Attachment A_ RFQ 36C10X26Q0119.pdf

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6515--Duodenoscope Image Controller FAR 6. 103-1 Only One Responsible Source
Solicitation number
36C10X26Q0119
Issued by

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Solicitation Summary

This is a Department of Veterans Affairs (VA) Solicitation/Contract/Order (36C10X26Q0119) for a nationwide Requirements Contract to procure Boston Scientific EXALT Model D Duodenoscope Image Controllers (Part Number M00542430) and associated accessories, consumables, and warranties for the Veterans Health Administration Equipment Life Cycle Management (ELCM) Program. The solicitation was issued on April 10, 2026, with an offer due date of April 22, 2026, at 10:00 AM EDT. Award is anticipated for April 10, 2026. This is an unrestricted acquisition for commercial products using a single-award, firm fixed-price requirements contract structure with an anticipated base period of 12 months and four 12-month option periods, not to exceed five years total duration.

The Government will accept quotes only from authorized distributors of the OEM; only new items with OEM warranty are acceptable, and no substitutes, equivalents, refurbished units, or gray-market items will be considered. Quoters must submit five separate volumes: technical documentation verifying the OEM item, a completed pricing schedule with unit prices rounded to two decimal places including a 3.0% Service Level Agreement (SLA) fee embedded in all pricing, and offer/certifications/representations. The maximum order limitation is $750,000 per single item or combination of items. Orders will be placed by designated VHA ELCM Ordering Officers via fully funded delivery orders through the NEC Order Portal, with inspections and acceptance at destination under FOB terms. The contractor must provide monthly sales reports by the 5th of each month and quarterly reports within 60 days of each fiscal quarter end, remit SLA fees within 60 days quarterly via pay.gov, and submit invoices electronically through the Tungsten e-invoicing system or X12 EDI format to the VA Financial Services Center. Liquidated damages of $37.50 per calendar day apply for delivery delays. The contract is administered by the Strategic Acquisition Center in Frederick, Maryland, with Contracting Officer Anthony Zibolski and a COR to be designated by the VHA Office of Supply Chain.

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Other files

File Type Posted
ATTACHMENT E_Template for Industry Questions_36C10X26Q0119.xlsx XLSX spreadsheet
36C10X26Q0119_2.docx DOCX document
ATTACHMENT B_Product Description_36C10X26Q0119.docx DOCX document
ATTACHMENT D_Price Cost Schedule_36C10X26Q0119.xlsx XLSX spreadsheet
ATTACHMENT C_Sales Reporting Tool_36C10X26Q0119.xlsx XLSX spreadsheet

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PAGE 1 OF 35 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C10X26Q0119 04-10-2026

Anthony Zibolski 04-22-2026

10:00 EDT

36C10X

Strategic Acquisition Center - Frederick

Department of Veterans Affairs

5202 Presidents Court, Suite 103

Frederick MD 21703

X

339112

1000 Employees

N/A

X

Nationwide via delivery orders

36C10X

Strategic Acquisition Center - Frederick

5202 Presidents Court, Suite 103

Frederick MD 21703

VAFSC

U.S. Department of Veterans Affairs

Financial Services Center

PO BOX 149971

(see Section B.3 invoicing/payment)

Austin TX 78714-8917

1-(877)-489-6135

See CONTINUATION Page

Veterans Health Administration

Equipment Life Cycle Management Program

Title:

Boston Scientific EXALT Model D Duodenoscope Image Controllers

See CONTINUATION Page

X X

X 1

Anthony Zibolski

Contracting Officer

36C10X26Q0119

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 CONTRACTOR REMITTANCE ADDRESS:

B.3 INVOICES:

B.4 GOVERNMENT INVOICE ADDRESS:

B.5 FSC MANDATORY ELECTRONIC INVOICE SUBMISSION:

B.6 TERMS AND CONDITIONS:

B.7 ACKNOWLEDGMENT OF AMENDMENTS

B.8 SPECIAL ORDERING INSTRUCTIONS

B.9 PRICE/COST SCHEDULE

SECTION C - CONTRACT CLAUSES

C.1 SAC 18-01 SAC SERVICE LEVEL AGREEMENT FEE AND SUBMISSION OF

QUARTERLY SALES REPORTS: OPEN MARKET (JAN 2016)

