693JK318Q0021.pdf

693JK318Q0021

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

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

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

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

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

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

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

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

06/29/2018

1 2

Multiple

Ben Patterson

07/16/2018 1600 ED

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

The U.S. Department of Transportation (DOT, Pipeline and Hazardous Materials Safety Administration (PHMSA), has a requirement to outfit it's Training and Qualifications Center.

The applicable NAICS code is 541330: Engineering Services.

Please read the following documents in their entirety as they contain pertinent information regarding this RFQ:

Attachment 1: RFQ details;

Attachment 2: Statement of Work; and Attachment 3: Clauses and Terms and Conditions.

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

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

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

693JK318Q0021

NOTE:

**See Attachment 1: RFQ Details for details on the Quote Contents.

** No pricing will be required on SF-18. Pricing must be submitted as part of Section I - Price.

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

U.S. Department of Transportation (USDOT) RFQ #693JK318Q0021 Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 1

PHMSA Request for Quotation (RFQ) #693JK318QQ0021

“Cathodic Protection Installation”

Attachment 1: RFQ Details

1. RFQ Requirements:

The U.S. Department of Transportation (DOT), Pipeline and Hazardous Materials Safety Administration (PHMSA), has a requirement to provide and install equipment for a government operated training facility.

You are invited to submit a quote in response to the PHMSA RFQ #693JK318Q0021. The applicable North American Industry Classification System (NAICS) code for this procurement is 541330 – Engineering Services. Attached you will find the Statement of Work (SOW) (Attachment 2) that contains the description of the services to be purchased under this RFQ.

Any resultant order from this RFQ will incorporate the clauses and terms and conditions specified in Attachment 3 (Clauses and Terms and Conditions), are applicable to the order.

2. Contract/Order Type and Award:

The Government intends to issue one firm fixed-price purchase order from this RFQ. Award will be made to the responsible quoter whose quote/response conforms to the RFQ and is the Best Value to the Government, in accordance with FAR 13.106-1(a)(2).

3. Period of Performance and Place of Performance:

PHMSA expects the period of performance to last six weeks from the date of award.

4. Quotation Details For this RFQ, a quote/submission must include three separate sections as follows: Section I – Administrative and Pricing Information; Section II- Technical Approach; and Section III – Past Performance. A quote will be no more than 7 pages in length (5 Pages Technical Approach, 2 Pages Past Performance) including cover page and 8 ½ by 11 inch paper using font size no smaller than eleven (11) point. The quoter must also provide its Data Universal Numbering System (DUNS) number. The SF-18, Administrative and Pricing Information and RFQ Amendments (if any) do not count toward the limitation for Technical Approach and Past Experience.

Quotes must reference PHMSA RFQ# 693JK318Q0021 and must include the following 3 (three) sections. Each section should be submitted as a separate attachment.

Section I – Administrative and Pricing Information Summary page including the following information:

(a) Name of Contractor (Quoter)

(b) DUNS

(c) TIN

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 1

(d) Quote Validity Period

(e) Exceptions Taken

(f) Points of Contact (Name, Email Address, Phone Number)

(g) Total Proposed Price (for all priced tasks)

(h) Subcontractor Names & DUNS (if applicable)

− Signed SF 18 Form

− Signed Amendments, if any are issued. [Note: If you are not sure if PHMSA issued any amendments, send an e-mail to the Contract Specialist.]

− Pricing Information

Section II – Technical Approach (must be limited to 5 pages).

For this section, pages beyond 5 will not be evaluated.

This section must include narrative of the quoter’s Presentation/Technical Approach; Project Plan with milestones; and Corporate Leadership involvement.

− Include staffing approach & Identify Key Personnel (if any); and − Include an explanation of how the proposed personnel will perform satisfactorily in the applicable area and how their qualifications and experience will enable them to achieve the requirements detailed in the SOW.

− Verify that the proposed personnel are qualified for cathodic protection systems design and installation under NACE CP 3 and CP 4 requirements.

Section III: Past Performance (must be limited to 2 pages) For this section, pages beyond 2 will not be evaluated.

− Include 2 References of past work of similar nature. Past performance references must be recent (within the past 5 years) and include the following:

− Name of agency/company;

− Contract/order number;

− Period of performance;

− Contract/order value;

− Agency/company point(s) of contact, including name, e‐mail address and phone number;

− Brief description of how the past performance project/(s) relates to the requirements of this solicitation;

− Outcome/(s) of the referenced past performance project/(s).

