Attach 2 - Offer Submission Package.pdf

OFFER SUBMISSION PACKAGE (OSP)

REQUEST FOR PROPOSAL

INTO-PLANE / PURCHASE PROGRAM

1.2P PACOM (OVERSEAS) SOLICITATION

SPE607-25-R-0200

PERIOD OF PERFORMANCE: 1 APR 2025 THROUGH 30 SEP 2028

CLOSING DATE AND TIME: January 22, 2025 @ 3:00 PM FORT BELVOIR, VA- EASTERN STANDARD TIME (EST). Late Offers: Any offers received after January 22, 2025 @ 3:00 PM will be considered “LATE” and may be excluded from the competition. Submit your offers well ahead of the closing date and time.

OSP CHECKLIST

1) STANDARD FORM 1449: Signature and date in ink or digitally in Blocks 30a, b and c. include your company name, address, telephone, and fax, “DUNS” and “CAGE code” number in Block 17a.

2) OFFEROR PRICE BREAKDOWN SHEET: For each item number/ICAO code. Sign and date in ink or digital signature.

3) CERTIFICATE OF ANALYSIS OR CERTIFICATE OF QUALITY: Offerors shall submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) from supplier verifying that the fuel meets Government’s specifications for the fuel type in the Solicitation (C16.08-2 for Jet A-1), per Factor 1: Technical Acceptability of FAR 52.212-2(a).

4) COMMITMENT LETTER (Reference template letter attached to solicitation)

5) SAM ACCOUNT: Completed or updated by Solicitation closing date: sam.gov/

6) Offerors must provide a Supplier Invoice with the price paid for fuel or government posting per location, effective as of the BASE REFERENCE DATE of May 1, 2024. (Invoice Date: April 1, 2024 – April 30, 2024).

By submitting your OSP, you agree to the terms and conditions of the entire Solicitation, and any Amendments, unless clearly stated herein.

http://beta.sam.gov/

INSTRUCTIONS TO OFFERORS

(PLEASE READ THE FOLLOWING CAREFULLY)

1. Only one CAGE code may be listed on an OSP. Offerors with more than one CAGE code MUST complete a separate OSP and Offer Price Breakdown Sheet for each company’s CAGE Code for every location that is offered on. DLA Energy will not accept an OSP with multiple CAGE Codes.

2. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received. All Offer Submission Packages must be factual, accurate, and complete. Failure to provide all information and documents required under the solicitation may render a proposal technically unacceptable and preclude further.

NOTE:

i. X Standard Form 1449 (SF1449) - Sign and date in ink or digitally in Blocks 30a, b and c. Include your company name, address, telephone, and fax, DUNS and CAGE numbers in Block 17a.

ii. X Offer Price Breakdown Sheet must be expressed in U.S. Dollars per gallon and to the 6th decimal. (Example: $0.000000) place for the Product being solicited.

3. Definitions:

i. Into-truck: Delivery of the fuel product into U.S. Government-owned or leased refueling units located at the delivery address identified in the Schedule of Supplies. This definition of into-truck supersedes any conflicting definition in the solicitation.

ii. Rapid Refueling: Delivery of the fuel product f.o.b. to the aircraft with one or more of the aircraft’s engines(s) operating during delivery.

4. Offerors MUST update and complete registration in the System for Award Management (SAM) database by the solicitation closing date. The Website to obtain details and instructions is: https://sam.gov/SAM.

5. Any violation of the Iran Sanctions Act is strictly forbidden. Contractor shall not source nor blend any portion of the fuel destined for DLA Energy with refined fuel products sourced from Iran. In accordance with FAR 52.212- 3 -- OFFEROR REPRESENTATIONS AND CERTIFICATIONS -- COMMERCIAL ITEMS (FEB 2024), by submission of its offer, the offeror 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.