C.2 52.211-11 LIQUIDATED DAMAGES—SUPPLIES, SERVICES, OR RESEARCH

AND DEVELOPMENT (SEPT 2000)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-21 REQUIREMENTS (OCT 1995)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.7 52.219-28 POSTAWARD SMALL BUSINESS PROGRAM REREPRESENTATION

(NOV 2025) (DEVIATION)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.9 VAAR 852.211-70 EQUIPMENT OPERATION AND MAINTENANCE MANUALS

(NOV 2018)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS—REPRESENTATION (DEVIATION OCT 2025)

E.2 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS

(DEVIATION OCT 2025)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (DEVIATION

OCT 2025)

E.4 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT

TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

E.5 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)

E.6 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.7 52.225-6 TRADE AGREEMENTS CERTIFICATE (FEB 2021)

E.8 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.9 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

E.10 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: TBD

POC

TITLE

EMAIL

PHONE

UNIQUE ENTITY ID

b. GOVERNMENT: Contracting Officer 36C10G

Anthony Zibolski U.S. Department of Veterans Affairs

Strategic Acquisition Center Anthony.Zibolski@va.gov

Deputy Program Manager, ELCM

TBD

VHA Office of Supply Chain

Contracting Officer’s Representative (COR), ELCM

TBD

VHA Office of Supply Chain mailto:Anthony.Zibolski@va.gov

B.2 CONTRACTOR REMITTANCE ADDRESS:

All payments by the Government to the Contractor will be made in accordance with

52.232-33, Payment by Electronic Funds Transfer—System for Award Management.

B.3 INVOICES:

Invoices shall be submitted monthly in arrears based upon delivery, acceptance, and receipt of a properly prepared invoice.

In order to comply with the Improper Payment Elimination and Recovery Act of 2010 (IPERA), the VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC).

The Contractor shall submit invoice within 30 days of delivery.

B.4 GOVERNMENT INVOICE ADDRESS:

All Invoices from the contractor shall be submitted electronically in accordance with

VAAR Clause 852.232-72 Electronic Submission of Payment Request.

B.5 FSC MANDATORY ELECTRONIC INVOICE SUBMISSION:

Contractors are required to submit payment requests in electronic form in accordance with the submission instructions below.

TUNGSTEN ELECTRONIC INVOICE SUBMISSION

FSC e-INVOICE PROGRAM THROUGH AUSTIN PORTAL

FSC MANDATORY ELECTRONIC INVOICE SUBMISSION FOR AUSTIN PAYMENTS

Contracting POCs: Contracting Officer –Anthony Zibolski

COR: TBD

Contract/Delivery Order Number: TBD

a. Vendor Electronic Invoice Submission Methods:

Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below.

1. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge.

2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the http://www.tungsten-network.com/US/en/veterans-affairs/ http://www.tungsten-network.com/US/en/veterans-affairs/

American National Standards Institute (ANSI). The X12 EDI Web site

(http://www.x12.org)

b. Vendor e-invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have question about the e-invoicing program or

Tungsten, please contact the FSC at the phone number or email address listed below.

1. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

3. FSC e-Invoice Contact Information: 1-877-353-9791

4. FSC e-invoice email: vafsccshd@va.gov

See https://www.fsc.va.gov/einvoice.asp for more information.

B.6 TERMS AND CONDITIONS:

a. Uninterrupted Source of Supply:

By establishing a contract, the Vendor agrees to supply established items to satisfy the Government’s requirement when an order is placed under the contract during the effective period of performance. If, however, the Vendor determines to terminate production of the selected item and contemplates replacement with an alternative item, the Government reserves the right to evaluate the potential replacement item(s). There is no guarantee that the Government will evaluate any replacement item(s) favorably. If the Government determines the replacement item(s) as unacceptable, the individual item(s) or the entire contract may be canceled.

b. Extent of Obligation:

The Government is obligated only to the extent of authorized purchases actually made under the resultant contract. The terms and conditions included in this contract apply to all purchases made pursuant to it. In the event of an inconsistency between the provisions of this contract and the Contractors invoice, the provisions of this contract will take precedence.

c. Purchase/Ordering Limitation:

Orders placed against this contract are limited to FAR Clause 52.216-19 Order Limitations, as noted in the contract. The estimated total quantities are listed on Section B.8 PRICE/COST SCHEDULE. The quantities provided are estimates only, and VA makes no guarantee regarding the actual quantities that may be purchased.

