75H70719Q00061,_MSU_Kitchen_and_Grocery_Supply_Agreement.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

IHSMSU CODE 16. ADMINISTERED BYCODE

X

X

311999

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

05/07/2019 1200 MS

04/23/2019

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70719Q00061

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 20 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

MESCALERO NEW MEXICO 88340

318 ABALONE LOOP

DIETARY DEPARTMENT

MESCALERO SERVICE UNIT

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The contractor shall provide groceries, kitchen supplies and paper ware supply agreement to the following Albuquerque Area Indian Health Service Facility:

Mescalero Service Unit Attn: Dietary Department 318 Abalone Loop Mescalero, New Mexico 88340

Acquisition will be for a 12 month base year (Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

ERIC K. WRIGHT

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

period with 4 one year options for renewal.

1 DESCRIPTION OF SERVICES/SUPPLIES

The contractor shall be in accordance with all

Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

20 2 of

75H70719Q00061, MSU Kitchen and Grocery Supply Agreement

Contract Administration Data

1. CONTRACT ADMINISTRATION DATA: All contract administration matters will be handled by the following individuals:

a. CONTRACT ADMINISTRATION: List below responsible parties that may be contacted during the term of this contract for matters pertaining to the contract:

Organization Name: ______________________________

Contractor Name: ______________________________

Title: ______________________________

Address: ______________________________

Telephone No: ______________________________

Facsimile: ______________________________

Email Address: ______________________________

Alternate Contractor Name: ______________________________

Title: ______________________________

Address: ______________________________

Telephone No: ______________________________

Facsimile: ______________________________

Email Address: ______________________________

Dun and Bradstreet Number (DUNS No.): ______________________________

Cage Number (CAGE No.): ______________________________

Taxpayer Identification Number (TIN No.): ______________________________

Federal Supply Schedule Contract Number: ______________________________ (If applicable)

b. GOVERNMENT: Eric K. Wright, Contract Specialist Albuquerque Area Indian Health Service 4101 Indian School Road NE Ste 225 Albuquerque, New Mexico 87110 Phone: (505) 256-6752 Fax: (505) 256-6848 Email: eric.wright@ihs.gov

1. PURPOSE

The contractor shall provide groceries, kitchen supplies and paper ware supply agreement to the following Albuquerque Area Indian Health Service Facility:

Mescalero Service Unit Attn: Dietary Department 318 Abalone Loop Mescalero, New Mexico 88340

Acquisition will be for a 12 month base year period with 4 one year options for renewal.

2. DESCRIPTION OF SERVICES/SUPPLIES

The contractor shall be in accordance with all Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

The contractor shall provide the following groceries, kitchen supplies and paper ware on an as needed basis:

Product Listing

Apple Juice singles Plastic Spoons Hot Cereal, Oatmeal individual packets

Orange Juice singles Plastic Forks Dry Cereal Cheerios

Pineapple Juice singles Styrofoam Cups Soup assorted

Graham Crackers 2 pack Pudding individual (i.e.: chocolate, vanilla, sugar free chocolate, sugar free vanilla) Chili #10 can

Sherbet cups Salt Packets Tuna canned

Lite Whipped spread (i.e.: Promise) Pepper packets 3 bean salad #10 can

Ice Cream individual cups Vanilla and Chocolate Beef Ground Fine 80/20 Applesauce #10 can

Sweetener Sucralose individual packets Skinless Boneless Chicken Breast Canned Fruit #10 can

Sugar individual packets Pork Chops boneless Evaporated Milk

Premium Mayo Ham Milk

Ranch Beef Skirt Steak Individual Eggs

Relish Fish Frozen Fresh Produce (various)

Culinary Packets (i.e.: Ketchup, Mustard, Mayonnaise) Hairnets Black, Lightweight Frozen Produce (various)

