S02_Attachment 0003_RFP 36C79126R0011_VAAR Clause 852.219-76_Limitations on Subcontracting_Fillable.docx

ATTACHMENT 0003 – VAAR Clause 852.219-76

ATTACHMENT 0003 – VAAR CLAUSE 852.219-76

DEPARTMENT OF VETERANS AFFAIRS (VA)

VA’S FY26 ETMPM-TENS Procurement Program Recompete Solicitation Number 36C79126R0011

VAAR Clause 852.219-76, VA Notice of Limitations on Subcontracting - Certificate of Compliance for Supplies and Products (JAN 2023) (DEVIATION).

Instructions to Offerors: Attachment 0003, VAAR Clause 852.219‑76, VA Notice of Limitations on Subcontracting – Certificate of Compliance for Supplies and Products, is a mandatory, fillable PDF document that each Offeror shall fully complete, sign, and submit with its proposal package. This certification is a material proposal submission requirement. Incomplete, unsigned, undated, or partially filled attachments will not be accepted. Proposals that do not include a properly completed, signed, and dated Attachment 0003 may be determined ineligible for further evaluation and award consideration under Solicitation 36C79126R0011. Complete Attachment 0003 as follows:

1. General Completion Requirements: Offerors must complete an Attachment 0003 in its entirety, using the fields, checkboxes, and signature blocks provided in the fillable PDF. Offerors shall:

a. Place check marks in all required selection boxes to indicate the Offeror’s correct status (e.g., Manufacturer or Nonmanufacturer).

b. Complete all fill‑in fields requiring company information, representations, names, titles, addresses, and other identifying information.

c. Attach a digital signature in the designated signature block.

d. Enter the date signed in the designated field.

e. Ensure all information provided is true, complete, and accurate, and fully consistent with the Offeror’s SAM.gov representations and certifications.

2. Required Offeror Representations & Certifying Selections: Attachment 0003 contains multiple sections requiring the Offeror to select the appropriate certification options. Offerors must check the applicable boxes to indicate:

a. Compliance with Limitations on Subcontracting: Offerors must certify whether they will comply as a:

i. Manufacturer/Producer; or

ii. Nonmanufacturer, including acknowledgment of the Nonmanufacturer Rule, employee size standards, domestic manufacturing requirements, or SBA waiver conditions as applicable.

b. Manufacturer or Nonmanufacturer Status: Offerors must check the applicable box indicating their status and certify compliance with the detailed requirements outlined in 13 CFR 121.406(b).

c. Nonmanufacturer Rule Requirements (If Applicable): A Nonmanufacturer must check each applicable box certifying it meets:

i. Employee size standards;

ii. Engagement in retail/wholesale trade;

iii. Industry‑appropriate ownership/possession of items; and

iv. Compliance with domestic small business manufacturing or SBA waiver requirements.

d. Acknowledgment of Criminal Penalties for False Certifications: Offerors must acknowledge the consequences outlined under Title 18 U.S.C. § 1001 through the attachment of digital signature.

3. Required Offeror Information Fields: Offerors must complete all fill-in fields. The individual signing the form must be authorized to legally bind the Offeror. Required fields include:

a. Legal business name of Offeror;

b. Printed name of authorized signatory;

c. Printed title of authorized signatory;

d. Business address; and

e. Authorized Digital Signature and Date Signed.

4. Digital Signature Requirements: Attachment 0003 must be signed using a digital signature compliant with commonly accepted electronic signature standards (e.g., Adobe, DocuSign, PKI, or other federally recognized formats). Typed signatures, scanned handwritten signatures, or inserted signature images without digital authentication are not acceptable.

5. Submission Requirements: Offerors shall:

a. Include the completed, signed, and dated PDF file within the Offeror’s proposal submission package;

b. Label the document as: “Attachment 0003 – VAAR 852.219‑76 Certification – [Offeror Name]”;

c. Submit Attachment 0003 as a standalone PDF, not embedded inside another document; and

d. Ensure the information provided in Attachment 0003 matches all representations made elsewhere in the proposal and in SAM.gov.

6. Impact of Non‑Submission: Failure to submit a fully completed and signed Attachment 0003 will result in:

a. A determination that the proposal is ineligible for further evaluation and award consideration;

b. No further evaluation under technical or price factors; and

c. Ineligibility for award under Solicitation 36C79126R0011.

