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REQUEST FOR QUOTATION

PAGE OF PAGES

AAP # 06SO151357144

UNDER BDSA REG. 2

AND/OR DMS REG. 1

USDA Forest Service Rogue River-Siskiyou National Forest 3040 Biddle Road Medford, OR 97504-4119 See Schedule

Linda Harmon – Contracting Michelle Bernard - Engineering 618-2021 957-3401

a. NAME OF CONSIGNEE

September 16, 2013 This is not a public opening.

submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

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

TOKETEE CAMPGROUND

WELL INSTALLATION

UMPQUA NATIONAL FOREST

DOUGLAS COUNTY, OREGON

This procurement is total Small Business Set-Aside

12. DISCOUNT FOR PROMPT PAYMENT

c. COUNTY

AREA CODE

NSN 7540-01-152-8084

Previous edition not usable

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

AG-04N7-S-13-0055

Toketee Campground Well Installation Umpqua National Forest

PART I—THE SCHEDULE

SECTION B--SUPPLIES OR SERVICES AND PRICES/COSTS

TOKETEE CAMPGROUND WELL INSTALLATION

Umpqua National Forest Douglas County

B.1 SCHEDULE OF ITEMS:

QTY.

UNIT

PRICE

TOTAL

AMOUNT

BASE ITEMS

TOTAL BASE ITEMS

OPTION ITEMS

Option Items (to be used if well is abandoned)

TOTAL OF OPTION ITEMS

TOTAL OF BASE AND OPTION ITEMS

Exercise of Option Items will be made by the Government if well is abandoned. See Section I, 52.217-7, Option for Increased Quantity – Separately Priced Line item and Section M – 52-217-5, Evaluation of Options.

The estimated start work date is: September 23, 2013.

All work shall be completed 30 calendar days after issuance of Notice to Proceed.

Quotes shall be submitted for the total items. Quotes for less than the total items will not be considered.

DUNS NUMBER: ______________________________________________________________

EMAIL ADDRESS: ____________________________________________________________

Quoters are urged to inspect work site before submitting quote.

The estimated start work date is: September 23, 2013.

All work shall be completed 30 calendar days after issuance of Notice to Proceed.

Quotes shall be submitted for the total items. Quotes for less than the total items will not be considered.

Facsimile offers are authorized. The number of facsimile equipment is: 541.618.2148.

ELECTRONIC OFFERS WILL NOT BE ACCEPTED. An offer that is emailed to government account will be rejected.

Offerors must respond to the other factors (Evaluation Criteria) as described in Sections L and M. Award will be made on the best value for the Government.

NOTE: Prospective awardees MUST be registered in the System for Award Management (SAM) to be awarded a Federal Government contract. If you are not registered, please register at the following site:

https://www.sam.gov/portal/public/SAM/

This is not a public bid opening. All offers submitted are considered confidential. The name of the contractor and the amount of the contract will be disclosed only after an award has been made.

TECHNICAL QUESTIONNAIRE

INSTRUCTIONS:

Offerors must respond to the following to receive full consideration for award.

Complete this questionnaire in its entirety, attach additional sheets if needed.

Providing a separate proposal that addresses these questions in their entirety is also acceptable.

This Technical Proposal should not exceed ten (10) single sided pages.

**SEE SOLICITATION SECTION M for EVALUATION CRITERIA**

1. GENERAL TECHNICAL CAPABILITY

1(a) General Technical Capability for Well Rehabilitation and Related Work Briefly explain your capability to accomplish the well drilling and development work for the proposed contract. Include a description of each part of the process (drilling, casing, screening, development, abandonment if neccesary, etc.).

1(b) Technical Capability – Key Personnel/State Licenses Identify key personnel by name and provide their qualifications and any State License(s) they possess. Also include applicable State licensing held by the company.

2. CONTRACTOR’S PAST PERFORMANCE

2(a) Past Performance Provide a listing of your work for the past five years, which is most closely related to work of this type.

