CRHC20-22.pdf

REQUEST FOR QUOTATIONS

ffHIS IS NOT AN ORDER)

THIS RFQ !S A SMALL BUSINESS SET-ASIDE

PACE OF PACES

1of 2

I REQUEST NO

9RHC-20-22

2 DATE ISSUED

5t15t2020

3, REQUISITION/PURCHASE REQUEST NO 4 CERT FOR NAT DEF

UNDER BDSA REC 2

AND/OR DMS REG I

RATINC

5A, ISSUED BY

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

6. DELIVER BY fDate,/

See Schedule.

5b, FOR INFORMATION Cl\LL (NO COLLECT CALLS) 7 DELIVERY OTHER

X ros resrtN^rrcN a Gee schedute)

NAMI

Stephanie Charger stephanie.redelkd@ihs.eov

TELEPHON ] NUMBER 9- DESTINATION

AREA CODE

NUMBER

964-0507 a NAME OF CONSICNEE

Cheyenne River Service Unit 8 TO: b STREET ADDRESS

24276 1661h St , PO Box 1012 a NAME b COMPANY c C]TY

Eagle Butte c, STREET ADDRESS d CITY c STATE T ZIP CODE d, STATE

SD

e ZIP CODE

JIOZJ

1O PLEASE FURNISH QUOTAI]ONS TO

THE ISSUING OFFICE IN BLOCK

5a ON OR BY l:00 PM MST ON (Ddle,)

May 29,202Q uotations fumished are not offiers Ifyou are unable toquote. plcase so indicate on this form and retum itto the address Block5a. This requ€st does notcommit the Covcrnment to pay an-v cosls incurrcd in the prepamtion ofthe submission this quoratron or to contract for supplies or services $lpplies arc o-f

Ooa".ti"orig,n unt";r;therwise indicated by quoter. Any representatrons and/or ccrtifications atlached lo 15is Requcst for

Ouotalions must be completed by thequot€r'

I I scHFDtjl.E tlnclude anolicable FederuI, Slale snd local laxes)

ITEM NO,

(4, SUPPLIES/SERVICES(u)_ QUANTITY (c)

T]N IT

(d)

UNIT PRICE

tel

AMOUN'I

(0

Firm Fixed-Price, Blanket Purchase Agreement (BPA) for the Optical Fabrication of Spectacles and Spectacle Repair Services, for the

Cheyenne River Health Center, located in

Eagle Butte, SD. The award resulting from this solicitation will not obligate funds; funds must be obligated prior to starting performance through the issuance of a BPA Call No.

Contractor should perform in accordance with the Statement of Work See attached bid schedule.

The "Unit Price" is an all-inclusive cost. "All-inclusive cost" is defined to include all costs

Dertinent this blanket purchase ing, freight, travel, lo efits, etc.. ') r, nrcanl I!T FOR PROMPT a. tO C,q.lSnOan OAYS

b. 20

CALENDAR

DAYS%

c 30 CALENDAR DAYS o/.

d, CALI]NDAR DAYS

PAYMENT NIJMBER PERCENTAGE

15 DATE OF

QUOTATION

NnTF Addirional nrovision5 and tepresentauons ale I I are nol arrdsrrEq

| 3-.mM E-AN D ;DDFEssoF QUoTER I5 SIGNATURE OT PLKsUN AU I HUKIZT-U IV

SIGN QUOTATION

a NAME OF QUOTER b STREFT ADDRESS c COUNTY

I6 SIGNER

a NAME [YPe ofPrint) :LEPH(]Nt

AREA CODD

c TIl LE (type or Prinl) NUMBER d CITY e STATE f. ZIP CO]Jb rM 18 (REV AR (48 CFR 5l-215-l(a) editron not usable Prescribcd by GSA-FAR (48

ITEM

NO.

{a)

SUPPLI ES/SERVICES

(b)

QUANTITY

(cl

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(0

Items ordered against BPA will be delivered l4 days from placement oforder, unless otherwise agreed.

Delivery Address:24276 166'h St. Airport Rd, Eagle Butte, SD 57625.

The government anticipates awarding multiple BPA's from this solicitation.

Period of Performance will be a Base Year (BY) plus 4 additional/Option Years (OY), as follows:

BY : 7 I | 12020 - 6130 12021

OY r: '71112021 - 6130/2022

OY 2: 7 I 1 12022 - 6/30/2023

OY 3 :'l I | 12023 - 6130 12024

OY 4: '7 I | 12024 - 613012025

Attachments:

-Statement of Work -Pricing list -ProvisionVClauses, incorporated by full text and by reference.

