RFQ_-_Combined_synopsis_-_95332A18T0029.docx

COMBINED SYNOPSIS/SOLICITATION

Combined Synopsis and Solicitation Notice Information

1. This is a combined synopsis/solicitation for commercial items prepared in accordance with FAR 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued.

2. Solicitation 95332A18T0029 and is being issued as a Request for Quotes (RFQ).

3. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular {2005-98, effective May 31, 2018}. See www.acquisition.gov/browsefar for this information.

4. The associated NAICS code is 532490 Other Commercial and Industrial Machinery and Equipment Rental and Leasing and this procurement:

|X| is not being set-aside for small businesses.

|_| is being set-aside for small businesses.

5. CNCS intends to award a firm fixed price purchase order for the procurement of a Forklift lease.

The table below lists the Contract Line Item Number(s) (CLIN(s)) and items, quantities and units of measure, inclusive of any applicable options:

CLIN item descriptions

CLIN 0001 - Base Year Forklift Lease

CLIN 0004 - Option Year 1 Forklift Lease

CLIN 0007 – Option Year 2 Forklift Lease

CLIN 0010 – Option Year 3 Forklift Lease

CLIN 0013 – Option Year 4 Forklift Lease

Location of Work: 1004 G Avenue, Vinton, IA 52349 Period of Performance: This purchase order will be for one-year base year with an option for up to four additional one-year optional years, (for a maximum of five years).

6. Statement of Work

STATEMENT OF WORK

LEASE AGREEMENT FOR FORKLIFT WITH MAINTENANCE AGREEMENT

FOR *NCCC NORTH CENTRAL REGION

REQUESTOR

Corporation for National and Community Services AmeriCorps National Civilian Community Corps (NCCC) North Central Region Campus

REQUESTOR LOCATION

1004 G Avenue, Vinton, IA 52349

REQUESTOR BACKGROUND DESCRIPTION

The North Central Campus requests a one year base plus four 1 year option lease for one pneumatic forklift with maintenance agreement to safely unload freight from trucks and to store supplies, equipment.

SERVICE DESCRIPTION (Performance, Functions) AmeriCorps *NCCC North Central Region requests to lease one gas/propane operated 5,000 lbs. 3 stage pneumatic 48 inch forklift with maintenance agreement.

MINIMUM SPECIFICATIONS FOR LEASED EQUIPMENT (Quantity, Essential Physical Characteristics)

1. One year Lease of one pneumatic forklift to be used primarily on a concrete floor, small gravel and driveways and road.

2. Project up to 1200 hours annual uses

3. Fuel: Gas/Propane operated

4. 5,000 lbs. lift capable

5. 48” fork length

6. 3 stage lift up to 10 feet high minimum

7. Height no taller than 86”

8. Width no wider than 42”

9. Maintenance and service agreement which covers breakdown repairs and manufacturer recommended services to be included in price

10. Vendor will provide operators safety training to safely operate forklift for up to 3 operators.

EMERGENCY “ON CALL” SERVICES

Maintenance and service agreement

VENDOR REQUIREMENTS

· Vendor must provide the manufacturer’s specification sheet for quoted equipment to validate the quoted item meets the minimum specifications for leased equipment.

· Vendor must provide a copy of the maintenance and service agreement identifying coverage of breakdown repairs and manufacturer recommended services

· Communicate with COR POC for specific instruction and work detail specific to delivery of forklift and return upon lease termination.

· Notify COR immediately if any unforeseen events cause the vendor to delay delivery.

· Vendor will provide operators safety training to safely operate forklift for up to 3 operators.

GOVERNMENT REQUIREMENTS

· COR will coordinate off loading and loading of forklift.

WORK SERVICE GUARANTEE

All industry warranties shall apply and will be covered in maintenance and service agreement.

DELIVERY REQUIREMENTS (Delivery Date of Materials/Date of Performance) September 30th, 2018 Delivery will be 1004 G Ave, Vinton, IA There is no dock at this location. Vender will call ahead to coordinate delivery.

SHIPPING INSTRUCTIONS

Will deliver to and from campus by requested date at no charge to the government.

SPECIAL NEEDS (Special arrangements, Compatibility, Conversion, Security, Patents, Warrantees, IT Security, Environmental requirements) All industry warranties shall apply and will be covered in maintenance and service agreement.

