Attachment_5_Forms_and_Provisions_to_Return_with_Proposal.docx

SOLICITATION NUMBER: 140P8426R0003

PARK - PMIS: 285171 PORE

DEVELOPED AREA: Point Reyes National Seashore (PORE), Marin County, CA

PROJECT TITLE: Rehabilitate Limantour Residence 160, PORE

Offerors are required to submit, at a minimum, an offer that conforms to the solicitation documents with pricing for line items. Failure to do so may render the proposal unacceptable. For the lump-sum line items, provide the total price only. If no specific line item exists for a portion of the work, include the costs in a related item. In case of error in calculation of extended prices, the unit price governs. In case of summation error, the total corrected amounts govern. Round totals & extended prices to whole dollars.

BASE PROJECT ITEMS:

OPTION ITEMS:

All dimensions and measurements provided herein are approximate and provided for reference. All dimensions and measurements should be verified by the contractor. Refer to full line item descriptions in Section 01 01 00 of the Specifications (Solicitation Attachment no. 3).

Offeror’s Business Name:

Business Address:

UEI Number from www.SAM.gov:

Point of Contact Email/Phone Number:

Submitted by – Printed Name:

Submitted by – Signature:

Submitted Date:

General Company Information and Proposed Team:

Do you plan to self-perform all of the work? ___________________________ YES or NO answer

Are you proposing to use a subcontractor? ___________________________ YES or NO answer

List any proposed subcontractor(s) and indicate what key trade they may be assigned to perform:

If you are proposing to use a subcontractor, describe what work activities you plan to self-perform:

Key Personnel

Per Section H of Attachment 1, Terms Clauses Provisions, Offeror shall fill in key personnel planned to be assigned to the contract, understanding no substitutions will be allowed to be requested by the contractor until after 30 calendar days once work begins onsite:

Project Manager:

On-site Superintendent:

On-site Quality Control Manager:

On-Site Safety Manager:

List any other key personnel:

Small Business Program Rerepresentation (Optional)

In accordance with the clause 52.219-28 incorporated by reference in Attachment 1, Part II, Section 1 – Clauses. Fill in the small business rerepresentation below only if the quoter does not have a representation in their SAM Reps/Certs for the NAICS code applicable to this solicitation.

The Contractor represents that it □ is, □ is not a small business concern under NAICS Code 236118 assigned to solicitation number 140P8426R0003 The associated small business size standard for NAICS 236118 is $45M.

(Print First/Last Name, Title, Company Name)

(Signature) (Date)

FAR 52.225-2, BUY AMERICAN ACT CERTIFICATE (FEB 2021)

52.209-13 VIOLATION OF ARMS CONTROL TREATIES OR AGREEMENTS-CERTIFICATION (NOV 2021)

(a) This provision does not apply to acquisitions at or below the simplified acquisition threshold or to acquisitions of commercial products and commercial services as defined in Federal Acquisition Regulation 2.101.

(b) Certification. [Offeror shall check either (1) or (2).] __ (1) The Offeror certifies that–

(i) It does not engage and has not engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State 's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state . The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; and

(ii) No entity owned or controlled by the Offeror has engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State 's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state . The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; or __ (2) The Offeror is providing separate information with its offer in accordance with paragraph (d)(2) of this provision.

(c) Procedures for reviewing the annual unclassified report (see paragraph (b)(1) of this provision). For clarity, references to the report in this section refer to the entirety of the annual unclassified report, including any separate reports that are incorporated by reference into the annual unclassified report.

(1) Check the table of contents of the annual unclassified report and the country section headings of the reports incorporated by reference to identify the foreign countries listed there. Determine whether the Offeror or any person owned or controlled by the Offeror may have engaged in any activity related to one or more of such foreign countries.

(2) If there may have been such activity, review all findings in the report associated with those foreign countries to determine whether or not each such foreign country was determined to be in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or to be not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state . For clarity, in the annual report an explicit certification of non-compliance is equivalent to a determination of violation. However, the following statements in the annual report are not equivalent to a determination of violation:

(i) An inability to certify compliance.

(ii) An inability to conclude compliance.

(iii) A statement about compliance concerns.

(3) If so, determine whether the Offeror or any person owned or controlled by the Offeror has engaged in any activity that contributed to or is a significant factor in the determination in the report that one or more of these foreign countries is in violation of its obligations undertaken in an arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state . Review the narrative for any such findings reflecting a determination of violation or non-adherence related to those foreign countries in the report, including the finding itself, and to the extent necessary, the conduct giving rise to the compliance or adherence concerns, the analysis of compliance or adherence concerns, and efforts to resolve compliance or adherence concerns.

(4) The Offeror may submit any questions with regard to this report by email to NDAA1290Cert@state.gov. To the extent feasible, the Department of State will respond to such email inquiries within 3 business days.

(d) Do not submit an offer unless—

(1) A certification is provided in paragraph (b)(1) of this provision and submitted with the offer; or

(2) In accordance with paragraph (b)(2) of this provision, the Offeror provides with its offer information that the President of the United States has

(i) Waived application under 22 U.S.C. 2593e(d) or (e); or

(ii) Determined under 22 U.S.C. 2593e(g)(2) that the entity has ceased all activities for which measures were imposed under 22 U.S.C. 2593e(b).

(e) Remedies. The certification in paragraph (b)(1) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly submitted a false certification, in addition to other remedies available to the Government, such as suspension or debarment, the Contracting Officer may terminate any contract resulting from the false certification.

(End of provision)

Employment Reports on Veterans Per 52.222-38, Compliance with Veterans’ Employment Reporting Requirements, offerors must have filed the most recent VETS-4212 Report at https://www.dol.gov/agencies/vets/programs/vets4212 if their company was awarded Federal Government contract(s) priced at or above $100,000 in the past year. If an offeror has not been awarded a Federal Government contract priced at or above $100,000 in the last year, include a written statement to that effect with your offer.

Please check one:

☐ The Offeror was awarded a Federal Government contract(s) priced at or above $100,000 in the past year, and has filed their most recent VETS-4212 Report online

☐ The Offeror was not awarded a Federal Government contract priced at or above $100,000 in the past year (no VETS-4212 filing required)

Submitted by:

_______________________________________________________________ (signature) __________________________ (date) _______________________________________________________________ (type name) _______________________________________________________________ (company name)