-Past Performance Questionare

DUNS & Bradstreet Number:

uired Provided You do

I and obtain one ) .!?4

The quoter is hereby notified that they rnust be registered in the System for Award Management (SAM) before the Government will issue an award. You may do this by going to yvy.!4!l=gqy 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.oie.hhs. gov) throughout the duration of the contract.

Federal Tax ID Number:

Email Address:

Net Terms:

Statement of Work for Optical Fabrication Of Spectacles and Spectacle Repair Services for the Chevenne River Service Unit

Eagle Butte, SD

Background

The 0ptometry clinic at the cheyenne River Service unit, Eagle Butte, south Dakota is stafied by two full-time Optometrists whose mission is to provide full-scope, quality optometric services and spectacles to patien!s from the Cheyenne River

Service Unit.

The Eye Clinic's goal is to provide all school age children with a yearly eye exam and subsequent speciacles, if iequired, under the IHS Cheyerne River Service Unit

Student progiam. Adult patients receiving eye care at the Optometry Clinic are required to p.epay, in full, for their spectacles and need to secure eyewear at cost'

Purpose

The primary purpose of this Blanket Purchase Agreement is for the provision of first quality opticit fatrication on prescription fu- 1.1 auth^orized providers and the d"tiu"ry it "."of to the IHS Chlyenne River Eye Clinic. Contractor must maintain an

"a.qu"i" stock of optical ,uppli"t. Each branch or agent must be fully equipped to renaer co-pt"te l"ns surfu.ing, edging, frame repair services' etc'' in keeping with the terms and specifications of this contract'

Tasks

TheContractorshallprovidethefollowingservices/suppliestothelHSCheyenne River Eye Clinic:

1. Optical fabrication of spectacles at a contract cost provided by the Contractor on a fee schedule.

2. The provision ofa suitable spectacle case for each complete pair ofspectacles fabricated on authorized prescription and included in the above fee schedule'

3. Services will include the irovision ofappropriate frame catalogs' the IHS

Cheyenne River Eye Clinic may purchase, on consignment' sample frames'

These frames may be ordered on a prescription order form'

4. The delivery of dbricated spectacles will be 14 working days The contractor shall notifyihe Service Unit of any factory-delayed order'

5. Contractoi shall be required to conduct a minimum of one annual site visit to the IHS Cheyenne River Eye Clinic to:

a. lntroduce new products carried by the Contractor

b. Address ,ny..ul or potential problems in ordering/delivery against the contract

c. Maintain open communication between Service Unit and Contractor

Product Quality

Type of Lens

The Contractor shall furnish single vision, bifocal, trifocal, progressive or aphakic high quality corrected curve clear or tinted lenses, glass impact resistant or plastic, mounted in ophthalmic quality frames.

unless otherwise specified, lenses, materials, powers, and workmanship shall be in accordance with the American National Standards Institute (ANSI), ANSI 280.1-l9B7 . All glass ophthalmic lenses, with the exception of glass safety lenses will be chemically strengthened to comply with FDA regulation 21 CFR, Part 3 and 4, for impact resistanci, unless otherwise specified by the prescriber' Except for physical ch;racteristics of the material used, plastic lenses furnished under this contract must conform to the performance specifications for corrected curve lenses made of glass and the ANSI ZAO.1.-1-9AZ Shndard. such plastic lenses shall be made from ilard resin plastic. Safety eyewear will comply with AN Sl 287 .7'1989 standards.

Safety lenses will be edged with safety approved bevel, etched with letter "G" on upperoutsidecorner,h-eathardenedanddropballtested.Theprescriptionorder will be certified and initiated.