7. The provision at FAR 52.212-1, Instructions to Offerors – Commercial applies to this acquisition and is amended as follows:

52.212-1 (ADDENDUM) ADDITIONAL INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS

a. This procurement is a FAR Part 12 commercial acquisition being conducted under FAR Part 13 accordingly, simplified acquisitions procedures apply.

b. The term “offeror” or “offer” as used in FAR 52.212-1 shall be understood to mean “quoter” and “quote,” respectively. Further, the term “award” shall be understood to describe the Government’s issuance of an purchase order.

c. The following paragraphs in FAR 52.212-1 shall not apply to this RFQ: b, c, d, f (except f(4)), and l.

d. SUBMISSION PACKAGE INSTRUCTIONS

1. Technical Capability

Volume 1 Technical Quote must address ALL of the following technical capability evaluation criteria:

a. One year Lease of one pneumatic forklift to be used primarily on a concrete floor, small gravel and driveways and road.

b. Project up to 1200 hours annual uses

c. Fuel: Gas/Propane operated

d. 5,000 lbs. lift capable

e. 48” fork length

f. 3 stage lift up to 10 feet high minimum

g. Height no taller than 86”

h. Width no wider than 42”

i. Maintenance and service agreement which covers breakdown repairs and manufacturer recommended services to be included in price

j. Vendor will provide operators safety training to safely operate forklift for up to 3 operators.

k. Vendor must provide the manufacturer’s specification sheet for quoted equipment to validate the quoted item meets the minimum specifications for leased equipment.

l. Vendor must provide a copy of the maintenance and service agreement identifying coverage of breakdown repairs and manufacturer recommended services

2. The price quote shall contain the following:

Volume 2 price quote shall contain the following in the table provided. The following pricing guidelines must be adhered to:

i. Price quote which identifies the requested item(s) unit cost, extended price

ii. Total Price for all items

iii. Remittance address, Tax identification Number, DUNS number and Cage Code

iv. Volume 2 must be submitted in the below table format

v. Supporting spreadsheets identifying all supporting elements of the lease to purchase prices (price breakdown for each period of performance including calculations) and early termination fees (price breakdown for each period of performance including calculations) must be submitted separately in Microsoft Excel separated by worksheets.

CLIN item descriptions

CLIN 0001 - Base Year Forklift Lease

CLIN 0004 - Option Year 1 Forklift Lease

CLIN 0007 – Option Year 2

CLIN 0010 – Option Year 3

CLIN 0013 – Option Year 4

Total Price:

All quoters must include a completed copy of FAR 52.212-3, Offeror Representations and Certifications – Commercial Items with its offer.

3. QUESTION DUE DATE: All questions shall be submitted no later than Wednesday, June 20, 2018 at 12:00 p.m. Eastern Standard Time (EST) via email to cismith@cns.gov. Questions submitted after this date and time shall not be answered.

4. QUOTE DUE DATE: Quotes in response to this solicitation shall be received no later than Wednesday, June 27, 2018 at 12:00PM EST. Responses received after this date and time will be considered non-responsive, in accordance with (IAW), Federal Acquisition Regulation (FAR) 52.214-7, Late Submissions, Modifications, and Withdrawals of Bids.

5. The points of contact for this requirement is Cindy Smith and Jessie Garcia at cismith@cns.gov and jgarcia@cns.gov. For all email correspondences, PLEASE REFERENCE THE SOLICITATION NUMBER IN THE SUBJECT LINE— 95332A18T0029.

6. Offers/quotes submitted in response to this solicitation shall not contain nor be subject to the offeror's/vendor's standard commercial terms and conditions. Any offer/quote submitted in response to this solicitation which includes the offeror's/vendor's standard commercial terms and conditions may be considered a material defect and may be rejected as being non-responsive to the solicitation.

7. Any data previously submitted in response to another solicitation, or market research will be assumed unavailable to the Contracting Officer, and this data must not be incorporated into the technical offer by reference.

8. EVALUATION CRITERIA

a. BASIS FOR AWARD :

Award will be made to the responsible, technically acceptable quoter, whose quote, conforming to the Request for Quotation, offers the lowest evaluated price on the following elements: (1) Technical Capability; (2) Price; (3) Past Performance.

To be considered Technically Acceptable, the vendor must meet ALL of the items listed in the Volume 1 Technical capability factor and evaluation will be conducted on the basis of the information furnished by the offeror or identified in the offer. The Contracting Officer is not responsible for locating or obtaining any information not identified in the offer.

