SATPC0025713 Tab 10 RFQ Open Market Template (CURRENT RFQ).pdf

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National Aeronautics and Space Administration

NASA Shared Services Center

Stennis Space Center, MS 39529-6000

2/10/2022

SUBJECT: Request for Quotation (RFQ) 80NSSC22787975Q, EUS Green Run Instrumentation

This solicitation includes the following sections:

1. Statement of Work/Bid Schedule – Section 1

2. Instructions to Offerors – Section 2

3. Solicitation Provisions/Representations and Certifications – Section 3

4. Clauses/Terms and Conditions – Section 4

5. Quote Evaluation Criteria – Section 5

SECTION 1

STATEMENT OF WORK/BID SCHEDULE

This is a Brand Name requirement.

ENTER SOW/BID SCHEDULE:

Statement of Work

EUS Green Run Instrumentation

The NASA, John C. Stennis Space Center (SSC) has been selected as the test site for the Exploration Upper Stage (EUS)

Green Run Test Project. This work is planned at Stennis Space Center’s (SSC) B-2 Test Stand. The work to be performed under this project consists of providing instrumentation to support EUS Green Run testing on the B-2 Test

Stand.

The new instrumentation for the B-2 Test Stand will consist of Static Pressure Transducers, Differential Pressure

Transducers, Static Pressure Transmitters, Differential Pressure Transmitters, Thermocouples, and Resistance

Temperature Devices (RTD) each having different pressure range and response time requirements.

1. Equipment shall be provided that meets NASA's requirements identified in the attached specification.

NASA SSC shall issue a Firm Fixed Price Contract for the following:

a) Two (2) delta pressure transmitters brand Yokogawa, model EJX110AEFS3G712NDFF1K2D1, or approved equal, with a minimum pressure range of -0.72 – 0.72 PSID or 0.4 – 20 inches of water and a response time of less than

125 mSecs as defined in the 0.4 – 20 inH2O data sheet included in the Instrument Specification for Pressure

Transmitters, 140HF-GE02.

b) Nine (9) static pressure transmitters brand Yokogawa, model EJX630AEBS3G712NDFF1K2D1, or approved equal, with a minimum pressure range of 0 – 200 PSIG and response time minimum pressure range of less than 125 mSecs as defined in the 0 – 200 PSIG data sheet included in the Instrument Specification for Pressure Transmitters, 140HF-GE02.

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c) Two (2) static pressure transmitters brand Yokogawa, model EJX630AECS3G712NDFF1K2D1, or approved equal, with a minimum pressure range of 0 – 1,000 PSIG and response time minimum pressure range of less than 125 mSecs as defined in the 0 – 1,000 PSIG data sheet included in the Instrument Specification for Pressure

Transmitters, 140HF-GE02.

d) Two (2) static pressure transmitters brand Yokogawa, model EJX630AEDS3G712NDFF1K2D1, or approved equal, with a minimum pressure range of 0 – 4,000 PSIG and response time minimum pressure range of less than

125 mSecs as defined in the 0 – 4,000 PSIG data sheet included in the Instrument Specification for Pressure

Transmitters, 140HF-GE02.

e) Ten (10) platinum RTD wire wound elements with internal bridge. Effective bridge resistance approximately 19

KΩ. Brand Kaye, model V0360, or approved equal, with a minimum temperature range of -40 – 80°C, accuracy of +/- 0.1°C and +/- 0.05°C per year, sensitivity of 0.0091 mV/V per °C, operates on 5 – 24V DC. Furnish with calibration certificate as defined in the Instrument Specification for B-2 Facility, 140HF-GE04.

f) Six (6) immersion chromega-alomega type K thermocouples brand Omega, model TJ36-CASS-14U-12, or approved equal, with a probe length of 12 inches and a ¼ inch diameter stainless steel sheath as defined in the

Instrument Specification for B-2 Facility, 140HF-GE03.

g) Five (5) immersion chromega-alomega type K thermocouples brand Omega, model TJ36-CASS-18U-12, or approved equal, with a probe length of 12 inches and a ⅛ inch diameter stainless steel sheath as defined in the

Instrument Specification for B-2 Facility, 140HF-GE03.

h) Two (2) immersion chromega-alomega type K thermocouples brand Omega, model TJ36-CAXL-38U-12, or approved equal, with a probe length of 12 inches and a ⅜ inch diameter Super OMEGACLAD XL sheath as defined in the Instrument Specification for B-2 Facility, 140HF-GE03.

