACTOR TRAVEL REQUIREMENTS

The following are the requirements for entry into Japan as of 2 November 2020 that Contractors shall comply with.

See Section 3 for Pre-departure requirements and Section 4 for procedures upon arrival in Japan.

1. IN UPDATE TO REF F, THE PURPOSE OF THIS MESSAGE IS TO

PROVIDE UPDATED POINT OF CONTACT INFORMATION TO SYSCOMS, WARFARE

CENTERS AND CONTRACTING ACTIVITIES RESPONSIBLE FOR THE COORDINATION

OF SHIP REPAIR AND MODERNIZATION EFFORTS IN JAPAN.

2. GUIDANCE ISO DOD AND INTERNATIONAL RESTRICTIONS AS A RESULT OF

COVID-19 MITIGATION ACTIONS. SRF-JRMC IS UTILIZING THE FUNCTIONALITY

OF THE REGIONAL MAINTENANCE AND MODERNIZATION COORDINATION OFFICE

(RMMCO) IDENTIFIED IN REFS (A) AND (B) TO MANAGE THESE UNIQUE TRAVEL

REQUIREMENTS.

3. ANY PERSONNEL SUPPORTING SRF-JRMC MAINTENANCE AND MODERNIZATION

SHALL COMPLY WITH THE GUIDANCE PROVIDED OR RISK DENIAL OF ENTRY TO

JAPAN AND/OR COMMANDER FLEET ACTIVITIES YOKOSUKA (CFAY) OR

COMMANDER FLEET ACTIVITIES SASEBO (CFAS). DUE TO COVID-19

RESTRICTIONS, ENTRY REQUIREMENTS TO JAPAN IN SUPPORT OF MISSION

ESSENTIAL MAINTENANCE/MODERNIZATION IN WHICH SRF-JRMC SERVES AS

THE NAVAL SUPERVISORY AUTHORITY (NSA) ARE AS FOLLOWS (PRE-DEPARTURE):

A. PERSONNEL MUST HAVE A VALID PASSPORT FOR THE INTENDED PERIOD

OF STAY IN JAPAN.

B. APPROVAL MUST BE OBTAINED THROUGH TRAVEL TRACKER INDIVIDUAL

ANTI-TERRORIST PLAN (TT/IATP) VIA THE IATP.PACOM.MIL WEBSITE. THIS

REQUIRES LEVEL 1 ANTI-TERRORIST AND SURVIVAL, EVASION, RESISTANCE,

AND ESCAPE (SERE) TRAINING BE ACCOMPLISHED VIA

JKODIRECT.JTEN.MIL/ATLAS2/PAGE/LOGIN/LOGIN.JSF WEBSITE; AND A

PERSONNEL RECOVERY MISSION SOFTWARE (PRMS) SUBMISSION THROUGH

PRMSGLOBAL.PRMS.AF.MIL.

C. APPROVAL MUST BE OBTAINED THROUGH AIRCRAFT AND PERSONNEL

AUTOMATED CLEARANCE SYSTEM (APACS) FOR ENTRY TO INDOPACOM AOR. (FOR

SRF-JRMC SPONSORED WORK, SEA21 WILL PROVIDE O7 APPROVAL. ALL OTHER

SPONSORS WILL OBTAIN O7 LEVEL APPROVAL VIA THEIR COC).

HTTPS:APACS.MILCLOUD.MIL

D. PERSONNEL MUST CONTACT THE SRF-JRMC YOKOSUKA, SASEBO AND CVN

RMMCO OFFICES AT DIST-RMMCO-YOKOSUKA(AT)SRF.NAVY.MIL,

DIST-RMMCO-SASEBO(AT)SRF.NAVY.MIL, OR

DIST-CVN76-RMMCO(AT)SRF.NAVY.MIL RESPECTIVELY, FOR ARRIVAL

PREPARATIONS AND VERIFICATION OF REQUIREMENTS.