EVALUATION CRITERIA FOR FORKLIFT LEASE

Factor 1-Technical Capability Factor

Any technical quotes that do not receive an acceptable rating for ALL of the evaluation criteria will receive an unacceptable rating for the technical quote. Award will be made to the lowest-priced, technically acceptable, responsible contractor.

Volume 1 Technical Quote must address ALL of the following technical capability evaluation criteria:

m. One year Lease of one pneumatic forklift to be used primarily on a concrete floor, small gravel and driveways and road.

n. Project up to 1200 hours annual uses

o. Fuel: Gas/Propane operated

p. 5,000 lbs. lift capable

q. 48” fork length

r. 3 stage lift up to 10 feet high minimum

s. Height no taller than 86”

t. Width no wider than 42”

u. Maintenance and service agreement which covers breakdown repairs and manufacturer recommended services to be included in price

v. Vendor will provide operators safety training to safely operate forklift for up to 3 operators.

w. Vendor must provide the manufacturer’s specification sheet for quoted equipment to validate the quoted item meets the minimum specifications for leased equipment.

x. Vendor must provide a copy of the maintenance and service agreement identifying coverage of breakdown repairs and manufacturer recommended services

Factor 2-Price

Price will be evaluated for completeness and reasonableness. For a price to be considered reasonable, it must represent a price to the Government that a prudent person would pay when consideration is given to prices in the market. Normally, price reasonableness is established through adequate price competition, but may also be determined through cost and price analysis techniques as described in FAR 15.404. Offeror(s) shall submit firm fixed prices for all items listed in the SOW.

This requirement, will be awarded as a Firm Fixed Price (FFP) Task Order, using the Lowest Price Technically Acceptable (LPTA) methodology. Quotation submittal and all other required documents must be submitted in accordance with the Request for quote. Failure to submit the aforementioned information correctly shall deem your quote as non-responsive; thus, it shall not receive consideration for award. Any questions regarding this RFQ shall be submitted to Cindy Smith at cismith@cns.gov.

The contractor found technically acceptable with the lowest overall price will be ranked accordingly.

Factor 3-Past Performance Past performance: Quoters' past performance information will be evaluated based on information obtained from the Government database called Past Performance Information Retrieval System (PPIRS) located at www.ppirs.gov.

The government will assess the relative risks associated with each quoter. Performance risks are those associated with a quoter's likelihood of success in performing the acquisition requirements as indicated by that quoter's record of past performance.

The assessment of performance risk is not intended to be a product of a mechanical or mathematical analysis of a quoter's performance on a list of contracts but rather the product of subjective judgment by the Government after it considers relevant information.

When assessing performance risks, the Government will focus on the past performance of the quoter as it relates to all acquisition requirements, such as the quoter's record of performing according to specifications, including standards of good workmanship; the quoter's record of controlling and forecasting costs; the quoter's adherence to contract schedules, including the administrative aspects of performance; the quoter's reputation for reasonable and cooperative behavior and commitment to customer satisfaction; and generally, the quoter's business-like concern for the interest of the customer.

The Government will consider the recency and relevance of the information, source of the information, context of the data, and general trends in the quoter's performance.

The lack of a relevant performance record may result in an unknown performance risk assessment, which will result in the Quoter being evaluated neither favorably nor unfavorably for past performance and the quoter will receive a neutral rating.

Past Performance will receive one of the following:

PASS (P): Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

FAIL (F): Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

NEUTRAL (N): No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

Past performance: Quoters' past performance information will be evaluated based on information obtained from the Government database called Past Performance Information Retrieval System (PPIRS).

PAGE RESTRICTIONS:

The quotes submitted must be legible, singled-spaced, typewritten (on one side only), in a font size not smaller than 10 point pitch with a one-inch margin on all sides, on paper not larger than eight and a half by eleven inches and not exceeding the page limits established in this quote. Pages in excess of the individual limitations shall not be read, and the quote shall be evaluated as if the excess pages did not exist.

A quoter’s Technical quote will be evaluated in accordance with the evaluation criteria for Volume 1 technical quote. Clarity and completeness of the quote are of the utmost importance. The quote must be written in a practical, clear, and concise manner. Each Volume must be clearly marked.

