Attachment J-11_Uniform BIL Data Report Form.xlsx
XLSX spreadsheet 85 KB Posted
- Attached to
- Screening Information Request (SIR) for Instrument Landing System (ILS) Installation Demonstrations
- Solicitation number
- 693KA8-24-R-00024
About this file
This document is an Attachment J-11 Uniform Bipartisan Infrastructure Law (BIL) Data Report form from the Federal Aviation Administration (FAA). It contains instructions and five tabs for the prime contractor to complete regarding BIL-funded contract performance, including reporting on Buy American compliance, energy savings initiatives, subcontracting, and jobs creation. The report must be submitted to the FAA with a copy to the cognizant Contracting Officer. Key details include the required reporting elements, due date, and OMB control number. The second document is a Screening Information Request (SIR) for Instrument Landing System (ILS) Installation Demonstrations, a Federal contract opportunity issued as a partial Small Business Set-Aside by the FAA. It describes the purpose, estimated number of awards, potential project locations, and instructions for submitting questions and proposals.
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Text version
Instructions
Uniform Bipartisan Infrastructure Law (BIL) Data Report
There are five tabs to complete. See below for Instructions related to each tab:
- Contractor Info
- Buy American
- Environmentally Friendly
- Subcontracting
- Jobs Creation
If you have questions, please contact 9-AFN-BIL-Questions@faa.gov Submit the completed report to 9-AFN-BIL-Reports@faa.gov with copy to cognizant Contracting Officer
| TAB 1 - CONTRACTOR INFO |
| This tab is to be completed with the information for the Prime contractor, the entity who is on contract with the FAA to perform the contractual requirements. |
| Contractor Point of Contact - Input the name, phone number, and e-mail address of the person filling out this report. |
| Business Name - Input the name of the prime contactor. |
| Business Address - Input the physical address of the prime contractor. |
| Business Socio-economic status - Use the drop down menu to select the socio-economic status of the prime contractor. Choose the appropriate designation as reflected in the SAM.gov representation. Reference AMS Policy Appendix C for additional information on status definitions. |
| Contract No. - Input the contract identifier for the agreement between the FAA and the Prime Contractor. The number is to be entered with a dash after the sixth, eighth, and ninth characters, i.e. XXXXXX-XX-X-XXXXX |
| Order No. - If the agreement is established by a Purchase or Task order against a parent contract, enter order number with a dash after the sixth, eighth, and ninth characters, i.e. XXXXXX-XX-X-XXXXX. If not enter N/A. |
| Modification No. - If the agreement is established by a modification to an existing contract or order, enter the six digit modification number. If not, enter "N/A". |
| Total Obligated to Date - Input the total dollars obligated to date for the performance of the contract requirement. Do not enter unobligated amounts. |
| JCN - Input the job control number for each project. Enter "9999" if there is no JCN. |
| Location of the project - Input the city, state, and zip where each JCN will be performed. |
| Dollar Value - Input the total obligated dollar value for each JCN. If a JCN is unfunded, enter zero. The total for all JCN dollar values must be equal to the value in Total Obligated to Date. |
| TAB 2- BUY AMERICAN | |
| JCN - List all JCNs that incorporate the use of non-domestic products/technology. If non-domestic product/technology is used but there is no JCN, enter "9999". | |
| Description - Describe the non-domestic product/technology to include manufacturer and model number, if more than one non-domestic product/technology is associated with the JCN, use multiple lines. | |
