Solicitation AG-82A7-S-12-0022.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS r- REQUISITION NUMBER

IPAG~

OF

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 563913 I ';!J

2. CONTRACT NO. 13. AWARDI r ORDER NUMBER r SOLICITATION NUMBER I~.SOLICITATION

EFFECTIVE DATE

AG-82A7-S-12-0022 ISSUE DATE

01/24/2012

I~NAME

r TELEPHONE NUMBER (No coiled calls) 18.OFFER DUE DATE/LOCAL TIME

7. FOR SOLICITATION

03/19/2012 1500 MS

INFORMATION CALL: SHIRLEE HARRISON 303-275-5305

9. ISSUED BY CODE 182A7 10. THIS ACQUISITION IS 0 UNRESTRICTED OR [KJ SET ASI DE: 100.00 % FOR:

IRl SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

JOB CORPS AQM o (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

USDA FOREST SERVICE

o HUBZONE SMALL SMALL BUSINESS PROGRAM

NAlcs:334310 BUSINESS o ECONOMICALLY DISADVANTAGED

740 SIMMS STREET WOMEN·OWNED SMALL BUSINESS

GOLDEN CO 80401

o SERVICE· DISABLED (EDWOSB) SIZE STANDARD: 750

VETERAN-OWNED

SMALL BUSINESS o 8(A)

11. DELIVERY FOR FOB DESTINA· 12. DISCOUNT TERMS 13b. RATING

TION UNLESS BLOCK IS o 13a. THIS CONTRACT IS A

MARKED RATED ORDER UNDER 14. METHOD OF SOLICITATION

o SEE SCHEDULE

DPAS (15 CFR 700)

OCIRFQ DIFB ORFP

15. DELIVER TO CODE 102RB

16. ADMINISTERED BY CODE 182A7

USDA FOREST SERVICE JOB CORPS AQM

CENTENNIAL JOB CORPS USDA FOREST SERVICE

3201 RIDGECREST DR 740 SIMMS STREET

NAMPA 10 83687 GOLDEN CO 80401

17a. CONTRACTORI CODE I FACILITY I 18a. PAYMENT WILL BE MADE BY CODE I

OFFEROR CODE

TELEPHONE NO.

017b. CHECK IF REMITIANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. S.UBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18. UNLESS BLOCK BELOW

IS CHECKED OSEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIESISERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Sound System - See attached Performance Based

Statement of Work and Schedule of Items.

Delivery: 0~/1'/2012

001 Sound System 1 LO

Product/Service Code: 5835

Product/Service Description: SOUND RECORDING AND

REPRODUCING EQUIPMENT

Continued ...

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 126. TOTAL AWARD AMOUNT (For Govt. Use Only)

1Zi27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212·1,52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA o 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ·ADDENDA

00 ARE

DARE

o ARE NOT ATTACHED.

DARE NOT ATTACHED

o 29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5).

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN. IS ACCEPTED AS TO ITEMS:

18]28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN __ 1 _

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

30b. NAME AND TITLE OF SIGNER (Type or print) 130C. DATE SIGNED 31 b. NAME OF CONTRACTING OFFICER (Type or print) r31 c. DA.TE SIGNED

RON B. PENROSE

30•. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 5/2011)

Prescribed by GSA • FAR (48 CFR) 53.212

2 of 2'fJ

20. 21. 22. 23. 24.

19.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Vendor must be CCR registered (www.ccr.gov) before award can be made.

Emai1

DUNS #

TIN #

SOURCE SELECTION INFORMATION See FAR 2.101 and 3.104.

32a. QUANTITY IN COLUMN 21 HAS BEEN o RECEIVED o INSPECTED o ACCEPTED AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED'

32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE \ 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

329. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER ~. VOUCHER NUMBER 35. AMOUNT VERIFIED 36. PAYMENT 37. CHECK NUMBER

CORRECT FOR

o COMPLETE o PARTIAL o FINALo PARTIAL o FINAL

38. SIR ACCOUNT NUMBER 39. SIR VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YYIMMlDO) \42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 5/20111 BACK

AG-82A 7-S-12-0022

Sound System

Page 3 of27

SECTION B--SUPPLIES OR SERVICES AND PRICES

This solicitation and any resulting contract is a firm-fixed price type of contract, which under the definition in FAR 16.202-1, "this type of contract provides for a price that is not subject to any adjustment on the basis of the contractor's cost experience in performing the contract. This contract type places upon the contractor maximum risk and full responsibility for all costs and resulting profit or loss."

