Attachment 6 - Section K (Reps.Certs).pdf

PDF 319 KB Posted

Attached to
Aircraft Defensive Electro-optical Protection Technologies (ADEPT) Federal contract opportunity
Solicitation number
FA2377-26-R-B011
Issued by
Department of the Air Force Materiel Command Research Laboratory

About this file

This is a representations and certifications form (Section K, Attachment No. 6) for the federal contract opportunity FA2377-26-R-B011, issued by the U.S. Air Force on August 14, 2026. The document serves as a template that offerors must complete and return with their bids, supplementing annual representations and certifications from the System for Award Management (SAM.gov) database.

The form requires offerors to complete multiple Federal Acquisition Regulation (FAR) and Defense Federal Acquisition Regulation Supplement (DFARS) provisions based on contract applicability thresholds. Key certifications include: System for Award Management registration (all offerors); Information Regarding Responsibility Matters for contracts exceeding $750,000; Certification Regarding Tax Matters for contracts exceeding $7 million; Cost Accounting Standards certifications for applicable contractors; Trafficking in Persons Compliance for contracts with at least $700,000 performed outside the U.S. and not entirely for commercial off-the-shelf items; and numerous DFARS-specific representations covering foreign ownership disclosure, cybersecurity maturity model certification (CMMC Level 2 Self required), cloud computing usage, supply chain risk, Xinjiang Uyghur Autonomous Region procurement prohibitions, Russian fossil fuels restrictions, foreign-made unmanned aircraft systems prohibitions, and covered defense telecommunications equipment. Offerors must verify that SAM.gov representations are current and accurate, identify any changes specific to this solicitation, and provide a digital signature certifying the accuracy and completeness of all submissions. Questions regarding completion should be directed to Contract Specialist Lesley Breitzman at lesley.breitzman@us.af.mil.

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Attachment No. 6 FA2377-26-R-B011

1 | P a g e

Section K Representations, Certifications and Other Statements of Offerors 14 August 2026

FA2377-26-R-B011

TBD

ADEPT

The following RFO/R-DFARS provisions shall be completed and returned as applicable to the contract information stated above. Please ensure the full text of these provisions are reviewed directly from the corresponding regulation prior to completing the fill-ins. This document supplements the annual Representations and Certifications from SAM.gov. If you have any questions, please contact the Contract

Specialist, Lesley Breitzman at lesley.breitzman@us.af.mil. Note to Offeror: Once completed, please print this document to Adobe PDF, insert digital signature on the final page and return.

In accordance with RFO 52.252-1, Solicitation Provisions Incorporated by Reference (FEB 1998):

1. These provisions are incorporated by reference and available in full text at https://www.acquisition.gov/

a. RFO: https://www.acquisition.gov/browse/index/far

b. R-DFARS: https://www.acquisition.gov/dfars

c. Class Deviations: Links to full text of applicable memorandum included in chart below.

2. Many provisions require fill-in information or disclosures from the offeror, as noted throughout below the table. If a provision has a fill-in, that information is contained in a row directly below that provision.

3. Those requiring completion by the Contractor will cite the applicable paragraph reference and be left blank upon receipt from the Contract Specialist. Please select the appropriate box by clicking on it, or enter the text in the space available with the paragraph reference.

RFO / R-

DFARS

Provision(s)

Title

Applicability

RFO 52.204-

System for Award Management (FEB 2026) All

RFO 52.204-

Offeror Identification (FEB 2026) All

RFO 52.209-

Information Regarding Responsibility Matters (FEB 2026) All greater than $750,000

(b) The offeror ☐has ☐does not have current active Federal contracts and grants with total value greater than $10,000,000.

https://www.acquisition.gov/ https://www.acquisition.gov/browse/index/far https://www.acquisition.gov/dfars

Attachment No. 6 FA2377-26-R-B011

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Certification Regarding Tax Matters (OCT 2025) All greater than $7M

(b)(1) Has ☐ filed all Federal tax returns required during the three years preceding the certification;

(b)(2) Has not ☐ been convicted of a criminal offense under the Internal Revenue Code of 1986; and

(b)(3) Has not ☐ more than 90 days prior to certification, been notified of any unpaid Federal tax assessment for which the liability remains unsatisfied, unless the assessment is the subject of an installment agreement or offer in compromise that has been approved by the Internal Revenue Service and is not in default, or the assessment is the subject of a non-frivolous administrative or judicial proceeding.