***Sections II and III, should not include any references to prices. Pricing information should only be included in Section I.***

5. Evaluation of Quotes:

All quotes received in response to this RFQ will be reviewed by the PHMSA Acquisition Services Division (PHF-20) prior to being forwarded to the Technical Evaluation Team (TET) for technical review. PHF-20 will confirm whether or not the quotes/submissions complied with the instructions in the RFQ and contained ALL required elements.

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 1

The Government will award one firm fixed-price purchase order resulting from this RFQ to the responsible quoter whose quote/submission conforming to the RFQ is the Best Value to the Government, in accordance with FAR 13.106-1(a)(2).

Evaluation Factor 1 - Technical Approach: This criterion will be used to evaluate the quoter’s understanding of the requirements; the reasonableness and logic of approach; and the availability of the dedicated resource(s) to fulfill the requirements.

Evaluation Factor 2 - Past Experience: This criterion will be used to evaluate the quoter’s past experience in supporting similar work as described in the SOW. The quoter must clearly relate the past experience to the effort being proposed. The quoter must provide at least two (2) past experience references for relevant and similar work performed within the past five (5) years.

Each reference must include the following:

1. Company Name and Address

2. Contract/Order Number and Award Date

3. Contract/Order Period of Performance and Dollar Value

4. Agency Point of Contact (name, telephone number, and e-mail address)

5. Description of Services provided (Summary of Project) relative to this RFQ and SOW including the outcome of projects/activities

Evaluation Factor 3 - Price: The Government will evaluate each quote in accordance with FAR 13.106-1(a)(2).

Price must not be mentioned in the Technical Approach and Past Experience Sections.

Evaluation Order of Importance – Evaluation Factor 1 (Technical Capability) and Evaluation Factor 2 (Past Experience) are of equal importance and when combined are significantly more important than Evaluation Factor 3 (Price).

**NOTE**

Prior to issuing any award, the Government will perform a search of Active Exclusions in the System for Award Management (SAM) to ensure that the prospective awardee and listed Key Personnel are not on the list of parties excluded from receiving federal contracts and sub-contracts. The Contracting Officer (CO) may also identify and analyze the past performance of the quoter on any other relevant contract that they currently have or had of which the CO has knowledge or obtains knowledge, including but not limited to projects listed in the Past Performance Information Retrieval System (PPIRS) and the Federal Awardee Performance and Integrity Information System (FAPIIS).

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 1

6. QUESTIONS REGARDING THIS RFQ

All questions regarding this RFQ must be emailed to Ben Patterson (ben.patterson@dot.gov) with a copy to Mr. Warren Osterberg (warren.osterberg@dot.gov). All questions must be received on or before Friday, July 6, 2018 at 4:00 PM, Eastern Daylight Time (EDT). Questions must reference PHMSA RFQ# 693JK318Q0021 and the company name in the subject line of the email.

7. SUBMISSION OF QUOTES:

Quotes must be submitted via email in PDF format to Mr. Ben Patterson at ben.patterson@dot.gov, with a copy to Mr. Warren Osterberg at warren.osterberg@dot.gov, no later than Monday July 16, 2018 at 4:00 pm, Eastern Daylight Time. Emails must reference RFQ #693JK318Q0021 and the company name in the subject line.

mailto:ben.patterson@dot.gov mailto:warren.osterberg@dot.gov mailto:warren.osterberg@dot.gov

U.S. Department of Transportation RFQ# 693JK318Q0021 Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 2

PHMSA Request for Quotation (RFQ) #693JK318QQ0021

Attachment 2: Statement of Work

I. Background The Department of Transportation, Pipeline & Hazardous Materials Safety Administration (PHMSA), Inspector Training and Qualifications (TQ) Division is responsible for providing economical, timely, state-of-the-art training programs on pipeline safety regulatory requirements and educational opportunities to mission-critical occupations. Specifically, the Corrosion Control of Pipeline Systems Course (PHMSA PL3293) and the External Corrosion Direct Assessment (ECDA) Field Course (PHMSA-PL3306) equip Federal and State pipeline safety inspectors/specialists/engineers with adequate knowledge and tools to perform inspections and safety audits of the nation’s pipelines and pipeline operators, a systems-based pipeline safety training program essential to PHMSA’s mission. With the Office of Pipeline Safety’s continuing responsibility to ensure the safe operation, maintenance, and integrity of the nation’s pipeline systems and ensure the federal pipeline safety regulations are being adhered to, the Corrosion Control and ECDA courses are essential to PHMSA’s mission.