6. Evaluation Criteria: Proposals will be evaluated pursuant to FAR 52.212-2 – Evaluation – Commercial Items. Proposals will be evaluated based on a lowest price technically acceptable (LPTA) source selection process. The Contracting Officer will evaluate proposals in accordance with the FAR 15.101-2 Lowest Price Technically Acceptable source selection process. DLA Energy will make award(s) to the technically acceptable proposal with the lowest evaluated price for the requirements as solicited for the particular airport. In order to be considered for award, an Offeror must meet or exceed technical acceptability standards. Offers will be evaluated and contracts awarded by airport location.

An offer for an airport location will be evaluated independently from all other airport locations for a contract award.

An Offeror who fails to offer on all products solicited at an airport location in Section B for an airport location will be ineligible for award for that location.

7. Offerors shall submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) for each line item offered verifying that the fuel delivered meets Government’s specifications for C16.08-3 TURBINE FUEL, AVIATION (JET A1). Offeror(s) must annotate each item number/ICAO code on the COAs and COQs. Offerors who are not the Refueler or Fixed- Based Operator are also required to submit a Commitment Letter from the FBO with its initial proposal. The Offeror must be able to demonstrate that the Offeror has secured arrangements that will enable it to support orders for the product specified, in accordance with the requirement schedule, and consistent with the delivery requirements and all other terms and conditions in the solicitation. Such commitment letters should be submitted with the Offeror’s initial proposal. COA and COQ must be in English. Reference sample Commitment Letter in the attachments. If the Offeror fails to submit a Certificate of Analysis or Certificate of Quality and Commitment Letter from the Fixed-Based Operator (FBO) with its proposal, the offer will be considered nonresponsive and eliminated from the competition.

8. All proposals must be received before 3:00 p.m. Ft. Belvoir, Virginia time, January 22, 2025. Any proposals received after 3:00 p.m. Ft. Belvoir, Virginia time, January 22, 2025, will be considered “late.” Offerors assume all risk for any delay in the transmission of their proposals. Refer to FAR 52.212-1(f). Faxed proposals are not authorized. Please e-mail your proposal to: DLA- Energy-PH.Requirements@dla.mil. Please ensure that your proposal (SF1449) assigned per FAR 52.212-1. Late proposals will be processed in accordance with FAR 52.212-1(f)–When submitting a proposal via e-mail, please ensure it is sent within enough time in order for it to be processed through the server. The maximum file size per email is 10 MB (IAW L2.11-4).

9. Exceptions to the specifications, terms, and conditions of this solicitation may be pursuant to the Provision M72 EVALUATION OF OFFERS (EXCEPTIONS/DEVIATIONS) (DLA ENERGY APR1997). Indicate any exceptions and the extent to which your offer differs from the solicitation requirements on company letter signed by an authorized representative of the company attached with your offer.

https://sam.gov/SAM

10. Offerors must agree to honor prices their proposal for 180 calendar days from the date of RFP closing date. The Offeror’s proposal in response to the solicitation may be incorporated into the resultant contract in whole or in part at the time of award.

11. FAR 52.229-6(c)(1) provides that the contract price includes applicable taxes “unless otherwise provided in this contract.”

Consistent with this clause, the offeror may not include foreign taxes in its offer prices. “Foreign taxes” means “all direct or indirect foreign customs duties, import and export taxes, excises, fees and other charges imposed at the national, local, or intermediate level of a foreign country (i.e., a country that is not the United States) other than charges for services requested and received, regardless of how a charge is denominated in foreign law or regulation.” Any offer that includes foreign taxes in the price will not be accepted. It is the contractor’s responsibility to pursue and obtain any foreign tax exemption available based on the contract being a United States contract.

12. Offerors must fully disclose and identify all contractor team arrangement relationships including proposed partnerships or joint ventures as defined by FAR 9.601 with its proposal before the solicitation close date. For example, Offerors should fully disclose and identify that a teaming arrangement with a third party Refueler at a fixed-based operator exists, and whether it is a Partnership, Joint Venture and/or Prime/Sub relationship. Offerors with such a contractor team arrangement shall specify the arrangement in the commitment letter. The Government will determine the responsibility of any potential partner/subcontractor identified by the Offeror in its contractor teaming arrangement in accordance with FAR subpart 9.1.