The Veterans Health Administration (VHA) Equipment Life Cycle Management (ELCM) Program identified the Non-Powered Patient Transfer Standing Aid product line as a candidate for a VA-wide (otherwise referred to as “national”) single award Requirement’s contract. The Government's intent for this Requirements contract is to include all ancillary items to ensure the equipment can function as designed by the Original Equipment Manufacturer (OEM) and as clinically required. The Government http://www.x12.org/ mailto:VA.Registration@Tungsten-Network.com mailto:vafsccshd@va.gov https://www.fsc.va.gov/einvoice.asp may through bilateral modification, add or remove items to this contract that are determined to be within scope of the solicited product line, not limited to the original items awarded. Additionally, any discontinued items may be replaced via future contract modification by the replacement part identified by the OEM, so long as the replacement part serves the same clinical purpose and function as the originally awarded item. Furthermore, any new technology that is presented during performance of this contract may be evaluated by the Government for inclusion into the contract, via bilateral modification. This new technology must be determined to be within scope of the original contract.

d. Individuals Authorized to Purchase Under the Contract:

This is a Strategic Acquisition Center (SAC) decentralized contract. Orders are placed by VA Government Ordering Officer (OO) in accordance with the terms and conditions of the specific contract identified in the OO appointment memorandum approved by a SAC Contracting Officer. OOs may only place orders for those contracts they are specifically appointed. Ordering Officers are responsible for issuing and administering orders placed under this contract. Ordering Officers may revise or modify their orders, but only within the scope of this contract. Ordering Officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the SAC Contracting Officer responsible for this contract. Orders placed only by designated VHA ELCM Ordering Officers shall be submitted on a fully funded and completed Delivery Order. No orders shall be placed without first obtaining approved funding from a VA facility. Requesting Facility submits order requests through the NEC Order Portal ELCM NEC Ordering Portal - Power Apps for verification. Questions may be submitted to the VHA ELCM OO Team via email at vaelcmnxeqorderingofficer@va.gov

The Contractor shall accept orders against this contract only from the designated VHA ELCM OO when the Delivery Order has been reviewed by the OO for this contract. Fulfilling orders from persons other than the approved Ordering Officer may result in loss or delay in payment for supplies/services provided under such orders. When a Contracting Officer appoints an Ordering Officer in writing after award, the Contracting Officer will furnish the contractor with an updated list of individual Ordering Officers authorized to place orders against the contract. The contractor will acknowledge receipt of any order submitted by an individual Ordering Officer specified by appointment against the contract.

e. Delivery Tickets:

The following provisions apply to all shipments:

Inspection: Destination Acceptance: Destination Shipping: Free on Board (FOB) – Destination Ship To and Mark For: Deliveries shall be marked and shipped to various VHA locations identified in each order placed against the contract.

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fapps.gov.powerapps.us%2Fplay%2Fe%2Fdefault-e95f1b23-abaf-45ee-821d-b7ab251ab3bf%2Fa%2Ff5a4b923-8e9a-4db8-85d0-d00eb0ca1d07%3FtenantId%3De95f1b23-abaf-45ee-821d-b7ab251ab3bf%26hint%3D4065f86d-3290-468a-93da-5e182e642f3e%26sourcetime%3D1707251534292&data=05%7C02%7C%7C99f912a006124f21351308dc58a3cca1%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C638482707742636597%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=PIgCdabLBHhw9mDSlAWIbA06V9opReZU4rMUVyIHB4Y%3D&reserved=0 mailto:vaelcmnxeqorderingofficer@va.gov

All shipments, either single or multiple container deliveries, shall bear and contain on the delivery tickets or sales slips (external shipping labels and associated manifests or packing lists) the following at a minimum:

(i) Name of supplier

(ii) Contract/Delivery Order/Task Order number

(iii) Date of purchase

(iv) Contract number

(v) Itemized list of supplies or services furnished

(vi) Quantity, unit price, and extension of each item, less applicable discounts (unit prices and extensions need not be shown when incompatible with the use of automated systems, provided the invoice is itemized to show this information).

(vii) Date of delivery or shipment In the case of multiple container deliveries, a statement readable near the VA Order number will indicate total number of containers for the complete shipment

(ex. “Package 1 of 2”), clearly readable on manifests and external shipping labels.

The Contractor shall provide an order confirmation within four (4) working days of receipt of the delivery order.

The Contractor will provide tracking information or use of a website to obtain delivery status and proof of delivery.

The After Receipt of Order (ARO) is defined as the established number of days from the Contractor’s receipt of order date to the line-item delivery date. The Contractor ARO is X days.

