AG-9AC7-S-15-0036_Optional_Forms.pdf

SF 1449 AG-9AC7-S-15-0036

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 727651

2. CONTRACT NO. 3. AWARD/

EFFECTIVE DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER

AG-9AC7-S-15-0036

6. SOLICITATION ISSUE DATE

12/19/2014

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

SANDRA VINCENT

Email: svincent02@fs.fed.us

b. TELEPHONE NUMBER

530-226-2408 Office

530-226-2474 Fax

8. OFFER DUE DATE/

01/05/2015

12:00PM Local Time

9. ISSUED BY 10. THIS ACQUISITON IS

USDA FOREST SERVICE

N. CALIFORNIA ACQUISITION SVC AREA

3644 AVTECH PARKWAY

REDDING, CA 96002

FAX 530-226-2474

UNRESTRICTED OR SET ASIDE: 100% FOR

SMALL BUSINESS

NAICS: 561720 EMERGING SMALL BUSINESS

HUBZONE SMALL BUSINESS

SIZE STANDARD SERVICE-DISABLED VETERAN-

$18.0 million 8(A) OWNED SMALL BUSINESS

11. DELIVERY FOR FOB

DESTINATION UNLESS

BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO (PLACE OF PERFORMANCE)

HAT CREEK RANGER DISTRICT OFFICES

43225 E. HWY 299 FALL RIVER MILLS, CA 96028

16. ADMINISTERED BY CODE

SEE BLOCK 9

17a. CONTRACTOR/ OFFEROR

NAME:

18a. PAYMENT WILL BE MADE BY:

ALL INVOICES MUST BE

SUBMITTED VIA THE INVOICE

PROCESSING PLATFORM AT

WWW.IPP.GOV.

PAYMENT WILL BE MADE BY EFT

(ELECTRONIC FUNDS TRANSFER).

ADDRESS:

PHONE:

DUNS #:

EMAIL:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

SEE ADDENDUM

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

ITEM N0. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT (21. x 23.)

BASE YEAR: 2/1/2015 – 12/31/2015

SERVICES 5X PER WEEK (JUN, JUL, AUG, SEP)

SERVICES 3X PER WEEK (REMAINING MONTHS)

OPTION YEAR 1: 1/1/2016 – 12/31/2016

OPTION YEAR 2: 1/1/2017 – 12/31/2017

MO

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND

52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR

52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ONE (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

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: ____________________

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

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV.3/2005)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 http://www.ipp.gov/ https://acquisition.gov/far/current/html/52_212_213.html#wp1179124 https://acquisition.gov/far/current/html/52_212_213.html#wp1179465

AG-9AC7-S-15-0036

SUBMISSION OF OFFERS

There is no need to return any portion of the solicitation that is not part of an offer.

Email submission of offers is preferred, to svincent02@fs.fed.us. Offers by fax of up to 20 pages are acceptable to

530-226-2474. Offers may be mailed/delivered to USDA FS NCASA | 3644 Avtech Parkway | Redding, CA 96002.

RESPONSE REQUIRED TO BE CONSIDERED FOR AWARD

SAM (System for Award Management) Entity

SAM replaces and consolidates CCR (Central Contractor Registration), ORCA (Online Representations and

Certifications) and other systems. Offerors must have a DUNS Number and an Active SAM Entity to receive award.

1. Offerors with an Active SAM Entity shall provide their DUNS Number.

2. Offerors without an Active SAM Entity shall:

a. Complete and return as part of an offer FAR Provision 52.212-3, Offeror Representations and

Certifications – Commercial Items. The Provision is provided in the Solicitation Provisions section.

b. Offerors may submit offers before SAM Entity Registration/Activation is complete, but are advised that Activation can take 10+ days to process after Registering and that award may follow as soon as one day after the Solicitation closes. Offerors without an Active SAM Entity cannot receive award.

There is no cost to obtain a DUNS Number or SAM Entity or to contact the FSD through official sources.

To obtain a DUNS Number: http://fedgov.dnb.com/webform

To Register or Renew a SAM Entity: www.sam.gov

To contact the SAM Helpdesk (The Federal Service Desk, or FSD): www.fsd.gov

AGAR Provision 452.209-70 (Provided)

All Offerors shall fill out AGAR Provision 452.209-70 (Representation by Corporations Regarding an Unpaid

Delinquent Tax Liability or a Felony Conviction, Deviation 2012-01, Alternate 1) and return it as a part of the offer.

