47PG1023R1072 Price and Responsibility Forms 20230906.pdf

For the best experience, open this PDF portfolio in

Acrobat X or Adobe Reader X, or later.

Get Adobe Reader Now!

http://www.adobe.com/go/reader

GSA Solicitation No. 47PG1023R1072

Document: C301/ MARCH 2023 (Offeror Representations and Certifications) Page 1 of 13

Offeror Representations and Certifications

1. FAR 52.204-8 Annual Representations and Certifications (DEC 2022)

(a) (1) The North American Industry Classification System (NAICS) code for this acquisition is 236220.

(2) The small business size standard is $45 million.

(3) The small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce is 500 employees if the acquisition—

(i) Is set aside for small business and has a value above the simplified acquisition threshold;

(ii) Uses the HUBZone price evaluation preference regardless of dollar value, unless the offeror waives the price evaluation preference; or

(iii) Is an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

(b) (1) If the provision at 52.204-7, System for Award Management, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the provision at 52.204-7, System for Award Management, is not included in this solicitation, and the Offeror has an active registration in the System for Award Management (SAM), the Offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The Offeror shall indicate which option applies by checking one of the following boxes:

Offeror Instruction: Select One

(i) Paragraph (d) applies.

(ii)Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c) (1) The following representations or certifications in SAM are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless–

(Offeror Representations and Certifications) Page 2 of 13

(A) The acquisition is to be made under the simplified acquisition procedures in part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.203-18, Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements-Representation. This provision applies to all solicitations.

(iv) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, System for Award Management.

(v) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that-

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

(C) Are for contracts that will be performed in the United States or its outlying areas.

(vi) 52.204-26, Covered Telecommunications Equipment or Services-Representation.

This provision applies to all solicitations.

(vii) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations- Representation.

(viii) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(ix) 52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. This provision applies to all solicitations.

(x) 52.214-14, Place of Performance-Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(xi) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

(Offeror Representations and Certifications) Page 3 of 13

(xii) 52.219-1, Small Business Program Representations (Basic, Alternates I, and II).

This provision applies to solicitations when the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(C) The provision with its Alternate II applies to solicitations that will result in a multiple-award contract with more than one NAICS code assigned.

(xiii) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(xiv) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

(xv) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xvi) 52.222-38, Compliance with Veterans’ Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial products or commercial services.

(xvii) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA–designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

(xviii) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA–designated items.

(xix) 52.223-22, Public Disclosure of Greenhouse Gas Emissions and Reduction Goals- Representation. This provision applies to solicitations that include the clause at 52.204- 7.)

(xx) 52.225-2, Buy American Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(Offeror Representations and Certifications) Page 4 of 13

(xxi) 52.225-4, Buy American-Free Trade Agreements-Israeli Trade Act Certificate.

(Basic, Alternates II and III.) This provision applies to solicitations containing the clause at 52.225-3.

(A) If the acquisition value is less than $50,000, the basic provision applies.

(B) If the acquisition value is $50,000 or more but is less than $92,319, the provision with its Alternate II applies.

(C) If the acquisition value is $92,319 or more but is less than $100,000, the provision with its Alternate III applies.

(xxii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xxiii) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan- Certification. This provision applies to all solicitations.

(xxiv) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-Representation and Certifications. This provision applies to all solicitations.

(xxv) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions.

(2) The following representations or certifications are applicable as indicated by the Contracting Officer:

(i) 52.204-17, Ownership or Control of Offeror.

(ii) 52.204-20, Predecessor of Offeror.

(iii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

(iv) 52.222-48, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment- Certification.

(v) 52.222-52, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Certification.

(vi) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA–Designated Products (Alternate I only).

(vii) 52.227-6, Royalty Information.

(Offeror Representations and Certifications) Page 5 of 13

(A) Basic.

(B) Alternate I.

(viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

(d) The offeror has completed the annual representations and certifications electronically in SAM website accessed through https://www.sam.gov. After reviewing the SAM information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within 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 the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. 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.

FAR Clause Title Date Change

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 on SAM.

2. FAR 52.204-16 Commercial and Government Entity Code Reporting (AUG 2020)

(a) Definition. As used in this provision –

“Commercial and Government Entity (CAGE) code” means–

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity by unique location; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

(b) The Offeror shall provide its CAGE code with its offer with its name and location address or otherwise include it prominently in its proposal. The CAGE code must be for

(Offeror Representations and Certifications) Page 6 of 13 that name and location address. Insert the word ‘‘CAGE’’ before the number. The CAGE code is required prior to award.