II. Objective

The objective is to finish the existing corrosion control training field located at the PHMSA TQ facilities in Oklahoma City. This training field is essential for the application of knowledge acquired in the classroom by our students. Providing the prospective inspectors with the appropriate hands on experience will ensure the better and more efficient audits and inspections of the actual pipeline systems throughout the Nation which will henceforth provide for safer pipeline operations.

III. Task Requirements and Deliverables The tasks to be performed will be as follows:

Task 1. Propane Tank CP Station

Provide and Install 1 Coated and 1 Uncoated 250-G Propane Tanks with Galvanic CP

• Two tanks (30” OD x 7’ 10” L) will be provided and will not contain any product

• Install individual service regulators and associated piping per specifications that will be provided once the project has been assigned.

• Uncoated tank will be blasted to bare metal.

• Coated tank will be commercial (as purchased) coating with appropriate repair of any significant coating damage.

U.S. Department of Transportation RFQ# 693JK318Q0021

• Tanks will be buried with top-of tank ~2’ below grade

• Tanks will include 4 bare or 2 coated 17-lb magnesium anodes with Cott Test

Station, #8 negative and test leads, Borin Cu-Cu-SO4 permanent reference electrode (PRE), shunt and bonding straps.

Vendor will proceed as follows:

Provide Bill of Materials as Required (all materials must be provided by contractor) o Coated and Uncoated 250-G Propane Tanks o 6 17-lb Magnesium Anodes o 2 Big-Fink test stations with shunt and bonding straps o 100’ #8 negative/test lead wire o 2 Borin PRE o CAD Weld materials & coating repair

Make requisite One-Call Notifications Mobilize Construction Crew with backhoe to facility Excavate ~5’ deep x 11’ long x 4’ wide for each tank burial Install tanks in ground (as mock installation – OK Tank Certification credential is not applicable) Thermite weld and recoat lead wires to tank Install 2 or 4 magnesium anodes and PRE, test station (placement at PHMSA direction), and backfill with native soils Finish by leveling work area to as-found condition Disposal of excess spoils is on-site or haulage fee may be applicable After installation – vendor technician will commission the installation and an as-built with commissioning report will be provided

Task 2. Phenolic Panels for Existing 20” x 20” Junction Boxes

• Locate the existing underground structures (pipelines, cables and anodes)

• Identify each connection and bonds

• Locate the existing underground structures (pipelines, cables and anodes)

• Identify each connection and bonds

• Terminate cables at the 3 existing enclosures and identify each one station and termination.

• Pricing for installation of required terminations, buss bars, circuits, shunts, switches, resistors and any other electrical requirement,

• Pricing for the phenolic panels inclusive of 3 busses, 30 terminations and 30 shunts plus 6 reference cell terminations.

Task 3. New 20V/10A Rectifiers

Provide, install and energize 3 new 20V/10A rectifiers at each station (3) for anode bed as specified in the provided drawings

U.S. Department of Transportation RFQ# 693JK318Q0021

20-10 air cooled rectifier Air Cooled Standard Silicon Stack Single phase 115/230 VAC, 1 Phase, 60 Hertz input, wired for 230 Pole Mount 6 Coarse/6 Fine Taps 120 VAC Convenience Outlet RMU Ready All AC service, materials and wiring

Task 4. Drawings

Provide drawings to scale and specifications of existing and new structures in the field.

IV. Skills and Qualifications of the Contractors

Contractor personnel overseeing installation must be qualified for cathodic protection systems design and installations under NACE (CP 3 and CP 4) requirements;

The contractor with NACE (CP 3 and CP 4) must be available on site;

All electrical installations must be made per federal and state regulations requirements by a licensed professional; and All excavation and backfilling activities must be performed by trained personnel assuring the integrity of existing underground structures.

V. Government Furnished Resources

PHMSA will provide drawings and specifications of the existing structures. Contact Ben

Patterson (ben.patterson@dot.gov) for electronic copies of the existing facilities. These drawings remain property of DOT PHMSA and may not be copied or used for any purpose other than to assess this project.

VI. Technical Point of Contact

This person can be contacted for questions or clarification on any topics covered in the Statement of Work: TBD.

VII. Place of Performance All work will be conducted at the PHMSA Training & Qualification Center in Oklahoma City, OK:

U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration

U.S. Department of Transportation RFQ# 693JK318Q0021

3700 South MacArthur Blvd., Ste B Oklahoma City, OK 73179-7612

VIII. Contract Type and Award PHMSA intends to award a fixed-price purchase order. The award will be made to the responsible vendor whose offer conforms to the solicitation and offers the best value to the Government.