As prescribed in VAAR 819.7011(c), insert the following clause. The Contracting Officer shall tailor the clause in paragraph (a)(2)(iii) as appropriate:

VA Notice of Limitations on Subcontracting—Certificate of Compliance for Supplies and Products (JAN 2023) (DEVIATION)

(a) Pursuant to 38 U.S.C. 8127(k)(2), the offeror certifies that—

(1) If awarded a contract (see FAR 2.101 definition), it will comply with the limitations on subcontracting requirement as provided in the solicitation and the resultant contract, as follows [Offeror fill-in - check each applicable box below. The Offeror must select the applicable provision below, identifying itself as either a manufacturer or nonmanufacturer]:

(i) ☐ In the case of a contract for supplies or products (other than from a non-manufacturer of such supplies), it will not pay more than 50% of the amount paid by the Government to it to firms that are not VIP-listed SDVOSBs as set forth in VAAR 852.219-73 or VOSBs as set forth in VAAR 852.219-74. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(ii) ☐ In the case of a contract for supplies from a nonmanufacturer, it will supply the product of a domestic small business manufacturer or processor, unless a waiver as described in 13 CFR 121.406(b)(5) is granted. [SBA Non-Manufacturer Class Waiver Granted Version June 2022 for NAICS Code 334510, Waiver Effective Date/Posted Date 20DEC2007].

The Offeror understands that, as provided in 13 CFR 121.406(b)(7), such a waiver has no effect on requirements external to the Small Business Act, such as the Buy American Act or the Trade Agreements Act.

(2) Manufacturer or nonmanufacturer representation and certification. [Offeror fill-in - check each applicable box below. The Offeror must select the applicable provision below, identifying itself as either a manufacturer or nonmanufacturer]:

i. ☐ Manufacturer or Producer. The Offeror certifies that it is the manufacturer or producer of the end item being procured, and the end item is manufactured or produced in the United States, in accordance with paragraph (a)(1)(i).

ii. ☐ Nonmanufacturer. The offeror certifies that it qualifies as a nonmanufacturer in accordance with the requirements of 13 CFR 121.406(b) and paragraph (a)(1)(ii). The Offeror further certifies it meets each element below as required in order to qualify as a nonmanufacturer.

iii. ☐ The Offeror certifies that it does not exceed 500 employees (or 150 employees for the Information Technology Value Added Reseller exception to NAICS code 541519, which is found at 13 CFR 121.201, footnote 18).

iv. ☐ The Offeror certifies that it is primarily engaged in the retail or wholesale trade and normally sells the type of item being supplied.

v. ☐ The Offeror certifies that it will take ownership or possession of the item(s) with its personnel, equipment, or facilities in a manner consistent with industry practice.

(3) The Offeror acknowledges that this certification concerns a matter within the jurisdiction of an Agency of the United States. The Offeror further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

(4) If VA determines that an SDVOSB/VOSB awarded a contract pursuant to 38 U.S.C. 8127 did not act in good faith, such SDVOSB/VOSB shall be subject to any or all of the following:

i. Referral to the VA Suspension and Debarment Committee;

ii. A fine under section 16(g) of the Small Business Act (15 U.S.C. 645(g)(1)); and

iii. Prosecution for violating section 1001 of title 18.

(b) The Offeror represents and understands that by submission of its offer and award of a contract it may be required to provide copies of documents or records to VA that VA may review to determine whether the offeror complied with the limitations on subcontracting requirement specified in the contract or to determine whether the offeror qualifies as a manufacturer or nonmanufacturer in compliance with the limitations on subcontracting requirement.

Contracting Officers may, at their discretion, require the contractor to demonstrate its compliance with the limitations on subcontracting at any time during performance and upon completion of a contract if the information regarding such compliance is not already available to the contracting officer. Evidence of compliance includes, but is not limited to, invoices, copies of subcontracts, or a list of the value of tasks performed.

(c) The Offeror further agrees to cooperate fully and make available any documents or records as may be required to enable VA to determine compliance. The offeror understands that failure to provide documents as requested by VA may result in remedial action as the Government deems appropriate.

(d) Offeror completed certification/fill-in required. The formal certification must be completed, signed and returned with the offeror's bid, quotation, or proposal.

The Government will not consider offers for award from offerors that do not provide the certification, and all such responses will be deemed ineligible for evaluation and award.

Certification:

I hereby certify that if awarded the contract [insert the name of the Offeror in the adjacent text box], ____________________________ will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of [insert the name of the Offeror in the adjacent text box], ______________________________.

Printed Name of Signee: ___________________________________.

Printed Title of Signee: ____________________________________.

Authorized Digital Signature: ___________________________.

Date Signed: _______________.

Legal Business Name and Business Address: ______________________________________

(End of Clause)