All school children will be provided with polycarbonate lenses unless the prescribing provider determines an individual prescription is not suited to ioiy.r.Uoi"t". The IHS will not authorize any tints or special coatings for school

.f,iiar"n unless medically-indicated and prescribed bythe provider' The base frame and lens cost will be limited to $31.g5 foi any prescription authorized by lHS, with overages based on medical necessity' Any additional lens, tint or frame charges will, be pafr by the patient, to the Contractor via money order, cashier's check' which will

Ue attacned to ihe prescription order form No cash will be accepted'

Guarantee

TheServiceUnitwillnotirytheContractorwithinoneyearafterdeliveryifanarticle furnished under this contract is found to be unsatisfactory due to defective workmanship and/or materials; the same shall be corrected' adjusted' or replaced' asnecessarybythecontractorwithoutadditionalcosttotheGovernment,andmake a"Liu".y in accordance with Part 7, above Contractor agrees that up tothree months from dite oforiginal spectacle prescription, 50olo ofcontract price will be charged when a patient I un"bl" to accept original prescription Contractor agrees that no less than 95% ofall prescription lenses ordered shall be free of imperfections or inaccuracies or be subject to consequent default'

Lens Certification

The Contractor shall return a copy ofthe complete spectacle prescription order with either manufacturer's lens envelope which contained the blank form from which the lens was fabricated, or an in-house laboratory form verifying the type ofproducts used in filling the spectacle prescription.

Substitution

If during the period ofthis contract any frames on contractor's fee schedule are discontinued, the contractor will be required to substitute another frame ofequal style and value.

Prescription Forms

Spectacles will be furnished by the Contractor up.on receipt of a properly completed prescriptionorderform.Prescriptionorderswillbernadeoncontractorapproved iorms, which are to be furnished by the Contractor' Each prescription form iszues shall identifli on its face the account number, which the prescription is ordered'

Other Stocked OPtical Material

The Government reserves the right to purchase from the Contractor any other stocked spectacle frames, parts, and lenses available from the company and not tp..in"a in the fee schedule, at a cost not to exceed laboratory prices' in lieu of any fiame, lenses, or parts specified in the fee schedule

Lab AccessibilitY

Contractor must have a minimum of one laboratory branch located within the

Aberdeen Area fcomprised of North Dakota, South Dakota' Iowa and Nebraska)'

Period of Performance

This contract shall begin at the time the contract is awarded and run through

September 30,2024 wirh oPtions'

Laboratory Qualifi cations

All fabrication servlces must be under the supervision of an American Board of

Opticianry [ABO) certified must.be designated to service the I servlce

Contractor agrees to trans concern ch and/or agenls, authorizing and instructi em to fu ies covered by the contract to the IHS activi overed t accordance with the conditions thereof'

P rivacy Act (F AR 52.22 4'21

Contractor will not maintain a system ofrecords on IHS patients; however, Contractor is bound by the Privacy Act of 1-974 in that no information regarding patient spectacle prescription may be released to any unauthorized individual. All release ofpatient information will be through the tHS Cheyenne River Service Unit's

Medical Record's Department.

Inspection and Acceptance - Fixed Price (FAR 52'246-4)(APR 1984)

Definitions. "services" as used in this clause, includes services performed, workmanship, and material furnished or utilized in the performance of services.

The Contractor shall provide and maintain an inspection system acceptable to the

Government covering the services under this conffact. complete records of all inspection work perfbrmed by the Contractor shall be maintained and made

"ujil"bl.

to the Government during contract performance and for as long afterwards as the contract requires.

The Government has the right to inspect and test all services called for by the contract, to the extent practicable at all times and places during the term of the contract.TheGovernmentshallperforminspectionsandtestsinamannerthatwill not unduly delay the work.

If any ofthe services do not conform to the contract requirements' the Government mayiequire the Contractor to perform the services again in conformity with the contract requirements, at no increase in contract amount' When the defects in services are unable to be corrected by re-performance, the Government may [1) require the Contractor to take necessary action to ensure that future performance conforms to contract requlrements and (2) reduce the contract price to reflect the reduced value of the services performed.

If the Contractor fails to promptly perform the services again or to take the necessary action to ensure future performance in conformity with contract requirements, the Government may (1) by contract or otherwise' perform the services and charge to the Contracioi in icost incurred by the Government that is directly related tJthe performance ofsuch service or (21 terminate the contract for default.

Ordering and Billing for Services Rendered

The Aberdeen Area Procurement 0fficer, upon identification of quality of q!antity and type of service, will prepare and issue to th-e laboratory a Blanket Purchase agi."t"tt (BPAJ which ouilines the terms of the contract' Each month of the contract,theProcurementofficerattheserviceUnitwillissuea.,call,,againstthis contract, citing the BPA number, each month of the contract period This submission ofthe "call" to the Contractor is required to prevent any delays in delivery or break in services.