E. FOR THOSE WITHOUT A COMMAND ACCESS CARD (CAC), BASE ACCESS

REQUESTS MUST BE THROUGH THE YOKOSUKA SECURITY OFFICER

MR. SEAEN DANYIS AT SEAEN.DANYUS(AT)SRF.NAVY.MIL OR THE SASEBO

SECURITY OFFICER MR. ANTONIO QUIJANO AT

ANTONIO.QUIJANO(AT)SRF.NAVY.MIL CONSISTING OF:

1. VISIT REQUEST LETTER ON COMPANY LETTERHEAD

2. INSTALLATION ACCESS REQUEST FORM

3. LETTER OF AUTHORIZATION (LOA) OR ORDERS

4. SECNAV 5512-1

5. COLOR COPY OF TRAVELERS PASSPORT

6. USFJ FORM 27

F. A PRE-DEPARTURE HEALTH SCREENING OF ALL TRAVELERS WILL BE

ACCOMPLISHED ICW RMMCO PRIOR TO BEING PERMITTED TO COMMENCE

TRAVEL.

G. UPON RMMCO VERIFICATION THAT ALL TRAVEL REQUIREMENTS ARE

MET, SRF-JRMC WILL ISSUE A SERIALIZED GOVERNMENT OF JAPAN (GOJ)

APPROVAL LETTER TO ACCOMPANY ALL OTHER REQUIRED DOCUMENTS, TO

INCLUDE; LETTER OF AUTHORIZATION (LOA) OR ORDERS AS PROOF OF SOFA

STATUS AND VALID PASSPORT. THESE DOCUMENTS WILL BE PRESENTED TO

JAPANESE IMMIGRATION OFFICIALS UPON ARRIVAL AT PORT OF ENTRY.

CURRENT AUTHORIZED PORT OF ENTRIES INCLUDE COMMERCIAL AIRPORTS AT

TOKYO (NRT OR HND) AND MILAIR VIA YOKOTA AND OTHER LOCATIONS

APPROVED BY C7F OR CPF.

4. UPON COMMENCING TRAVEL, THE FOLLOWING POST-DEPARTURE

REQUIREMENTS ARE IN EFFECT:

A. TRANSPORTATION FROM THE PORT OF ENTRY TO CFAY OR CFAS WILL

BE COORDINATED THROUGH THE RMMCO OFFICE. RMMCO OFFICE WILL PROVIDE

GOVERNMENT TRANSPORTATION INFORMATION ONLY. TRANSPORTATION WILL

BE VIA GOVERNMENT TRANSPORTATION AND SHALL NOT INCLUDE USE OF PUBLIC

TRANSPORTATION BETWEEN PORT OF ENTRY AND LOCAL RESTRICTION OF

MOVEMENT (ROM) BASE (CFAY OR CFAS). IT IS THE TRAVELERS

RESPONSIBILITY TO UTILIZE GOVERNMENT TRANSPORTATION FROM PORT OF

ENTRY TO CFAY OR CFAS.

B. TRAVELERS WILL BE TESTED FOR COVID-19 UPON ENTERING JAPAN

AND ARE HIGHLY RECOMMENDED TO BE TESTED FOR COVID VIRUS WITHIN

72 HOURS PRIOR TO TRAVELING. TRAVELERS WHO ARE FOUND POSITIVE FOR

COVID-19 MUST BE PREPARED FOR:

1. ISOLATION FOR A MINIMUM OF 14 DAYS WITHIN CFAY

BARRACKS OR DESIGNATED QUARANTINE FACILITY.

2. ROOM CLEANING CHARGE UP TO $1000.

3. CASH OR ELECTRONIC FUNDS TRANSFER TO ALLOW FOR

PURCHASING OF FOOD AND INCIDENTALS.

C. TRAVELERS WILL ENTER A 14 DAY ROM PERIOD ON BASE

(CFAY OR CFAS) AND WILL NOT BE ALLOWED TO UTILIZE PUBLIC

TRANSPORTATION. DAILY SELF HEALTH CHECKS WILL COMMENCE UPON

ENTRY INTO JAPAN. TRAVELERS SHOULD INCLUDE A PERSONAL THERMOMETER

FOR TAKING DAILY TEMPERATURE READINGS. THE DAILY HEALTH CHECKS WILL

BE REPORTED TO THE APPROPRIATE RMMCO OFFICE OR ON-SITE SPONSOR. IN

THE EVENT A TRAVELER SHOWS INDICATION OF INFLUENZA LIKE ILLNESS

(ILI), SRF-JRMC RMMCO OFFICE WILL COORDINATE FURTHER HEALTH

ASSESSMENT REQUIREMENTS WITH THE LOCAL MILITARY TREATMENT FACILITY

(MTF).