Violation of Arms Control Treaties or Agreements- Certification (FEB 2026)

All exceeding SAT

(b)Certification [Offer shall check either (1) or( 2)] ☐(1) ☐(2)

RFO 52.211-

Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use (APR 2008)

All

RFO 52.215-

Limitations on Pass-Through Charges-Identification of Subcontract Effort (Oct 2009)

Applies when award exceeds the threshold for obtaining cost or pricing data and is other than fixed price.

RFO 52.222-

Certification Regarding Trafficking in Persons Compliance Plan (FEB 2026)

Applies when at least $700k of anticipated contract value may be performed outside US AND acquisition is not entirely for COTS items

RFO 52.229-

Tax on Certain Foreign Procurements—Notice and Representation (FEB 2026)

All

(d)(1) It ☐is ☐ is not a foreign person (d)(2) ☐a full exemption, or ☐ partial or no exemption

Reference (e)(2) for offeror submission should (d)(1) represent the offeror is a foreign person

RFO 52.230-

Cost Accounting Standards Notices and Certification (FEB 2026)

Applicable to all subject to CAS (generally all except small businesses or foreign governments)

(c) Check the appropriate box below:

Attachment No. 6 FA2377-26-R-B011

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(1) ☐ Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows:

(i) Original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and

(ii) One copy to the cognizant Federal auditor.

(Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable.

Forms may be obtained from the cognizant ACO or Federal official.)

Date of Disclosure Statement: ______________________ Name and Address of Cognizant ACO or Federal Official Where Filed: _______________________________________

The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

(2) ☐ Certificate of Previously Submitted Disclosure Statement. The offeror hereby certifies that the required Disclosure Statement was filed as follows:

Date of Disclosure Statement: _________________________ Name and Address of Cognizant ACO or Federal Official Where Filed: _______________________________________

The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

(3) ☐ Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.

(4) ☐ Certificate of Interim Exemption. The offeror hereby certifies that (i) the offeror first exceeded the monetary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR 9903.202-1, the offeror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a revised certificate to the Contracting Officer, in the form specified under paragraph (c)(1) or (c)(2) of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

Attachment No. 6 FA2377-26-R-B011

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Caution: Offerors currently required to disclose because they were awarded a CAS-covered prime contract or subcontract of $50 million or more in the current cost accounting period may not claim this exemption (4). Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

II. Cost Accounting Standards-Eligibility for Modified Contract Coverage

If the offeror is eligible to use the modified provisions of 48 CFR 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause.

☐ The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAS-covered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.

Caution: An offeror may not claim the above eligibility for modified contract coverage if this proposal is expected to result in the award of a CAS-covered contract of $50 million or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more.

III. Additional Cost Accounting Standards Applicable to Existing Contracts

The offeror shall indicate below whether award of the contemplated contract would, in accordance with paragraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts.

☐ Yes ☐ No

(End of provision)

RFO 52.230-

Proposal Disclosure-Cost Accounting Practice Changes

(APR 2005)

Applicable to contracts subject to CAS

☐ yes ☐ no

Reference paragraph (1) & (2) for offer required submission(s) should “Yes” be selected above.