Contractor's Billing close-out of each account will occur on the last working day of each month. Each statement submitted by the Contractor for payment shall bear the BPA number and an itemized listing ofeach item ordered. This list shall include: (1) the date the spectacle prescritdon was received at the laboratory; (2) the invoice number; (3J patient name; [4j a record ofany co-payment by the patient; (5] amount ofinvoice;

and [6) a running balance brought forward'

Any payments by the IHS shall be indicated on the contractor's statement by a line item entry with ih" dtt" of payment, month/year, and the amount of the payment subtracted from the balance brought forward. Any changes can be made by telephone or a credit/debit can be made on the next statement from the laboratory.

The contractor will return to the service unit Eye Clinic one billing set for each

"call" that us issued:

The Service Unit Eye Clinic should review each monthly statement submitter for a ,icall,,, make.o..".iion, and forward to the Project Officer. The Project Officer shall review, and appropriately process.

Payment Due Date (HHSAR 352'242-7 4')

Payments under this contract will be due on the 20th calendar day after the date of aciual receipt of a proper invoice in the office designated to receive the invoice'

Interest on Overdue PaYments

The Prompt PaymentAct, Public Law 97-177 (96Stat' 85' 31USC 1801) is

"ppfiJf" to payments under this contract and requires the payment to Contractors oi interest on-overdue payments and improperly taken discounts'

Reports

A Iist ofall outstanding unpaid spectacle orders shall be submitted monthly to:

Cheyenne River EYe Clinic 2427 6 766th Sveet Eagle Butte, SD 57 625 cRHC20-22

Cheyenne River Health Center Pricing/Bid Schedule

Vendors are to provide a full line of optical/spectacle supplies to meet the needs of the Optometry

Department of the Cheyenne River Health Center.

Approximately 1,400 - 2,ooo eyeglasses are anticipated to be ordered with a one(1) year time frame.

There will be peck periods, for example in September & October when school starts and it will be important for vendor to meet the delivery time frame.

This is not an all-inclusive list of supplies, vendors are encourage to supply a full description, with pricing, of what they can offer.

1) High power Charges

O SPHERE/CYLINDER

2) Transition Charges

TRANSITION

(PLASTIC/POLY AND GLASS LENSES)...'.-

EXTRA DARK

3) Bifocal cha rges:

r NO LINE o FT 28 o TRIFOCAL

4) Lens material (Prices):

o PLASTIC

O GLASS

o POLY o HIGH INDEX (THIN) ......'...'. S o HYPER INDEX (THINNER) '."..'..'..'......".".". S o THIN AND LIGHr (THINNEST) .'......'..'.....'...'... S

5) Coatings (offer):

o SCRATCH COAT

ANTI REFLECTION COATING

CRIZAL

MIRROR COATING

BLUE BLOCKER

6) Student package:

q s

7) Affordable adult Package:

cRHC20.22

8) Tint charges:

o solrD ................................. s o GRADIENT ................. s

9) Frame oversize charge: List pricing

10) Rimless/Drill Mount: List pricing

11) Prizm charges: List Pricing

12) Roll and polish: List pricing

13) Repair fees: List pricing.

Pate 2 ol2

Request For Quotel CRI1C20-22

CLAUSES INCORPORATED BY REFERENCE

(Firm Fixed-Price Serv ice-Commercial ltem)

FAR CITATION(S): 52.252-l: Solicitation Provision Incorporated by Reference. (FEB f998) & 52.252-2 Clauses

Incorporated by Reference (FEB f998) This solicitation & contract incorporates one or more solicitation provisions & clauses by reference, with the sarne fbrce and effect as if they were given in full text. Upon request, the Contracting Offrcer 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 ofthose provisions, the offeror may identify the provision by pu.ug.upi1 identifier and provide the appropriate information with its quotation or offer. Also, the full text ofa solicitation p.o.,rision & clauses may be accessed electronically at this/these address(es): httos://www.acquisition.gov/far