IX. Period of Performance

PHMSA expects the performance to begin within three (3) weeks of award of the purchase order and to complete within six (6) weeks of award.

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

PHMSA Request for Quotation (RFQ) #693JK318Q0021

Attachment 3: Clauses and Terms and Conditions

Any resultant order from this RFQ will incorporate the terms and conditions of the awardee’s Blanket Purchase Agreement. In addition, the following clauses and terms and conditions are applicable to the order:

FEDERAL ACQUISITION REGULATIONS (FAR)

FAR 52.252-2 – Clauses Incorporated by Reference (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

• http://acquisition.gov/far

• http://farsite.hill.af.mil/vftara.htm

FAR Clauses Incorporated by Reference

52.202-1 DEFINITIONS (JAN 2012)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT (SEPT 2006)

52.203-7 ANTI-KICKBACK PROCEDURES (OCT 2014)

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POSTCONSUMER FIBER

CONTENT PAPER (MAY 2011)

52.204-7 SYSTEM FOR AWARD MANAGEMENT (OCT 2016)

52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2016)

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER

SUBCONTRACT AWARDS (AUG 2012)

52.204-19 – INCORPORATION BY REFERENCE OF REPRESENTATIONS

AND CERTIFICATIONS (Dec 2014)

52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN SUBCONTRACTING

WITH CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR

DEBARMENT (DEC 2010)

52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (FEB 2012)

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS (MAY 2012)

52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (JAN 2017)

52.213-2 – INVOICES (Apr 1984)

52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS (JAN 2011)

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN (JAN 2011)

http://acquisition.gov/far http://farsite.hill.af.mil/vftara.htm

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

52.219-16 LIQUIDATED DAMAGES—SUBCONTRACTING PLAN (JAN 1999)

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (APR 2012)

52.222-3 CONVICT LABOR (JUNE 2003)

52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND REMEDIES (MAR 2012)

52.222-21 PROHIBITION OF SEGREGATED FACILITIES (FEB 1999)

52.222-26 EQUAL OPPORTUNITY (MAR 2007)

52.222-35 EQUAL OPPORTUNITY FOR VETERANS (SEP 2010)

52.222-36 AFFIRMATIVE ACTION FOR WORKERS WITH DISABILITIES (OCT 2010)

52.222-37 EMPLOYMENT REPORTS ON VETERANS (SEP 2010)

52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE NATIONAL LABOR

RELATIONS ACT (DEC 2010)

52.222-43 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT ACT—

PRICE ADJUSTMENT (MULTIPLE YEAR AND OPTION CONTRACTS) (SEP 2009)

52.222-50 COMBATING TRAFFICKING IN PERSONS (FEB 2009)

FAR 52.223-2 – AFFIRMATIVE PROCUREMENT OF BIOBASED PRODUCTS UNDER

SERVICE AND CONSTURCTION CONTRACTS (SEP 2013)

52.223-5 POLLUTION PREVENTION AND RIGHT-TO-KNOW INFORMATION (MAY 2011)

52.223-6 DRUG-FREE WORKPLACE (MAY 2001)

52.223-11 OZONE-DEPLETING SUBSTANCES (MAY 2001)

52.223-17 AFFIRMATIVE PROCUREMENT OF EPA-DESIGNATED ITEMS IN

SERVICE AND CONSTRUCTION CONTRACTS (MAY 2008)

52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT

MESSAGING WHILE DRIVING (AUG 2011)

52.225-1 BUY AMERICAN ACT—SUPPLIES (FEB 2009)

52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES (JUNE 2008)

52.225-25 PROHIBITION ON CONTRACTING WITH ENTITIES ENGAGING IN CERTAIN

ACTIVITIES OR TRANSACTIONS RELATING TO IRAN—REPRESENTATION

AND CERTIFICATIONS (DEC 2012)

52.232-25 PROMPT PAYMENT (OCT 2008)

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER—

CENTRAL CONTRACTOR REGISTRATION (OCT 2003)

52.233-1 DISPUTES (JULY 2002)

52.233-3 PROTEST AFTER AWARD (AUG 1996)

52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM (OCT 2004)

2.242-15 – STOP-WORK ORDER (APR 1989)

52.245- 1 GOVERNMENT PROPERTY (APR 2012)

52.249-1 TERMINATION FOR CONVENIENCE OF THE GOVERNMENT

(FIXED-PRICE) (SHORT FORM) (APR 1984)

FAR Clauses Full Text

FAR 204-3 – Taxpayer Identification (Oct 1998)

(a) Definitions.