Cream Cheese individual Teabags individual Bread Fresh

Cheese Sticks mozzarella individual Decaffeinated Tea Bags Bread Frozen

Saltine Crackers Clamshell, Styrofoam Garlic Bread

Fruit Cups individual No Salt/Mrs. Dash Individual Bulk Flour

Peanut Butter Cups individual Picante Sauce Bulk Sugar

3 compartment plates Cereal Bars individual Spoon, Fork, Knife packet

3. DELIVERY LOCATION

An agreement for kitchen supplies and groceries be provided to the following Albuquerque Area Indian Health Service Facility:

Mescalero Service Unit Attn: Dietary Department 318 Abalone Loop Mescalero, New Mexico 88340

4. PERIOD OF PERFORMANCE

The items required under this contract shall commence NLT 10 days after award:

Start End Base TBD/2019 TBD/2020

Option Year 1 TBD/2020 TBD/2021 Option Year 2 TBD/2021 TBD/2022 Option Year 3 TBD/2022 TBD/2023 Option Year 4 TBD/2023 TBD/2024

Performance shall be for the period of TBD/2019 through TBD/2020 unless the period is changed by written modification in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

Total contract award shall not exceed 5 years. Option year renewals will be based on services provided satisfactorily, availability of funds for the appropriate fiscal year, and on the basis of existing requirements.

5. PRICING

Offers for a kitchen and grocery supply agreement will be provided to the specified Albuquerque Area Indian Health Service Health Center in the following format:

Base Year Option Year #1 Option Year #2 Option Year #3 Option Year #4

Product Description Estimated Yearly Amounts TBD/2019 TBD/2020 TBD/2021 TBD/2022 TBD/2023

Apple Juice singles (case) 12 cases $_______ each $_______ each $_______ each $_______ each $_______ each

Orange Juice singles (case) 12 cases $_______ each $_______ each $_______ each $_______ each $_______ each

Pineapple Juice singles (case) 6 cases $_______ each $_______ each $_______ each $_______ each $_______ each

Graham Crackers 2 pack (box) 12 boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Sherbet cups (case) 12 cases $_______ each $_______ each $_______ each $_______ each $_______ each

Lite Whipped spread (i.e.: Promise) (box) 3 boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Ice Cream individual cups Vanilla and Chocolate (box) 12 boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Sweetener Sucralose individual packets (box) 3 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Sugar individual packets (box) 3 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Premium Mayo (gallon) 4 Gallons $_______ each $_______ each $_______ each $_______ each $_______ each

Ranch (gallon) 3 Gallons $_______ each $_______ each $_______ each $_______ each $_______ each

Relish (gallon) 3 Gallons $_______ each $_______ each $_______ each $_______ each $_______ each

Culinary Packets (i.e.: Ketchup, Mustard, Mayonnaise) (box) 4 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Cream Cheese individual (box) 3 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Cheese Sticks mozzarella individual (box) 6 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Saltine Crackers (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Fruit Cups individual (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Peanut Butter Cups individual (box) 4 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

3 compartment plates (case) 8 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Plastic Spoons (box) 6 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Plastic Forks (box) 6 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Styrofoam Cups (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Pudding individual (i.e.: chocolate, vanilla, sugar free chocolate, sugar free vanilla) (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Salt Packets (box) 4 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Pepper packets (box) 4 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Beef Ground Fine 80/20 (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Skinless Boneless Chicken Breast (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Pork Chops boneless (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Ham 6 $_______ each $_______ each $_______ each $_______ each $_______ each

Beef Skirt Steak Individual (box) 6 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Fish Frozen (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Hairnets Black, Lightweight (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Teabags individual (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Decaffeinated Tea Bags (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Clamshell, Styrofoam (case) 6 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

No Salt/Mrs. Dash Individual (case) 3 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Picante Sauce (bottle) 2 Bottles $_______ each $_______ each $_______ each $_______ each $_______ each