Include the following:

· Who it was for

· Description of work

· Dates of performance

· Contact Person

· Contact Phone Number

3. CONTRACTOR’S ABILITY TO COMPLETE PROJECT IN A TIMELY MANNER

3(a) Ability to complete projects within time requirements Provide a listing of your work success in completing projects within required contract time frame for the past five years in related work.

Include the following:

· Who it was for

· Time requirements

· Contact Person

· Contact Phone Number

3 (b) Project Schedule Provide your expected project schedule including sequence of work items and approximate time to complete each item, considering contract requirements and potential site weather conditions.

PART IV--REPRESENTATIONS AND INSTRUCTIONS

SECTION K--REPRESENTATIONS, CERTIFICATIONS, AND

OTHER STATEMENTS OF OFFERORS OR RESPONDENTS

K-1 SIZE STANDARD AND NAICS CODE INFORMATION (AGAR 452.219-70) (JANUARY 2005)

The North American Industrial classification System Code(s) and business size standard(s) describing the products and/or services to be acquired under this solicitation are listed below:

Contract line item(s): ALL --NAICS Code 237110 --Size Standard $33.5 million

The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

K-2 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (DEC 2012)

(a)(1) The North American Industry Classification System (NAICS) code for this acquisition is 237110

(2) The small business size standard is $33.5 million

(3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

(b)(1) If the clause at 52.204-7, Central Contractor Registration, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the clause at 52.204-7 is not included in this solicitation, and the offeror is currently registered in CCR, and has completed the ORCA electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes:

[ ] (i) Paragraph (d) applies.

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

(d) The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) website accessed through https://www.acquisition.gov. After reviewing the ORCA database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

FAR Clause # Title Date Change

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

K-3 Government Employees, Former USDA Employees, and USDA Retirees

The offeror represents and certifies that --

A. It [ ] is, [ ] is not a current Federal Government employee.

B. It [ ] is, [ ] is not a former USDA employee.

C. It [ ] is, [ ] is not a retired USDA employee. If retired, give date of retirement:_________.

D. It [ ] is, [ ] is not related by blood or marriage to a current Forest Service employee on the Rogue River-Siskiyou National Forest. If so, list employee's name and location:______________________________.

E. It [ ] is, [ ] is not substantially owned or controlled by a former USDA employee or retiree.

K-4 AGAR 452-209-70 Alternate 1 (Feb 2012) REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID DELINQUENT TAX LIABILITY OR A FELONY CONVICTION (AGAR 452.209-70) (DEVIATION 2012-01)

(FEB 2012) (ALTERNATE 1)

(a.) Awards made under this solicitation are subject to the provisions contained in the Consolidated Appropriations Act, 2012 (P.L. No. 112-74), Division E, Sections 433 and 434 regarding corporate felony convictions and corporate federal tax delinquencies. To comply with these provisions, all offerors must complete paragraph (1) of this representation, and all corporate offerors also must complete paragraphs (2) and (3) of this representation.

(b) The Offeror represents that –

(1) The Offeror is [ ], is not [ ] (check one) an entity that has filed articles of incorporation in one of the fifty states, the District of Columbia, or the various territories of the United States including American Samoa, Federated States of Micronesia, Guam, Midway Islands, Northern Mariana Islands, Puerto Rico, Republic of Palau, Republic of the Marshall Islands, U.S. Virgin Islands. (Note that this includes both for-profit and non-profit organizations.)

If the Offeror checked “is” above, the Offeror must complete paragraphs (2) and (3) of the representation. If Offeror checked “is not” above, Offeror may leave the remainder of the representation blank.

(2) (i) The Offeror has [ ], has not [ ] (check one) been convicted of a felony criminal violation under Federal or State law in the 24 months preceding the date of offer.

(ii) Offeror has [ ], has not [ ] (check one) had any officer or agent of Offeror convicted of a felony criminal violation for actions taken on behalf of Offeror under Federal law in the 24 months preceding the date of offer.

(3) The Offeror does [ ], does not [ ] (check one) have any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.