13. DFARS 252.225-7966 Prohibition Regarding Russian Fossil Fuel Business Operations—Representation (Deviation 2024-O0006).

Use the following provision in solicitations that include the clause at 252.225-7967:

PROHIBITION REGARDING RUSSIAN FOSSIL FUEL BUSINESS OPERATIONS— REPRESENTATION (FEB

2024)

(a) Definitions. The terms business operations and fossil fuel company have the meanings given in the 252.225-7067 clause of this solicitation.

(b) Representation. By submission of an offer, the Offeror represents it is not, or that it does not knowingly have fossil fuel business operations with an entity or individual that is, 50 percent or more owned, individually or collectively, by—

(1) An authority of the government of the Russian Federation; or

(2) A fossil fuel company that operates in the Russian Federation, except if the fossil fuel company transports oil or gas—

(i) Through the Russian Federation for sale outside of the Russian Federation; and

(ii) That was extracted from a country other than the Russian Federation with respect to the energy sector of which the President has not imposed sanctions as of the date on which the contract is awarded.

DFARS 252.225-7967 Prohibition Regarding Russian Fossil Fuel Business Operations (Deviation 2024O0006).

As prescribed in Class Deviation 2024-O0006, use the following clause:

PROHIBITION REGARDING RUSSIAN FOSSIL FUEL OPERATIONS (DEVIATION 2024O0006) (FEB 2024)

(a) Definitions. As used in this clause—

“Business operations” means knowingly engaging in commerce in any form, including acquiring, developing, maintaining, owning, selling, possessing, leasing, or operating equipment, facilities, personnel, products, services, personal property, real property, or any other known apparatus of business or commerce. The term does not include—

(1) Any shipment subject to price caps as specified in the—

(i) “Statement of the G7 and Australia on a Price Cap for Seaborne Russian-Origin Crude Oil”, issued on December 2, 2022, between member countries of that coalition; or

(ii) “Statement of the G7 and Australia on Price Caps for Seaborne Russian-Origin Petroleum Products Berlin, Brussels, Canberra, London, Ottawa, Paris, Rome, Tokyo, Washington”, issued on February 4, 2023, between such members, if such shipment complies with the applicable price caps; or

(A) Actions taken for the benefit of the country of Ukraine, as determined by the Secretary; or

(B) Actions taken to support the suspension or termination of business operations for commercial activities during the period beginning on the effective date and ending on December 31, 2029, including—

(1) Any action to secure or divest from facilities, property, or equipment;

(2) The provision of products or services provided to reduce or eliminate operations in territory internationally recognized as the Russian Federation or to comply with sanctions relating to the Russian Federation; and;

(3) Activities that are incident to liquidating, dissolving, or winding down a subsidiary or legal entity in Russia. Fossil fuel company means an entity or individual that— (1) Carries out oil, gas, or coal exploration, development, or production activities;

(2) Processes or refines oil, gas, or coal; or (3) Transports, or constructs facilities for the transportation of, Russian oil, gas, or coal.

(b) Prohibition. In accordance with section 804 of the National Defense Authorization Act for Fiscal Year 2024

(Pub. L. 118-31), the Contractor is prohibited from entering into a subcontract or other contractual instrument for the procurement of products or services with any entity or individual that is known to be, or that is known to have fossil fuel business operations with an entity or individual that is, not less than 50 percent owned, individually or collectively, by—

(1) An authority of the government of the Russian Federation; or

(2) A fossil fuel company that operates in the Russian Federation, except if the fossil fuel company transports oil or gas—

(i) Through the Russian Federation for sale outside of the Russian Federation; and

(ii) That was extracted from a country other than the Russian Federation with respect to the energy sector of which the President has not imposed sanctions as of the date on which the contract is awarded.