Cereal Bars individual (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Hot Cereal, Oatmeal individual packets (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Dry Cereal Cheerios (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Soup assorted (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Chili #10 can (case) 6 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Tuna canned (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

3 bean salad #10 can (case) 6 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Applesauce #10 can (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Canned Fruit #10 can (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Evaporated Milk (case) 12 Cases $_______ each $_______ each $_______ each $_______ each $_______ each

Milk (gallon) 50 Gallons $_______ each $_______ each $_______ each $_______ each $_______ each

Eggs (dozen) 25 Dozens $_______ each $_______ each $_______ each $_______ each $_______ each

Fresh Produce (various) (package) 50 Packes $_______ each $_______ each $_______ each $_______ each $_______ each

Frozen Produce (various) (package) 25 Packages $_______ each $_______ each $_______ each $_______ each $_______ each

Bread Fresh (package) 12 Packages $_______ each $_______ each $_______ each $_______ each $_______ each

Bread Frozen (package) 12 Packages $_______ each $_______ each $_______ each $_______ each $_______ each

Garlic Bread (package) 6 Packages $_______ each $_______ each $_______ each $_______ each $_______ each

Bulk Flour 12 Bulk $_______ each $_______ each $_______ each $_______ each $_______ each

Bulk Sugar 12 Bulk $_______ each $_______ each $_______ each $_______ each $_______ each

Spoon, Fork, Knife packet (box) 12 Boxes $_______ each $_______ each $_______ each $_______ each $_______ each

Grand Total $_______ $_______ $_______ $_______ $_______

6. COMPENSATION

The Contractor shall be compensated at the agreed contract amount based on monthly invoices submitted and only for services in direct performance of this contract. Per mandate by the U. S. Department of Treasury and effective July 1996, payments by Electronic Funds Transfer System will be made to the Contractor's designated financial institute. The Contractor's pricing/cost includes all mandatory Federal, State and Local taxes.

It is the sole responsibility of the Contractor to collect and pay for all New Mexico State Gross Receipt Taxes for business/work performed in the State of New Mexico, regardless of county the business/service/work was performed. As an independent Contractor; billing and collecting for the federal, state and other local city/county taxes is the burden of the Contractor, this includes the New Mexico Gross Receipt Taxes (NMGRT) for services provided in any county of the State of New Mexico. The Contractor's price/cost for services under this contract should include all applicable taxes for Internal Revenue Service (IRS), State of New Mexico Taxation and Revenue agency and/or other revenue agencies. The Indian Health Service will not withhold taxes nor will it issue a W-2 to the contractor.

7. EVALUATION FACTORS FOR AWARD:

The proposal shall be evaluated to determine the Offeror's ability to complete all requirements necessary for successful performance under the contract. A proposal which merely paraphrases the requirements stated in Performance Objectives will be ineligible for award. In addition, a proposal that addresses only a part of the requirements will be considered unresponsive to this solicitation and unacceptable for award. The proposal should show that the requirements stated in the description of services/supplies of this solicitation are understood and offer a logical approach for their achievement. Qualifications require that the Offeror provides documentation of successful compliance with current state and federal Food Codes ensuring proper food purchase sources, storage facilities and temperature controlled delivery vehicles. Past Performance required is a minimum of 3 past years successful experience in providing same/similar type of food services. Provide a reference letter for each of the last three contracts awarded to you. The letter shall include: (1) name, address and telephone number of the awarding business, and a point of contact name; (2) contract award date and the contract period of performance; (3) statement by the awarding entity on the Contractor quality of work and reliability concerning this proposal with respect to each mandatory requirement as stated in this RFP. Contractor must show a background in providing services in a healthcare food service setting as a past performance, and must provide proof for the past 3 years. The Government will award a Fixed-Price contract resulting from this solicitation to the responsible Offeror whose offer, conforming to this solicitation; will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

(1) Qualifications

(2) Past Performance

(3) Price

A written notice of award or acceptance of an offer mailed or otherwise furnished to the successful Offeror within the time for acceptance specified in the offer, shall result in a binding contract after acceptance of the Offeror. Before the offer's specified expiration time, the Government may accept an offer, whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. An award will be made on a both qualification and price. An award will be made only in the event that the Offeror's proposal is found to be technically acceptable, based upon the evaluation criteria, and the Offeror is determined responsive and responsible in accordance with the terms and conditions of this solicitation.