Packing Slips/Labels and Lists shall include the following:

IFCAP PO # ____________ (i.e., 166-E11234) Total number of Containers: Package ___ of ___. (i.e., Package 1 of 3)

f. Inspection and Acceptance:

The acceptance paragraph in FAR 52.212-4 is based upon the assumption that the Government will rely on the Contractor’s assurances that the commercial item tendered for acceptance conforms to the contract requirements. The Government inspection of commercial items will not prejudice its other rights under the acceptance paragraph.

See FAR 52.212-4.

g. Reports:

Monthly Report: In order for the contracting office to submit the required financial reporting on SAM.gov, the contractor needs to submit ATTACHMENT C – REPORTING TOOL – NX EQ Boston Scientific EXALT Model D Duodenoscope Image Controllers on a monthly basis to the Contract Specialist and COR. The report is due by the 5th of each month.

Quarterly Report: In addition to the monthly submission, the same ATTACHMENT C – REPORTING TOOL – NX EQ Boston Scientific EXALT

Model D Duodenoscope Image Controllers needs to be submitted quarterly as outlined below.

In order to track compliance, VA requires the contractor to submit the quarterly report of sales in the approved format listed in ATTACHMENT C – REPORTING TOOL – NX EQ Boston Scientific EXALT Model D Duodenoscope Image Controllers based on the Governments fiscal calendar year. See below:

QUARTER PERIOD OF SALES SUBMISSION DUE DATE

1st October – December Last day in February

2nd January – March May 31st

3rd April – June August 31st

4th July – September November 30th

The contractor agrees that they shall adhere to this requirement. The contractor shall provide a quarterly report, no later than 60 calendar days after the end of each fiscal quarter ending December, March, June, and September. Reports shall be sent electronically to the Government points of contact until the contractor is notified, in writing, of a different point of contact.

a. Contracting Officer: Anthony Zibolski

b. COR: TBD

h. Maintenance, Repairs, and Replacements:

Instructions and procedures will be provided by the vendor specific to the warranty, maintenance, repairs, and replacement of product and services. At minimum, the vendor will provide the manufacturer warranty period that may include response time, parts, associated maintenance services, products, and consumables.

i. Product Refresh:

Product refresh is when a current CLIN is no longer being manufactured due to obsolescence and the product is being replaced with a newer, and more often, superior version of the same product. The current CLIN product may be revised to reflect the refreshed product information, manufacturer’s part number, price

(inclusive of Service Level Agreement (SLA) fee), etc., when advised of a product’s obsolescence.

The Government reserves the right to not accept the products offered/quoted under product refresh. The contractor will be notified in writing if a product refresh is not accepted. All products offered/quoted shall be provided with the warranty that is agreed upon for this contract.

The contractor agrees to ensure that all upgraded improved/replaced products meet American with Disabilities Act (ADA) and Health Insurance Portability and

Accountability Act (HIPAA) Federal requirements.

The contractor shall provide the following information for product refresh:

(1) A list of specific awarded CLIN(s) being refreshed in the Price/Cost

Schedule(to include commercial pricing, discount offered, and price (inclusive of

SLA fee));

(2) Product literature for the refreshed product(s).

(3) A detailed description of the differences or benefits of refreshed as compared to the CLIN(s) being discontinued or added.

(4) Proper identification of any product requirements and/or procedures related to those product(s) proposed to be refreshed or upgraded.

(5) FDA approval, if applicable

(6) Provide historical sales to VA by product(s), if applicable

(7) Copy of Commercial Warranty

The request shall be submitted to the COR, copy to the Contract Specialist and

Contracting Officer, for review and recommendation of approval to be submitted to the CO. The CO shall prepare a bilateral modification for execution, if approved.

j. Product Removal or Recall:

For any product awarded under this contract removed or recalled by the manufacturer due to defects in the product or potential dangers to patients, or if any required removal or recall is suggested or mandated by a regulatory or official agency, the manufacturer agrees to take the following steps immediately:

Notify the COR and CO at the Strategic Acquisition Center, in writing, by the most expeditious manner possible.

Provide copies of the notification to the Contracting Officer, Contract Specialist, Contracting Officer’s Representative, and Manager at Product Recall Office, all

Agencies and VA Facilities who purchased the product, which include, but not be limited to the following:

(1) Complete item description and/or identification, order numbers from customers and the contract number assigned as a result of an issuance on the solicitation;

(2) Reasons for modifications, removal or recall; and

(3) Necessary instructions for return for credit, replacement or corrective action.