D. UPON COMPLETION OF THE 14-DAY ROM PERIOD, THE RMMCO OFFICE

WILL COORDINATE THE BASE CHECK IN PROCESS. ENTRY ON TO

COMMANDER FLEET ACTIVITIES YOKOSUKA OR SASEBO WILL REQUIRE:

1. CAC (IF GOVERNMENT EMPLOYEE)

2. REGISTRATION IN DBIDS IS CRITICAL TO ENSURE BASE ACCESS

PRIORITY ISO MISSION ESSENTIAL TASKING IN CASE BASE HPCON LEVEL

CHANGES.

3. VISIT REQUEST VIA JPAS FOR SHIPBOARD ENTRY.

4. GOVERNMENT ORDERS (IF GOVERNMENT EMPLOYEE) OR LETTER

OF AUTHORIZATION (IF CONTRACTOR EMPLOYEE). THESE DOCUMENTS SHOULD

INDICATE MISSION ESSENTIAL NATURE OF WORK.

5. SATISFACTORY DAILY SELF HEALTH CHECK.

E. COMMENCE WORK THROUGH WORK COMPLETION PERIOD. DAILY HEALTH

SCREENINGS WILL BE REQUIRED TO BE CONDUCTED BY EACH TRAVELER AND

REPORTED TO THEIR RESPECTIVE ONSITE LEAD OR SPONSOR, AND REPORTED TO

THE RMMCO OFFICE. ADDITIONAL SCREENINGS BY BASE OR SHIP PERSONNEL

ARE LIKELY AND MAY INCLUDE TEMPERATURE CHECKS. FACE MASKS ARE

MANDATORY TO BE WORN AT ALL TIMES WHILE ON BASE (CFAY OR CFAS), AND

HIGHLY ENCOURAGED TO BE WORN OFF BASE. IF AT ANY TIME A TRAVELER

SHOWS INDICATIONS OF ILI, THEY SHOULD RETURN OR REMAIN AT THEIR

TEMPORARY LODGING AND REPORT STATUS TO THEIR RESPECTIVE ONSITE

LEAD OR SPONSOR, TO BE REPORTED TO THE RMMCO OFFICE.

F. UPON COMPLETION OF WORK, TRAVELERS SHALL REPORT AND CHECKOUT

WITH THE RMMCO OFFICE TO VERIFY ANY ADDITIONAL PERMISSIONS REQUIRED

FOR EXITING JAPAN.

5. ADDITIONAL REQUIREMENTS:

A. IAW REF A, ALTERATION INSTALL TEAM (AIT)S ARE REQUIRED TO

START RMMCO CHECK-IN PROCESS PRIOR TO ARRIVAL IN JAPAN. RMMCO

YOKOSUKA POCS ARE MR. STEVEN FARRIS AND MR. RICHARD PETERS,

DSN (315)243-0994, EMAIL: DIST-RMMCO-YOKOSUKA(AT)SRF.NAVY.MIL.

RMMCO SASEBO POCS ARE MR. THOMAS BUCK AND MR. LEONARDERIC MANALO,

DSN (315)252-6602/2805, EMAIL: DIST-RMMCO-SASEBO(AT)SRF.NAVY.MIL.

RMMCO CVN POCS ARE MR. RENATO DACUMOS,

RENATO.DACUMOS(AT)SRF.NAVY.MIL, DSN (315)243-2282, AND

MS. SARAH BROWN, SARAH.BROWN.CTR(AT)SRF.NAVY.MIL, DSN (315)243-2290,

OR DIST-CVN76-RMMCO(AT)SRF.NAVY.MIL.

B. IAW REF C, COUNTRY CLEARANCE REQUESTS ARE TO BE SUBMITTED A

MINIMUM OF 30 DAYS PRIOR TO TRAVEL.

C. ANY TRAVELER ENTERING CFAY OR CFAS IS SUBJECT TO DEBARMENT

FROM BASE AND REVOCATION OF VISIT CLEARANCE IF FOUND IN VIOLATION

OF ROM AND OR LIBERTY REQUIREMENTS.

PERFORMANCE WORK STATEMENT

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Job

PORT BOAT VEST DAVIT

FFP

PORT BOAT VEST DAVIT period of performance starting 12 Mar 2021 – 01 May 2021.