RELATIVE IMPORTANCE OF EVALUATION CRITERIA

Factor 1 is more important than Factor 2. Factors 1 and 2, when combined, are significantly more important than price.

The award will be made on a best-value basis; both price and other factors considered. The Source Selection Team will evaluate the technical aspects; the contracting officer will evaluate the pricing.

8. CONTRACT OFFICER REPRESENTATIVE (COR)

Marina Mendez, 575-464-3806, is hereby designated as Contract Officer’s Representative for this service. The Contract Officer Representative responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer’s Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

9. QUESTIONS

In accordance with FAR 15.201 Exchanges with Industry before receipt of proposals, please refer to solicitation #(RFP19- 242-SOL-00016) when requesting information regarding the solicitation via e-mail to eric.wright@ihs.gov, facsimile: (505) 256-6848 or phone: (505) 256-6752.

10. IHS CONTRACTING OFFICER:

The authority to negotiate a change in terms, conditions, or amounts cited is reserved for the IHS contracting Officer. The COR designated holds no such authority.

11. CLIENT BACKGROUND

Some of the IHS patients receiving services under this contract may only speak a native language or may have limited comprehension of the English language, and/or may reside on a Native American Indian Reservation. The Contractor is expected to demonstrate sensitivity to cross-cultural and language difference and have the ability to work through interpreters.

12. SUBCONTRACTS:

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the Contracting Officer.

13. GOVERNMENT HOLIDAYS (https://www.federalpay.org/holidays) New Year’s Day Martin Luther King’s Birthday President’s Day Memorial Day Independence Day Labor Day Columbus Day Veteran’s Day Thanksgiving Day Christmas Day *Any other day specifically declared by the President of the United States to be a national holiday (www.opm.gov/fedhol).

14. PAYMENT OFFICE

METHOD OF PAYMENT:

- Payment shall be made in arrears;

- Electronic Funds Transfer (EFT) shall be utilized as method for processing payment;

- Upon receipt of the properly prepared Contractor invoice, the COR is responsible for certifying the invoice for acceptance of service and contacting a UFMS receiver to request a receiving receipt.

The payment office is: Electronic Funds Transfer (EFT) Disbursed by:

Albuquerque Indian Health Service U S Department of Treasury Division of Accounting Services Office of Disbursements 4101 Indian School Road NE, Suite 225 Austin, TX 73301 Albuquerque, NM 87110

15. PROPER INVOICE:

Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule, progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all required information for it to constitute a proper invoice.

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice.

For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

The Contractor shall submit proper invoices and all required back-up documentation to:

a. COR: Geneva Sanchez, Geneva.sanchez@ihs.gov

b. Albuquerque Finance: ALB_AOAPinvoices@ihs.gov

Do not send non-invoice related documents (i.e. deliverables, reports, and balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your emailed invoice submission shall contain the contractor name, contract/order number, and invoice number (e.g. Company Name, Contract HHSI2422014XXXXXX, Invoice #123). The Contractor shall send one email per ORDER. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. Excel formats will NOT be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

FAR 52.212-4(G) INVOICE.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors.

Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

16. CONTRACTOR PERFORMANCE EVALUATION REPORT

During the life of this contract, the contractor’s performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. Evaluation will become part of the contract file and will be used as past performance information in evaluating the Contractor’s, and any significant subcontractors’ or affiliates, past performance on future contracts.

Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report.

After review by the Contracting Officer, the report becomes a permanent record of the Contractor’s past performance.