(c) CAGE codes may be obtained via–

(1) Registration in the System for Award Management (SAM) at www.sam.gov. If the Offeror is located in the United States or its outlying areas and does not already have a CAGE code assigned, the DLA Commercial and Government Entity (CAGE) Branch will assign a CAGE code as a part of the SAM registration process. SAM registrants located outside the United States and its outlying areas shall obtain a NCAGE code prior to registration in SAM (see paragraph (c)(3) of this provision).

(2) The DLA Contractor and Government Entity (CAGE) Branch. If registration in SAM is not required for the subject procurement, and the Offeror does not otherwise register in SAM, an Offeror located in the United States or its outlying areas may request that a CAGE code be assigned by submitting a request at https://cage.dla.mil.

(3) The appropriate country codification bureau. Entities located outside the United States and its outlying areas may obtain an NCAGE code by contacting the Codification Bureau in the foreign entity's country if that country is a member of NATO or a sponsored nation. NCAGE codes may be obtained from the NSPA at https://eportal.nspa.nato.int/AC135Public/scage/CageList.aspx if the foreign entity’s country is not a member of NATO or a sponsored nation. Points of contact for codification bureaus, as well as additional information on obtaining NCAGE codes, are available at http://www.nato.int/structur/AC/135/main/links/contacts.htm.

(d) Additional guidance for establishing and maintaining CAGE codes is available at https://cage.dla.mil.

(e) When a CAGE code is required for the immediate owner and/or the highest-level owner by Federal Acquisition Regulation (FAR) 52.204–17 or 52.212–3(p), the Offeror shall obtain the respective CAGE code from that entity to supply the CAGE code to the Government.

(f) Do not delay submission of the offer pending receipt of a CAGE code.

(g) If the solicitation includes FAR clause 52.204–2, Security Requirements, a subcontractor requiring access to classified information under a contract shall be identified with a CAGE code on the DD Form 254. The Contractor shall require a subcontractor requiring access to classified information to provide its CAGE code with its name and location address or otherwise include it prominently in the proposal. Each location of subcontractor performance listed on the DD Form 254 is required to reflect a corresponding unique CAGE code for each listed location unless the work is being performed at a Government facility, in which case the agency location code shall be used. The CAGE code must be for that name and location address. Insert the word ‘‘CAGE’’ before the number. The CAGE code is required prior to award.

(Offeror Representations and Certifications) Page 7 of 13

3. FAR 52.209-7 Information Regarding Responsibility Matters. (OCT 2018)

Definitions. As used in this provision—

“Administrative proceeding” means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

“Federal contracts and grants with total value greater than $10,000,000” means—

(1) The total value of all current, active contracts and grants, including all priced options;

and

(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).

“Principal” means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

Offeror Instruction: Select One

(b) The offeror has does not have current active Federal contracts and grants with total value greater than $10,000,000.

(c) If the offeror checked “has” in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(Offeror Representations and Certifications) Page 8 of 13

(iii) In an administrative proceeding, a finding of fault and liability that results in–

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management, which can be accessed viahttps://www.sam.gov (see 52.204- 7).

4. FAR 52.209-13 Violation of Arms Control Treaties or Agreements-Certification

(NOV 2021)

(a) This provision does not apply to acquisitions at or below the simplified acquisition threshold or to acquisitions of commercial products and commercial services as defined in Federal Acquisition Regulation 2.101.

(b) Certification. [Offeror shall check either (1) or (2).]

Offeror Instruction: Select either one (1) or (2)

(1) The Offeror certifies that–

(i) It does not engage and has not engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; and

(ii) No entity owned or controlled by the Offeror has engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any

(Offeror Representations and Certifications) Page 9 of 13 arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; or

(2) The Offeror is providing separate information with its offer in accordance with paragraph (d)(2) of this provision.

(c) Procedures for reviewing the annual unclassified report (see paragraph (b)(1) of this provision). For clarity, references to the report in this section refer to the entirety of the annual unclassified report, including any separate reports that are incorporated by reference into the annual unclassified report.

(1) Check the table of contents of the annual unclassified report and the country section headings of the reports incorporated by reference to identify the foreign countries listed there. Determine whether the Offeror or any person owned or controlled by the Offeror may have engaged in any activity related to one or more of such foreign countries.