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

“Common parent,” as used in this provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.

“Taxpayer Identification Number (TIN),” as used in this provision, means the number required by the Internal Revenue Service (IRS) to be used by the offeror in reporting income tax and other returns. The TIN may be either a Social Security Number or an Employer Identification Number.

(b) All offerors must submit the information required in paragraphs (d) through (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M and implementing regulations issued by the IRS. If the resulting contract is subject to the reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract.

(c) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror’s relationship with the government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror’s TIN.

(d) Taxpayer Identification Number (TIN).

[_] TIN:_____________________.

[_] TIN has been applied for.

[_] TIN is not required because:

[_] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

[_] Offeror is an agency or instrumentality of a foreign government;

[_] Offeror is an agency or instrumentality of a Federal Government;

(e) Type of organization.

[_] Sole proprietorship;

[_] Partnership;

[_] Corporate entity (not tax-exempt):

[_] Corporate entity (tax-exempt):

[_] Government entity (Federal, State, or local);

[_] Foreign government;

[_] International organization per 26 CFR 1.6049-4;

[_] Other _________________.

(f) Common Parent.

[_] Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

[_] Name and TIN of common parent:

Name_______________________________

TIN________________________________

(End of Provision)

FAR 52.204-9 Personal Identity Verification of Contractor Personnel (Jan 2011)

(a) The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

(b) The Contractor shall account for all forms of Government-provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government;

(1) When no longer needed for contract performance.

(2) Upon completion of the Contractor employee’s employment.

(3) Upon contract completion or termination.

(c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements.

(d) The Contractor shall insert the substance of clause, including this paragraph (d), in all subcontracts when the subcontractor’s employees are required to have routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.

(End of Clause)

FAR 52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters (Jul 2013)

(a) The Contractor shall update the information in the Federal Awardee Performance and Integrity Information System (FAPIIS) on a semi-annual basis, throughout the life of the contract, by posting the required information in the System for Award Management database via https://www.acquisition.gov.

(b) As required by section 3010 of the Supplemental Appropriations Act, 2010 (Pub. L. 111-212), all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available. FAPIIS consist of two segments—

(1) The non-public segment, into which Government officials and the Contractor post information, which can only be viewed by—

(i) Government personnel and authorized users performing business on behalf of the Government;

or

(ii) The Contractor, when viewing data on itself; and

(2) The publicly-available segment, to which all data in the non-public segment of FAPIIS is automatically transferred after a waiting period of 14 calendar days, except for--

(i) Past performance reviews required by subpart 42.15;

(ii) Information that was entered prior to April 15, 2011; or

(iii) Information that is withdrawn during the 14-calendar-day waiting period by the Government official who posted it in accordance with paragraph (c)(1) of this clause.

(c) The Contractor will receive notification when the Government posts new information to the Contractor’s record.

(1) If the Contractor asserts in writing within 7 calendar days, to the Government official who posted the information, that some of the information posted to the non-public segment of FAPIIS is covered by a disclosure exemption under the Freedom of Information Act, the Government official who posted the information must within 7 calendar days remove the posting from FAPIIS and resolve the issue in accordance with agency Freedom of Information procedures, prior to reposting https://www.acquisition.gov/

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3 the releasable information. The contractor must cite 52.209-9 and request removal within 7 calendar days of the posting to FAPIIS.

(2) The Contractor will also have an opportunity to post comments regarding information that has been posted by the Government. The comments will be retained as long as the associated information is retained, i.e., for a total period of 6 years. Contractor comments will remain a part of the record unless the Contractor revises them.

(3) As required by section 3010 of Pub. L. 111-212, all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available.

(d) Public requests for system information posted prior to April 15, 2011, will be handled under Freedom of Information Act procedures, including, where appropriate, procedures promulgated under E.O. 12600.

(End of clause)

52.212-5 -- Contract Terms and Conditions Required to Implement Statutes or Executive Orders -- Commercial Items (JAN 2018)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015)

(3) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).

(4) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77, 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the contracting officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.]

X (1) 52.203-6, Restrictions on Subcontractor Sales to the Government (Sept 2006), with Alternate I (Oct 1995) (41 U.S.C. 4704 and 10 U.S.C. 2402).