The following page restrictions by Volume are:

Volume 1 technical quote - Technical Quote shall not exceed 10 pages Volume 2 price quote - Price Quote shall not exceed 5 pages

Items not included within the page restriction count are as follows: System for Award Management (SAM), cover pages, cover letters, table of contents, blank section dividers, resumes, charts, graphs, and glossary of terms, exhibits, drawings, sample formats, and items of an illustrative nature. Together, any attached charts, graphs, glossary of terms, exhibits, drawings, sample formats, or other illustrative documents shall not exceed 10 pages.

(End of Addendum)

9. 52.207-5 -- Option to Purchase Equipment. (Feb 1995)

(a) The Government may purchase the equipment provided on a lease or rental basis under this contract. The Contracting Officer may exercise this option only by providing a unilateral modification to the Contractor. The effective date of the purchase will be specified in the unilateral modification and may be any time during the period of the contract, including any extensions thereto.

(b) Except for final payment and transfer of title to the Government, the lease or rental portion of the contract becomes complete and lease or rental charges shall be discontinued on the day immediately preceding the effective date of purchase specified in the unilateral modification required in paragraph (a) of this clause.

(c) The purchase conversion cost of the equipment shall be computed as of the effective date specified in the unilateral modification required in paragraph (a) of this clause, on the basis of the purchase price set forth in the contract, minus the total purchase option credits accumulated during the period of lease or rental, calculated by the formula contained elsewhere in this contract.

(d) The accumulated purchase option credits available to determine the purchase conversion cost will also include any credits accrued during a period of lease or rental of the equipment under any previous Government contract if the equipment has been on continuous lease or rental. The movement of equipment from one site to another site shall be “continuous rental.”

(End of Clause)

10. 52.208-4 -- Vehicle Lease Payments (Apr 1984)

(a) Upon the submission of proper invoices or vouchers, the Government shall pay rent for each vehicle at the rate(s) specified in this contract.

(b) Rent shall accrue from the beginning of this contract, or from the date each vehicle is delivered to the Government, whichever is later, and shall continue until the expiration of the contract term or the termination of this contract. However, rent shall accrue only for the period that each vehicle is in the possession of the Government.

(c) Rent shall not accrue for any vehicle that the Contracting Officer determines does not comply with the Condition of Leased Vehicles clause of this contract or otherwise does not comply with the requirements of this contract, until the vehicle is replaced or the defects are corrected.

(d) Rent shall not accrue for any vehicle during any period when the vehicle is unavailable or unusable as a result of the Contractor’s failure to render services for the operation and maintenance of the vehicle as prescribed by this contract.

(e) Rent stated in monthly terms shall be prorated on the basis of 1/30th of the monthly rate for each day the vehicle is in the Government’s possession. If this contract contains a mileage provision, the Government shall pay rent as provided in the Schedule.

(End of Clause)

11. 52.208-5 -- Condition of Leased Vehicles (Apr 1984) Each vehicle furnished under this contract shall be of good quality and in safe operating condition, and shall comply with the Federal Motor Vehicle Safety Standards (49 CFR 571) and State safety regulations applicable to the vehicle. The Government shall accept or reject the vehicles promptly after receipt. If the Contracting Officer determines that any vehicle furnished is not in compliance with this contract, the Contracting Officer shall promptly inform the Contractor in writing. If the Contractor fails to replace the vehicle or correct the defects as required by the Contracting Officer, the Government may --

(a) By contract or otherwise, correct the defect or arrange for the lease of a similar vehicle and shall charge or set off against the Contractor any excess costs occasioned thereby; or

(b) Terminate the contract under the Default clause of this contract.

(End of Clause)

12. 52.208-6 -- Marking of Leased Vehicles (Apr 1984)

(a) The Government may place nonpermanent markings or decals, identifying the using agency, on each side, and on the front and rear bumpers, of any motor vehicle leased under this contract. The Government shall use markings or decals that are removable without damage to the vehicle.

(b) The Contractor may use placards for temporary identification of vehicles except that the placards may not contain any references to the Contractor that may be construed as advertising or endorsement by the Government of the Contractor.

(End of Clause)

13. 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (Apr 2016) 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 accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (r) 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—

(1) 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

(2) 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).

“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 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—

(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 https://www.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 (r) 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 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—

(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 --

(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 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:

[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.)

(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.

(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:

(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:

(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

(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

(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…