(2) If there may have been such activity, review all findings in the report associated with those foreign countries to determine whether or not each such foreign country was determined to be in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or to be not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. For clarity, in the annual report an explicit certification of non-compliance is equivalent to a determination of violation.

However, the following statements in the annual report are not equivalent to a determination of violation:

(i) An inability to certify compliance.

(ii) An inability to conclude compliance.

(iii) A statement about compliance concerns.

(3) If so, determine whether the Offeror or any person owned or controlled by the Offeror has engaged in any activity that contributed to or is a significant factor in the determination in the report that one or more of these foreign countries is in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. Review the narrative for any such findings reflecting a determination of violation or non-adherence related to those foreign countries in the report, including the finding itself, and to the extent necessary, the conduct giving rise to the compliance https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/

(Offeror Representations and Certifications) Page 10 of 13 or adherence concerns, the analysis of compliance or adherence concerns, and efforts to resolve compliance or adherence concerns.

(4) The Offeror may submit any questions with regard to this report by email to NDAA1290Cert@state.gov. To the extent feasible, the Department of State will respond to such email inquiries within 3 business days.

(d) Do not submit an offer unless—

(1) A certification is provided in paragraph (b)(1) of this provision and submitted with the offer; or

(2) In accordance with paragraph (b)(2) of this provision, the Offeror provides with its offer information that the President of the United States has

(i) Waived application under 22 U.S.C. 2593e(d) or (e); or

(ii) Determined under 22 U.S.C. 2593e(g)(2) that the entity has ceased all activities for which measures were imposed under 22 U.S.C. 2593e(b).

(e) Remedies. The certification in paragraph (b)(1) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly submitted a false certification, in addition to other remedies available to the Government, such as suspension or debarment, the Contracting Officer may terminate any contract resulting from the false certification.

5. FAR 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

(Offeror Representations and Certifications) Page 11 of 13

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) Representation. The Offeror represents that—

(Offeror Representations and Certifications) Page 12 of 13

(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.

(Offeror Representations and Certifications) Page 13 of 13

(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.

FAR ClauseRow1:

TitleRow1:

DateRow1:

ChangeRow1:

FAR ClauseRow2:

TitleRow2:

DateRow2:

ChangeRow2:

Check Box1: Off

Check Box2: Off

Check Box3: Off

Check Box4: Off

Check Box5: Off

Check Box7: Off

Check Box9: Off

Check Box10: Off

Check Box12: Off

Check Box13: Off

CONTRACTOR'S QUALIFICATIONS AND FINANCIAL INFORMATION OMB Control Number: 3090-0007 Expiration Date: 10/31/2024

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0007. We estimate that it will take 1.5 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - GENERAL INFORMATION

1A. NAME

1B. STREET ADDRESS

1C. CITY 1D. STATE 1E. ZIP CODE

2. TYPE OF ORGANIZATION (Check one)

A. SOLE PROPRIETORSHIP

B. GENERAL PARTNERSHIP

C. LIMITED PARTNERSHIP

D. CORPORATION

E. SUBCHAPTER S CORPORATION

I. OTHER (Specify below)

3. TAXPAYER ID NUMBER 4. DATE ORGANIZATION ESTABLISHED 5. STATE OF INCORPORATION

6. TRADE STYLE NAME (Provide a copy of filing) 7. KIND OF PRODUCT OR SERVICE PROVIDED

8. FORMER BUSINESS NAME

D. RETAILER

E. OTHER (Specify) B. FIFO

A. LIFO C. AVERAGE COST

D. OTHER (Specify)

11. OWNERSHIP INFORMATION-PARTNERS-PRINCIPAL STOCKHOLDERS-OTHERS

NAME

10. INVENTORY VALUATION METHOD

9. KIND OF BUSINESS

A. MANUFACTURER

B. CONTRACTOR

C. WHOLESALER

TITLE

(If partner, state G(General) or L(Limited) in column)

ACTUAL TITLE G OR L

PERCENT

BUSINESS OWNED

12. PARENT COMPANY (If applicable)

13. IF "YES" TO ANY QUESTION BELOW, PROVIDE DETAILED

INFORMATION IN SECTION VIII, REMARKS YES NO

A. NAME

B. CITY C. STATE

A. HAVE YOU, OR ANY OF YOUR AFFILIATES EVER FILED FOR BANKRUPTCY?

B. DO YOU HAVE ANY JUDGMENTS, LIENS, OR PENDING SUITS?

C. DO YOU HAVE ANY CONTINGENT LIABILITIES?

D. HAVE YOU OR ANY OF YOUR AFFILIATES DISCONTINUED BUSINESS

OPERATIONS WITH OUTSTANDING DEBTS?