___ (2) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

___ (3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (Jun 2010) (Section 1553 of Pub L. 111-5) (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009).

X (4) 52.204-10, Reporting Executive compensation and First-Tier Subcontract Awards (Oct 2016) (Pub. L. 109-282) (31 U.S.C. 6101 note).

___ (5) [Reserved] ___ (6) 52.204-14, Service Contract Reporting Requirements (Oct 2016) (Pub. L. 111-117, section 743 of Div. C).

___ (7) 52.204-15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (Oct 2016) (Pub. L. 111-117, section 743 of Div. C).

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

X (8) 52.209-6, Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Oct 2015) (31 U.S.C. 6101 note).

___ (9) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (Jul 2013) (41 U.S.C. 2313).

___ (10) [Reserved] ___ (11) (i) 52.219-3, Notice of HUBZone Set-Aside or Sole-Source Award (Nov 2011) (15 U.S.C.

657a).

___ (ii) Alternate I (Nov 2011) of 52.219-3.

___ (12) (i) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Oct 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer)(15 U.S.C.

657a).

___ (ii) Alternate I (Jan 2011) of 52.219-4.

___ (13) [Reserved] X (14) (i) 52.219-6, Notice of Total Small Business Aside (Nov 2011) (15 U.S.C. 644).

___ (ii) Alternate I (Nov 2011).

___ (iii) Alternate II (Nov 2011).

___ (15) (i) 52.219-7, Notice of Partial Small Business Set-Aside (June 2003) (15 U.S.C. 644).

___ (ii) Alternate I (Oct 1995) of 52.219-7.

___ (iii) Alternate II (Mar 2004) of 52.219-7.

___ (16) 52.219-8, Utilization of Small Business Concerns (Nov 2016) (15 U.S.C. 637(d)(2) and (3)).

___ (17) (i) 52.219-9, Small Business Subcontracting Plan (Jan 2017) (15 U.S.C. 637 (d)(4)).

___ (ii) Alternate I (Nov 2016) of 52.219-9.

___ (iii) Alternate II (Nov 2016) of 52.219-9.

___ (iv) Alternate III (Nov 2016) of 52.219-9.

___ (v) Alternate IV (Nov 2016) of 52.219-9.

___ (18) 52.219-13, Notice of Set-Aside of Orders (Nov 2011) (15 U.S.C. 644(r)).

___ (19) 52.219-14, Limitations on Subcontracting (Jan 2017) (15 U.S.C. 637(a)(14)).

___ (20) 52.219-16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C. 637(d)(4)(F)(i)).

___ (21) 52.219-27, Notice of Service-Disabled Veteran-Owned Small Business Set-Aside (Nov 2011) (15 U.S.C. 657f).

___ (22) 52.219-28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C.

632(a)(2)).

___ (23) 52.219-29, Notice of Set-Aside for, or Sole Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (Dec 2015) (15 U.S.C. 637(m)).

___ (24) 52.219-30, Notice of Set-Aside for, or Sole Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (Dec 2015) (15 U.S.C.

637(m)).

X (25) 52.222-3, Convict Labor (June 2003) (E.O. 11755).

X (26) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (Jan 2018) (E.O.

13126).

X (27) 52.222-21, Prohibition of Segregated Facilities (Apr 2015).

X (28) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246).

X (29) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

X (30) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

X (31) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

X (32) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496).

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

X (33) (i) 52.222-50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and E.O.

13627).

___ (ii) Alternate I (Mar 2015) of 52.222-50, (22 U.S.C. chapter 78 and E.O. 13627).

___ (34) 52.222-54, Employment Eligibility Verification (Oct 2015). (E. O. 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial items as prescribed in 22.1803.)

___ (35) (i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008) (42 U.S.C. 6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

___ (ii) Alternate I (May 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

___ (36) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Jun 2016) (E.O.13693).

___ (37) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Jun 2016) (E.O. 13693).

___ (38) (i) 52.223-13, Acquisition of EPEAT® -Registered Imaging Equipment (Jun 2014) (E.O.s 13423 and 13514 ___ (ii) Alternate I (Oct 2015) of 52.223-13.

___ (39) (i) 52.223-14, Acquisition of EPEAT® -Registered Television (Jun 2014) (E.O.s 13423 and 13514).

___ (ii) Alternate I (Jun 2014) of 52.223-14.

___ (40) 52.223-15, Energy Efficiency in Energy-Consuming Products (Dec 2007) (42 U.S.C. 8259b).

___ (41) (i) 52.223-16, Acquisition of EPEAT® -Registered Personal Computer Products (Oct 2015) (E.O.s 13423 and 13514).

___ (ii) Alternate I (Jun 2014) of 52.223-16.

X (42) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging while Driving (Aug 2011) (E.O. 13513).