(c) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (c), in all subcontracts and other contractual instruments, including those for the acquisition of commercial products or commercial services.

14. Primary Solicitation Point of Contact: For clarification, explanation, and additional information, please contact Joseph Teye-

Kofi at 970-412-5140; email: joseph.teye-kofi@dla.mil mailto:joseph.teye-kofi@dla.mil

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NUMBER

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

REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

SEE ADDENDUM

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

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: REFERENCE 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

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

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

THE DEFENSE PRIORITIES

AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FREE ON

BOARD (FOB) DESTINATION

UNLESS BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

8(A)

ECONOMICALLY

DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30. 1. REQUISITION NUMBER

700472214/7010110028

5. SOLICITATION NUMBER

SPE607-25-R-0200

a. NAME

Joseph Teye-Kofi 970-412-5140

NET 30

SEE SCHEDULE

1.2P (PACOM): Various commercial airports in Australia, Brunei Darussalam, India, Indonesia, Malaysia, Marshall Islands, New Zealand, Palau, Papua New Guinea, Singapore, Thailand, The Philippines, Guam, Nepal, Fiji, Timor-Leste, Japan and Vietnam.

PERIOD OF PERFORMANCE

01 APR 2025 - 30 SEP 2028

324110

12/9/2024

LOCAL TIME

01/22/2025

3:00 PM EST

SPE607

DEFENSE LOGISTIC AGENCY ENERGY

8725 JOHN J. KINGMAN RD.

FORT BELVOIR VA, 22060

email: DLA-Energy-PH.Requirements@dla.mil

STOCK RECORD (S/R)

STANDARD FORM 1449 (REV. 11/2021) BACK

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE RECEIVED (MM/DD/YYYY) 42d. TOTAL CONTAINERS

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. EMAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

CORRECT FOR

PARTIAL FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE PARTIAL FINAL

Offerors, who submit an offer under Solicitation SPE607-25-R-0200 with any Amendments, for all locations, must complete all Certifications and Representations below. Full text for all Certifications and Representations are found in Solicitation SPE607-25-R-0200. Those Certifications and Representations available in SAM shall be completed in SAM; those not available in SAM shall be completed below.

FAR CLAUSES, DFARS CLAUSES AND DLA ENERGY CONTRACT TEXTS:

1. B-0001 - B15.01, SUPPLIES AND ESTIMATED QUANTITIES TO BE FURNISHED (INTO-PLANE)

(DLA ENERGY(DEC 2018)

2. G-0002 – G9.07-5 ELECTRONIC TRANSFER OF FUNDS PAYMENTS –RESERVE WIRE

TRANSFER SYSTEM (DLA ENERGY JAN 2012) – Provide account details if Offeror is using a Non United States Bank

3. FAR 52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

4. FAR 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO

INFLUENCECERTAIN FEDERAL TRANSACTIONS (SEP 2007)

5. FAR 52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE

CERTAIN INTERNAL CONFIDENTIALITY AGREEMENTS OR STATEMENTS—

REPRESENTATION (JAN 2017)

6. FAR 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (AUG 2020)

7. FAR 52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (AUG 2020)

8. FAR 52.204-20 PREDECESSOR OF OFFEROR (AUG 2020)

9. FAR 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS-REPRESENTATION (NOV 2015)

10. FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

11. FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

12. FAR 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX

LIABILITY OR AFELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

13. FAR 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (FEB 2024)

14. FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

15. FAR 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE

PLAN (OCT 2020)

16. FAR 52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS – NOTICE AND

REPRESENTATION (JUNE 2020)

17. DFARS 252.204-7016 COVERED DEFENSE TELECOMMUNICATIONS EQUIPMENT OR

SERVICES – REPRESENTATION (DEC 2019)

18. DFARS 252.204-7017 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES – REPRESENTATION (MAY 2021)

19. DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN

GOVERNMENT (DEC 2022)DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR

CONTROL BY A FOREIGN GOVERNMENT (DEC 2022)

20. DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

21. DFARS 252.247-7022 REPRESENTATION OF EXTENT OF TRANSPORTATION BY SEA (JUN

2019)

22. K-0001 K15 RELEASE OF UNIT PRICES (DLA ENERGY MAR 2009)

23. K-0002 K33.01 AUTHORIZE NEGOTIATORS (DLA ENERGY APR 2007)

24. K-0004 K150 WIDE AREA WORKFLOW (DLA ENERGY MAY 2014)

The Offeror has completed the Certifications and Representations 1 through 24 above for the Solicitation

SPE607-25-R-0200.

Print Name of Authorized Official: _

Signature of Authorized Official: Date:

OFFER PRICE BREAKDOWN SHEET (OVERSEAS version) Jet A-1 w/o FSII, Jet A-1 w/FSII

AIRPORT NAME AND ICAO CODE:

(Identify the airport and its ICAO code found in the solicitation schedule)

VENDOR CAGE CODE: LARGE OR SMALL BUSINESS:

CLIN NUMBER: STATE/ COUNTRY:

EST QUANTITY GALLONS:

IF THE INCUMBENT, STATE YOUR CONTRACT NUMBER #:

REFERENCE DATE: 1 MAY 2024

JET A-1 WITHOUT FSII:

MARKET PRICE (PLATTS/SUPPLIER NOTICE) FOR THE ABOVE REFERENCE DATE:

INTO-PLANE FEE (Differential & additional fees, inclusive of fees)

TOTAL UNIT PRICE (Sum of A and B)

($ USD Currency)

$ A.

$ B.

$ C.

JET A-1 WITH FSII:

($ USD Currency)

MARKET PRICE (PLATTS/SUPPLIER NOTICE) FOR THE ABOVE REFERENCE DATE: $ ________A.

INTO-PLANE FEE (Differential & additional fees, inclusive of fees for all modes of delivery: $ B.

into-plane, truck, rapid refuel)

TOTAL UNIT PRICE (Sum of A and B) $ C.

PUBLICATION/REFERENCE SELECTED FOR MARKET PRICE ADJUSTMENT

PLATTS:

SUPPLIER NOTICE:

Prices will change on [ ] Monday [ ] Tuesday [ ] Weekly [ ] Monthly[ ] Other

** NOTE Call Out Fees and hours are not evaluated items; however, in the event that 24-hour service is not available and the Government is unable to provide advance notification of after-hour delivery requirements, into-plane fuel may be procured from another source.

Per Hour or Per Occurrence (Included)

Hours of Operations [ ] 24 hours per day, 7 days per week (preferred) OR [ ] Other (Specify hours/call-out, and phone number for call-outs):

Circle One

Call-Out/Overtime Fee and Advance Notice: Holidays Included: YES or NO

Are you the REFUELER for this offer under this location? (Please check one) YES or NO

**** (Commitment letter must match the name and Address of the Refueler/FBO information below. COA or COQ must be in English)

Refueler (FBO) Point of Contact Name:

Full Physical Address (Country & State):

Person at Facility Phone Number:

Refinery Source Name:

Physical Address:

Phone Number:

K-0002 - K33.01 Authorized Negotiators (Reference: DLA Energy APR 2007)

Name & Title: Email &Phone:

Name & Title: Email &Phone:

FAR 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS-

REPRESENTATION (NOV 2015)

(C) REPRESENTATION. THE OFFEROR REPRESENTS THAT-

(1) IT □ IS, □ IS NOT AN INVERTED DOMESTIC CORPORATION; AND

(2) IT □ IS, □ IS NOT A SUBSIDIARY OF AN INVERTED DOMESTIC CORPORATION.

