Attachment J-2 ARQ.pdf

PDF 415 KB Posted

Attached to
Aviation Maintenance and Support Services (AMSS) Federal contract opportunity
Solicitation number
15F06724R0000230
Issued by
Department of Justice Federal Bureau of Investigation Headquarters Division

About this file

This document is a set of Acquisition Risk Questions (ARQ) that are part of Section K of a federal solicitation. The ARQ questions address foreign ownership, control, or influence (FOCI) over the organization responding to the solicitation. The questions cover details such as any foreign person or entity owning 5% or more of the organization, whether the organization owns 10% or more of a foreign interest, if non-U.S. citizens hold key positions, if any foreign person or entity can influence management decisions, and whether the organization has any contractual agreements, indebtedness, or income sources involving foreign interests. The organization is required to provide detailed responses to each question. This ARQ is related to a federal contract opportunity for Aviation Maintenance and Support Services (AMSS) to be provided to the Federal Bureau of Investigation's Critical Incident Support Group.

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Section K Acquisition Risk Questions

1. In the aggregate, does any foreign person own, or have any type of ownership of 5 percent or more in your organization in either a direct or indirect way?

If yes, please list all parents, both foreign and domestic, by name and address, through to the ultimate parent, to include percentage of ownership. This should include any and all foreign investments in the entity. Include country of origin. Include any special right or privileges involved in the ownership. Foreign person is defined as any foreign interest and any U.S. Person effectively owned or controlled by a foreign interest. Foreign interest is defined as any foreign government, to include any agency or representatives of that government; or any form of business or legally organized entity chartered or incorporated under the laws of any country other than the U.S. or its possessions; and any person who is not a citizen of the U.S.

2. Does your organization, either directly or indirectly, own 10 percent or more of a foreign interest?

________ (enter Yes or No)

If yes, please list all involved by name, address, and country, with percentage of ownership. Include the names of the personnel running the facilities.

3. Are there any non-U.S. citizens holding a position at the organization as either a corporate officer, member of the Board of Directors (or other similar governing body), or any other position such as executive / senior management personnel, partners, regents, or trustees? ________ (enter Yes or No)

Please list all corporate officers (Chairman of the Board, President, Chief Executive Officer, VicePresidents, Secretary, Treasurer, Chief Information Officer, Chief Financial Officer, and General Counsel), executive personnel (Facility Security Officer) and all other Board of Director members by full legal name, title, date and place of birth, Social Security Number, and citizenship.

Company Name: ________________________________________________________ Address: _______________________________________________________________ Date: _______________ Solicitation Number___________________________________________________

_______ (enter Yes or No)

4. Does any foreign person or entity have direct or indirect ability to influence or control the appointment or tenure of the Board of Directors (or similar governing body); any other management positions; or the direction, control, or decisions of the organization? ________ (enter Yes or No) control or influence.

5. Does the organization have any type of contractual agreement or understanding with any foreign interest?

________ (enter Yes or No)

This would include licenses, distributorships, contracts, purchase orders, sales agreements, etc. For each instance, provide the name of the foreign entity, its country, the percentage of gross income derived, and the nature of the involvement including what type of technology or product is involved, whether the product or service is either defense or nuclear related, whether classified or export controlled information is involved, and whether there is compliance with all U.S. export laws. If not defense or nuclear related, the listing of contracts can be done by listing similar equipment by country and percentage.

6. Does the organization have any indebtedness, liabilities, obligations, or act as a guarantor to any foreign interest?

If yes, give details concerning with whom the debt or guarantee is, where they are located, the conditions or covenants regarding the debt, and what collateral, if any, was pledged. If stock or assets are pledged, provide copies of the pertinent documents. Provide details on procedures for default of the loans. This answer must be answered affirmatively even if the entity holding the loan is a U.S. entity of a foreign institution.

7. In the last fiscal year, did the organization derive 5 percent or more of its income from one single foreign source, and/or more than 30 percent aggregately from numerous foreign sources?

If yes to either portion, please identify the sources from which the income is derived, to include name of entity, country, and percentage. Identify whether classified or export controlled information or technology is involved. If so, attach copies of licenses.

________ (enter Yes or No)

8.

beneficial owner, such

If yes, identify the foreign institutional investors by name, address, and percentage of securities owned. Indicate whether there have been any attempts to exert control or influence over management or policies of the organization.

If available, include SEC Schedules 13D or 13H.

9. Do any corporate officers (Chairman of the Board, President, Chief Executive Officer, Vice-Presidents, Secretary, Treasurer, Chief Information Officer, Chief Financial Officer, and General Counsel), executive personnel (Facility Security Officer) and all other Board of Director members) also hold any type of position with a foreign interest? ________ (enter Yes or No)

Identify by name, title, citizenship or immigration status, whether the individual holds a personnel security clearance or is excluded from access, each individual meeting this criteria. Also, identify the name and address of each organization with which the individual holds a position, and in what capacity.

10.Are there any other factors or issues that may indicate or show the possibility of foreign influence or control over the management of the organization that have not already been addressed?

If yes, please describe in detail the involvement of the foreign entity, as well as why it is not reportable in accordance with the previous questions.

Section K:
Address:
1 In the aggregate does any foreign person own or have any type of ownership of 5 percent or more in your:
possessions and any person who is not a citizen of the US 1:
possessions and any person who is not a citizen of the US 2:
possessions and any person who is not a citizen of the US 3:
2 Does your organization either directly or indirectly own 10 percent or more of a foreign interest:
the personnel running the facilities 1:
the personnel running the facilities 2:
the personnel running the facilities 3:
member of the Board of Directors or other similar governing body or any other position such as:
Social Security Number and citizenship 1:
Social Security Number and citizenship 2:
Social Security Number and citizenship 3:
tenure of the Board of Directors or similar governing body any other management positions or the:
control or influence 1:
control or influence 2:
control or influence 3:
5 Does the organization have any type of contractual agreement or understanding with any foreign interest:
similar equipment by country and percentage 1:
similar equipment by country and percentage 2:
similar equipment by country and percentage 3:
similar equipment by country and percentage 4:
interest:
affirmatively even if the entity holding the loan is a US entity of a foreign institution 1:
affirmatively even if the entity holding the loan is a US entity of a foreign institution 2:
affirmatively even if the entity holding the loan is a US entity of a foreign institution 3:
source andor more than 30 percent aggregately from numerous foreign sources:
so attach copies of licenses 1:
so attach copies of licenses 2:
1:
2:
enter Yes or No:
If available include SEC Schedules 13D or 13H 1:
If available include SEC Schedules 13D or 13H 2:
If available include SEC Schedules 13D or 13H 3:
personnel Facility Security Officer and all other Board of Director members also hold any type of:
organization with which the individual holds a position and in what capacity 1:
organization with which the individual holds a position and in what capacity 2:
control over the management of the organization that have not already been addressed:
accordance with the previous questions 1:
accordance with the previous questions 2:
accordance with the previous questions 3:
Company Name:
Company Name100:

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