___ (43) 52.223-20, Aerosols (Jun 2016) (E.O. 13693).

___ (44) 52.223-21, Foams (Jun 2016) (E.O. 13696).

___ (45) (i) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

___ (ii) Alternate I (Jan 2017) of 52.224-3.

X (46) 52.225-1, Buy American--Supplies (May 2014) (41 U.S.C. chapter 83).

___ (47) (i) 52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act (May 2014) (41 U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112- 41, 112-42, and 112-43).

___ (ii) Alternate I (May 2014) of 52.225-3.

___ (iii) Alternate II (May 2014) of 52.225-3.

___ (iv) Alternate III (May 2014) of 52.225-3.

___ (48) 52.225-5, Trade Agreements (Oct 2016) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

X (49) 52.225-13, Restrictions on Certain Foreign Purchases (Jun 2008) (E.O.’s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

___ (50) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

___ (51) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (Nov 2007) (42 U.S.C. 5150).

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

___ (52) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov 2007) (42 U.S.C. 5150).

___ (53) 52.232-29, Terms for Financing of Purchases of Commercial Items (Feb 2002) (41 U.S.C.

4505), 10 U.S.C. 2307(f)).

___ (54) 52.232-30, Installment Payments for Commercial Items (Jan 2017) (41 U.S.C. 4505, 10 U.S.C. 2307(f)).

X (55) 52.232-33, Payment by Electronic Funds Transfer— System for Award Management (Jul 2013) (31 U.S.C. 3332).

___ (56) 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management (Jul 2013) (31 U.S.C. 3332).

___ (57) 52.232-36, Payment by Third Party (May 2014) (31 U.S.C. 3332).

___ (58) 52.239-1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a).

___ (59) 52.242-5, Payments to Small Business Subcontractors (Jan 2017) (15 U.S.C. 637(d)(12)).

___ (60) (i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631).

___ (ii) Alternate I (Apr 2003) of 52.247-64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.]

___ (1) 52.222-17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495) ___ (2) 52.222-41, Service Contract Labor Standards (May 2014) (41 U.S.C. chapter 67.).

___ (3) 52.222-42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

___ (4) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (Multiple Year and Option Contracts) (May 2014) (29 U.S.C.206 and 41 U.S.C. chapter 67).

___ (5) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

___ (6) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C.

chapter 67).

___ (7) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67).

___ (8) 52.222-55, Minimum Wages Under Executive Order 13658 (Dec 2015) (E.O. 13658).

___ (9) 52.222-62, Paid Sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

___ (10) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C. 1792).

___ (11) 52.237-11, Accepting and Dispensing of $1 Coin (Sep 2008) (31 U.S.C. 5112(p)(1)).

(d) Comptroller General Examination of Record The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215-2, Audit and Records -- Negotiation.

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor’s directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause—

(i) 52.203-13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

(ii) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(iii) 52.219-8, Utilization of Small Business Concerns (Nov 2016) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $700,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219-8 in lower tier subcontracts that offer subcontracting opportunities.

(iv) 52.222-17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495). Flow down required in accordance with paragraph (1) of FAR clause 52.222-17.

(v) 52.222-21, Prohibition of Segregated Facilities (Apr 2015).

(vi) 52.222-26, Equal Opportunity (Sep 2016) (E.O. 11246).

(vii) 52.222-35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

(viii) 52.222-36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

(ix) 52.222-37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

(x) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222-40.

(xi) 52.222-41, Service Contract Labor Standards (May 2014), (41 U.S.C. chapter 67).

(xii) (A) 52.222-50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and E.O.

13627).

(B) Alternate I (Mar 2015) of 52.222-50 (22 U.S.C. chapter 78 E.O. 13627).

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

(xiii) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements (May 2014) (41 U.S.C.

chapter 67.)

(xiv) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Requirements (May 2014) (41 U.S.C. chapter 67)

(xv) 52.222-54, Employment Eligibility Verification (Oct 2015) (E. O. 12989).

(xvi) 52.222-55, Minimum Wages Under Executive Order 13658 (Dec 2015).

(xvii) 52.222-62, Paid sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706).

(xviii) (A) 52.224-3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

(B) Alternate I (Jan 2017) of 52.224-3.

