Attachment 2 - Contractor Submittal Form.docx
DOCX document 25 KB Posted
- Solicitation number
- FA251720Q0037
About this file
This document contains a contractor submittal form and details of a federal contract opportunity. The contractor submittal form requests company information and certifications to be provided by offerors in response to Solicitation Number FA251720Q0037 for security barriers maintenance services at Peterson Air Force Base and Cheyenne Mountain Air Force Station. Offerors must be registered in the System for Award Management under NAICS code 561621 and complete representations and certifications. The solicitation seeks a non-personal services contract to provide management, tools, materials, parts, equipment and labor for inspection, maintenance and repairs of security gates, lift arms and pop-up barriers at the two locations in accordance with commercial standards and applicable regulations to ensure continuous, safe and reliable operation. Offerors must submit pricing on the attached CLIN pricing sheet by the response date. The contract will be awarded by the Department of the Air Force Space Command.
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Other files
| File | Type | Posted |
|---|---|---|
| FA251720Q0037_ Response to Questions.docx | DOCX document | |
| Attachment 1 - Performance Work Statement (PWS) Security Barriers 11 May 2020.docx | DOCX document | |
| Combo FA251720Q0037 Ver.3 - Security Barriers.docx | DOCX document | |
| Attachment 3 - Offerors CLIN Pricing Sheet.xls | XLS spreadsheet |
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Text version
Attachment 2 Contractor Submittal Form
FA251720Q0037
Security Barriers Peterson AFB and CMAFS
Offeror to complete the following:
| 1 |
| Contractor Name |
| 2 |
| DUNS Number |
| 3 |
| CAGE Code |
| 4 |
| NAICS Code (Offeror must be registered in SAM under NAICS 561621 in order to be considered responsive) |
| 5 |
| Point of Contact |
| 6 |
| Address |
| 7 |
| Phone Number |
| 8 |
| Email address |
| 9 |
| Payment Terms (Net 30 unless any discount terms are offered) |
| 10 |
| [Contractor Name]: |
| Takes no Exception to the PWS and Attachments |
Takes Exception to the PWS and Attachments
Please complete the following:
FAR 52.212-3 -- Offeror Representations and Certifications -- Commercial Items ( Jan 2017) **Note to Offerors: Please reference http://farsite.hill.af.mil/vffara.htm for full text of this provision.
The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site accessed through http://www.sam.gov/portal. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) of this provision.
(b)
(1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the SAMwebsite.
(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation 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 (u) 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 electronically on SAM.]
Offeror to complete the following:
DFARS 252.209-7999, Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law (Class Deviation 2012-O0004) (January 23, 2012)
(a) In accordance with sections 8124 and 8125 of Division A of the Consolidated Appropriations Act, 2012, (Pub. L. 112-74), none of the funds made available by this or any other Act may be used to enter into a contract with any corporation that-
(1) 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, where the awarding agency is aware of the unpaid tax liability, unless the agency has considered suspension or debarment of the corporation and made a determination that this further action is not necessary to protect the interests of the Government; or
(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless the agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.
(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,
(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)
Company Name
Name
Title
| ___________________________________ | ________________ | |
| Signature | Date |
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