TO BE CONSIDERED RESPONSIVE VENDOR MUST QUOTE ON ALL ITEMS. Award will be made to the Quoter with the overall low price.

ITEM DESCRIPTION UNIT OF UNIT TOTAL

NO. ISSUE QTY. PRICE PRICE

0001 AV System Materials LOT 1 $ $

001a Speaker s EA $ s

OOlb .Wireless Microphone EA 2 s $

001c Wireless Lapel Microphone EA 2 $ $

001d 2 Disc CD Player EA 1 $ $

OOle iPod Dock EA 1 $ $

OOlf FMTuner EA 1 $ $

OOlg Protective Grates EA $ $

001h Motorized Movie Screen 24" X 24" EA 1 $ $

EA

001i Projector w/remote hookup 1 $ $

CARDIOIWEIGHT ROOM

0002 CardioRoom EA

002a Speakers (mill 8") w/subwoofer EA 4 $ $

GYMNASIUM

SOURCE SELECTION INFORMATION See FAR 2.101 and 3.104

Page 4 of27

002b CD player wi iPod hookup and enclosure EA 1 $ $

002c Protective grates for speakers EA 4 $ $

0003 Weight Room

003a Speakers (min 8") 4 EA $ $

003b CD Player w/iPod hookup and enclosure 1 EA $ $

003c Protective Grates for Speakers 4 EA $ $

0004 Stage

004a Choir Microphone 4 EA $ $

004b Portable Rack System 1 EA $ $

0005 Main Control/Component Room $ $

005a Zone Controller 1 EA $ $

OOSb PA Rack System w/locking front and $ $zone mixer (min 4 zones)

0006 Installation 1 EA $ $

GRAND TOTAL $

Quoter to supply list and prices of all new and replaced equipment for the Audio Visual System; however, a total price is required to be placed in box 26 on page lofthis request for quote (RFQ).

Page 5 of27

SECTION C - DESCRIPTION OF WORK

PERFORMANCE BASED STATEMENT OF WORK

Audio/Visual System for Recreation Building

The purpose of this Performance Based Statement of Work is to procure and install an audioNisual system at the Centennial Job Corps Center located at 3201 Ridgecrest Drive, Nampa, ID 83687. These components will be installed in the Recreation center, building D. Vendor is required to be registered in the Central Contractor Registration website www.ccr.gov.prior to contract award, please provide DUNS and Tax ID number with quote. Installation should be done during the hours of 8:00 am - 4:00 pm Monday through Friday so as not to disrupt the recreation time of the students.

OBJECTIVE: The objective is to update and enhance the current audio system by creating a protected and versatile sound system for events and recreational use that will provide optimal audio with a 360 degree sound for the gymnasium, stage, cardio and weight rooms. The sound system needs to be able to play in all rooms at the same time or each individual room separately.

Scope of work to be performed in the Gymnasium:

• Replace, update, and! or move current speaker system to create optimal audio with 360 degree sound for the room.

• Provide 2 each wireless microphones and 2 each wireless lapel microphones.

• Provide 1 each 2 disc CD player, 1 each iPod dock, and 1 each FM tuner.

• Provide and install protective grates for speakers.

• Zone control to allow for volume adjustment in the Gymnasium separately.

• 24' x 24' motorized movie screen suspended mid court.

• Projector with remote hookup so that it can be used to hook up a laptop for dances and presentations, needs to have the ability to hook into the sound system for surround sound.

Objective for cardio room/weight room: Create a surround sound system to provide listeners with a quality listening experience while working out. The system should have a CD player with iPod hookup in each room with volume control in central location.

Scope of work for cardio room:

• Mounting of 4 each speaker's minimum of 8" in comers along with a subwoofer.

• Mounting of 1 each CD player with 1 each iPod hookup and enclosure.

• Provide and install protective grates for speakers.

Scope of Work for weight room:

• Mounting of 4 each speaker's minimum of 8" in comers along with a subwoofer.

• Mounting of 1 each CD player with I each iPod hookup and enclosure.

• Provide and install protective grates for speakers.

Scope of work for stage:

• Install 4 each choir microphones on a horizontal support that will be capable of being raised and lowered.

• Need to be able to regulate all 4 microphones separately through the portable rack system.

Page 6 of27

Scope of work for main control/component room:

• Installation of zone controller will be in storage room behind Recreation Staff office

• Install PA rack system with locking front and a zone mixer with a minimum of 4 zones which will include the gymnasium, weight room, cardio room and stage.