SECTION II - GOVERNMENT FINANCIAL AID AND INDEBTEDNESS

14A. ARE YOU DELINQUENT ON ANY FEDERAL DEBT (OMB CIRCULAR A-129)

(If "Yes", provide detailed information, Section VIII, Remarks)

14B. DO YOU OWE THE

GOVERNMENT

FOR ANY

CONTRACT OR

OTHER CLAIMS?

YES NO

IF "YES", COMPLETE THE ITEMS BELOW

AGENCY CLAIM AMOUNT PAYMENT MATURITY BALANCE

15A. AGENCY INVOLVED WITH DELINQUENCY 15B. AMOUNT OF DELINQUENCY ($)

16. ARE YOU

CURRENTLY

RECEIVING

GOVERNMENT

FINANCING?

YES

NO (Go to Section III )

17. COMPLETE ITEMS BELOW IF APPLICABLE

A. INDUSTRIAL REVENUE BONDS

B. GUARANTEED LOANS

C. ADVANCED PAYMENTS

D. PROGRESS PAYMENTS

AUTHORIZED ($) IN USE ($) GOVERNMENT AGENCY INVOLVED

E. OTHER (Specify)

GENERAL SERVICES ADMINISTRATION GSA 527 (REV. 10/2021)

F. LIMITED LIABILITY COMPANY

G. JOINT VENTURE

H. TRUST

TYPE OF FINANCING

GSA 527 (REV. 10/2021) PAGE 2

SECTION III - FINANCIAL STATEMENTS

Prepared Financial Statements with notes may be provided in lieu of completing Section III

When financial statements are prepared or certified by independent accountants and transcribed to this form, please furnish the name and address of accountant of accounting firm.

18. ARE YOU THE INCUMBENT CONTRACTOR FOR THIS SOLICITATION?

NO

19A. NAME

19B. STREET ADDRESS

19C. CITY 19D. STATE 19E. ZIP CODE

20. IF TRANSCRIBED STATEMENTS DIFFER FROM INDEPENDENT ACCOUNTANT'S,

PLEASE DESCRIBE ADJUSTMENT IN SECTION VII, REMARKS. ALL OF THE

LISTED FIGURES ARE:

ACTUAL

IN THOUSANDS

IN MILLIONS

U.S. DOLLARS

FOREIGN CURRENCY (Specify)

21. BALANCE SHEET AS OF (Month, Day, Year) 22. FISCAL YEAR ENDS (Month, Day, Year) 23. PREPARED STATEMENTS

YES

ARE ATTACHED

24. ASSETS 25. LIABILITIES AND NET WORTH

A. Current Assets A. Current Liabilities

Cash Short Term cash investments Accounts receivable, less allowance for doubtful accounts of $ Inventories Other current assets (Itemize below)

Total Current Assets

B. Property, Plant and Equipment

Accounts payable Notes payable (current) Current portion of long term debt Accrued expenses Accrued taxes on income/excess profits Other current liabilities (Itemize below)

Total Current Liabilities

B. Other Liabilities

Land Buildings and equipment Leasehold improvements Less accumulated depreciation and amortization

Total Property, Plant and Equipment C. Other Assets

Investments in and advance to affiliated company Goodwill, less amortization Due from officer, employee Other (Itemize below)

Total Other Assets

D. TOTAL ASSETS

Mortgages Bonds Deferred income taxes Other long term debt

Total Other Liabilities

Total Liabilities

C. Minority Interest in Subsidiary D. Net Worth

Preferred stock Common stock Additional paid-in capital Retained earnings/owner's equity Less, Treasury stock

Total Net Worth

E. TOTAL LIABILITIES AND NET WORTH

SECTION IV - INCOME STATEMENT

26. FROM (Month, Day, Year) 27. TO (Month, Day, Year)

A. Net Sales

28. INCOME

Cost and Expenses Cost of Goods Sold Depreciation and Amortization

Selling, General, and Admin. Expenses Interest Expense Other Expenses (Itemize below)

Minority Interest in Earnings of Subsidiaries

Total Costs and Expenses

Earnings Before Taxes Taxes on Income Income Before Extraordinary Items Extraordinary Gains (Losses) Net of Taxes

NET INCOME (LOSS)

ZIP CODE

Yes No

A.