A copy of the notification will be provided to:

Manager, Product Recall Office

National Center for Patient Safety

Veterans Health Administration

24 Frank Lloyd Wright Drive, Lobby M

Ann Arbor, MI 48106

B.7 ACKNOWLEDGMENT OF AMENDMENTS

The quoter acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO. DATE

B.8 SPECIAL ORDERING INSTRUCTIONS

Not applicable

B.9 PRICE/COST SCHEDULE

This is a nationwide Department of Veterans Affairs Requirements Contract for the procurement of NX EQ Boston Scientific EXALT Model D Duodenoscope Image

Controllers, to include accessories, consumables, and warranties, in accordance with

ATTACHMENT B PRODUCT DESCRIPTION. The quantity delivered will be dependent on the numbers ordered by the VA Medical Centers.

[The price/cost schedule will be incorporated into the fully executed contract]

36C10X26Q0110

SECTION C - CONTRACT CLAUSES

This contract is awarded pursuant to the Government‑wide class deviation implementing the Revolutionary FAR Overhaul (RFO). The RFO‑deviated FAR governs all FAR parts, provisions, and clauses incorporated into this contract. In the event of conflict between the standard FAR and the RFO‑deviated FAR, the RFO‑deviated FAR controls. This clause supplements the Order of Precedence clause in this contract, and the RFO‑deviated FAR takes precedence over any inconsistent solicitation language carried forward into the contract

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the

Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 SAC 18-01 SAC SERVICE LEVEL AGREEMENT FEE AND SUBMISSION

OF QUARTERLY SALES REPORTS: OPEN MARKET (JAN 2016)

a. Service Level Agreement Fee.

The Service Level Agreement (SLA) fee is established by the Supply Fund Board and is provided as a means of reimbursement for customary acquisition-related services necessary to obtain contractor services and/or supplies as required. The SLA is reimbursed to the SAC based on rates established by the supply fund board and are recouped based on a percentage of total quarterly sales. The Supply Fund Board may change the percentage at any time, but typically not more than once per year. Upon a change in the SLA, the Contracting Officer (CO) shall issue a unilateral modification to apply the change to CLIN prices based upon the SLA rate change. The SAC will provide reasonable notice prior to the effective date of the change.

In order to facilitate SLA reimbursement, quoters must include (imbed) the SLA fee into their prices; therefore, the fee will be reflected in the total amount charged and transparent to ordering activities.

The current SLA which applies to this contract action is 3.0%. This SLA Fee shall be imbedded in the awarded contract/agreement price(s) and offers submitted in response to this solicitation shall include this SLA Fee in the price of every line item offered.

b. Quarterly Sales Reports.

The Contractor shall report all contract sales under this contract and submit collected

SLAs as follows:

(1) The Contractor shall accurately report the dollar value, in U.S. dollars and rounded to the nearest whole dollar, of all sales made under this contract by calendar quarter (January 1–March 31, April 1–June 30, July 1–September 30, and October 1–

December 31). Reported sales must include all sales made to all authorized contract or agreement users, whether shipped directly to the users or through Prime Vendor contractors. The report shall reflect sales by contract line item and shall segment sales by the Department of Veterans Affairs (VA) and Other Government Agencies (OGA).

The reported contract sales shall include the SLA Fee and each quarterly report shall show the total SLA Fee amount collected on the reported sales. The Contractor shall maintain a consistent accounting method of sales reporting, based on the Contractor’s established commercial accounting practice. The Contractor shall consistently use only one of the following acceptable points at which sales may be reported-—

i. Receipt of order;

ii. Shipment or delivery, as applicable;

iii. Issuance of an invoice; or

iv. Payment.

(2) Sales under this contract/agreement shall be reported to the SAC within 60 calendar days following the completion of each reporting quarter. The Contractor shall continue to furnish quarterly reports, including “zero” sales, through physical completion of the last outstanding order of the contract/agreement.

(3) The sales report signed by an authorized representative of the contractor shall be emailed to the appropriate individual(s) listed in the terms and conditions of the contract or agreement.

c. SLA Remittance

The Contractor shall remit the SLA fee to the SAC in U.S. dollars within 60 calendar days after the end of the reporting quarter and final payment shall be remitted within 60 days after physical completion of the last outstanding task order or delivery order of the contract.