• Ability to limit volume of weight room, cardio room, stage and microphones in gymnasium.

• .Ability to address all rooms at the same time or a single room separately.

Site visit will be scheduled for all interested Contractors.

Page 7 of27

Salient Characteristics of Recreation Sound System

Gymnasium

• 6-1015" professional speakers

• Rigging and assembly

• 1800 watt amplifier

Aerobics room

• 3-8" professional speakers

• 15" subwoffer

• Rigging and assembly

• Audio rack with Mp3/ ipod jacks

• 1800 watt amplifier

• All lockable and enclosed

Weight room

• 4-8" professional speakers

• 15" subwoffer

• Rigging and assembly

• 1800 watt amplifier

• Audio rack with mp3/ipod jack

• AI/lockable and enclosed

Main System

• Rack enclosure lockable

• 4 channel zone mixer

• Zone controller

• Wireless microphone and lapel microphone

• Compressor/limiter

• Equalizer

Stage

• 4 professional microphones

• 4 professional lapel microphones

All to include cable, hardware, labor.

A G-82A 7-S-12-0022

Page 8 of27

SECTION 2

CLAUSES AND PROVISIONS

FAR 52.212-1 Instructions to Offerors-Commercial Items (June 2008) FAR 52.237-2 Protection of Government Buildings. Equipment, and Vegetation (APR 1984) FAR 52.225-25 Prohibition on Contracting with Entities Engaging in Sanctioned Activities Relating to Iran--Representation and Certification. (NOV 2011)

FAR 52.212-3 Offeror Representations and Certifications-Commercial Items. (Nov 2011)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (c) through (0) 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 SI 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 ofthe 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.

"Inverted domestic corporation", as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.c. 39S(b), i.e., a corporation that used to be incorporated in the United States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 D.S.C. 39S(b), applied in accordance with the rules and definitions of ~ u.s.c. 39S(c). An inverted domestic corporation as herein defrned does not meet the defrnition of an inverted domestic corporation as defrned by the Internal Revenue Code at 26 U.S.c. 7874.

"Manufactured end product" means any end product in Federal Supply Classes (FSC) 1000-9999, except-

(1) FSC SSlO, Lumber and Related Basic Wood Materials;

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

(S) FSC 9410, Crude Grades of Plant Materials;

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

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

(8) FSC 9610, Ores;

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

(10) FSC 9630, Additive Metal Materials.

SOURCE SELECTION INFORMATION See FAR2.101 and 3.104

Page 9 of27

"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.

"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 of2007) 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) ofthe 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 D.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.s.C. 10 l( 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.

"Subsidiary" means an entity in which more than 50 percent of the entity is owned-

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

"Veteran-owned small business concern" means a small business concern-

Page 10 of27

(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 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 ofthe United States.

(b)

(1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph

(b)(2) ofthis provision do not automatically change the representations and certifications posted on the Online Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website at http://orca.bpn.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications-Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), 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 (0) 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 on ORCA.]

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

(1) Small business concern. The offeror represents as part of its offer that it 0 is, 0 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)(i) of this provision.] The offeror represents as part of its offer that it o is, 0 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 0 is, 0 is not a service-disabled veteran-owned small business concern.

Page 11of27

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(I) of this provision.] The offeror represents, for general statistical purposes, that it 0 is, 0 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)(I) of this provision.] The offeror represents that it 0 is, 0 is not a women-owned small business concern.

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

(i) It 0 is,o 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 0 is, 0 is not ajoint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern or concerns that are participating in the joint venture: .] Each WOSB concern 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 0 is, 0 is not an EDWOSB 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 0 is, 0 is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) ofthis provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns that are participating in the joint venture: . Each EDWOSB concern participating in the joint venture shall submit a separate signed copy ofthe EDWOSB representation.

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

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(I) of this provision.] The offeror represents that it 0 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) [Complete only if the solicitation contains the clause at FAR 52.219-23. Notice of Price Evaluation Adjustmentfor Small Disadvantaged Business Concerns, or FAR 52.219-25, Small Disadvantaged Business Participation Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.]

