EXHIBIT AA - FAR 52.204-24 Representation Digital 08.23.24.pdf

FAR Clause Aug 23, 2024 PDF 169 KB Posted

Attached to
X1DZ--Berk Community Base Outpatient Clinic
Solicitation number
36C24424R0033
Issued by

About this file

This document is a representation form related to the prohibition on contracting for certain telecommunications and video surveillance services or equipment, as required by FAR 52.204-24. The form requires the offeror to represent whether it will provide, or use, any covered telecommunications equipment or services in the performance of the contract. If the offeror responds "will" or "does", additional disclosure information is required, including details on the covered equipment or services. The representation is related to a solicitation for a Berk Community Base Outpatient Clinic, issued by the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 4. The solicitation number is 36C24424R0033.

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Who attaches FAR 52.204-24

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EXHIBIT Z - Past Performance Questionnaire 08.23.24.pdf PDF
EXHIBIT B - AgencyTechnical Requirements Final Revision 08.23.24.pdf PDF
EXHIBIT H - Prelease FPLS Evaluation Form 12000 08.23.24.pdf PDF
EXHIBIT P - Space Requirement 08.23.24.pdf PDF
EXHIBIT L - DOL Wage Determination 08.23.24.pdf PDF
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EXHIBIT E - 3517B General Clauses.Oct. 2023 08.23.24.pdf PDF
EXHIBIT J - Security Standards 08.23.24.pdf PDF
EXHIBIT AD.VA Provision Addendum Alternate Protest Procedure Real Property Lease Procurements 08.pdf PDF
EXHIBIT A - 36C24424L0003 08.23.24.docx DOCX document
EXHIBIT AC - LA-23-04 FAR Clause 52.204-27 08.23.24.pdf PDF
EXHIBIT M - Unit Price List. Berk County 08.23.24.xlsx XLSX spreadsheet
Global Request for Lease Proposal 36C24424R0033 08.23.24.pdf PDF
EXHIBIT K - Security Unit Price List FSL II.Jun. 2022 08.23.24.xlsx XLSX spreadsheet
EXHIBIT Q - PACT Space Module Design Guide 08.23.24.pdf PDF
EXHIBIT C - Security Requirements.FSL Level II.08.23.24.pdf PDF
EXHIBIT F - 1364 Proposal to Lease Space.Jan. 20230 8.23.24.pdf PDF
EXHIBIT N - Tenant Improvements Cost Summary TICS Table Jul. 2022 08.23.24.xlsx XLSX spreadsheet
EXHIBIT W - Signage Design Manual 08.23.24.pdf PDF
EXHIBIT D - 3516 Solicitation Provisions.Oct. 2023 08.23.24.pdf PDF
EXHIBIT O - Contract Submittal Schedule 08.23.24.docx DOCX document
EXHIBIT G - Form 1217 - Lessor_s Annual Cost Statement.Nov. 2016 08.23.24.pdf PDF
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EXHIBIT B - AgencyTechnical Requirements Final Revision 7.11.24.docx DOCX document
EXHIBIT B - AgencyTechnical Requirements Final Revision RESUB.docx DOCX document
EXHIBIT K - Security Unit Price List FSL II.Jun. 2022 RESUB.xlsx XLSX spreadsheet
EXHIBIT J - Security Standards RESUB.pdf PDF
EXHIBIT M - Unit Price List. Berk County RESUB.xlsx XLSX spreadsheet
EXHIBIT H - Prelease FPLS Evaluation Form 12000 RESUB.docx DOCX document
EXHIBIT G - Form 1217 - Lessor_s Annual Cost Statement.Nov. 2016 RESUB.pdf PDF
EXHIBIT P - Space Requirement RESUB.pdf PDF
EXHIBIT O - Contract Submittal Schedule RESUB.docx DOCX document
EXHIBIT L - DOL Wage Determination RESUB.pdf PDF
EXHIBIT F - 1364 Proposal to Lease Space.Jan. 2023 RESUB.pdf PDF
EXHIBIT AC - LA-23-04 FAR Clause 52.204-27 RESUB.docx DOCX document
36C24424R0033 RESUB.docx DOCX document
EXHIBIT N - Tenant Improvements Cost Summary TICS Table Jul. 2022 RESUB.xlsx XLSX spreadsheet
EXHIBIT AA - FAR 52.204-24 Representation Digital RESUB.docx DOCX document
EXHIBIT C - Security Requirements.FSL Level II.1.12.24 RESUB.docx DOCX document
EXHIBIT Q - PACT Space Module Design Guide RESUB.pdf PDF
36C24424R0033_3.docx DOCX document
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Text version

EXHIBIT AA

Lease No. 36C24424L0003

BERK CBOC

Lessor:_______________________

Government:__________________

Representation Regarding Certain

Telecommunications and Video Surveillance Services or Equipment

REV (11/21)

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

See instructions within the representation regarding whether or not completion of this form is required If required, complete appropriate boxes, sign the form, and return form, along with any other required disclosure information, to LCO or his/her designee.

NOTE: The "Offeror," as used on this form, is the owner of the property offered, not an individual or agent representing the owner.

52.204‐24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (NOV 2021)

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 Products or Commercial Services. 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.

Regarding Certain

Telecommunications and Video Surveillance Services or Equipment

(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) Representation. 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);

Regarding Certain

Telecommunications and Video Surveillance Services or Equipment

(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

Regarding Certain

Telecommunications and Video Surveillance Services or Equipment relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(End of provision)

OFFEROR OR

LEGALLY

AUTHORIZED

REPRESENTATIVE

NAME, ADDRESS (INCLUDING ZIP CODE)

TELEPHONE NUMBER

Signature

Date

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