SEE ATTACHED PERFORMANCE WORK STATEMENT FOR SERVICE

REQUIREMENT.

PERSONNEL TRAVELING TO JAPAN WILL HAVE TO BE ON

RESTRICTION OF MOVEMENT (ROM) FOR 14-21 DAYS UPON ARRIVAL

PRIOR TO START OF PERIOD OF PERFORMANCE.

FOB: Destination

MILSTRIP: N6275821RCUS725

PURCHASE REQUEST NUMBER: N6275821RCUS725

PSC CD: J020

NET AMT

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 12-MAR-2021 TO

01-MAY-2021

N/A N62758 SRF AND JRMC

GOVT REPRESENTATIVE

SEE PAGE 4 OF ORDER FOR

SHIPMENT REQUEST PROCEDURES

. WA 00000

FOB: Destination

N62758

CLAUSES INCORPORATED BY REFERENCE

52.203-18 Prohibition on Contracting With Entities That Require Certain

Internal Confidentiality Agreements or Statements-- Representation

JAN 2017

52.204-2 Security Requirements AUG 1996 52.204-7 System for Award Management OCT 2018 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-13 System for Award Management Maintenance OCT 2018 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 52.204-17 Ownership or Control of Offeror AUG 2020 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020 52.209-2 Prohibition on Contracting with Inverted Domestic

Corporations--Representation

NOV 2015

52.212-1 Instructions to Offerors--Commercial Items JUN 2020 52.212-4 Contract Terms and Conditions--Commercial Items OCT 2018 52.222-22 Previous Contracts And Compliance Reports FEB 1999 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011 52.223-5 Alt I Pollution Prevention and Right-to-Know Information (May

2011) Alternate I

MAY 2011

52.223-5 Alt II Pollution Prevention and Right-to-Know Information (May 2011) Alt II

MAY 2011

52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-- Representation and Certifications.

JUN 2020

52.228-3 Worker's Compensation Insurance (Defense Base Act) JUL 2014 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.237-2 Protection Of Government Buildings, Equipment, And Vegetation

APR 1984

52.242-17 Government Delay Of Work APR 1984 52.247-34 F.O.B. Destination NOV 1991 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting

DEC 2019

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

MAY 2016

252.204-7016 Covered Defense Telecommunications Equipment or Services -- Representation

DEC 2019

252.204-7017 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services -- Representation

DEC 2019

252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services

DEC 2019

252.211-7003 Item Unique Identification and Valuation MAR 2016 252.222-7002 Compliance With Local Labor Laws (Overseas) JUN 1997 252.223-7006 Prohibition On Storage, Treatment, and Disposal of Toxic or

Hazardous Materials

SEP 2014

252.225-7041 Correspondence in English JUN 1997 252.225-7042 Authorization to Perform APR 2003 252.225-7048 Export-Controlled Items JUN 2013 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

252.232-7008 Assignment of Claims (Overseas) JUN 1997 252.232-7010 Levies on Contract Payments DEC 2006 252.233-7001 Choice of Law (Overseas) JUN 1997 252.243-7001 Pricing Of Contract Modifications DEC 1991 252.244-7000 Subcontracts for Commercial Items OCT 2020 252.246-7003 Notification of Potential Safety Issues JUN 2013 252.247-7023 Transportation of Supplies by Sea FEB 2019

CLAUSES INCORPORATED BY FULL TEXT

52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services-- Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications- Commercial Items. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision-

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

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L.

115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to--

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

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

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L.

115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to--

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

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

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

(d) Representations. The Offeror represents that--

(1) It [] will, [] will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

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

It [] does, [] does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

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

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

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services--

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

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

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

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

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

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

(ii) For covered services--

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

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (OCT

2020)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

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

(c) Representations.

(1) The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that--

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that--

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2020)

ALTERNATE I (OCT 2014)

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

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

“Covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“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.

“Reasonable inquiry” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“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"—

(1) 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.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

“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 the 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 in SAM.

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM 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(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __.

[Offeror to identify the applicable paragraphs at (c) through (v) 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 is to 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.

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

(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.

(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.

(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.)

[The offeror shall check the category in which its ownership falls]:

___ Black American.

___ Hispanic American.

___ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).

___ Asian-Pacific…