(i) General. The offeror represents that either-

(A) It 0 is, 0 is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged

SOURCE SELECTION INFORMA nON See FAR 2.101 and 3.104

Page 12 of27 business concern in the CCR Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.1 04(c)(2); or

(B) It 0 has, 0 has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

(ii) 0 Joint Ventures under the Price Evaluation Adjustmentfor Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR l24.1002(t) and that the representation in paragraph (c)(lO)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. [The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture:

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

(i) It 0 is, 0 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 0 is, 0 is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(ll)(i) of this provision is accurate for each HUB Zone small business concern participating in the HUBZonejoint 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 HUB Zone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) Representations required to implement provisions of Executive Order 11246.-

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

(i) It 0 has, 0 has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(ii) It 0 has, 0 has not filed all required compliance reports.

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

(i) It 0 has developed and has on file, 0 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 0 has not previously had contracts subject to the written affrrmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions Q 1 V.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, Page 13of27 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 Act Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act-Supplies, is included in this solicitation.)

(1) The offeror certifies that each end product, except those listed in paragraph (t)(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 ofthis solicitation entitled "Buy American Act- 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)(l) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American Act-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)(l )(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, 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 Act- 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, or Peruvian end products) or Israeli end products as defmed in the clause of this solicitation entitled "Buy American Act-Free Trade Agreements-Israeli Trade Act":

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

Line Item No. Country of Origin

SOURCE SELECTION INFORMATION See FAR 2.101 and 3.J 04

Page 14 of27 .

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(l)(ii) ofthis provision) as defined in the clause of this solicitationentitled "Buy American Act-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 quality 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:

Line Item No. Country of Origin

[List as necessary]

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

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

(g)(l)(ii) The offeror certifies that the following supplies are Canadian end products as defmed in the clause ofthis solicitation entitled "Buy American Act-Free TradeAgreements-Israeli Trade Act":

Canadian End Products:

Line Item No.

[List as necessary]

(3) Buy American Act-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)(l)(ii) of the basic provision:

(g)(l)(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 Act-Free Trade Agreements-Israeli Trade Act":

Canadian or Israeli End Products:

Line Item No. Country of Origin

Page 15 of27

[List as necessary]

(4) 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)(4)(ii) of this provision, is a U.S.-made or designated country end product, as defmed in the clause ofthis 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:

Line Item No. Country of Origin

[List as necessary]

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the W'TO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American Act. 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) 0 Are, 0 are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) 0 Have, 0 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;

(3) 0 Are, 0 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) ofthis clause; and

(4) 0 Have, 0 have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

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

(A) The tax liability isfinally determined. The liability is finally determined if it has been assessed. A liability is not fmally determined ifthere is a pending administrative or judicial challenge. In

Page 16 of27 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 LR.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 appeal 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 LR.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 fmal tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to LR.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. I503(b).]

(1) Listed end products.

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)(l) ofthis provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it 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.

G) 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-

Page 17 of27

(1) 0 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) 0 Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Act. (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 ifparagraph (k)(l) or (k)(2) applies.]

[. ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1 003-4(c)(1).

The offeror 0 does 0 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

(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 22.1 003-4( d)(1). The offeror 0 does 0 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 22.1 003-4( 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 ofless than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period ifthe 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)(l) or (k)(2) of this clause applies-

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

Officer did not attach a Service Contract Act 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)(l) or (k)(2) ofthis clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(I) Taxpayer Identification Number (TIN) (26 U.S.c. 6109.31 u.s.e. 770l). (Not applicable if the offeror is required to provide this information to a central contractor registration database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (1)(3) through (1)(5) of this provision to comply with debt collection requirements of31 U.S.C. nOl(c) and 3325(d), reporting

Page 18 of27 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 V.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).

o TIN: _ o TIN has been applied for.

o TIN is not required because:

o 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 business or a fiscal paying agent in the United States;

o Offeror is an agency or instrumentality of a foreign government;

o Offeror is an agency or instrumentality of the Federal Government.

(4) Type of organization.

o Sole proprietorship;

o Partnership;

o Corporate entity (not tax-exempt);

o Corporate entity (tax-exempt);

o Government entity (Federal, State, or local);

o Foreign government;

o International organization per 26 CFR 1.6049-4;

o Other~ _

(5) Common parent.

o Offeror is not owned or controlled by a common parent;

o Name and TIN of common parent:

Name _

TIN _

(m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan.

(n) Prohibition on Contracting with Inverted Domestic Corporations.

(1) Relation to Internal Revenue Code. An inverted domestic corporation as herein defmed does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code 25 V.S.c.

7874.

(2) Representation. By submission of its offer, the offeror represents that--

(i) It is not an inverted domestic corporation; and

(ii) It is not a subsidiary of an inverted domestic corporation.