(END OF PROVISION)

FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

(A) (1) THE OFFEROR CERTIFIES, TO THE BEST OF ITS KNOWLEDGE AND BELIEF, THAT—

(I) THE OFFEROR AND/OR ANY OF ITS PRINCIPALS–

(A) ARE □ ARE NOT □ PRESENTLY DEBARRED, SUSPENDED, PROPOSED FOR DEBARMENT, OR DECLARED

INELIGIBLE FOR THE AWARD OF CONTRACTS BY ANY FEDERAL AGENCY;

(B) HAVE □ HAVE NOT □, WITHIN A THREE-YEAR PERIOD PRECEDING THIS OFFER, BEEN CONVICTED OF OR HAD A CIVIL JUDGMENT RENDERED AGAINST THEM FOR: COMMISSION OF FRAUD OR A CRIMINAL OFFENSE IN CONNECTION WITH OBTAINING, ATTEMPTING TO OBTAIN, OR PERFORMING A PUBLIC (FEDERAL, STATE, OR LOCAL) 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 (IF OFFEROR CHECKS "HAVE", THE OFFEROR SHALL ALSO SEE 52.209-7, IF INCLUDED

IN THIS SOLICITATION);

(C) ARE □ ARE NOT □ PRESENTLY INDICTED FOR, OR OTHERWISE CRIMINALLY OR CIVILLY CHARGED BY A GOVERNMENTAL ENTITY WITH, COMMISSION OF ANY OF THE OFFENSES ENUMERATED IN PARAGRAPH (A)(1)(I)(B) OF

THIS PROVISION;

(D) HAVE □, HAVE NOT □, WITHIN A THREE-YEAR PERIOD PRECEDING THIS OFFER, BEEN NOTIFIED OF ANY DELINQUENT FEDERAL TAXES IN AN AMOUNT THAT EXCEEDS THE THRESHOLD AT 9.104-5(A)(2) FOR WHICH THE

LIABILITY REMAINS UNSATISFIED.

(END OF PROVISION)

FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

(B) THE OFFEROR □ HAS □ DOES NOT HAVE CURRENT ACTIVE FEDERAL CONTRACTS AND GRANTS WITH TOTAL

VALUE GREATER THAN $10,000,000.

(END OF PROVISION)

https://www.acquisition.gov/far/52.209-7#FAR_52_209_7 https://www.acquisition.gov/far/9.104-5#FAR_9_104_5

DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

(B) CERTIFICATION AND IDENTIFICATION OF COUNTRY OF ORIGIN.

(1) FOR ALL LINE ITEMS SUBJECT TO THE TRADE AGREEMENTS—BASIC CLAUSE OF THIS SOLICITATION, THE OFFEROR CERTIFIES THAT EACH END PRODUCT TO BE DELIVERED UNDER THIS CONTRACT, EXCEPT THOSE LISTED IN PARAGRAPH (C)(2) OF THIS PROVISION, IS A U.S.-MADE, QUALIFYING COUNTRY, OR DESIGNATED COUNTRY END PRODUCT.

(2) THE FOLLOWING SUPPLIES ARE OTHER NON-DESIGNATED COUNTRY END PRODUCTS:

(LINE ITEM NUMBER) (COUNTRY OF ORIGIN)

(END OF PROVISION)

FAR 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A FELONY

CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(b) The Offeror represents that–

(1) It is □ is not □ a corporation that has 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; and

(2) It is □ is not □ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN GOVERNMENT

(DEC 2022)

(a) Definitions.As used in this provision—

(1) “Effectively owned or controlled” means that a foreign government or any entity controlled by a foreign government has the power, either directly or indirectly, whether exercised or exercisable, to control the election, appointment, or tenure of the Offeror’s officers or a majority of the Offeror’s board of directors by any means, e.g., ownership, contract, or operation of law (or equivalent power for unincorporated organizations).

(2) “Entity controlled by a foreign government”—

(i) Means—

(A) Any domestic or foreign organization or corporation that is effectively owned or controlled by a foreign government; or

(B) Any individual acting on behalf of a foreign government.

(ii) Does not include an organization or corporation that is owned, but is not controlled, either directly or indirectly, by a foreign government if the ownership of that organization or corporation by that foreign government was effective before October 23, 1992.

(3) “Foreign government” includes the state and the government of any country (other than the United States and its outlying areas) as well as any political subdivision, agency, or instrumentality thereof.

(4) “Proscribed information” means—

(i) Top Secret information;

(ii) Communications security (COMSEC) material, excluding controlled cryptographic items when unkeyed or utilized with unclassified keys;

(iii) Restricted Data as defined in the U.S. Atomic Energy Act of 1954, as amended;

(iv) Special Access Program (SAP) information; or

(v) Sensitive Compartmented Information (SCI).

(b) Prohibition on award. No contract under a national security program may be awarded to an entity controlled by a foreign government if that entity requires access to proscribed information to perform the contract, unless the Secretary of Defense or a designee has waived application of 10 U.S.C. 4874.

(c) Disclosure.The Offeror shall disclose any interest a foreign government has in the Offeror when that interest constitutes control by a foreign government as defined in this provision. If the Offeror is a subsidiary, it shall also disclose any reportable interest a foreign government has in any entity that owns or controls the subsidiary, including reportable interest concerning the Offeror’s immediate parent, intermediate parents, and the ultimate parent. Use separate paper as needed, and provide the information in the following format:

Offeror’s Point of Contact for Questions about Disclosure

(Name and Phone Number with Country Code, City Code and Area Code, as applicable)

Name and Address of Offeror

Name and Address of Entity Controlled by a Foreign Government

Description of Interest, Ownership Percentage, and Identification of Foreign Government

(End of provision)

G9.07-5 ELECTRONIC TRANSFER OF FUNDS PAYMENTS – FEDERAL RESERVE WIRE TRANSFER

SYSTEM (DLA ENERGY JAN 2012)

(a) The Contractor shall supply the following information to the Contracting Officer no later than 5 days after contract award and before submission of the first request for payment. The bank designated as the receiving bank must be capable of receiving Federal wire transactions via either a SWIFT Code or an

IBAN.

(b) Any change by the Contractor in the designation of the bank account to receive electronic transfer of funds in accordance with this contract textmust be received by the Contracting Officer no later than 30 days prior to the date the change is to become effective.

(c) The electronic transfer of funds does not constitute an assignment of such funds in any form or fashion.

COMPLETE THE FOLLOWING INFORMATION (TYPE WRITTEN OR CLEAR PRINTING)

RECIPIENT’S NAME: | | | | | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 25 CHARACTERS)

ORIGINATOR ABA: 044036205 (DLA ENERGY fill-in)

CONTRACT NUMBER: (DLA ENERGY fill-in)

RECIPIENT’S CAGE CODE:

[ ] CHECKING TYPE 22

[ ] SAVINGS TYPE 32

RECIPIENT’S DUNS NUMBER:

BENEFICIARY’S BANK NAME: | | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 29 CHARACTERS)

BENEFICIARY’S BANK ADDRESS: | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 25 CHARACTERS)

(DO NOT EXCEED 25 CHARACTERS)

BENEFICIARY’S BANK ACCOUNT NUMBER:

BENEFICIARY’S BANK SWIFT NUMBER: | | | | | | | | | | | |

(EITHER 8 OR 11 CHARACTERS ONLY)

IBAN NUMBER:

BENEFICIARY’S BANK SORT CODE: | | | | | | | (FOR BANKS IN THE UNITED KINGDOM

ONLY)

(6 CHARACTERS ONLY)

(d) CONTRACTOR’S DESIGNATED OFFICIAL SUBMITTING ELECTRONIC FUNDS TRANSFER

INFORMATION.

NAME | | | | | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 25 CHARACTERS)

TITLE | | | | | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 25 CHARACTERS)

TELEPHONE NUMBER | | | | | | | | | | | | | | | | | | | | | | | |

(DO NOT EXCEED 25 CHARACTERS)

SIGNATURE

control.

(e) Notwithstanding any other provision of the contract, the requirements of this contract text shall