The SLA Fee amount collected and due shall be paid electronically. To ensure that the payment is credited properly, the contractor shall electronically transmit the SLA fee along with the coinciding quarterly sales report at www.pay.gov (VA Strategic

Acquisition Center (SAC)); specific instructions shall be provided when the contract action resulting from this solicitation is awarded (i.e. post-award/BPA issuance conference and/or post-award letter when used in lieu of a conference).

The Government reserves the right to inspect, without further notice, such records of the

Contractor as pertinent to sales under any contract or agreements resulting from this solicitation. Failure to remit the full amount of the SLA within 60 calendar days after the end of the applicable reporting period constitutes a contract debt to the United States

Government under the terms of Federal Acquisition Regulation (FAR) Subpart 32.6. The

Government may exercise all rights under the Debt Collection Improvement Act of 1996, including withholding or setting off payments and interest on the debt (see FAR clause

52.232-17, Interest). Should the Contractor fail to submit the required sales reports, falsify them, or fail to timely pay the SLA, the Government shall have, in addition to the rights and remedies described in this clause, all other rights and remedies permitted by

Federal law and statutes.

(End of Clause)

C.2 52.211-11 LIQUIDATED DAMAGES—SUPPLIES, SERVICES, OR

RESEARCH AND DEVELOPMENT (SEPT 2000)

(a) If the Contractor fails to deliver the supplies or perform the services within the time specified in this contract, the Contractor shall, in place of actual damages, pay to the

Government liquidated damages of $37.50 per calendar day of delay.

(b) If the Government terminates this contract in whole or in part under the Default—

Fixed-Price Supply and Service clause, the Contractor is liable for liquidated damages accruing until the Government reasonably obtains delivery or performance of similar supplies or services. These liquidated damages are in addition to excess costs of repurchase under the Termination clause.

(c) The Contractor will not be charged with liquidated damages when the delay in delivery or performance is beyond the control and without the fault or negligence of the

Contractor as defined in the Default—Fixed-Price Supply and Service clause in this contract.

(End of Clause)

C.3 52.216-18 ORDERING (AUG 2020)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued during the active ordering period of the contract, which includes the base year and any exercised option years.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) A delivery order or task order is considered "issued" when—

(1) If sent by mail (includes transmittal by U.S. mail or private delivery service), the

Government deposits the order in the mail;

(2) If sent by fax, the Government transmits the order to the Contractor’s fax number;

or

(3) If sent electronically, the Government either—

(i) Posts a copy of the delivery order or task order to a Government document access system, and notice is sent to the Contractor; or

(ii) Distributes the delivery order or task order via email to the Contractor’s email address.

(d) Orders may be issued by methods other than those enumerated in this clause only if authorized in the contract.

(End of Clause)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than Not Applicable, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor—

(1) Any order for a single item: $750,000.00.

(2) Any order for a combination of items: $750,000.00.

(3) A series of orders from the same ordering office within $750,000.00 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order

(or orders) is returned to the ordering office within [not applicable] days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of Clause)

C.5 52.216-21 REQUIREMENTS (OCT 1995)

(a) This is a requirements contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies or services specified in the Schedule are estimates only and are not purchased by this contract. Except as this contract may otherwise provide, if the Government's requirements do not result in orders in the quantities described as "estimated" or "maximum" in the Schedule, that fact shall not constitute the basis for an equitable price adjustment.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. Subject to any limitations in the Order Limitations clause or elsewhere in this contract, the Contractor shall furnish to the Government all supplies or services specified in the Schedule and called for by orders issued in accordance with the Ordering clause. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(c) Except as this contract otherwise provides, the Government shall order from the

Contractor all the supplies or services specified in the Schedule that are required to be purchased by the Government activity or activities specified in the Schedule.

(d) The Government is not required to purchase from the Contractor requirements in excess of any limit on total orders under this contract.

(e) If the Government urgently requires delivery of any quantity of an item before the earliest date that delivery may be specified under this contract, and if the Contractor will not accept an order providing for the accelerated delivery, the Government may acquire the urgently required goods or services from another source.

(f) Any order issued during the ordering period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's ordering period; provided, that the Contractor shall not be required to make any deliveries after this contract has expired .

(End of Clause)

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR

2000)

(a) The Government may extend the term of this contract by written notice to the

Contractor within 30 days before the contract expires; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed five (5) years.

(End of Clause)

C.7 52.219-28 POSTAWARD SMALL BUSINESS PROGRAM

REREPRESENTATION (NOV 2025) (DEVIATION)

(a) Definitions. As used in this clause—

Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority.