| Dollar Value - Insert the dollar value of the non-domestic product/technology. | |
| FAA 4400-93 (01/23) | i |
| TAB 3 -ENERGY SAVINGS | |
| JCN - List all JCNs that incorporate energy savings initiatives. If energy savings initiatives are involved but there is no JCN, enter "9999". | |
| Description, Product/Technology Replaced - Describe the product/technology that is to be removed/replaced to include manufacturer, model number, size, age, etc. If more than one energy savings initiative is associated with the JCN, use multiple lines. |
| TAB 4 - SUBCONTRACTING |
| JCN - List each JCN on the contract/order/modification. If subcontracting is performed but there is no JCN, enter "9999". |
| Insert the total dollars subcontracted to date to first tier subcontractors for each JCN by socio-economic category. |
| TAB 5 - JOBS CREATION |
| JCN - Input the job control number for each project. If jobs are created but there is no JCN, enter "9999". |
| Jobs Created - Input, by JCN, the number of jobs created expressed as "full-time equivalent" which must include full-time, part-time, temporary, and permanent positions as expressed as a "person-year," for the Contractor and all first tier subcontractors. |
| PAPERWORK REDUCTION ACT STATEMENT. |
| A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0595. Public reporting for this collection of information is estimated to be approximately 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524 |
FAA 4400-93 (01/23) ii
OMB Control No. 2120-0595 https://fast.faa.gov/docs/acquisitionManagementPolicy/AcquisitionManagementPolicyAppendixC.pdf Tab 1- Contractor Info Bipartisan Infrastructure Law (BIL) Funds Report
| Contractor Point of Contact | ||||||
| Full Name | ||||||
| Phone Number | ||||||
| Date of Submission | 8/12/24 0:00 | |||||
| Business Information | ||||||
| Business Name | ||||||
| Business Address | ||||||
| City | ||||||
| State | ||||||
| Zipcode (Zip + 4) | ||||||
| Business Socio-economic Status | ||||||
| Contract No. | ||||||
| Order No. (if applicable) | ||||||
| Modification No. (if applicable) | ||||||
| Total Obligated to Date | $ - 0 | |||||
| Job Control Number(s) (JCN) | ||||||
| Complete the following entries for all JCNs on the contract/order/modification. If additional space is needed, contact the FAA POC on the Instructions tab for a supplemental JCN sheet. Enter "9999" if there is no JCN. | ||||||
| Location of Performance | ||||||
| JCN | City | State | ZIP +4 | Dollar Value |
FAA 4400-93 (01/23) &P
Tab 2 - Buy American
| Buy American Data | ||
| Identify all non-domestic purchases to date associated with this contract/order/modification by associated JCN, description, and dollar value. If additional space is needed, contact the FAA POC on the Instructions tab for a supplemental Buy American sheet. | ||
| JCN | Description | Dollar Value |
FAA 4400-93 (01/23) &P
Tables
| Large Business Concern | |
| Small Business Concern | |
| Small Disadvantaged Business Concern | |
| Socially and Economically Disadvantaged Small Business (8(a) Certified) | |
| Woman Owned Small Business Concerns | |
| Service Disabled Veteran Owned Small Business Concerns | |
| Hubzone Small Business Concerns | |
| Veteran -Owned Small Business Concerns | |
| Historically Black Colleges and Universities (HBCU) and Minority Institutions (MI ) | |
| Alabama | AL |
| Alaska | AK |
| Arizona | AZ |
| Arkansas | AR |
| California | CA |
| Colorado | CO |
| Connecticut | CT |
| Delaware | DE |
| Florida | FL |
| Georgia | GA |
| Hawaii | HI |
| Idaho | ID |
| Illinois | IL |
| Indiana | IN |
| Iowa | IA |
| Kansas | KS |
| Kentucky | KY |
| Louisiana | LA |
| Maine | ME |
| Maryland | MD |
| Massachusetts | MA |
| Michigan | MI |
