Attachment 4 - RFP Information and General Compliance Worksheet.xlsx

XLSX spreadsheet 27 KB Posted

Attached to
S&RTS Rotterdam, Netherlands
Solicitation number
HTC71126RE121
Issued by

About this file

This is a compliance worksheet and submission checklist for RFP HTC71126RE121 for Stevedoring and Related Terminal Services (S&RTS) at Rotterdam, Netherlands. Offerors must complete this attachment to acknowledge compliance with all RFP requirements and represent that they have fulfilled mandatory submission items across multiple categories.

The worksheet requires offerors to provide company registration and contact information, including SAM registration status, CAGE code, NAICS code 488320, tax identification number, and banking details (IBAN/SWIFT code). Offerors must certify completion of federal representations and certifications including FAR 52.204-24 (telecommunications equipment), FAR 52.209-7 (responsibility matters), FAR 52.212-3 (commercial products/services), FAR 52.229-11 (foreign procurement tax), DFARS 252.204-7017 (defense telecommunications equipment), and DFARS 252.229-7001 (tax relief). Additional requirements include submission of a Small Business Subcontracting Plan (for large businesses only), a Trafficking in Persons (CTIP) compliance plan, a Technical Worksheet (15-page maximum), a Mission Essential Plan (5-page maximum), a Schedule of Rates with unit prices (two decimal places, no formulas), and signed SF 1449 and SF 30 forms acknowledging acceptance of contract terms and conditions. The contract period runs from 1 November 2026 through 31 October 2031, with proposals valid for a minimum of 180 calendar days. Government points of contact are Becky Molloy (Contracting Officer) and Katherine Alexander (Contract Specialist) at USTRANSCOM/TCAQ-R.

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Sheet1

RFP HTC71126RE121 - Attachment 4
SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104 (When Filled-in, this Document becomes CUI//SP-SSEL)
ATTACHMENT 4: RFP Information and General Compliance Worksheet
REQUEST FOR PROPOSAL: HTC71126RE121
Stevedoring & Related Terminal Services (S&RTS) Rotterdam, Netherlands
Period of Performance: 1 November 2026 - 31 October 2031
Government Points of Contact:
Becky Molloy, Contracting Officer

USTRANSCOM/TCAQ-R

508 Scott Drive, Bldg. 1900W Scott AFB, IL 62225 Becky.s.molloy.civ@mail.mil Katherine Alexander, Contract Specialist

USTRANSCOM/TCAQ-R

508 Scott Drive, Bldg. 1900W Scott AFB, IL 62225 Katherine.f.alexander.civ@mail.mil

GENERAL INFORMATION - Complete the requested information below.
COMPANY NAME:
COMPANY ADDRESS:
COMPANY TELEPHONE NUMBER:
COMPANY EMAIL ADDRESS:
BUSINESS SIZE (NAICS 488320):
CAGE CODE:
SAM NUMBER:
TAX IDENTIFICATION NUMBER:
IBAN/SWIFT CODE:
REMITTANCE ADDRESS: (Only if remittance address is different, such address must be registered in the System for Award Management (SAM) database, If not mark as N/A)
PRIMARY POC: To include title and contact information
(Person/s with authority to make decision and negotiate with respect to the
proposal and who can obligate your company contractually.)
ALTERNATE POC: To include title and contact information
(Person/s with authority to make decision and negotiate with respect to the
proposal and who can obligate your company contractually.)
PROMPT PAYMENT DISCOUNT: (If applicable, If not mark as N/A)
DATE/TIME OF SUBMISSION:
PROPOSAL VALIDITY DATE: (180 calendar days, at minimum)
CONTRACT DOCUMENTATION
GENERAL:ACTION ITEMSCOMPLETEDCOMMENTS
Active in SAM (Offeror must be registered as Active in SAM by proposal due date)
NAICS in SAM contains 488320
REPRESENTATIONS AND CERTIFICATIONS (REPS & CERTS): **Please fully complete each action item in the RFP and acknowledge on Attachment 4, if not in SAM.gov**ACTION ITEMSCOMPLETEDCOMMENTS
FAR 52.204-24, Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021). NOTE: FAR 52.204-24 only needs to be completed if FAR 52.204-26 is not completed in SAM.gov, or if the offeror represents it “will” provide or “does” use covered telecommunications equipment.
FAR 52.209-7, Information Regarding Responsibility Matters (Oct 2018)
FAR 52.212-3, Offeror Representations and Certifications—Commercial Products and Commercial Services (DEVIATION 2025-O0003 and 2025-O0004) (Mar 2025)
FAR 52.229-11, Tax On Certain Foreign Procurements Notice & Representation (Jun 2020) NOTE: Offerors representing as a "foreign person" must also submit an IRS Form W-14.
DFARS 252.204-7017, Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services—Representation (May 2021). NOTE: DFARS 252.204-7017 only needs to be completed if DFARS 252.204-7016 is not completed in SAM.gov, or if the offeror represents it “does” provide covered defense telecommunications equipment or services in DFARS 252.204-7016.
DFARS 252.229-7001, Tax Relief (Apr 2020)
ANCILLARY DOCUMENTATION
SMALL BUSINESS SUBCONTRACTING PLAN:ACTION ITEMSCOMPLETEDCOMMENTS
Attachment 6, Small Business Subcontracting Plan, completed and submitted. (Large Businesses Only)
CERTIFICATION REGARDINGACTION ITEMSCOMPLETEDCOMMENTS
TRAFFICKING IN PERSONS (CTIP)
COMPLIANCE PLAN:
In accordance with FAR 52.222-56, offerors shall submit an English certification implementing a compliance plan for prohibiting trafficking in person or trafficking-related activities. More details and instructions are found within the aforementioned FAR clause. NOTE: Submit certification and compliance plan.
TECHNICAL PROPOSAL
TECHNICAL WORKSHEETACTION ITEMSCOMPLETEDCOMMENTS
Attachment 5, Technical Worksheet, completed and submitted.
Technical Worksheet did not exceed the page requirement - 15 pages.
MISSION ESSENTIAL PLANACTION ITEMSCOMPLETEDCOMMENTS
Attachment 3, Mission Essential Plan, completed and submitted.
Mission Essential Plan did not exceed the page requirement - 5 pages.
PRICE PROPOSAL, SCHEDULE OF RATES (SOR)
ACTION ITEMSCOMPLETEDCOMMENTS
Attachment 2, Schedule of Rates, completed and submitted on the correct SOR. (If the SOR was Amended, it must be on the last Amended SOR.)
Unit prices were free of formulas.
Unit prices were only two decimal places.
All unit prices were completed for each quantity.
ACKNOWLEDGMENTS
SF1449:ACTION ITEMSCOMPLETEDCOMMENTS
Completed SF 1449 Block 12 (should be completed even if no discount is offered)
Completed SF 1449 Block 17a
Completed SF 1449 Block 30a
Completed SF 1449 Block 30b
Completed SF 1449 Block 30c
Returned signed and dated on the SF 1449 (In doing so, offeror accedes to the contract terms and conditions as written in the RFP, with attachments)
Completed SF 1449 Block 17b (Only if remittance address is different, such address must be registered in the System for Award Management (SAM) database.
SF30:ACTION ITEMSCOMPLETEDCOMMENTS
Completed SF 30 Block 8 on each SF 30
Completed SF 30 Block 15a on each SF 30
Completed SF 30 Block 15b on each SF 30

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