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in its field of operation, and qualified as a small business under the criteria in 13 CFR part 121 and the size standard in paragraph (c) of this clause.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

(b) If the Contractor represented that it was a small business concern, a small disadvantaged business concern, or a joint venture that was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (e) of this clause or, if applicable, paragraph (g) of this clause, upon occurrence of any of the following:

(1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract.

(2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract.

(3) For long-term contracts-

(i) Within 60 to 120 days prior to the end of the fifth year of the contract; and

(ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter.

(c) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North

American Industry Classification System (NAICS) code(s) assigned to this contract. The small business size standard corresponding to this NAICS code(s) can be found at https://www.sba.gov/document/support--table-size-standards.

(d) The small business size standard for a Contractor providing an end item that it does not manufacture, process, or produce itself, for a contract other than a construction or service contract, is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition—

(1) Was set aside for small business and has a value above the simplified acquisition threshold;

(2) Used the HUBZone price evaluation preference regardless of dollar value, unless the Contractor waived the price evaluation preference; or

(3) Was an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

(e) Except as provided in paragraph (g) of this clause, the Contractor shall make the representation(s) required by paragraph (b) of this clause by validating or updating all its representations in the Representations and Certifications section of the System for

Award Management (SAM) and its other data in SAM, as necessary, to ensure that they reflect the Contractor's current status. The Contractor shall notify the contracting officer in writing within the timeframes specified in paragraph (b) of this clause, that the data have been validated or updated, and provide the date of the validation or update.

(f) If the Contractor represented that it was other than a small business concern prior to award of this contract, the Contractor may, but is not required to, take the actions required by paragraphs (e) or (g) of this clause.

(g) If the Contractor does not have representations and certifications in SAM, or does not have a representation in SAM for the NAICS code applicable to this contract, the

Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

(1) The Contractor represents that it [ ] is, [ ] is not a small business concern under

NAICS Code 339112 assigned to contract number (CONTRACT NUMBER).

https://www.sba.gov/document/support--table-size-standards

(2) [Complete only if the Contractor represented itself as a small business concern in paragraph (g)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1001.

(3) Women-owned small business (WOSB) joint venture eligible under the WOSB

Program. The Contractor represents that it [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _____.]

(4) Economically disadvantaged women-owned small business (EDWOSB) joint venture. The Contractor represents that it [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _____.]

(5) Service-disabled veteran-owned small business (SDVOSB) joint venture eligible under the SDVOSB Program. The Contractor represents that it [ ] is, [ ] is not an

SDVOSB joint venture eligible under the SDVOSB Program that complies with the requirements of 13 CFR 128.402. [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _____.]

(6) HUBZone joint venture eligible under the HUBZone Program. [Complete only if the offeror is a HUBZone small business concern.] The offeror represents, as part of its offer, that It [ ] is, [ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR 126.616(a) through (c). [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _____.] Each HUBZone small business concern participating in the HUBZone joint venture must be certified as a HUBZone concern.

[Contractor to sign and date and insert authorized signer's name and title.

(End of Clause)

C.8 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part- 52#FAR_52_252_1 (FAR) and http://www.va.gov/oal/library/vaar/index.asp (VAAR).

FAR Number Title Date

52.203-3 GRATUITIES APR 1984

https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part-52#FAR_52_252_1 https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part-52#FAR_52_252_1 http://www.va.gov/oal/library/vaar/index.asp

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE

GOVERNMENT ALTERNATE I

NOV 2021

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN

FEDERAL TRANSACTIONS

JUN 2020

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS NOV 2023

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL

CONFIDENTIALITY AGREEMENTS OR STATEMENTS

JAN 2017

52.204-13 SYSTEM FOR AWARD MANAGEMENT—MAINTENANCE

(DEVIATION)

NOV 2025

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN

SUBCONTRACTING WITH CONTRACTORS DEBARRED,

SUSPENDED, PROPOSED FOR DEBARMENT, OR

VOLUNTARILY EXCLUDED

JAN 2025

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION

REGARDING RESPONSIBILITY MATTERS

OCT 2018

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED

DOMESTIC CORPORATIONS

NOV 2015

52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

NOV 2023

52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS

(DEVIATION)

NOV 2025

52.222-3 CONVICT LABOR (DEVIATION) NOV 2025

52.222-19 CHILD LABOR—COOPERATION WITH AUTHORITIES AND

REMEDIES (DEVIATION)