17. IDENTIFICATION AND DISPOSITION OF DATA, REPORTS, AND OTHER DELIVERABLES

• The Contractor is not permitted to make use of any data derived from these services for any purpose not directly related to and/or authorized by the Albuquerque Area Indian Health Service.

• All patient data/information are subject to the Privacy Act and the Confidentiality of Information Clause (HHSAR

352.224-70)

• Upon completion/termination of the contract, all information, statistical or analytical material or reports and other data generated by the Contractor shall become the property of the Albuquerque Area Indian Health Service.

• The Contractor is prohibited from gathering data, statistics, or use of material for publication and/or research for its own benefits. Dissemination of information, prior approval shall be obtained from the Government Contracting Officer for the release or dissemination of information related to this contract.

18. ADDITIONAL REQUIREMENTS CONCERNING DATA, DATA RIGHTS AND COMPUTER SOFTWARE

• Copies of the final Reports and Deliverables under each task must be officially sent to the Indian Health Service and kept on file by the Contractor. At the end of the contract, all files must be kept by the Contractor for audit purposes.

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: https://www.acquisition.gov/?q=/browse/far/52

FAR TITLE DATE

52.212-4 Contract Terms and Conditions—Commercial Items (OCT 2018) 52.246-4 Inspection of Services – Fixed-Price (AUG 1996)

52.212-3 Offeror Representations and Certifications-Commercial Items (Oct 2018) The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u)) of this provision.

(a) Definitions. As used in this provision— https://www.acquisition.gov/?q=/browse/far/52

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation”, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except—

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

“Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.

“Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.“Sensitive technology”—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3)of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

“Service-disabled veteran-owned small business concern”—

(1) Means a small business concern—

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veteransor, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service connected, as defined in 38 U.S.C. 101(16).

“Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

“Small disadvantaged business concern”, consistent with13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that—

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—

(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

“Subsidiary” means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.“Veteran-owned small business concern” means a small business concern—(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and(2) The management and daily business operations of which are controlled by one or more veterans.“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term “successor” does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.“Women-owned business concern” means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.“Women-owned small business concern” means a small business concern—

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program” (in accordance with 13 CFR part127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States.

(b)

(1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications-Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ______________.

[Offeror to identify the applicable paragraphs at (c) through (u) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on

SAM.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it □is, □is not a small business concern.

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph(c)(1) of this provision.] The offeror represents as part of its offer that it □is, □is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph(c)(1) of this provision.] The offeror represents, that it □is, □is not a small disadvantaged business concern as defined in 13CFR124.1002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph(c)(1) of this provision.] The offeror represents that it □ is, □ is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that-

(i) It □ is,□ is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □is, □is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: __________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that-

(i) It □ is, □ is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: __________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

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

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph(c)(1) of this provision.] The offeror represents that it □is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50percent of the contract price:____________________________________

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph(c)(1) of this provision.] The offeror represents, as part of its offer, that–

(i) It □is, □is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It □ is, □ is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) Representations required to implement provisions of Executive Order11246-

(1) Previous contracts and compliance. The offeror represents that-

(i) It □ has, □ has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(ii) It □ has, □ has not filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that-

(i) It □ has developed and has on file, □ has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or

(ii) It □ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American-Supplies, is included in this solicitation.)

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products,i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American-Supplies.”

(2) Foreign End Products:

Line Item No.

Country of Origin

[List as necessary]

(3) The Government will evaluate offers in accordance with the policies and procedures of FAR part 25.

(g)

(1) Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if the clause at FAR52.225-3, Buy American-Free Trade Agreements-Israeli Trade Act, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off-the-shelf (COTS) item,”

“component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American-Free Trade Agreements–Israeli Trade Act.”

(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American-Free Trade Agreements-Israeli Trade Act”:

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No.

Country of Origin

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph(g)(1)(ii) of this provision) as defined in…