(xix) 52.225-26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

(xx) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42 U.S.C.

1792). Flow down required in accordance with paragraph (e) of FAR clause 52.226-6.

(xxi) 52.247-64, Preference for Privately-Owned U.S. Flag Commercial Vessels (Feb 2006) (46 U.S.C.

Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247-64.

(2) While not required, the Contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

(End of Clause)

TRANSPORTATION ACQUISITION REGULATIONS (TAR) CLAUSES

1. TAR 1252.223-73 SEAT BELT USE POLICIES AND PROGRAMS (APR 2005):

In accordance with Executive Order 13043, Increasing Seat Belt Use in the United States, dated April 16, 1997, the contractor is encouraged to adopt and enforce on-the-job seat belt use policies and programs for its employees when operating company-owned, rented, or personally-owned vehicles. The National Highway Traffic Safety Administration (NHTSA) is responsible for providing leadership and guidance in support of this Presidential initiative. For information on how to implement such a program or for statistics on the potential benefits and cost-savings to your company or organization, please visit the Buckle Up America section of NHTSA’s website at www.nhtsa.dot.gov. Additional resources are available from the Network of Employers for Traffic Safety (NETS), a public-private partnership headquartered in the Washington, D.C. metropolitan area, and dedicated to improving the traffic safety practices of employers and employees. NETS is prepared to help with technical assistance, a simple, user friendly program kit, and an award for achieving the President’s goal of 90 percent seat belt use. NETS can be contacted at 1-888-221-0045 or visit its website at www.trafficsafety.org.

2. TAR 1252.237-73 - KEY PERSONNEL (APR 2005):

(a) The personnel as specified below are considered essential to the work being performed under this contract and may, with the consent of the contracting parties, be changed from time to time during the course of the contract by adding or deleting personnel, as appropriate.

(b) Before removing, replacing, or diverting any of the specified individuals, the Contractor shall notify the contracting officer, in writing, before the change becomes effective. The Contractor shall submit http://www.trafficsafety.org/

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3 information to support the proposed action to enable the contracting officer to evaluate the potential impact of the change on the contract. The Contractor shall not remove or replace personnel under this contract until the Contracting Officer approves the change.

The Key Personnel under this Contract are: TBD

(End of clause)

3. TAR 1252.223-71 ACCIDENT AND FIRE REPORTING (APR 2005):

(a) The Contractor shall report to the Contracting Officer any accident or fire occurring at the site of the work which causes:

(1) A fatality or as much as one lost workday on the part of any employee of the Contractor or subcontractor at any tier;

(2) Damage of $1,000 or more to Government-owned or leased property, either real or personal;

(3) Damage of $1,000 or more to Contractor or subcontractor owned or leased motor vehicles or mobile equipment; or

(4) Damage for which a contract time extension may be requested.

(b) Accident and fire reports required by paragraph (a) above shall be accomplished by the following means:

(1) Accidents or fires resulting in a death, hospitalization of five or more persons, or destruction of Government-owned or leased property (either real or personal), the total value of which is estimated at $100,000 or more, shall be reported immediately by telephone to the Contracting Officer or his/her authorized representative and shall be confirmed by telegram or facsimile transmission within 24 hours to the Contracting Officer. Such telegram or facsimile transmission shall state all known facts as to extent of injury and damage and as to cause of the accident or fire.

(2) Other accident and fire reports required by paragraph (a) above may be reported by the Contractor using a state, private insurance carrier, or Contractor accident report form which provides for the statement of:

(i) The extent of injury; and

(ii) The damage and cause of the accident or fire.

Such report shall be mailed or otherwise delivered to the Contracting Officer within 48 hours of the occurrence of the accident or fire.

(c) The Contractor shall assure compliance by subcontractors at all tiers with the requirements of this clause.

(End of clause)

Pipeline and Hazardous Materials Safety Administration (PHMSA) Attachment 3

DOT/PHMSA SPECIFIC CLAUSES

1. 811, CALL BEFORE YOU DIG PROGRAM (JUNE 2014):

Damage to pipelines during excavation is a leading cause of accidents resulting in serious injuries and fatalities, but these accidents are preventable, and you can help in preventing them.

811 is designated as the national call-before-you-dig number. Every state has a one-call law requiring excavators to have underground utilities marked before digging.

There are five steps to safer digging:

1. Make a free call to 811 a few days before digging.

2. Wait the required time – which is prescribed in state law but generally two to three days.

3. Locate/mark the utilities…