I. 52.204-7

2. 52.204-9

3. 52.204-t3

4. 52.204-16

5. 52.204-18

6. 52.204-t9

'7. 52.204-22

8. 52.2ll-6

9. 52.21t-t1 r 0. 52.212-l

I l. 52.212-4 t2. 52.215-5

13. 52.217-s

14. 52.223-6

15. 52.225-13

16. 52.229-3 t7. 52.232-l

18. 52.232-8

19. 52.232-18

Systern for Award Management

Personal Identity Verification of Contractor Personnel

System for Award Management Maintenance

Commercial and Government Entity Code Reporting

Commercial and Govemment Entity Code Maintenance

Incorporation by Reference of Representations and Certifications

Alternative Line Item Proposal

Brand Name or Equal

Delivery of Excess Quantities

Instructions to Offerors - Commercial Items

Contract Terms and Conditions - Commercial ltems

Facsimile Proposals

Evaluation of Options

Drug-Free Workplace

Restrictions on Certain Foreign Purchases

Federal, State, and Local Taxes

Payments

Discounts for PromPt PaYment

Availability ofFunds pase 1 orzz

Oct 2018

Janlutl

Oct 201 8

Jul 2016

Jul 2016

Dec 201 4

Jan 2017

Aug 1999

Sep 1989

Mar 2020

Oct 2018

Oct 1997

Jul 1990

May 2001

Jun 2008

Feb 2013

Apr 1984

Feb 2002

Apr 1984

Request For Quote/ CRHC20-22

20.

21.

22.

1A

25.

26.

27.

28.

29.

30.

52.232-33

52.232-39

52.232-40

52.233-l

52.243-l

52.244-6

52.246-2

52.246-16

52.247-34

52.249-l

52.249-8

52.253-1

Payment by Electonic Funds Transfer - System for Award Mgtm

Unenforceability of Unauthorized Obligations

Providing Accelerated Payments to Small Business Subcontractors

Disputes

Changes-Fixed-Price

Subcontracts for Commercial Items lnspection of Supplies-Fixed Price

Responsibility for Supplies

F.o.b. Destination

Termination for Convenience of the Govemment

Default (Fixed-Price Supply and Service) (Fixed-Price)(Short Form)

Computer Generated Forms

Oct 2018

Jun 2013

Dec 2013

IN{.ay 2014

Aug 1987

Aug 2019

Aug 1996

Apr 1984

Nov I 991

Apr 1984

Apr 1984

Jan l99lJt.

II. Federal Acquisition Regulations @AR) (48 CFR Chapter 1) Clauses in Full Text l.

z.

3.

4.

5.

6.

7.

52.204-l

52.211-8

\) ) t)-')

52.212-3

\) ) 1'r-\

52.2t7-9

{t )1r- I R

Approval ofContract

Time of Delivery

Evaluation-Commercial Iterns

Offeror Representation and Certifications

- Commercial Items

Contract Terms and Conditions Required to Implement

Statutes or Executive Orden - Commercial ltems

Option to Extend the Term ofthe Contract

Availability ofFunds

52,204-l -- ApProval of Contract.

PaCe 2 of 22

Dec l9E9

Irun 1997

Oct 2014

Mar 2020

Mar 2020

Mar 2000

Apr 1984

The Govemment will evaluate equally. as regards rime ofdelivery. o flers that propose delivery ofeach quantity within the applicable delivery period specified above. Offers that propose delivery that will not clearly fall within the appticaUte required deliveryperiod specified above, will be considered nonresponsive and rejected.

The Govemment reserves the ght to award under either the required delivery schedule or the proposed deliverv schedule. when an offeior ofl'ers an earlier delivery schedule than required above lf the offeror

Request For Quote/ CRHC20-22

This contract is subject to the written approval of the Contracting Officer and shall not be binding until so approved.

(End of Clause)

52.211-8 - Time of Delivery.

(a) The Govemment requires delivery.to be made according to the,following sch,edule:.

REQUIRED DELIVERY SCHEDULE

r [Contracting Officer insert specific detailsl

ITEM NO. QUANTITY WITHIN DAYS AFTER

DATE OF CONTRACT

: BPA Call Slip : BPA Call Slip IBPA Call Slip p.opor", no other delivery schedule, the required delivery schedule above will apply'

TTEMNa'.

'''t '-

QUANTTTY

OFFEROR'S PROPOSED DELIVERY SCHEDULE

wllrlll\ L,r.f\rJ f\r rDr\

DATE OF CONTRACT

WITHIN DAYS AT,'Th,R t- \_rl v\Jr\ r r\^v r nonresponsive and rejected.

(End of Clause)

52.212-2 -- Evaluation -- Commercial Items'

(a)t.heresultingfromthissolicitationtotheresporrsib|eofferorwhoseoffer contbrm advunta-g"ous to the Govemment' price and other factors considered The followin offers:

(i) Pctst Petformance

Page 3 of22 iut Att.ntion ii aGit"a to itte coni or acceptance of offer mailed, or other

Govemment will mail or olherwise award is dated. Therefore, the offeror should compute t actual date of award, rather than the date the written notice of award is received from the Contracting Officer ttrrougtr ttre ordinary mails. However, the Govemment will evaluate an offer that proposes delivery based on the

Contr-actor's date ofreceipt ofthe contract or notice ofaward by adding

(l) rdlnary malls' or

(2) or notice of award will be transmitted ele s weekends and U'S' Federal holidays') If' as so computed, the offered delivery date is later than the required delivery date' the offer will be considered

Request For Quotei CRHC20-22

(ii) Ability to meet specification requirements

(iii) Ability ro meet delivery schedule

(iv) Price Reasonableness (3%-5% variance in comparison with other quotes)

Govemment anticipate issuing up to two BPA (Blanket Purchase Agreement) awards from this solicitation. Technical and past performance, when combined, are approximately equal to cost or price.

(b) Options. The Govemment 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 ifthe option prices are significantly unbalanced. Evaluation of options shall not obligate the Govemment to exercise the option(s).

(cj A written notice of award or acceptance of an offer, mailed or otherwise fumished to the successfi,rl 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 Govemment 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 Certilications-Commercial ltems'

The Offeror shall complete only paragraph (b) ofthis provision if the Offeror has completed the annual representations and certification electronically in th" -Syit"r for Awaid Management (SAM) accessed through https:/iwww.sam.gov. If the Offeror has not completej the annual representations and cefiifications electronically, the Offeror shall complete only paragraphs (c) through (v)) of this provision.

(a) Definitions. As used in this provision- ,.bovered 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.

Economicilly disadvantaged women-owned small business (EDWOSB) concern means a small business concem that is at least 5l percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are iitizens ofthe United States and who are economically disadvantaged in accordance with t: CFn 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-

( l) Exacted from any person under the age of l8 und:r the menace ofany 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 meins the entity that owns or controls an immediate owner ofthe offeror' or that owns or controls one or more entities that controi an immediate owner ofthe offeror. No entity owns or exercises control ofthe highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control ofthe oft'eror. Indicators ofcontrol include, but are not limited to, on" oi n]o." of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the in-u".t"a aot.rti" corporation, means a foreign incorporated n ofan inverted domestic corporation under6 U.S.i.395(b), applied in accordance with th SC 395(c)'

Manufactured end product meani any end product in product and service codes (PSCs) 1000-9999' except- ( I ) PSC 5510, Lumber and Related Basic Wood Materials;

i2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

' Inedible;

Forestrv Products;

(8) PSC 9610, Ores;

iS) pSC qOZO, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials' Paqe 4 of22

Place ofmanufacture 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.

Predecessor means an entiry that is replaced by a successor and includes any predecessors of the predecessor, Restricted business operations means business operations in Sudan that include power production activities, rnineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment A ct of 2007 (Pub. L. I l0- 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-

( [ ) Are conducted under contract directly and exclusively with the regional govemment of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office ofForeign Assets Control in the Department ofthe Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist ofproviding goods or services to marginalized populations ofSudan;

(4) Consist ofproviding goods or services to an intemationally 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-

(l) 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 lran; or

(ii) To disrupt, monitor, or otherwise restrict speech ofthe people of lran; 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)ofthe International Emergency Economic Powers Act (50 u.s.c. 1702(bx3).

Service-disabled veteran-owned small business conce (l ) Means a small business concem-

(i) Not less than 5 I percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 5 I percent ofthe stock of which is owned by one or more service-disabled veterans; ano

(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 3 8 U.S.C. I 0l (2), with a disability that is serv ice connected, as defined in 38 U.S.C. l0l(16).

Small business concern means a concem, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Govemment contracts, and qualified as a small business under the criteria in l3 CFR Part l2l and size standards in this solicitation.

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

(l) Is at least 5l percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-

(i) One or more socially disadvantaged (as defined atl3 CFR 124.103) and economically disadvantaged (as defined at l3 CFR 124.104) individuals who are citizens ofthe United States; and

(ii) Each individual claiming economic disadvantage has a net wofth not exceeding $750,000 after taking into account the applicable exclusions set forth at I 3 CFRI24.l 04(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at l3.CFR 124.106) by individuals, who meet the criteria in paragraphs (l)(i) and (ii) ofthis definition.

Subsidiary means an entity in which more than 50 percent ofthe entity is owned-

(l ) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation

Pagc 5 of22

Request For Quotel CRHC20-22

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 ofthe responsibility of the successor for the liabilities ofthe predecessor may vary, depending on State law and specific circumstances.

Veteran-owned small business concem means a small business concern-

(l) Not Iess than 5l 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 5l percent ofthe 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) concem eligible under the WOSB Program (in accordance with 13 CFR patt

127), means a small business concem that is at least 5l 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 ofthe 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 ofany publicly owned business, at least5l percent ofthe 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)

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

(2) The offeior hasiompleted the annual representations and certifications electronically in SAM accessed through http:/iwww.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations aid certifications currently posted electronically at FAF.52.2l2-3, Offeror Representations and

Cirtifications-Commercial ltems, have been entered or updated in the last l2 months, are current, accurate, complete, and applicable ro this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this soiicitationy, at rhe time this offer is submitted and are incorporated in this offer by reference (see FAR 4 120 I )' except for

DaraqraDns' -tOff"r- to la.ntify tn" applicable paragraphs at (c) through (v) ofthis provision that the offeror has completed for the purposes of this solicitation only, if any.' ihese amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as ofthe date ofthis 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 SAMI

(c) Offerors must complete the following representations when the resulting contract will be performed in the United

States or its outlying areas. Check allthat apply.

(l ) SmalL buiiness concem. The offjror represents as part of its offer that it I is, o is not a small business concern i2i V"t"r*-o*n.d small business concem. [Complete only if the offeror represented itself as a small business

"on..rn in paragraph (c)(l) ofthis provision.l The offeror represents as part of its offer that it D is' o is not a veteran-owned small business concem.

(3) Service-disabled veteran-owned small business concern. [Complete onlyif the offeror represented itselfas a veteran-owned small business concem in paragraph (c)(2) ofthis provision.] The offeror represents as part of its offer that it tr is, n is not a service-disabled veteran-owned small business concem

(4) Small disadvantaged business concern. [Complete only if the offeror represented itselfas a small business

"on""-in paragraph (c)(l) ofthis provision.l The offerbr represents, that it tr is, c is not a small disadvantaged business concern as defined in l3 CFRl24.l002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business

.on".rn in p*ug.uph (c)(1) of this provision.l The offeror represints that it I is, n is not a women-owned small business concem.--"-'(e)wosgconcemeligibleunderthewosBProgram.[completeonlyiftheofferorrepresenteditselfasawomen-owned small business concern in paragraph (c)(5) ofthis pro' sents that-

(i) It o is, o is not a w1jsg ionce.n eligiule ona ptovided all the required documents to the WOSB Repository, and no change in circumstances een issued that affects its eligibility;

and Paee 6 of 22

(ii) It c is, a is not ajoint venture that complies with the requirements of l3 CFR parl 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 ofter small businesses that are participating in the joint venture: .l Each WOSB concem eligible under the WOSB Program participating in thejoint venture shall submit a separate signed copy ofthe WOSB representation.

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

(i) It r is, tr is not an EDWOSB concem, 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) lt o is, n is not ajoint venture that complies with the requirements of l3 CFR part 127, and the representation in paragraph (c)(7Xi) of this provision is accurate for each EDWOSB concem participating in thejoint venture. [The offeror shall enter the name or names ofthe EDWOSB concern and other small businesses that are participating in thejoint venture: .l Each EDWOSB concem participating in thejoint venture shall submit a separate signed copy ofthe 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 concem). fComplete only if the offeror is a women-owned business concem and did not represent itselfas a small business concem in paragraph (c)(l) ofthis provision.l The offeror represents that it D is a women-owned business concern.

(9) Tie bid priority for labor surplus area concems. Ifthis 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 ofthe contract price:

( l0) HUBZone small business concern. [Complete only if the offeror represented itselfas a small business concem in paragraph (c)(l) of this provision.l The offeror represents, as part of its offer, that-

(l) It o is, n is not a HUBZone small business concem listed, on the dale ofthis representation, on the List of

Qualified HUBZone Small Business Concems 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 l3 CFR Part 126; and

(ii) It o is, I is not a HUBZonejoint venture that complies with the requirements of l3 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concem participating in the HUBZonejoint venture. [The offeror shall enter the names ofeach ofthe HUBZone small business concerns participating in the lIUBZonejoint venture: .l Each HUBZone small business concern participating in the

HUBZonejoint venture shall submit a separate signed copy ofthe HUBZone representation.

