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CONSTRUCTION RFQ

AG-3395-S-11-0020

LEE RANGER DISTRICT

CULVERT REPLACEMENTS CUB RUN ROAD

CONSTRUCTION RFQ

AG-3395-S-11-0020

LEE RANGER DISTRICT

CULVERT REPLACEMENTS CUB RUN ROAD

REQUEST FOR QUOTATION

PAGE OF PAGES

IS NOT A SMALL BUSINESS SET- ASIDE

AND/OR DMS REG. 1

USDA Forest Service

5162 Valleypointe Parkway

Roanoke VA 24019-3050

SEE SECTION F

FOB DESTINATION

FORMCHECKBOX

OTHER (See Schedule)

a. NAME OF CONSIGNEE

95 Railroad Avenue

Edinburg

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

George Washington and Jefferson

National Forests

FORMTEXT

12. DISCOUNT FOR PROMPT PAYMENT

are not attached.

c. COUNTY

AREA CODE

NSN 7540-01-152-8084

Previous edition not usable

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

PART I—THE SCHEDULE

SECTION B--SUPPLIES OR SERVICES AND PRICES/COSTS

FSR 65, Cub Run Road Culvert Replacements

Lee Ranger District

Pay Item Number Description Method of Meas.

Unit Quantity Unit Price Total 18” Aluminized Steel, Type 2, Corrugated Steel Pipe, 0.064” Thickness

DQ

L.F.

232.00 24” Aluminized Steel, Type 2, Corrugated Steel Pipe, 0.064” Thickness

DQ

L.F.

148.00 30” Aluminized Steel, Type 2, Corrugated Steel Pipe, 0.064” Thickness

DQ

L.F.

70.00 42” Aluminized Steel, Type 2, Corrugated Steel Pipe, 0.079” Thickness

DQ

L.F.

38.00 Crushed Aggregate Surfacing, Grade VDOT No. 26

DQ

TON

255.00 Seeding, Dry Method with Mulch

LSQ

L.S.

1.00 Machine Placed Riprap

DQ

C.Y.

12.50 TOTAL (Base Item I):

Option 1 Pay Item Number Description Method of Meas.

Unit Quantity Unit Price Total 24” Aluminized Steel, Type 2, Corrugated Steel Pipe, 0.064” Thickness

DQ

L.F.

56.00 Crushed Aggregate Surfacing, Grade VDOT No. 26

DQ

TON

15.00 Seeding, Dry Method with Mulch

LSQ

L.S.

1.00 TOTAL (Option Item 1) Total Base Bid and Option: $__________________

PART IV--REPRESENTATIONS AND INSTRUCTIONS

SECTION K--REPRESENTATIONS, CERTIFICATIONS, AND

OTHER STATEMENTS OF OFFERORS OR RESPONDENTS

NOTE: Offerors should address questions concerning VETS-100 reporting and reporting requirements to the Office of Veterans Employment and Training Services offices at the following address:

U. S. Department of Labor

VETS-100 Reporting

4200 Forbes Blvd., Suite 202

Lanham, MD 20703

Telephone: (301) 306-6752

Website: www.vets100.cudenver.edu

Reporting Questions: HelpDesk@vets100.com

Reporting Verification: Verify@vets100.com

52.204-8 Annual Representations and Certifications (JAN 2011)

(a)(1) The North American Industry Classification System (NAICS) code for this acquisition is 237310.

(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.

(c)(1) The following representations or certifications in ORCA are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless—

(A) The acquisition is to be made under the simplified acquisition procedures in Part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the clause at 52.204-7, Central Contractor Registration.

(iv) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that—

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

(C) Are for contracts that will be performed in the United States or its outlying areas.

(v) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(vi) 52.214-14, Place of Performance—Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(vii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

(viii) 52.219-1, Small Business Program Representations (Basic & Alternate I). This provision applies to solicitations when the contract will be performed in the United States or its outlying areas.

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(ix) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas.

(x) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

(xi) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xii) 52.222-38, Compliance with Veterans’ Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial items.

(xiii) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA–designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

(xiv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA–designated items.

(xv) 52.225-2, Buy American Act Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(xvi) 52.225-4, Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate. (Basic, Alternate I, and Alternate II) This provision applies to solicitations containing the clause at 52.225-3.

(A) If the acquisition value is less than $25,000, the basic provision applies.

(B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies.

(C) If the acquisition value is $50,000 or more but is less than $67,826, the provision with its Alternate II applies.

(xvii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xviii) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan—Certification. This provision applies to all solicitations.

(xix) 52.225-25, Prohibition on Engaging in Sanctioned Activities Relating to Iran-Certification. This provision applies to all solicitations.

(xx) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to—

(A) Solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions; and

(B) For DoD, NASA, and Coast Guard acquisitions, solicitations that contain the clause at 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns.

(2) The following certifications are applicable as indicated by the Contracting Officer:

[Contracting Officer check as appropriate.]