B.

C.

CITY STATE ZIP CODE

AREA CODE NUMBER

AREA CODE NUMBER EXTENSION

STREET ADDRESS

37. Maximum Amount Authorized ($)

38. Amount Outstanding ($)

39. Loans Secured by Company's Assets - Real and Personal Property

BANK 1 BANK 2

SECTION V - BANKING AND FINANCE COMPANY INFORMATION

(Please attach a separate sheet using this format for any additional banks.)

ITEM

29. Name of Bank

30. Contact Person

31. Phone Number

32. Fax Number

33. Address

34. Amount Owing ($)

35. Term Loans

36. Line of Credit

D.

SECURED PARTY NAME CONTACT NAME

STREET ADDRESS CITY STATE ZIP CODE

SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)

40. ARE ANY OF THE ASSETS SHOWN ON THE BALANCE SHEET

PLEDGED OR MORTGAGED, EXCEPT AS STATED ABOVE?

41B. TOTAL

LIABILITY ($)

41A. IF CONTRACTOR IS A PARTNERSHIP OR SOLE PROPIERTORSHIP,

ARE THE INDIVIDUAL LIABILITIES OF THE PROPIETOR(S) FOR

FEDERAL AND STATE INCOME AND/OR EXCESS PROFIT TAXES

INCLUDED ON THE BALANCE SHEET?

42. ARE YOU NOW IN OR PENDING DEFAULT ON ANY OBLIGATIONS, I.E., BANKS, FINANCIAL INSTITUTIONS, SUPPLIERS, OTHER?

NO YES (Explain in Section VII, Remarks)

NO YES (Provide detailed information in Section VII, Remarks)

GSA 527 (REV. 10/2021) PAGE 3

CITY STATE

SECTION VI - PRINCIPAL MERCHANDISE OR RAW MATERIAL SUPPLIER INFORMATION

(Please attach separate sheet(s) using this format for additional suppliers.)

43. PAST DUE ACCOUNTS PAYABLE ($)

ITEM 44. SUPPLIER 1 45. SUPPLIER 2

STATECITY ZIP CODE

ITEM 46. SUPPLIER 3 47. SUPPLIER 4

A. Name of Supplier B. Contact Person

C. Telephone

D. Fax

E. Address

F. Amount Now Owing ($) G. High Credit ($)

A. Name of Supplier B. Contact Person

F. Amount Now Owing ($) G. High Credit ($)

SECTION VII - CONSTRUCTION/SERVICE CONTRACTS INFORMATION (Public Buildings Service Contracts Only)

CONTRACTS IN FORCE

GSA 527 (REV. 10/2021) PAGE 4

ITEM 48. CONTRACT 1 49. CONTRACT 2

A. Location B. Owner's Name

C. Address

D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date

F. Percent Completed

50. CONTRACT 3 51. CONTRACT 4

CITY STATE ZIP CODECITY STATE ZIP CODE

GSA 527 (REV. 10/2021) PAGE 5

D. Telephone

E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)

ITEM 58. JOB 3 59. JOB 4

B. Contact's Name

ITEM 60. JOB 5 61. JOB 6

ITEM 52. CONTRACT 5 53. CONTRACT 6

F. Percent Completed

F. Percent Completed

54. CONTRACT 7 55. CONTRACT 8

LARGEST JOBS YOU HAVE COMPLETED IN THE LAST FIVE YEARS

ITEM 56. JOB 1 57. JOB 2

CERTIFICATION

For the purpose of establishing financial responsibility with, or procuring credit from the U.S. General Services Administration, we furnish the above as a true and correct statement of our financial condition and further certify that all other statements are true and correct. There has been no material change in the applicant's financial condition since the date of the above statement. We agree to notify you immediately in writing of any materially unfavorable change in our financial condition. In the absence of such notice or of a new and full financial statement, this is to be considered as a continuing statement.

NAME OF BUSINESS BY (Signature of Authorized Official)

NAME OF AUTHORIZED OFFICIAL (Type or print)

TITLE OF AUTHORIZED OFFICIAL (Type or print)

DATE

GSA 527 (REV. 10/2021) PAGE 6

NUMBER

64. PRESENT AMOUNT OF BONDING

COVERAGE ($)

65. HAS YOUR APPLICATION FOR SURETY

BOND EVER BEEN DECLINED? (If Yes, please provide detailed information in

Remarks)

66. DURING THE PAST 2 YEARS, HAVE YOU BEEN CHARGED WITH A

FAILURE TO MEET THE CLAIMS OF YOUR SUBCONTRACTORS OR

SUPPLIERS? (If Yes, please provide detailed information in Remarks)

YES NO YES NO

SECTION VIII - REMARKS

REMARKS (Cite those sections of the form relating to your remarks. If additional space is required, attach additional sheet(s).)