Response to Evaluation Factors (Technical and Price Criteria)

All Offerors must respond to all Evaluation Factors as described in the Evaluation Factors section. Incomplete offers may not be considered.

Site Visit (Pre-Quote)

There is no Site Visit scheduled, but Offerors are urged and expected to inspect the site where services are to be performed and to satisfy themselves regarding all general and local conditions that may affect the cost of contract performance, to the extent that the information is reasonably obtainable. In no event shall failure to inspect the site constitute grounds for a claim after contract award.

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED 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. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECTFOR

36. PAYMENT 37. CHECK NUMBER

|PARTIAL | |FINAL COMPLETE PARTIAL FINAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

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

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

42b. RECEIVED AT (Location)

42c. DATE RECD (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV.4/2002) BACK

mailto:svincent02@fs.fed.us http://fedgov.dnb.com/webform http://www.sam.gov/ http://www.fsd.gov/

Hat Creek Ranger Station Janitorial AGAR Provision

AGAR Provision 452.209-70

AGAR 452.209-70 Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a

Felony Conviction (FEB 2012) -- Alternate I (FEB 2012) (DEVIATION)

(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.

Name of Company:

Name of Company Representative:

Signature of Representative:

Date:

http://www.dm.usda.gov/procurement/policy/docs/USDAFARDeviation03-22-2012Solicitation.pdf

Hat Creek Ranger Station Janitorial Optional Response Forms

EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE

Instructions: See Box 10, REMARKS, if extra space is needed to answer any items below. Mark "X" in the appropriate spaces. Please list N/A for inapplicable items.

1. Offeror's Name, Address, Email, Telephone Number & DUNS Number 2. Type of Business Name: ____ Company

____ Corporation

____ Non-profit Organization

____ Co-partner

____ Individual

Address:

Email:

Telephone:

DUNS #:

3. How many years of experience do you have in this line of work? ___________________

4. How many years of experience as a prime contractor? _________ Subcontractor? ________

5. List relevant contracts your business has performed with at least one performed in the last three years.

Contract Name Facility Type/Size Service Dates Annual Amount / Description of Services

6a. Have you ever failed to complete any work awarded to you? ____ YES ____ NO

6b. Has work ever been completed by performance bond? ____ YES ____ NO

6c. If "yes" to either Question 7a. or 7b., please specify location(s) and reason(s):

7. List up to three references for whom your business has performed relevant work:

Contact Name(s) Company Name Project Performed Contact Phone Number(s)

EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE

8. Organization that will be available for this project:

a. Minimum No. of employees: _______________ Maximum No. of employees: ________________

b. Are proposed employees regularly on your payroll? ____ YES ____ NO

c. If applicable, specify equipment available for this contract:

9. List the experience of the principal individuals of your business.

Individual's Name Present Position Years Experience Type of Work

10. Remarks:

CERTIFICATION: I certify that all of the statements made above 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.

Signature Title Date

CONTRACTOR’S OPERATING PLAN, SCHEDULE AND QUALITY CONTROL PROGRAM

PERFORMANCE

OBJECTIVE AREA

OPERATING PLAN

(Description of Work to be Performed)

WORK SCHEDULE

(Days / Frequency)

QUALITY CONTROL PROGRAM

1. Front Office

2. Restrooms

3. Office Space (Engine

Office, Old and New

Modular, Conference

Room, Library)

4. Drinking Fountains

CONTRACTOR’S OPERATING PLAN, SCHEDULE AND QUALITY CONTROL PROGRAM

PERFORMANCE

OBJECTIVE AREA

OPERATING PLAN

(Description of Work to be Performed)

WORK SCHEDULE

(Days / Frequency)

QUALITY CONTROL PROGRAM

5. High Cleaning

Surfaces above 70 inches

6. Kitchens

7. Wellness Restroom

8. Wellness Room

Plan to address deficiencies, notify employees of deficiencies in their area of responsibility (if applicable), and ensure corrective action:

Plan to ensure that all issued keys, access cards or identification items are not lost, misplaced, or used by unauthorized persons:

Planned supplies and equipment to be provided and used by the Contractor in the performance of this contract:

Title(s) of person(s) to perform inspection: