Attachment_3_Forms_to_Return_with_Quote_140P8324Q0067.docx

PRICE SCHEDULE - INSTRUCTIONS

Quoter shall fill in price in all line items; do not add line items or costs elsewhere. Failure to do so may render the quote ineligible from further consideration. In case of errors in summations, the total of the corrected amounts governs. Round totals and extended prices to whole dollars. Quoter shall factor prices quoted to include all labor, travel, equipment, materials, transportation, overhead and profit necessary for completing all work performed in accordance with Attachment 1 Scope of Work (SOW), Attachment 2 DOL SCA Wage Determination for 2015-5507, terms, provisions, and clauses. Payment for services may be requested as noted in the Scope of Work.

Business Name:_______________________________________________________________________

SAM Unique Identity Number (UEI):____________________________________________________ Contractor must supply UEI# as DUNS no longer used. UEI numbers can be found on your SAM.gov registration.

Business Mailing Address:_____________________________________________________________

Point of Contact Name:________________________________________________________________

Point of Contact Email Address:________________________________________________________

Point of Contact Phone Number:________________________________________________________

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision— Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that— It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

LIST OF RELEVANT EXPERIENCE (LIST OF PROJECTS) & PAST PERFORMANCE REFERENCES:

The purpose of this form is for the quoter to list projects (preferably performed during the past five (5) years) that are similar to the work described in this solicitation. The number of projects listed shall not exceed five (5) and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the capability criteria described in the Request for Quotes. Include area codes with all telephone numbers. Type or print legibly.

The Government may contact the entities listed herein to obtain past performance reviews of the quoter’s team. Past performance is a measure of the degree to which the Quoter satisfied its customers in the past and complied with federal, state, and local laws and regulations. The past performance of the quoter, key personnel (if applicable), and proposed subcontractors on projects similar in scope and complexity (i.e. relevant to the current project) will be evaluated in the areas of quality, timeliness, and business relations. It is especially important that the quoter disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The quoter should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that a quoter has been less than candid with the Government, which could result in an unfavorable assessment of the quoter’s past performance record.

1) Project Title: ___________________________ Contract # (if known): _________________________ Agency/Owner: ___________________________ $ Amount: __________________________________ Performance Period: ___________________________________________________________________ Past Performance Reference (Name & Title): ________________________________________________ Phone Number: ___________________________ Email: ______________________________________ Briefly describe how this project is similar in nature and scope to current advertised requirement:

2) Project Title: ___________________________ Contract # (if known):__________________________ Agency/Owner: ___________________________ $ Amount: ___________________________________ Performance Period: ____________________________________________________________________ Past Performance Reference (Name & Title): ________________________________________________ Phone Number: ___________________________ Email: ______________________________________ Briefly describe how this project is similar in nature and scope to current advertised requirement:

3) Project Title: ___________________________ Contract # (if known):__________________________ Agency/Owner: ___________________________ $ Amount: ___________________________________ Performance Period: ____________________________________________________________________ Past Performance Reference (Name & Title): ________________________________________________ Phone Number: ___________________________ Email: ______________________________________ Briefly describe how this project is similar in nature and scope to current advertised requirement: