COMPLETE RFQ PACKAGE-CRHC22-08.pdf

REQUEST FOR QUOTATIONS

(THIS IS NOT AN ORDER)

THIS RFQ IS IEE SMALL BUSINESS SET-ASIDE

PAGE OF PAGES

1. REQUEST NO.

CRHC22-08

2. DATE ISSUED

12/13/2021

3. REQUISITION/PURCHASE REQUEST NO.

IHS1442690

4. CERT.FOR NAT. DEF.

UNDER BDSA REG.2

AND/OR DMS REG. 1

RATING

5A. ISSUED BY

Eagle Butte Indian Health Service, Cheyenne River Service Unit 24276 166th St, PO Box 1012, Eagle Butte, SD 57625

6. DELIVER BY (Date)

See schedule

5b. FOR INFORMATION CALL (NO COLLECT CALLS) 7. DELIVERY OTHER

FOB DESTINATION (See Schedule)

NAME

Colbee Woodward

Colbee.woodward@ihs.gov

TELEPHONE NUMBER 9. DESTINATION

AREA CODE

NUMBER

964-1566

a. NAME OF CONSIGNEE

Cheyenne River Service Unit

8. TO: b. STREET ADDRESS

24276 166th St , PO Box 1012

a. NAME

b. COMPANY

c. CITY

Eagle Butte

c. STREET ADDRESS

d. CITY

e. STATE

f. ZIP CODE

d. STATE

SD

e. ZIP CODE

57625

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK

5a ON OR BY 1:00 PM MST ON (Date)

December 22nd, 2021

IMPORTANT: This is a request for information, and quotations furnished are not offiers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for

Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

**Buy Indian Set Aside** Firm Fixed Price

Purchase Order for replacement of the roll up fire door for the Cheyenne River Health Center, Eagle

Butte, SD. Price is all inclusive. See Attached PWS.

See Specification Sheet and SOW

12. DISCOUNT FOR PROMPT

PAYMENT

a. 10 CALENDAR DAYS

b. 20

CALENDAR

DAYS%

c. 30 CALENDAR DAYS

d. CALENDAR DAYS

NUMBER

PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER 15. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

15. DATE OF

QUOTATION a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY 16. SIGNER

a. NAME (Type of print)

b. TELEPHONE

AREA CODE

d. CITY e. STATE f. ZIP CODE

c. TITLE (type or print) NUMBER

AUTHORIZED FOR LOCAL REPRODUCTION FormFlow/Delrina Inc. STANDARD FORM 18 (REV 6-95) Previous edition not usable Prescribed by GSA-FAR (48 CFR) 53-215-1(a) mailto:Colbee.woodward@ihs.gov

ITEM

NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

DUNS & Bradstreet Number:

(The Duns & Bradstreet number is required.

Provided you do not have it, you may call 866-705-

5711 and obtain one.) You will need a DUNS &

Bradstreet NUMBER to be awarded the purchase order and registered with the System for Award

Management; you can register at www.sam.gov

The quoter is hereby notified that they must be registered in the System for Award Management

(SAM) before the Government will issue an award. You may do this by going to www.sam .gov to register and you are required to update this registration every year prior to the expiration date.

No contract award shall be made to a vendor listed on the OIG Exclusion List

(http://exlusions.oig.hhs.gov) throughout the duration of the contract.

Federal Tax ID Number:

Email Address:

Net Terms:

http://exlusions.oig.hhs.gov/

SCOPE OF WORK/SPECIFICATIONS

THIS IS A BRAND NAME OR EQUAL PURCHASE

DESCRIPTION

Item #1

Quantity – 1 ea.

Cookson ERD10 Fire Door

Opening Width – 7 foot 7 inches

Opening Height – 9 foot

UL Classified to – ANSI/UL 10B and CAN/ULC-

S104

Curtain Material and Finish – Galvanized steel with GalvaNex coating system. Color - Gray

Bottom Bar Material and Finish – Structural steel, polyester powder coating. Color – Gray

Guides Material and Finish – Structural steel, polyester powder coating. Color – Gray

Hood Material and Finish – Galvanized steel with GalvaNex coating system. Color – Gray

Plain Steel Material and Finish – Polyester powder coating. Color – Gray

22 gauge interlocking slats with galvanized endlocks

Three button push button station “Open – Close

– Stop” in NEMA 1 enclosure, surface mount.

Electric sensing edge with SJO coil cord.

1/3 HP AlarmGard FS-31 failsafe operator, UL listed. Operator includes open drip proof motor removable without resetting limit switch. UL listed thermal overload protection, electric brake and rotary limit switches, transformer with 24 volt control secondary: all components pre-wired to terminal block.

Current Characteristics – 120V 1PH 60Hz

3 Hour UL Fire Rated

Shipping/Freight

No shipping charge – Shipping included.

Total: $_____________

STATEMENT OF WORK

Replacement of Roll-Up Fire Door

PURPOSE

The purpose of this project is to replace the roll-up fire door between the Emergency Room and EMS ambulance bays in the Cheyenne River Health Center. The replacement of this door with all electric operating components will increase safety for Maintenance staff when testing and resetting this door and reduce the risk of injury for Maintenance staff when testing and resetting this door.

SCOPE

The contractor shall provide all labor, materials, transportation and supplies required to complete the following work:

1. Removal of existing roll-up fire door.

The existing roll-up fire door and all mounting components will need to be removed and disposed of by contractor.

Any damage to sheetrock, walls, and/or building framework that occurred during removal of roll-up fire door will need to be repaired to match surrounding surfaces.

Scheduling shall include close coordination with the facility departments.

2. Prepare door frame and opening.

The door frame and opening will need to be properly prepared for the installation of the new roll-up fire door.

Any holes in sheetrock, walls, and building framework that are not used by new roll-up fire door will need to be patched and painted to match surrounding surfaces.

3. Install new roll-up fire door.

Install new roll-up fire door to manufacturer’s specifications.

Wiring must be completed to code.

Ensure that fire door operates properly with fire alarm system and fire alarm heat detector on ambulance bay side of door as well as fire alarm heat detector in alcove on Emergency Room side of door.

Ensure that door operates properly with three button push button station.

Ensure that electrical sensing edge is functioning properly.

Repair ceiling tile grid as necessary to ensure proper fit of new roll-up fire door.

Replace all ceiling tiles that were damaged or need replaced to accommodate the installation of new roll-up fire door.

Ensure that all penetrations are performed with the use of fire stopping grommets with a minimum of 2 hour fire rating or EZ Path fire-rated pathway or equivalent with a minimum of 2 hour fire rating.

CLEAN UP

The construction area involved shall be free of debris, rubbish, left over material, and scraps upon completion of this project. The Facility Manager or designee will inspect the site prior to final payment to ensure the site is returned to its original condition prior to repairs.

The Contractor shall minimize interference to the function of the ambulance bay during repairs. During repairs, any resulting power shut downs or ambulance bay shut downs shall be scheduled with a 1-day notice prior to the shutdown to allow the

Cheyenne River Health Center to plan accordingly.

HOURS OF OPERATION/PERIOD OF PERFORMANCE

The hours of operation will be 8:00 AM to 5:00 PM, Monday through Friday.

Any work conducted outside of the scheduled operation time must be approved by the Facility Manager with ample notification. The period of performance allotted for this project shall be 60 days from the notice to proceed.

CONTRACTING OFFICER’S REPRESENTATIVE

Stephanie Charger – (605) 964-0507

NOTICE TO QUOTERS

REQUEST FOR QUOTES (RFQ): CRHC22-08

QUOTE DUE DATE: Quotes are due December 22nd, @ 1:00 PM MST

RETURN RFQ TO: Cheyenne River Service Unit

Attn: Colbee Woodward

PO Box 1012

Eagle Butte, SD 57625

Telephone: 605-964-7724 Ext. 1566

Fax: 605-964-7737

GENERAL DESCRIPTION:

** Buy Indian Set Aside** Firm Fixed Price, Purchase Order, for replacement of roll up fire door at the

Cheyenne River Health Center located in Eagle Butte, SD. The Delivery: 60 days after ARO. The quoted “unit price” shall be an all inclusive price.

This RFQ is issued as an IEE 100% Small Business Set Aside and the associated NAICS code is 332321 with a small business size standard of 750 employees.

BASIS FOR AWARD:

LPTA: (a) The Government will award one or more contracts resulting from this solicitation to the responsible offeror(s) whose offer, conforming to the solicitation, is the Lowest Price Technically Acceptable (LPTA). To be considered technically acceptable, offerer must submit proof of minimum qualification outlined in the

Performance Work Statement. LPTA factors in determining the successful contractor:

1. Provide Brand Name or Equal Items listed in the Specification Sheet/Price Schedule

2. Complete/Submit Indian Health Service Buy Indian Act Indian Firm Representation Form

3. Meet the Delivery Schedule. Provide proof of ability to meet Delivery Schedule.

Contractor must be registered with the System for Award Management. The website to register is at:

www.sam.gov

INSTRUCTION TO QUOTERS:

To be considered an acceptable quote, the following items must be completed and returned by the due date stated above.

1. Complete and sign SF-18 – Request for Quotation (Signature required)

2. Complete Taxpayer Identification Form (FAR Part 52.204-3 – Taxpayer Identification)

3. Complete Annual Representations & Certifications form (FAR 52.212-5)

4. Indian Health Service Buy Indian Act Indian Firm Representation Form http://www.sam.gov/

ATTACHMENTS:

1. SF-18 Request for Quotations

2. Notice to Quoters

3. Scope of Work

4. Clauses incorporated by reference

5. Clauses incorporated in full text

6. Representations and Certifications

7. Indian Health Service Buy Indian Act Indian Firm Representation Form

Questions in regards to this solicitation shall be submitted in writing by email to

(Colbee.Woodward@ihs.gov). The last day to submit questions is December 20th, 2021, 1:00pm, MST.

ACCEPTANCE PERIOD: Your quote must stipulate that it is predicated upon all the terms and conditions of this Solicitation. In addition, it must contain a statement to the effect that it is firm for a period of at least 60 days from the date of receipt by the Government.

NO CONTRACT AWARD SHALL BE MADE TO ANY VENDOR OR PROVIDER LISTED ON THE OIG

EXLUSION LIST http://exlusions.oig.hhs.gov THROUGHOUT THE DURATION OF THE CONTRACT. IT

SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO NOTIFY THE ACQUISITION

OFFICIAL IF THERE IS A CHANGE IN PROVIDER.

SECURITY

Performance of this contract will require access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee are favorable.

The Contractor, at his discretion, is responsible for completing investigations and background checks for all employees, including sub-contractors and their employees that perform work under this contract at the physical job site. The contractor is responsible for any and all actions of prime contractor and sub-contractor employees

(at any tier) permitted access to the job site during the performance of work under this contract. The contractor is responsible to ensure all employees’ access is limited to authorized work zones.

The employees of the Contractor or its subcontractors, during their performance on-site will be accompanied by an IHS employee the entire time they are on-site.

The Contractor assumes responsibility for all damage or injury to persons or property occasioned through the use, maintenance, and operation of the Contractor’s vehicles or other equipment by, or the action of, the

Contractor or the Contractor’s employees and agents. The Contractor assumes responsibility for any and all damage and/or injury to persons or property resulting from any action of prime contractor and subcontractor employees (at any tier).

The Contractor, at the Contractor’s expense, shall maintain adequate public liability and property damage insurance during the continuance of this contract, insuring the Contractor against all claims for injury or damage.

The Contractor shall maintain Workers’ Compensation and other legally required insurance with respect to the

Contractor’s own employees and agents.

http://exlusions.oig.hhs.gov/

The Government shall in no event be liable or responsible for damage or injury to any person or property occasioned through the use, maintenance, or operation of any vehicle or other equipment by, or the action of, the Contractor or the Contractor’s employees and agents in performing under this contract, and the Government shall be indemnified and held harmless against claims for damage or injury in such cases.

In accordance with Indian Health Service Circular No. 19-05, that all Indian Health Service (IHS) health care providers, including (but not limited to) employees, volunteers, and CONTRACTORS shall review, Chapter 20

– Protecting Children from Sexual Abuse by Health Care Providers (Policy can be found at https://www.ihs.gov/ihm/pc/part-3/p3c20/) and review the training titled, “Child Sexual Abuse Briefing-IHS

June 2019 (Training slides are available at Orientation or Contact the Contacting Officer).

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov.

All required information must be submitted in order to be considered responsive and eligible for award.

https://www.ihs.gov/ihm/pc/part-3/p3c20/

DEPARTMENT OF HEALTH & HUMAN SERVICES

Indian Health Service Division of Acquisition Policy (DAP)

5600 Fishers Lane Rockville, MD 20857

INDIAN HEALTH SERVICE

BUY INDIAN ACT

INDIAN FIRM REPRESENTATION FORM

SOLICIATION NUMBER: _________________________________________________

PROJECT TITLE: ________________________________________________________

DATE: ___________________________________________________________________

In accordance with 25 U.S.C. 47 the Buy Indian Act, the signature below constitutes self-certification that the Offeror meets the definition of an “Indian Firm” (HHSAR 326.602) with “Indian Ownership” (HHSAR 326.603), in response to this solicitation and resultant contract.

The enterprise must meet the definition of “Indian Firm” throughout the following time periods:

(1) At the time an offer is made in response to this solicitation;

(2) At the time of contract award; and

(3) During the full term of the contract performance period. At any point during these periods, if the Contractor no longer meets the eligibility requirements, the contractor must provide immediate written notification to the Contracting Officer.

Individual Contracting Officers may require documentation of eligibility before awarding a set-aside or sole source contracts under the Buy Indian Act and awards may be subject to protest if the eligibility of the successful Offeror is in question. In addition to the self-certification requirements, successful Offerors must also be registered with DUN and Bradstreet (D&B) and the System of Award Management (SAM).

Any false or misleading information submitted by an enterprise when submitting an offer in consideration of an award set-aside under the authority of the Buy Indian Act is a violation of the law and punishable under 18 U.S.C. 1001.

False claims submitted as part of contract performance are subject to the penalties enumerated in 31 U.S.C. 3729 to 3731 and 18 U.S.C. 287.

REPRESENTATION

The Offeror represents as part of its offer that it does _____, does not _____ meet the definition of an “Indian Firm” with “Indian Ownership” under the authority of the Buy Indian Act.

Business Name Certifying Signature

DUNS Number Print Name

CRHC 22-08

CLAUSES INCORPORATED BY REFERENCE

(Firm Fixed-Price Service-Commercial Items)

FAR CITATION: 52.252-1: Solicitation Provision Incorporated by Reference. (FEB 1998)

This solicitation incorporates one or more solicitation provisions by reference, with the same force and defect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): https://www.acquisition.gov/?q=browsefar

I. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses

No. FAR Citation Clause Title Clause Date_______

1. 52.204-7 System for Award Management (P) Oct 2018

2. 52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011

3. 52.204-13 System for Award Management Maintenance Oct 2018

4. 52.204-16 Commercial and Government Entity Code Reporting Aug 2020

5. 52.204-18 Commercial and Government Entity Code Maintenance Aug 2020

6. 52.204-21 Basic Safeguarding of Covered Contractor Information Systems Nov 2021

7. 52.212-1 Instructions to Offerors – Commercial Items Nov 2021

8. 52.212-4 Contract Terms and Conditions - Commercial Items Nov 2021

9. 52.215-5 Facsimile Proposals Oct 1997

10. 52.217-5 Evaluation of Options Jul 1990

11. 52.222-3 Convict Labor Jun 2003

12. 52.222-26 Equal Opportunity Sep 2016

13. 52.222-41 Service Contract Labor Standards Aug 2018

14. 52.222-43 Fair Labor Standards Act and Service Contract Labor Standards Aug 2018

15. 52.222-44 Fair Labor Standards Act and Service Contract Act-Price Adjustments May 2014

16. 52.222-55 Minimum Wage Under Executive Order 13658 Nov 2020

17. 52.223-5 Pollution Prevention and Right-To-Know Information May 2011

18. 52.223-6 Drug-Free Workplace May 2001

19. 52.224-1 Privacy Act Notification Apr 1984 https://www.acquisition.gov/?q=browsefar

20. 52.224-2 Privacy Act Apr 1984

21. 52.225-13 Restrictions on Certain Foreign Purchases Feb 2021

22. 52.232-1 Payments Apr 1984

23. 52.232-8 Discounts for Prompt Payment Feb 2002

24. 52.232-18 Availability of Funds Apr 1984

25. 52.232-25 Prompt Payment Jan 2017

26. 52.232-33 Payment by Electronic Funds Transfer – System for Award Mgtm Oct 2018

27. 52.232-39 Unenforceability of Unauthorized Obligations Jun 2013

28. 52.232-40 Providing Accelerated Payments to Small Business Subcontractors Nov 2021

29. 52.233-1 Disputes May 2014

30. 52.233-3 Protest After Award Aug 1996

31. 52.233-4 Applicable Law for Breach of Contract Claim Oct 2004

32. 52.237-1 Site Visit (P) Apr 1984

33. 52.237-2 Protection of Government Buildings, Equipment and Vegetation Apr 1984

34. 52.237-3 Continuity of Services Jan 1991

35. 52.237-7 Indemnification and Medical Liability Insurance Jan 1997

36. 52.242-15 Stop-Work Order Aug 1989

37. 52.243-1 Changes-Fixed-Price Aug 1987

38. 52.244-6 Subcontracts for Commercial Items Nov 2021

39. 52.246-4 Inspection of Services – Fixed-Price Aug 1996

40. 52.249-1 Termination for Convenience of the Government Apr 1984

41. 52.249-8 Default (Fixed-Price Supply and Service) Apr 1984

42. 52.253-1 Computer Generated Forms Jan 1991

II. Federal Acquisition Regulations (FAR) (48 CFR Chapter 1) Clauses in Full Text

No. FAR Citation Clause Title Clause Date_______

1. 52.204-3 Taxpayer Identification (P) Oct 1998

2. 52.212-2 Evaluation-Commercial Items Nov 2021

3. 52.212-3 Offeror Representation and Certifications Nov 2021

- Commercial Items

4. 52.212-5 Contract Terms and Condition Required to Implement Nov 2021

Statutes or Executive Orders - Commercial Items

5. 52.216-18 Ordering Aug 2020

6. 52.217-8 Option to Extend Services Nov 1999

52.204-3 Taxpayer Identification

As prescribed in 4.905, insert the following provision:

TAXPAYER IDENTIFICATION (OCT 1998)

(a) Definitions.

“Common parent,” as used in this position, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.

“Taxpayer Identification Number (TIN),” as used in this provision, means the number required by the

Internal Revenue Service (IRS) to be used by the offeror in reporting income tax and other returns. The

TIN may be either a Social Security Number or an Employer Identification Number.

(b) All offerors must submit the information required in paragraphs (d) through (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C.

6041, 4051A, and 6050M, and implementing regulations issued by the IRS. If the resulting contract is subject to the payment reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract.

(c) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror’s relationship with the Government (31 U.S.C. 7701©(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror’s TIN.

(d) Taxpayer Identification Number (TIN)

TIN:

TIN has been applied for.

TIN is not required because:

Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

Offeror is an agency or instrumentality of a foreign Government;

Offeror is an agency or instrumentality of the Federal Government.

(e) Type of organization.

Sole proprietorship;

Partnership;

Corporate entity (not tax-exempt);

Corporate entity (tax-exempt);

Government entity (Federal, State, or local);

Foreign government;

International organization per 26 CFR 1.6049-4;

Other ;

(f) Common parent.

Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

Name and TIN of common parent:

Name

TIN

(End of provision) 52.212-2 -- Evaluation -- Commercial Items.

As prescribed in 12.301(c), the Contracting Officer may insert a provision substantially as follows:

EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

________________________________________________[Contracting Officer shall insert the significant evaluation factors, such as (i) technical capability of the item offered to meet the Government requirement; (ii) https://www.acquisition.gov/far/12.301#FAR_12_301 price; (iii) past performance (see FAR 15.304); and include them in the relative order of importance of the evaluation factors, such as in descending order of importance.]

Technical and past performance, when combined, are __________ [Contracting Officer state, in accordance with FAR 15.304, the relative importance of all other evaluation factors, when combined, when compared to price.]

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the

Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

52.212-3 Offeror Representations and Certifications-Commercial Items.

As prescribed in 12.301(b)(2), insert the following provision:

OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

(NOV 2021)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v)) of this provision.

(a) Definitions. As used in this provision—

"Covered telecommunications equipment or services" has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

Forced or indentured child labor means all work or service— https://www.acquisition.gov/far/15.304#FAR_15_304 https://www.acquisition.gov/far/15.304#FAR_15_304 https://www.acquisition.gov/far/12.301#FAR_12_301 https://www.sam.gov/ https://www.acquisition.gov/far/52.204-25#FAR_52_204_25

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

Inverted domestic corporation, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6

U.S.C. 395(c).

Manufactured end product means any end product in product and service codes (PSCs) 1000-9999, except—

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the

Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title6-section395&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title6-section395&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title6-section395&num=0&edition=prelim

Predecessor means an entity that is replaced by a successor and includes any predecessors of the predecessor.

Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for

Certain Telecommunications and Video Surveillance Services or Equipment.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the

Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern

Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the

Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended."Sensitive technology"—

Sensitive technology—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3)of the International Emergency Economic

Powers Act (50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business concern—

(1) Means a small business concern—

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and https://www.acquisition.gov/far/52.204-25#FAR_52_204_25

(ii) The management and daily business operations of which are controlled by one or more service-disabled veteransor, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service connected, as defined in 38 U.S.C. 101(16).

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR part 121 and size standards in this solicitation.

(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.

Small disadvantaged business concern, consistent with13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that—

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—

(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR

124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation

Successor means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term "successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

Veteran-owned small business concern means a small business concern— http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section101&num=0&edition=prelim http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title38-section101&num=0&edition=prelim

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C.

101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States.

Women-owned small business concern means a small business concern—

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

(b)

(1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror

Representations and Certifications-Commercial Products and Commercial Services, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

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.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it □ is, □ is not a small business concern.

http://www.sam.gov/ https://www.acquisition.gov/far/52.212-31#FAR_52_212_3 https://www.acquisition.gov/far/4.1201#FAR_4_1201

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, that it □ is, □ is not a small disadvantaged business concern as defined in 13 CFR124.1002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is, □ is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that-

(i) It □ is, □ is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the

WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture:

__________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that-

(i) It □ is, □ is not an EDWOSB concern, has provided all the required documents to the WOSB

Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: __________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph

(c)(1) of this provision.] The offeror represents that it □ is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:____________________________________

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that–

(i) It □ is, □ is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It □ is, □ is not a HUBZone joint venture that complies with the requirements of 13 CFR Part

126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the

HUBZone small business concerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the

HUBZone representation.

(d) Representations required to implement provisions of Executive Order11246-

(1) Previous contracts and compliance. The offeror represents that-

(i) It □ has, □ has not participated in a previous contract or subcontract subject to the Equal

Opportunity clause of this solicitation; and

(ii) It □ has, □ has not filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that-

(i) It □ has developed and has on file, □ has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or

(ii) It □ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions

(31 http://uscode.house.gov/ U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or http://uscode.house.gov/browse.xhtml;jsessionid=114A3287C7B3359E597506A31FC855B3 employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a

Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-

1, Buy American-Supplies, is included in this solicitation.)

(1)

(i) The Offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product.

(ii) The Offeror shall list as foreign end products those end products manufactured in the United

States that do not qualify as domestic end products.

(iii) The terms "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Supplies."

(2) Foreign End Products:

Line Item No. Country of Origin

[List as necessary]

(3) The Government will evaluate offers in accordance with the policies and procedures of

FAR part 25.

(g)

(1) Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if the clause at

FAR 52.225-3, Buy American-Free Trade Agreements-Israeli Trade Act, is included in this solicitation.)

https://www.acquisition.gov/far/52.225-1#FAR_52_225_1 https://www.acquisition.gov/far/52.225-1#FAR_52_225_1 https://www.acquisition.gov/far/part-25#FAR_Part_25 https://www.acquisition.gov/far/52.225-3#FAR_52_225_3

(i)

(A) The Offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (iii) of this provision, is a domestic end product.

(B) The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,"

"domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade

Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

(ii) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli

Trade Act."

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country of Origin

[List as necessary]

(iii) The Offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free

Trade Agreements-Israeli Trade Act." The Offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products.

Other Foreign End Products:

Line Item No. Country of Origin

[List as necessary]

(iv) The Government will evaluate offers in accordance with the policies and procedures of

FAR part 25.

(2) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Canadian End Products:

Line Item No.

[List as necessary]

(3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli

Trade Act":

https://www.acquisition.gov/far/part-25#FAR_Part_25

Canadian or Israeli End Products:

[List as necessary]

(4) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli

Trade Act":

Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country of Origin

[List as necessary]

(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled

"Trade Agreements."

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products:

Line Item No. Country of Origin

[List as necessary]

(iii) The Government will evaluate offers in accordance with the policies and procedures of

FAR part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The

Government will consider for award only offers of U.S.-made or designated country end products unless the

Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals–

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

(2) □ 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 Federal, state or local government contract or subcontract; violation of

Federal or state antitrust statutes relating to the submission of offers; or…