LIST COMPANIES FROM WHOM YOU OBTAIN SURETY BONDS

ITEM 62. SURETY COMPANY 1 63. SURETY COMPANY 2

A. Company Name

AREA CODE

Barbara Williams

GSA 527 - Contractor's Qualifications and Financial Information

CONTRACTOR'S QUALIFICATIONS AND FINANCIAL INFORMATION

OMB Control Number: 3090-0007 Expiration Date: 10/31/2024

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0007. We estimate that it will take 1.5 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - GENERAL INFORMATION

1A. NAME

1B. STREET ADDRESS

1C. CITY

1D. STATE

1E. ZIP CODE

2. TYPE OF ORGANIZATION (Check one)

A. SOLE PROPRIETORSHIP

B. GENERAL PARTNERSHIP

C. LIMITED PARTNERSHIP

D. CORPORATION

E. SUBCHAPTER S CORPORATION

I. OTHER (Specify below)

3. TAXPAYER ID NUMBER

4. DATE ORGANIZATION ESTABLISHED

5. STATE OF INCORPORATION

6. TRADE STYLE NAME (Provide a copy of filing)

7. KIND OF PRODUCT OR SERVICE PROVIDED

8. FORMER BUSINESS NAME

D. RETAILER

E. OTHER (Specify)

B. FIFO

A. LIFO

C. AVERAGE COST

D. OTHER (Specify)

11. OWNERSHIP INFORMATION-PARTNERS-PRINCIPAL STOCKHOLDERS-OTHERS

NAME

10. INVENTORY VALUATION METHOD

9. KIND OF BUSINESS

A. MANUFACTURER

B. CONTRACTOR

C. WHOLESALER

TITLE

(If partner, state G(General) or L(Limited) in column)

ACTUAL TITLE

G OR L

PERCENT

BUSINESS OWNED

12. PARENT COMPANY (If applicable)

13. IF "YES" TO ANY QUESTION BELOW, PROVIDE DETAILED

INFORMATION IN SECTION VIII, REMARKS

YES

NO

A. NAME

B. CITY

C. STATE

A. HAVE YOU, OR ANY OF YOUR AFFILIATES EVER FILED FOR BANKRUPTCY?

B. DO YOU HAVE ANY JUDGMENTS, LIENS, OR PENDING SUITS?

C. DO YOU HAVE ANY CONTINGENT LIABILITIES?

D. HAVE YOU OR ANY OF YOUR AFFILIATES DISCONTINUED BUSINESS OPERATIONS WITH OUTSTANDING DEBTS?

SECTION II - GOVERNMENT FINANCIAL AID AND INDEBTEDNESS

14A. ARE YOU DELINQUENT ON ANY FEDERAL DEBT (OMB CIRCULAR A-129)(If "Yes", provide detailed information, Section VIII, Remarks)

14B. DO YOU OWE THE

GOVERNMENT

FOR ANY CONTRACT OR OTHER CLAIMS?

YES

NO

IF "YES", COMPLETE THE ITEMS BELOW

AGENCY

CLAIM AMOUNT

PAYMENT

MATURITY

BALANCE

15A. AGENCY INVOLVED WITH DELINQUENCY

15B. AMOUNT OF DELINQUENCY ($)

16. ARE YOU CURRENTLY

RECEIVING

GOVERNMENT

FINANCING?

YES

NO

YES

NO (Go to Section III )

17. COMPLETE ITEMS BELOW IF APPLICABLE

A. INDUSTRIAL REVENUE BONDS

B. GUARANTEED LOANS

C. ADVANCED PAYMENTS

D. PROGRESS PAYMENTS

AUTHORIZED ($)

IN USE ($)

GOVERNMENT AGENCY INVOLVED

E. OTHER (Specify)

GENERAL SERVICES ADMINISTRATION

GSA 527 (REV. 10/2021)

F. LIMITED LIABILITY COMPANY

G. JOINT VENTURE

H. TRUST

TYPE OF FINANCING

GSA 527 (REV. 10/2021) PAGE 2

SECTION III - FINANCIAL STATEMENTS

Prepared Financial Statements with notes may be provided in lieu of completing Section III

When financial statements are prepared or certified by independent accountants and transcribed to this form, please furnish the name and address of accountant of accounting firm.