| Minnesota | MN |
| Mississippi | MS |
| Missouri | MO |
| Montana | MT |
| Nebraska | NE |
| Nevada | NV |
| New Hampshire | NH |
| New Jersey | NJ |
| New Mexico | NM |
| New York | NY |
| North Carolina | NC |
| North Dakota | ND |
| Ohio | OH |
| Oklahoma | OK |
| Oregon | OR |
| Pennsylvania | PA |
| Rhode Island | RI |
| South Carolina | SC |
| South Dakota | SD |
| Tennessee | TN |
| Texas | TX |
| Utah | UT |
| Vermont | VT |
| Virginia | VA |
| Washington | WA |
| West Virginia | WV |
| Wisconsin | WI |
| Wyoming | WY |
| American Samoa | AS |
| District of Columbia | DC |
| Federated States of Micronesia | FM |
| Guam | GU |
| Marshall Islands | MH |
| Northern Mariana Islands | MP |
| Palau | PW |
| Puerto Rico | PR |
| Virgin Islands | VI |
http://www.alaska.gov/http://www.hawaii.gov/http://www.idaho.gov/http://www.illinois.gov/http://www.in.gov/http://www.iowa.gov/http://www.kansas.gov/http://www.kentucky.gov/http://www.louisiana.gov/http://www.maine.gov/http://www.maryland.gov/https://az.gov/http://www.mass.gov/http://www.michigan.gov/http://www.mn.gov/http://www.ms.gov/http://www.mo.gov/http://www.montana.gov/http://www.nebraska.gov/http://www.nv.gov/http://www.nh.gov/http://www.nj.gov/http://www.arkansas.gov/http://www.newmexico.gov/http://www.ny.gov/http://www.nc.gov/http://www.nd.gov/http://www.ohio.gov/http://www.ok.gov/http://www.oregon.gov/http://www.state.pa.us/http://www.ri.gov/http://www.sc.gov/http://www.ca.gov/http://sd.gov/http://www.tennessee.gov/http://www.texas.gov/http://www.utah.gov/http://www.vermont.gov/http://www.virginia.gov/http://access.wa.gov/http://www.wv.gov/http://www.wisconsin.gov/http://www.wyo.gov/http://www.colorado.gov/http://www.asg-gov.com/http://www.dc.gov/http://www.visit-micronesia.fm/http://www.guam.gov/http://www.rmiembassyus.org/http://governor.gov.mp/http://www.visit-palau.com/http://pr.gov/http://www.usvi.net/http://www.ct.gov/http://www.delaware.gov/http://www.myflorida.com/http://www.georgia.gov/ Tab 3- Energy Savings
| Energy Savings | |
| Identify all Energy Savings initiatives to date by associated JCN and description. At the completion of the installation and prior to acceptance by the FAA, a detailed accounting of the energy savings must be submitted on the Energy Savings Information spreadsheet at the following link: https://www.faa.gov/other_visit/consultants_contractors/. If additional space is needed, contact the FAA POC on the Instructions tab for a supplemental Energy Savings sheet. | |
| Description | |
| JCN | Product/Technology to be Replaced |
FAA 4400-93 (01/23) &P
Tab 4 - Subcontracting
| August 12, 2024 | |||||||||
| Subcontracting | |||||||||
| Input the total dollars awarded to date on all first-tier subcontracts by socio-economic category, for each JCN. | |||||||||
| If additional space is needed, contact the FAA POC on the Instructions tab for a supplemental Subcontracting sheet. | |||||||||
| JCN | LARGE BUSINESS CONCERN | SMALL BUSINESS CONCERN | SMALL DISADVANTAGE BUSINESS CONCERN | WOMAN OWNED BUSINESS CONCERN | SOCIALLY AND ECONOMICALLY DISADVANTAGED BUSINESS CONCERN (8a) | SERVICE DISABLED VETERAN OWNED SMALL BUSINESS CONCERN | HUBZONE SMALL BUSINESS CONCERN | VETERAN OWNED SMALL BUSINESS CONCERN | HISTORICALLY BLACK COLLEGES AND UNIVERSITIES |
| TOTAL | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| % OF CONTRACT |
FAA 4400-93 (01/23) &P
Tab 5 - Jobs Creation
| August 12, 2024 | ||
| Jobs Creation | ||
| Identify the number of jobs created to date by JCN. If additional space is needed, contract the FAA POC on the Instructions tab for a supplemental Jobs Creation sheet. | ||
| JCN | Number of Jobs Created by Contractor | Number of Jobs Created by First Tier Subcontractors |
FAA 4400-93 (01/23) &P
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