MAR 2026

52.222-35 EQUAL OPPORTUNITY FOR VETERANS (DEVIATION) NOV 2025

52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES

(DEVIATION)

NOV 2025

52.222-37 EMPLOYMENT REPORTS ON VETERANS (DEVIATION) NOV 2025

52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE

NATIONAL LABOR RELATIONS ACT (DEVIATION)

NOV 2025

52.222-50 COMBATING TRAFFICKING IN PERSONS (DEVIATION) NOV 2025

52.223-23 SUSTAINABLE PRODUCTS (DEVIATION) NOV 2025

52.225-5 TRADE AGREEMENTS NOV 2023

52.226-8 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT

MESSAGING WHILE DRIVING

MAY 2024

52.229-12 TAX ON CERTAIN FOREIGN PROCUREMENTS FEB 2021

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER—SYSTEM

FOR AWARD MANAGEMENT

OCT 2018

52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS JUN 2013

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL

BUSINESS SUBCONTRACTORS

MAR 2023

52.233-3 PROTEST AFTER AWARD AUG 1996

52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM OCT 2004

52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (DEVIATION) NOV 2025

52.244-6 SUBCONTRACTS FOR COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES

OCT 2025

852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE DEC 2022

852.203-70 COMMERCIAL ADVERTISING MAY 2018

852.212-71 GRAY MARKET AND COUNTERFEIT ITEMS FEB 2023

852.222-71 COMPLIANCE WITH EXECUTIVE ORDER 13899

(DEVIATION)

APR 2025

852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS NOV 2018

852.242-71 ADMINISTRATIVE CONTRACTING OFFICER OCT 2020

852.246-71 REJECTED GOODS OCT 2018

C.9 VAAR 852.211-70 EQUIPMENT OPERATION AND MAINTENANCE

MANUALS (NOV 2018)

The Contractor shall follow standard commercial practices to furnish manual(s), handbook(s) or brochure(s) containing operation, installation, and maintenance instructions, including pictures or illustrations, schematics, and complete repair/test guides, as necessary, for technical medical equipment and devices, and/or other technical and mechanical equipment provided per CLIN(s) 0001 - 4001. The manuals, handbooks or brochures shall be provided in hard copy, soft copy or with electronic access instructions, consistent with standard industry practices for the equipment or device. Where applicable, the manuals, handbooks or brochures will include electrical data and connection diagrams for all utilities. The documentation shall also contain a complete list of all replaceable parts showing part number, name, and quantity required.

(End of Addendum to 52.212-4)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR

ATTACHMENTS

Attachment A: 36C10X26Q0119

Attachment B: Product Description_36C10X26Q0119

Attachment C: Sales Reporting Tool_36C10X26Q0119

Attachment D: Price Cost Schedule_36C10X26Q0119

Attachment E: Template for Industry Questions_36C10X26Q0119

SECTION E - SOLICITATION PROVISIONS

ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

Provisions that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the

Contracting Officer will make their full text available.

The following provisions are incorporated into 52.212-1 as an addendum to this solicitation:

E.1 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC

CORPORATIONS—REPRESENTATION (DEVIATION OCT 2025)

(a) Definitions. Inverted domestic corporation and subsidiary have the meaning given in the clause of this contract entitled Prohibition on Contracting with Inverted Domestic

Corporations (52.209-10).

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4.

(c) Representation. The Offeror represents that—

(1) It [ ] is, [ ] is not an inverted domestic corporation; and

(2) It [ ] is, [ ] is not a subsidiary of an inverted domestic corporation.

(End of Provision)

E.2 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS

(DEVIATION OCT 2025)

(a)(1) The Offeror certifies, to the best of its knowledge and belief, that—

(i) The Offeror and/or any of its Principals—

(A) Are □ are not □ presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have □ have not □, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public

(Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks "have", the offeror shall also see 52.209-7, if included in this solicitation);

(C) Are □ are not □ presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph

(a)(1)(i)(B) of this provision; and

(D) Have □, have not □, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) for which the liability remains unsatisfied. Federal taxes are considered delinquent if both of the following criteria apply:

(1) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if a pending administrative or judicial challenge remains. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(2) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) The Offeror has □ has not □, within a 3-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

(2) "Principal," for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the

Government will consider the certification in connection with a determination of the

Offeror's responsibility. Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.

(d) This provision does not require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a).

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