RFO 52.240-

Security Prohibitions and Exclusions Representations and Certifications (FEB 2026)

All

RFO 52.252-

Authorized Deviations in Provisions (NOV 2020) All

Attachment No. 6 FA2377-26-R-B011

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(b) The use in this solicitation of any R-DFARS (48 CFR Chapter 2) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

RFO

252.203-

Representation Relating to Compensation of Former DoD Officials (SEP 2022)

All

R- DFARS

252.204-

Alternate A, Annual Representations and Certifications

(DEVIATION 2026-O0043)(FEB 2026)

All o Paragraph (f)(2) is applicable as noted below (f)(2) The following representations or certifications in SAM are applicable to this solicitation as indicated by the Contracting Officer: [Contracting Officer check as appropriate.]

__X__(i) 252.209-7002, Disclosure of Ownership or Control by a Foreign Government.

____(ii) 252.225-7000, Buy American—Balance of Payments Program Certificate.

____(iii) 252.225-7020, Trade Agreements Certificate.

____Use with Alternate I.

____(iv) 252.225-7031, Secondary Arab Boycott of Israel.

____(v) 252.225-7035, Buy American—Free Trade Agreements—Balance of Payments Program Certificate.

____Use with Alternate I.

____Use with Alternate II.

____Use with Alternate III.

____Use with Alternate IV.

____Use with Alternate V.

____ (vi) 252.226-7002, Representation for Demonstration Project for Contractors Employing Persons with Disabilities.

__X__ (vii) 252.232-7015, Performance-Based Payments—Representation.

(g) The Offeror has completed the annual representations and certifications electronically via the SAM website at https://www.sam.gov After reviewing the SAM database information, the Offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in RFO 52.204-7 and paragraph (f) of this provision have been entered or updated within 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 RFO 4.203-1); except for the changes identified below [Offeror to insert changes, identifying change by provision number, title, date]. 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

RFO/R-DFARS provision No. Title Date Change https://www.sam.gov/

Attachment No. 6 FA2377-26-R-B011

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Any changes provided by the Offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications located in the SAM database.

R- DFARS

252.204-

Compliance with Safeguarding Covered Defense Information Controls (OCT 2016)

All

R-DFARS

252.204-

Covered Defense Telecommunications Equipment or Services – Representation (DEC 2019)

All , can delete if included in contractor reps & certs.

(c) ☐does ☐does not

R-DFARS

252.204-

Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services— Representation (MAY 2021)

Leave in if KTR has completed 252.204-7016 in SAM reps & certs with positive reply or if they have not completed 252.204-7016. If KTR answered “does not” to 252.204-7016, delete.

(c) ☐will ☐will not

Reference paragraph (e) for applicable disclosure information required to be provided should the offer provide a positive response

R-DFARS

252.204-

Notice on the Use of the Supplier Performance Risk System (MAR 2023)

All (except for supplies or services exempted by DoDI

5000.79. R&D is not exempted)

R-DFARS

252.204-

Notice of Cybersecurity Maturity Model Certification Level Requirements (NOV 2025)

All when clause 252.204-7021 applies (include in all unless acquisition is solely for COTS items)

(b)(1) Cybersecurity Maturity Model Certification (CMMC) level. The CMMC level required by this solicitation is: CMMC Level 2 (Self). This CMMC level, or higher (see 32 CFR part 170), is required prior to award for each contractor information system that will process, store, or transmit Federal contract information (FCI) or controlled unclassified information (CUI) during performance of the contract.

R-DFARS

252.209-

Representation for Restriction on the Use of Certain Institutions of Higher Education (Oct 2023)

Only applies for acquisitions to an institution of higher education

R-DFARS

252.215-

Supplies and Services Provided by Nontraditional Defense Contractors (JAN 2023)

All

R-DFARS

252.219-

Advancing Small Business Growth (Jun 2023) Applies when the estimated annual value of the contract is expected to exceed the small business size standard or $70M if small business size standard

Attachment No. 6 FA2377-26-R-B011

7 | P a g e is expressed as #’s of employees for the NASIC Code in this solicitation

R-DFARS

252.225-

Report of Intended Performance Outside the United States

(OCT 2025)

Applies if anticipated contract value will exceed $20M

R-DFARS

252.225-

Representation Regarding Business Operations with the Maduro Regime (MAY 2022)