__ (i) 52.219-22, Small Disadvantaged Business Status.

__ (A) Basic.

__ (B) Alternate I.

__ (ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

__ (iii) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification.

__ (iv) 52.222-52, Exemption from Application of the Service Contract Act to Contracts for Certain Services–Certification.

__ (v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA–Designated Products (Alternate I only).

__ (vi) 52.223-13, Certification of Toxic Chemical Release Reporting.

__ (vii) 52.227-6, Royalty Information.

__ (A) Basic.

__(B) Alternate I.

__ (viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

(d) The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) website at http://orca.bpn.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.

(a) Definitions. As used in this clause—

Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority.

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 the size standard in paragraph (c) of this clause. Such a concern is “not dominant in its field of operation” when it does not exercise a controlling or major influence on a national basis in a kind of business activity in which a number of business concerns are primarily engaged. In determining whether dominance exists, consideration shall be given to all appropriate factors, including volume of business, number of employees, financial resources, competitive status or position, ownership or control of materials, processes, patents, license agreements, facilities, sales territory, and nature of business activity.

(b) If the Contractor represented that it was a small business concern prior to award of this contract, the Contractor shall rerepresent its size status according to paragraph (e) of this clause or, if applicable, paragraph (g) of this clause, upon the occurrence of any of the following:

(1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract.

(2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract.

(3) For long-term contracts—

(i) Within 60 to 120 days prior to the end of the fifth year of the contract; and

(ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter.

(c) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North American Industry Classification System (NAICS) code assigned to this contract. The small business size standard corresponding to this NAICS code can be found at http://www.sba.gov/services/contractingopportunities/sizestandardstopics/.

(d) The small business size standard for a Contractor providing a product which it does not manufacture itself, for a contract other than a construction or service contract, is 500 employees.

(e) Except as provided in paragraph (g) of this clause, the Contractor shall make the rerepresentation required by paragraph (b) of this clause by validating or updating all its representations in the Online Representations and Certifications Application and its data in the Central Contractor Registration, as necessary, to ensure that they reflect the Contractor’s current status. The Contractor shall notify the contracting office in writing within the timeframes specified in paragraph (b) of this clause that the data have been validated or updated, and provide the date of the validation or update.

(f) If the Contractor represented that it was other than a small business concern prior to award of this contract, the Contractor may, but is not required to, take the actions required by paragraphs (e) or (g) of this clause.

(g) If the Contractor does not have representations and certifications in ORCA, or does not have a representation in ORCA for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

The Contractor represents that it [ ] is, [ ] is not a small business concern under NAICS Code ______________ assigned to contract number ______________.

[Contractor to sign and date and insert authorized signer’s name and title].

TECHNICAL CAPABILITY, EXPERIENCE AND PAST/PRESENT PERFORMANCE QUESTIONNAIRE

Instructions: Complete by inserting information or Xing box, as indicated. If extra space is needed to complete an item, use the remarks block (indicate item number in remarks block) .

1. Contractor Name, Address, and Telephone Number

DUNS Number:

FEDERAL TAX ID NO.:

2. Submitted to (Office Name & Address)

George Washington & Jefferson National Forest

Attn: Sherry D. Helmick 5162 Valleypointe Parkway

Roanoke VA 24019-3050

RE: Solicitation #AG-3395-S-11-0020

3. Business

· Company ( Partnership

· Corporation ( Individual

· Non-profit Organization

4. How many years do you or your firm have in the line of work contemplated by this solicitation? ________ Years

5. How many years experience in contracting have you or your business had as a (a) prime contractor ________ and/or

(b) sub-contractor ______ for same/similar services.

6. List below the projects your business has completed within the last three years (continue on separate sheet if necessary):

Contract

Amount

Completed Point of Contact, Business/Agency Name, Street Address, Email address, Telephone Number and Fax Number

7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation (continue on separate sheet if necessary):

Contract

Amount

(Units) Percent

Completed Date Contract to be

Completed

8a. Have you ever failed to complete any work awarded to you? _____ Yes _____ No

8b. Has work ever been completed by performance bond? _____ Yes _____ No

8c. If “Yes” to either item 8a or 8b specify location(s) and reason(s) why (continue on separate sheet if necessary):

9. Organization and work that will be available for this project:

a. (1) Minimum number of employees:__________ and a (2) Maximum number of employees:__________

b. Are employees regularly on your payroll? _____ Yes _____ No

c. Provide proposed work schedule, including start and stop dates, estimated number of days of work/production rate, such as acres/day, and labor crew.

d. Describe THE SAFETY MEASURES AND PROCEDURES employed by your firm. Specifically address: 1) how maximum safety is ensured for both employees and the public who may be on the work site during contract performance, 2) transportation safety for employees to and from work, and 3) First Aid and evacuation plans in the event of an illness or injury.

Use a separate sheet of paper if necessary.

10. List below the major equipment that will be utilized full time on this project:

Capacity, etc

11. List below the experience of the principal individuals of your business:

CERTIFICATION

I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.

12a.Certifying Official’s Name and Title (Printed/Typed)

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