(0) Sanctioned activities relating to Iran.

(1) The offeror shall e-mail questions concerning sensitive technology to the Department of State at

CISAD A I06@state.gov.

(2) Representation and Certification. Unless a waiver is granted or an exception applies as provided in paragraph (0)(3) of this provision, by submission of its offer, the offeror--

Page 19 of27

(i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; and

(ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act.

(3) The representation and certification requirements of paragraph (0)(2) of this provision do not apply if-

(i) This solicitation includes a trade agreements certification (e.g., 52.2l2-3(g) or a comparable agency provision); and

(ii) The offeror has certified that all the offered products to be supplied are designated country end products.

(End of provision)

FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders

- Commercial Items. (JAN 2012)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions oflaw or Executive orders applicable to acquisitions of commercial items:

(1) 52.222-50, Combating Trafficking in Persons (FEB 2009) (22 U.S.C. 7104(g)).

[ ] Alternate I (Aug 2007) of 52.222-50 (22 D.S.C. 7104(g)).

(2) 52.233-3, Protest After Award (AVG 1996) (31 V.S.C. 3553).

(3) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub. L. 108-77, 108-78).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items: Contracting Officer check as appropriate.

[ ](1) 52.203-6, Restrictions on Subcontractor Sales to the Government (SEP 2006), with Alternate I (OCT 1995) (41 U.S.C. 253g and 10 V.S.C. 2402).

[ ](2) 52.203-13, Contractor Code of Business Ethics and Conduct (APR 201 O)(pub. L.

110-252, Title VI, Chapter 1 (41 U.S.C. 251 note)).

[ ](3) 52.203-15, Whistleblower Protections under the American Recovery and Reinvestment Act of2009 (JUN 201O)(Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of2009.)

[X ](4) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUL 2010) (Pub. L. 109-282)(31 U.S.C. 6101 note).

[](5) 52.204-11, American Recovery and Reinvestment Act--Reporting Requirements

Page 20 of27

(JUL2010)(pub.L.111-5).

[X ](6) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (DEC 2010) (31 U.S.C.

6101 note).

[ ](7) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (IAN 2012) (41 U.S.C. 2313).

[ ](8) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (section 740 of Division C of Public Law 111-117, section 743 of Division D of Public Law 111-8, and section 745 of Division D of Public Law 110-161)

[ ](9) 52.219-3, Notice of HUB Zone Set-Aside or Sole-Source Award (NOY 2011) (15 D.S.C.657a).

[ ](10) 52.219-4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (JAN 2011) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 D.S.C. 657a).

[ ](11) (Reserved)

[X ](12)(i) 52.219-6, Notice of Total Small Business Set-Aside (NOY 2011) (15 D.S.C.

644).

[ ](ii) Alternate I (NOY 2011).

[ ](iii) Alternate II(NOY 2011).

[](13)(i) 52.219-7, Notice of Partial Small Business Set-Aside (JUN 2003) (15 U.S.C.

644).

[ ](ii) Alternate I (OCT 1995) of 52.219-7.

[ ] (iii) Alternate II (MAR 2004) of 52.219-7.

[](14) 52.219-8, Utilization of Small Business Concerns (JAN 2011) (15 U.S.C. 637 (d)(2) and (3».

[](15)(i) 52.219-9, Small Business Subcontracting Plan (JAN 2011) (15 D.S.C.

637(d)(4).

[ ](ii) Alternate I (OCT 2001) of 52.219-9.

[](iii) Alternate II (OCT 2001) of52.219-9.

[ ](iv) Alternate III (JUL 2010) of 52.219-9.

[](16) 52.219-13, Notice of Set-Aside of Orders (NOY 2011) (15 U.S.C. 644(r)).

[](17) 52.219-14, Limitations on Subcontracting (NOY 2011) (15 V.S.C. 637(a)(14».

[](18) 52.219-16, Liquidated Damages--Subcontracting Plan (IAN 1999) (15 U.S.c.

637(d)( 4)(F)(i».

Page 21 of27

[ ](19)(i) 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns (OCT 2008) (10 U.S.C. 2323)(ifthe offeror elects to waive the adjustment, it shall so indicate in its offer.)

[ ](ii) Alternate I (JUN 2003) of 52.219-23.

[](20) 52.219-25, Small Disadvantaged Business Participation Program--Disadvantaged Status and Reporting (DEC 2010) (Pub. L. 103-355, section 7102, and 10 U.S.C. 2323).

[…