All

R-DFARS

252.225-

Preaward Disclosure of Employment of Individuals Who Work in the People’s Republic of China (AUG 2022)

All

R-DFARS

252.225-

Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region–Representation (JUN 2023)

All

R-DFARS

252.225-

Prohibition Regarding Russian Fossil Fuels Business Operations – Representation (DEVIATION 2024-O0006, REVISION 1) (MAR 2024) https://www.acq.osd.mil/dpap/policy/policyvault/USA0005 13-24-DPC.pdf

All over SAT unless contracts are- Jointly determined by the Secretary of Defense and Secretary of State to be—

• Necessary for purposes of— o Providing humanitarian assistance to the people of Russia;

or o Disaster relief and other urgent lifesaving measures;

• Vital to the national security interests of the United States; or

• A business operation with a fossil fuel company in a country other than the Russian Federation that was entered into prior to the date of the effective date of the prohibition;

• Related to the operation and maintenance of the U.S. Government’s consular offices and diplomatic posts in Russia; or x Licensed by the Office of Foreign Assets Control of the Department of the Treasury or otherwise https://www.acq.osd.mil/dpap/policy/policyvault/USA000513-24-DPC.pdf https://www.acq.osd.mil/dpap/policy/policyvault/USA000513-24-DPC.pdf

Attachment No. 6 FA2377-26-R-B011

8 | P a g e authorized to operate in Russian by the U.S. Government.

R-DFARS

252.225-

Prohibition on the Procurement of Foreign-Made Unmanned Aircraft Systems—Representation.

(DEVIATION 2024-O0014) (AUG 2024)

https://www.acq.osd.mil/dpap/policy/policyvault/USA0018 78-24-DPCAP.pdf

• All, unless

(1) Counter-unmanned aircraft system surrogate testing and training; or

(2) Intelligence, electronic warfare, and information warfare operations, texting, analysis, and training; or

(b) A waiver has been granted by the Secretary of Defense in accordance with section 848 of the National Defense Authorization Act for Fiscal Year 2020 (Pub. L. 116-92) and section 817 of the NDAA for FY 2023 (Pub. L. 117-263)

R-DFARS

252.227-

Technical Data or Computer Software Previously Delivered to the Government (JUN 1995)

All

R-DFARS

252.227-

Identification and Assertion of Use, Release, or Disclosure Restrictions (DEVIATION 2026-O0036)(FEB 2026)

All

Note to Offeror: Reference Attachment No. 9, Identification and Assertion of Use, Release, or Disclosure Restrictions dated Feb 2026

R-DFARS

252.228-

Ground and Flight Risk (MAR 2023) Only applicable if conditions under R-DFARS 228-371(b) apply

R-DFARS

252.239-

Representation of Use of Cloud Computing (SEP 2015) Applies to information technology services (include for most R&D)

(c) ☐does ☐does not

R-DFARS

252.239-

Notice of Supply Chain Risk (DEC 2022) All

R-DFARS

252.239-

Prohibition on Contracting to Maintain or Establish a Computer Network Unless Such Network is Designed to Block Access to Certain Websites - Representation

(DEVIATION 2021-O0003)(APR 2021)

All https://www.acq.osd.mil/dpap/policy/policyvault/USA001878-24-DPCAP.pdf https://www.acq.osd.mil/dpap/policy/policyvault/USA001878-24-DPCAP.pdf

Attachment No. 6 FA2377-26-R-B011

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End of Provision Chart

Signature signifying accuracy and completeness of the above representations and Certifications:

SIGNATURE/DATE: _____________________________________

NAME: ___________________________________________

TITLE:

https://www.acq.osd.mil/dpap/policy/policyvault/USA000226-21-DPC.pdf https://www.acq.osd.mil/dpap/policy/policyvault/USA000226-21-DPC.pdf

Section K Representations, Certifications and Other Statements of Offerors

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