i) Six (6) static pressure transducers brand Stellar, model GT200-25G-155, or approved equal, with a minimum pressure range of 0 – 25 PSIG a response time of less than 125 mSecs as defined in the 0 – 25 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

j) Six (6) static pressure transducers brand Taber, model A2211A500GXBBKGX, or approved equal, with a minimum pressure range of 0 – 50 PSIG a response time of less than 125 mSecs as defined in the 0 – 50 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

k) Five (5) static pressure transducers brand Taber, model A2211A500GXBDKGX, or approved equal, with a minimum pressure range of 0 – 50 PSIG a response time of less than 125 mSecs as defined in the 0 – 50 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

l) Five (5) static pressure transducers brand Taber, model A2211A750GXBCKGX, or approved equal, with a minimum pressure range of 0 – 75 PSIG a response time of less than 125 mSecs as defined in the 0 – 75 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

m) Two (2) static pressure transducers brand Taber, model A2211A101GXBBKGX, or approved equal, with a minimum pressure range of 0 – 100 PSIG a response time of less than 125 mSecs as defined in the 0 – 100 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

n) Fifteen (15) static pressure transducers brand Taber, model S0206A102GXBBKGX, or approved equal, with a minimum pressure range of 0 – 1,000 PSIG a response time of less than 125 mSecs as defined in the 0 – 1,000 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

o) Five (5) static pressure transducers brand Taber, model S0206A751GXBBKGX, or approved equal, with a minimum pressure range of 0 – 750 PSIG a response time of less than 125 mSecs as defined in the 0 – 750 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

p) Two (2) static pressure transducers brand Taber, model S0206A202GXBBKGX, or approved equal, with a minimum pressure range of 0 – 2,000 PSIG a response time of less than 125 mSecs as defined in the 0 – 2,000 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

q) Three (3) static pressure transducers brand Taber, model S0206A402GXBBKGX, or approved equal, with a minimum pressure range of 0 – 4,000 PSIG a response time of less than 125 mSecs as defined in the 0 – 4,000 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

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r) Eight (8) static pressure transducers brand Taber, model S0206A502GXBBKGX, or approved equal, with a minimum pressure range of 0 – 5,000 PSIG a response time of less than 125 mSecs as defined in the 0 – 5,000 PSIG data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

s) Two (2) delta pressure transducers brand Taber, model A2217A020BXBBKGX, or approved equal, with a minimum pressure range of 0 – 2 PSID or 0 – 5.662 inches of water and a response time of less than 125 mSecs as defined in the 0 – 2 PSID data sheet included in the Instrument Specification for Pressure Transducers, 140HF-

GE01.

t) Two (2) delta pressure transducers brand Taber, model A2217A030BXBBKGX, or approved equal, with a minimum pressure range of 0 – 3 PSID or 1.361 – 66.703 inches of water and a response time of less than 125 mSecs as defined in the 0 – 3 PSID data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

u) Three (3) delta pressure transducers brand Taber, model A2217A050BXBBKGX, or approved equal, with a minimum pressure range of 0 – 5 PSID or 0.649 – 103.116 inches of water and a response time of less than 125 mSecs as defined in the 0 – 5 PSID data sheet included in the Instrument Specification for Pressure Transducers, 140HF-GE01.

v) Two (2) delta pressure transducers brand Taber, model A2217A200BXBBKGX, or approved equal, with a minimum pressure range of 0 – 20 PSID or 0 – 458.648 inches of water and a response time of less than 125 mSecs as defined in the 0 – 20 PSID data sheet included in the Instrument Specification for Pressure Transducers, 140HF-

GE01.

2. The vendor shall provide a completed calibration test report, which shall include:

a) A description of the test configuration, including a figure depicting this configuration.

b) Test results, which indicate that the device meets the uncertainty requirements of the specification.

3. NASA shall review the test data for adequacy and acceptability.

4. The vendor shall perform these tests at the vendor’s facility.

5. The vendor shall provide lead time for delivery for all transmitters:

6. The vendor shall propose a project schedule identify all tasks identified in this Statement of Work.

7. The vendor shall identify standard terms for hardware maintenance.

8. The vendor shall provide documentation per the included specifications.

9. The vendor shall identify equipment compliance with section 508 of the Rehabilitation Act of 1973 (Ref 36 CFR

1194) and NASA Procurement Information Circular per the following web site:

http://www.hq.nasa.gov/office/procurement/regs/pic05-01.html.

10. The vendor shall identify equipment compliance with the Environmental Protection Agency’s (EPAs) comprehensive guideline lists (CPGs) per the following web site: http://epa.gov/epaoswer/non-hw/procure/products.htm.

11. The vendor is requested to provide cost and schedule proposals for providing hardware elements only that are fully compliant with the referenced NASA Specifications (140HF-GE01 through 140HF-GE04).

http://www.hq.nasa.gov/office/procurement/regs/pic05-01.html http://epa.gov/epaoswer/non-hw/procure/products.htm http://epa.gov/epaoswer/non-hw/procure/products.htm

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SECTION 2

INSTRUCTION TO OFFERORS

☒52.212-1 Instructions to Offerors – Commercial Products and Commerical Services. (Nov 2021)

Addendum to 52.212-1

Quotes for the item(s) described in the RFQ are due by 2/14/2022 by 2:00 p.m. CT to Cody Guidry at cody.d.guidry@nasa.gov in order to be considered for award. If it is in the best interest of the Government, quotes submitted after the due date may be accepted. Quotes shall remain valid for 30 days unless otherwise expressly stated on the quote. Submitted Quotes shall list two points of contacts including name, phone number, and email address.

All contractual and technical questions must be in writing (e-mail) to Cody Guidry at cody.d.guidry@nasa.gov no later than 2/11/2022 by 2:00 p.m. CT. Telephone questions shall not be accepted.

The NAICS Code for this procurement is 334513.

This procurement is set aside for small business.

Offeror’s shall be registered at www.sam.gov in order to be considered for award.

Delivery is FOB Destination.

Please include the lead time for delivery on your submitted quote.

Please include your company’s SAM Cage Code/DUNS number on the submitted quote.

Please note that Provisions 52.204-24 Representation Regarding Certain Telecommunications and Video

Surveillance Services or Equipment (Oct 2020) and 52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020) are included in this RFQ. You are required to complete these two provisions and return the RFQ document with your quote. Failure to complete these Provisions will result in the Government being unable to make award to your firm.

SECTION 3

SOLICITATION PROVISION/REPRESENTATIONS AND CERTIFICATIONS

☒52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions 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. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

http://www.sam.gov/

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FAR FAR | Acquisition.GOV

NFS NASA FAR Supplement

FEDERAL ACQUISITIONI REGULATION (FAR) PROVISIONS INCORPORATED BY

REFERENCE:

☒52.204-07 System for Award Management (Oct 2018)

☒52.204-16 Commercial and Government Entity Code Reporting (Aug 2020)

☒52.204-17 Ownership or Control of Offeror (Aug 2020)

☒52.204-19 Incorporation by Reference of Representations and Certifications (Dec 2014)

☒52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021)

☒52.204-26 Covered Telecommunications Equipment or Services-Representation (Oct 2020)

☐52.209-02 Prohibition on Contracting with Inverted Domestic Corporations – Representation (Nov

2015)

☒52.225-25 Prohibition on Contracting with Entities Engaging in Sanctioned Activities Or

Transactions Relating to Iran – Representation and Certifications (Jun 2020)

☒52.223-1 Biobased Product Certification (May 2012)

FAR PROVISISIONS IN FULL TEXT:

ATTENTION: On December 7, 2021, the United States District Court for the Southern District of

Georgia Augusta Division (hereinafter “the Court”) ordered a nationwide injunction enjoining the

Government from implementing Executive Order 14042 in all covered contracts. As a result, NASA will take no action to enforce the clause implementing requirements of Executive Order 14042, absent further written notice from the agency, where the place of performance identified in the contract is in a U.S. state or outlying area subject to a court order prohibiting the application of requirements pursuant to the

Executive Order (hereinafter, “Excluded State or Outlying Area”). A current list of such Excluded States and Outlying Areas is maintained at https://www.saferfederalworkforce.gov/contractors/

☒52.223-99 Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors. (DEVIATION 21-

03)

(a) Definition. As used in this clause -

United States or its outlying areas means—

(1) The fifty States;

(2) The District of Columbia;

(3) The commonwealths of Puerto Rico and the Northern Mariana Islands;

(4) The territories of American Samoa, Guam, and the United States Virgin Islands; and https://www.acquisition.gov/browse/index/far https://www.hq.nasa.gov/office/procurement/regs/NFS.pdf https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.saferfederalworkforce.gov%2Fcontractors%2F&data=04%7C01%7Cjohnny.m.hisaw%40nasa.gov%7Cc3187332aa704957c5f508d9bbe3b0a7%7C7005d45845be48ae8140d43da96dd17b%7C0%7C0%7C637747408853056822%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&sdata=ZSzjt6BsEzHvz13Dl8UZBRN87kSJ6WtnAZfo%2Bp0cF6A%3D&reserved=0

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(5) The minor outlying islands of Baker Island, Howland Island, Jarvis Island, Johnston Atoll, Kingman

Reef, Midway Islands, Navassa Island, Palmyra Atoll, and Wake Atoll.