(d) Representations required to implement provisions ofExecutive Orderl1246- ( I ) Previous contracts and compliance. The offeror represents that-

(i) It o has, . has not participated in a previous contract or subcontract subject to the Equal Oppoftunity clause of this solicitation; and

(ii) It n has, I has not filed all required compliance repofts.

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

(i) It n has developed und hu, on file, o 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 a has not previously had contracts ,ub.j".t to the written affirmative action programs requirement of the rules and regulations ofthe Secretary ofLabor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 http://uscode.house.gov/ U.S C. 1352).

l, pplies only ifthe con-tract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its kno*ledgs and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or a fficer or emplbyeeofany agency, a Member ofcongess, an officer or employee ofcongress o r of Congress on his or her behaif in connection with the award of any resultant contract. If a bbying disclosure Act of 1995 have made a lobbying contact on behalfofthe offeror with

Paee 7 of 22 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 ofthe 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-l,Buy American-Supplies, is included in this solicitation.)

(l) The offeror certifies that each end product, except those listed in paragraph (f)(2) ofthis provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products,i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) ofthe definition of "domestic end product." The terms "commercially available off-the-shelf (COTS) item" "component," "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 ofFAR part 25.

(c)

(l) 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.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(l)(ii) or (gXl)(iii) ofthis provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off+he-shelf (COTS) item," "component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free

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

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or

Peruvian End Products) or Israeli End Products:

Line ltem 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)( I)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-

Iiraeli Trade Act." The offeror shall list as other foreign end products those end products manufactured in the United

States that do not qualiry as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) ofthe definition of"domestic end product."

Other Foreisn End Products:

Line Item No.

Page 8 of22

Request For Quote/ CRtIC20-22

Line ltem No. Country of Origin

[List as necessary]

(iv) The Govemnent will evaluate offers in accordance with the policies and procedures of FAR part 25.

(2) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Altemate I. lf Altemate I to the clause at F AR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(l)(ii) for paragraph (g)(l)(ii) ofthe basic provision:

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

Canadian End Products:

Line ltem No.

IList as necessary]

(3) Buy American-Free Trade Agreementslsraeli Trade Act Certificate, Altemate II. If Alternate ll to the clause at

FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(tXii) for paragraph (g)(lXii) ofthe basic provision:

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

Canadian or lsraeli End Products:

Line ltem No. Country of Origin

[List as necessary]

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

(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-lsraeli 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

IList as necessary] lS; trade Agre#ents Certificate. (Applies only if the clause at FAFt 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (gX5)(ii) of this provision, is a

U.S.-made or designated country end product, ai defined in the clause ofthis 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:

Page a of22

Line ltem No. Country of Origin

[List as necessary]

(iii) The Govemment 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 ofthe Buy American statute. The Govemment 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 ofthe 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 beliel that the offeror and/or any of its principals-

(l) r Are, tr are not presently debaned, suspended, proposed for debarment, or declared ineligible for the award of conffacts by any Federal agency;

(2) I Have, r have not, within a three-year period preceding this offer, been convicted ofor had a civiljudgment 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 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;

(3) c Are, tr are not presently indicted for, or otherwise criminally or civilly charged by a Govemment entity with, commission ofany ofthese offenses enumerated in paragraph (h)(2) ofthis clause; and

(4) a Have, tr have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,500 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent ifboth ofthe following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined ifthere is a pending administrative orjudicial challenge. In the case ofajudicial challenge to the liability, the liability is not finally determined until alljudicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent ifthe 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) Examples.

(A) The taxpayer has received a statutory notice ofdeficiency, under I.R.C. $6212, which entitles the taxpayer to seek Tax

Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised alljudicial appeal rights.

(B) The IRS has filed a notice ofFederal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. $6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals conresting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing ln the course oflhe hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior oppoftunity to contest the Iiability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer tiik t"* "ourt

."uiew, this will not be a final ta-r liability until the taxpayer has exercised alljudicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. $6159. The taxpayer is making timely palments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(b) The taxpayer has filid for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under I I U.S'C $362 (he Bankn'rptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126) [The

Coniiacting Officer muit list in p"tug.uptt 1i;1t; any end products being acquired under this solicitation that are included in the List;fproducts Requiring Contrictor Cenification as to Forced or Indentured Child Labor, unless excluded at

22 1503(b)'l Pa,'e 10 ot 22

( 1) Listed end products.

Listed End Product Listed Countries ofOrigin

(2) Certification. [Ifthe Contracting Officer has identified end products…