18. ARE YOU THE INCUMBENT CONTRACTOR FOR THIS SOLICITATION?

NO

19A. NAME

19B. STREET ADDRESS

19C. CITY

19D. STATE

19E. ZIP CODE

20. IF TRANSCRIBED STATEMENTS DIFFER FROM INDEPENDENT ACCOUNTANT'S, PLEASE DESCRIBE ADJUSTMENT IN SECTION VII, REMARKS. ALL OF THE

LISTED FIGURES ARE:

ACTUAL

IN THOUSANDS

IN MILLIONS

U.S. DOLLARS

FOREIGN CURRENCY (Specify)

21. BALANCE SHEET AS OF (Month, Day, Year)

22. FISCAL YEAR ENDS (Month, Day, Year)

23. PREPARED STATEMENTS

YES

ARE ATTACHED

24. ASSETS

25. LIABILITIES AND NET WORTH

A. Current Assets

A. Current Liabilities

Cash

Short Term cash investments

Accounts receivable, less allowance for doubtful accounts of $

Inventories

Other current assets (Itemize below)

Total Current Assets

B. Property, Plant and Equipment

Accounts payable

Notes payable (current)

Current portion of long term debt

Accrued expenses

Accrued taxes on income/excess profits

Other current liabilities (Itemize below)

Total Current Liabilities

B. Other Liabilities

Land

Buildings and equipment

Leasehold improvements

Less accumulated depreciation and amortization

Total Property, Plant and Equipment

C. Other Assets

Investments in and advance to affiliated company

Goodwill, less amortization

Due from officer, employee

Other (Itemize below)

Total Other Assets

D. TOTAL ASSETS

Mortgages

Bonds

Deferred income taxes

Other long term debt

Total Other Liabilities

Total Liabilities

C. Minority Interest in Subsidiary

D. Net Worth

Preferred stock

Common stock

Additional paid-in capital

Retained earnings/owner's equity

Less, Treasury stock

Total Net Worth

E. TOTAL LIABILITIES AND NET WORTH

SECTION IV - INCOME STATEMENT

26. FROM (Month, Day, Year)

27. TO (Month, Day, Year)

A. Net Sales

28. INCOME

Cost and Expenses

Cost of Goods Sold

Depreciation and Amortization

Selling, General, and Admin. Expenses

Interest Expense

Other Expenses (Itemize below)

Minority Interest in Earnings of Subsidiaries

Total Costs and Expenses

Earnings Before Taxes

Taxes on Income

Income Before Extraordinary Items

Extraordinary Gains (Losses) Net of Taxes

NET INCOME (LOSS)

\\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg

Image of a triangle pointing to field 41B: Total Liability.

ZIP CODE

Yes

No

Yes

No

A.

B.

C.

CITY

STATE

ZIP CODE

Yes

No

Yes

No

AREA CODE

NUMBER

AREA CODE

NUMBER

EXTENSION

AREA CODE

NUMBER

STREET ADDRESS

37. Maximum Amount

Authorized ($)

38. Amount

Outstanding ($)

39. Loans Secured by Company's Assets - Real and Personal Property

BANK 1

BANK 2

SECTION V - BANKING AND FINANCE COMPANY INFORMATION

(Please attach a separate sheet using this format for any additional banks.)

ITEM

29. Name of Bank

30. Contact Person

31. Phone Number

32. Fax Number

33. Address

34. Amount Owing ($)

35. Term Loans

36. Line of Credit

D.

SECURED PARTY NAME

CONTACT NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

SECURING ASSETS

MATURITY DATE

MONTHLY PAYMENT ($)

SECURED PARTY NAME

CONTACT NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

SECURING ASSETS

MATURITY DATE

MONTHLY PAYMENT ($)

SECURED PARTY NAME

CONTACT NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

SECURING ASSETS

MATURITY DATE

MONTHLY PAYMENT ($)

SECURED PARTY NAME

CONTACT NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

SECURING ASSETS

MATURITY DATE

MONTHLY PAYMENT ($)

40. ARE ANY OF THE ASSETS SHOWN ON THE BALANCE SHEET

PLEDGED OR MORTGAGED, EXCEPT AS STATED ABOVE?