(b) Authority. This clause implements Executive Order 14042, Ensuring Adequate COVID Safety Protocols for

Federal Contractors, dated September 9, 2021 (published in the Federal Register on September 14, 2021, 86 FR

50985).

(c) Compliance. The Contractor shall comply with all guidance, including guidance conveyed through

Frequently Asked Questions, as amended during the performance of this contract, for contractor or subcontractor workplace locations published by the Safer Federal Workforce Task Force (Task Force Guidance) at https://www.saferfederalworkforce.gov/contractors/.

☒52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL Produccts and Commercial Services. (Nov 2021)

The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at System for Award Management (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--

“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.

“Forced or indentured child labor” means all work or service—

(6) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(7) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

“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).

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.saferfederalworkforce.gov%2Fcontractors%2F&data=04%7C01%7Cjonathan.g.gomez%40nasa.gov%7C58eb845a66d542afbb7b08d98743e6bf%7C7005d45845be48ae8140d43da96dd17b%7C0%7C0%7C637689547960485635%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=vZ0gQ55VaU6m5el2%2Fm%2FkpFvkZLDIAgN6%2FnMCbscRS%2FM%3D&reserved=0 https://www.sam.gov/SAM/

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“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.

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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 veterans or, 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 with 13 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 at 13 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 CFR 124.104(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—

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(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

“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.

“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.

“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 the 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 least 51 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 part 127),” 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 posted on the

SAMwebsite.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through Acquisition Systems | Acquisition.GOV. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation 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), as of the date of this offer 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 https://www.acquisition.gov/Acquisition_Systems

10 V2.4 Jan 2022 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 is to 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 13 CFR 124.1002.

(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.

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

(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—

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(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.

(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 50 percent 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 Order 11246 --

(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 --

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(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 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 tohave 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 FAR 52.225-3, Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)

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(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:

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) or this provision) as defined in the clause of this solicitation entitled “Buy

American—Free Trade Agreements—Israeli Trade Act.” The offeror shall list as other 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.”

Other Foreign End Products:

(iv) The Government will evaluate offers in accordance with the policies and procedures of FAR

Part 25.

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(2) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled “Buy American—Free Trade

Agreements—Israeli Trade Act”:

Canadian End Products:

Line Item No.:

[List as necessary]

(3) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or

Israeli end products as defined in the clause of this solicitation entitled “Buy American--

Free Trade Agreements--Israeli Trade Act'':

Canadian or Israeli End Products:

Line Item No.: Country of Origin:

(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, 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, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

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(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product as defined in the clause of this solicitation entitled “Trade Agreements.”

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR

Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals--

(1) [_] Are, [_] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) [_] Have, [_] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; and

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(3) [_] Are, [_] are not presently indicted for, or otherwise criminally or civilly charged by a

Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) [_] Have, [_] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,500 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples.

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appear rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals Contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms.

The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. §362 (the Bankruptcy

Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The

Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(1) Listed End Product

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Listed End Product: Listed Countries of Origin:

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

[_] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

[_] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) [_] In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) [_] Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards.

(Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.]

(1) [_] Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1).

The offeror [_] does [_] does not certify that—

(i) The items of equipment to be serviced under this contract are used regularly for other than

Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

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(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

(2) [_] Certain services as described in FAR 22.1003-4(d)(1). The offeror [_] does [_] does not certify that—

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and

(iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers.

(3) If paragraph (k)(1) or (k)(2) of this clause applies—

(i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the

Contracting Officer did not attach a Service Contract Labor Standards wage determination to the solicitation, the offeror shall notify the Contracting Officer as soon as possible; and

(ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(l) Taxpayer identification number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) 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 Internal Revenue

Service (IRS).

(2) 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.

(3) Taxpayer Identification Number (TIN).

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[_] 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…