41B. TOTAL

LIABILITY ($)

41A. IF CONTRACTOR IS A PARTNERSHIP OR SOLE PROPIERTORSHIP,

ARE THE INDIVIDUAL LIABILITIES OF THE PROPIETOR(S) FOR

FEDERAL AND STATE INCOME AND/OR EXCESS PROFIT TAXES

INCLUDED ON THE BALANCE SHEET?

YES

NO

42. ARE YOU NOW IN OR PENDING DEFAULT ON ANY OBLIGATIONS, I.E., BANKS, FINANCIAL INSTITUTIONS, SUPPLIERS, OTHER?

NO

YES (Explain in Section VII, Remarks)

NO

YES (Provide detailed information in Section VII, Remarks)

GSA 527 (REV. 10/2021) PAGE 3

AREA CODE

NUMBER

EXTENSION

STREET ADDRESS

CITY

STATE

SECTION VI - PRINCIPAL MERCHANDISE OR RAW MATERIAL SUPPLIER INFORMATION

(Please attach separate sheet(s) using this format for additional suppliers.)

43. PAST DUE ACCOUNTS PAYABLE ($)

ITEM

44. SUPPLIER 1

45. SUPPLIER 2

AREA CODE

NUMBER

EXTENSION

AREA CODE

NUMBER

STREET ADDRESS

STATE

CITY

ZIP CODE

ITEM

46. SUPPLIER 3

47. SUPPLIER 4

A. Name of Supplier

B. Contact Person

C. Telephone

D. Fax

E. Address

F. Amount Now

Owing ($)

G. High Credit ($)

A. Name of Supplier

B. Contact Person

C. Telephone

D. Fax

E. Address

F. Amount Now

Owing ($)

G. High Credit ($)

AREA CODE

NUMBER

EXTENSION

AREA CODE

NUMBER

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

AREA CODE

NUMBER

AREA CODE

NUMBER

EXTENSION

AREA CODE

NUMBER

STREET ADDRESS

CITY

STATE

ZIP CODE

SECTION VII - CONSTRUCTION/SERVICE CONTRACTS INFORMATION (Public Buildings Service Contracts Only)

CONTRACTS IN FORCE

STREET ADDRESS

CITY

STATE

ZIP CODE

GSA 527 (REV. 10/2021) PAGE 4

ITEM

48. CONTRACT 1

49. CONTRACT 2

A. Location

B. Owner's Name

C. Address

D. Type of Work

E. Contract Amount ($)

F. Percent Completed

G. Estimated Completion Date

STREET ADDRESS

CITY

STATE

ZIP CODE

STREET ADDRESS

CITY

STATE

ZIP CODE

ITEM

A. Location

B. Owner's Name

C. Address

D. Type of Work

E. Contract Amount ($)

F. Percent Completed

G. Estimated Completion Date

50. CONTRACT 3

51. CONTRACT 4

STREET ADDRESS

CITY

STATE

ZIP CODE

CITY

STATE

ZIP CODE

STREET ADDRESS

GSA 527 (REV. 10/2021) PAGE 5

C. Address

D. Telephone

E. Type of Work

F. Contract Amount ($)

G. Amount Sublet ($)

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

ITEM

58. JOB 3

59. JOB 4

A. Location

B. Contact's Name

C. Address

D. Telephone

E. Type of Work

F. Contract Amount ($)

G. Amount Sublet ($)

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

ITEM

60. JOB 5

61. JOB 6

A. Location

B. Contact's Name

C. Address

D. Telephone

E. Type of Work

F. Contract Amount ($)

G. Amount Sublet ($)

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

STREET ADDRESS

CITY

STATE

ZIP CODE

AREA CODE

NUMBER

EXTENSION

ITEM

52. CONTRACT 5

53. CONTRACT 6

A. Location

B. Owner's Name

C. Address

D. Type of Work

E. Contract Amount ($)

F. Percent Completed

G. Estimated Completion Date

STREET ADDRESS

CITY

STATE

ZIP CODE

STREET ADDRESS

CITY

STATE

ZIP CODE

ITEM

A. Location

B. Owner's Name

C. Address

D. Type of Work

E. Contract Amount ($)

F. Percent Completed

G. Estimated

Completion Date

54. CONTRACT 7

55. CONTRACT 8

STREET ADDRESS

CITY

STATE

ZIP CODE

STREET ADDRESS

CITY

STATE

ZIP CODE