Exhibit P FAR 52.204-24 Representation Digital Rev 10 20. FAR 52.204-24 Representation Digital Rev 10 20.pdf

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Attached to
X1DZ--Space for Lease at Ashtabula, OH for a CBOC 16, 218 RSF/ 13, 815 ABOA/ 12, 013 NUSF
Solicitation number
36C24424R0066
Issued by

About this file

This document is a Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment form (FAR 52.204-24) related to a lease solicitation for the Department of Veterans Affairs. The form addresses prohibitions under the John S. McCain National Defense Authorization Act regarding the use of covered telecommunications equipment or services. Specifically, the document requires the offeror to disclose whether they will provide or use covered telecommunications equipment or services, with restrictions on equipment from certain manufacturers that may pose national security risks.

The solicitation (RLP NO. 36C24424R0066) is for a lease space in Ashtabula, OH for a Community-Based Outpatient Clinic (CBOC), with the total space requirements of 16,218 RSF (Rentable Square Feet), 13,815 ABOA (Assignable Building Area), and 12,013 NUSF (Net Usable Square Feet). The form mandates that offerors review the System for Award Management (SAM) for excluded parties and provide detailed disclosures about any covered telecommunications equipment or services they intend to use, including the producer, equipment description, and proposed use.

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Other files

File Type Posted
Questions_Answers 2. Ashtabula.pdf PDF
36C24424R0066 0003.pdf PDF
36C24424R0066_4.docx DOCX document
Exhibit D-1 VA Provision Addendum Alternate Protest Procedure - Real Property Lease Procurements.pdf PDF
Attachment 1. Ashtabula OH Pre-Proposal Presentation.pdf PDF
Exhibit M-Tenant-Improvements-Cost-Summary--TICS--Table--Oct-2024-.xlsx XLSX spreadsheet
Attachment 2. Questions_Answers. Ashtabula.pdf PDF
36C24424R0066_3.docx DOCX document
36C24424R0066 0002.pdf PDF
Attachment 1 Pre-Proposal Meeting- Ashtabula OH.pdf PDF
36C24424R0066 0001.pdf PDF
Attachment 2. Questions_Answers. Ashtabula OH.pdf PDF
36C24424R0066_2.docx DOCX document
Exhibit B. Agency Specific Requirements Ashtabula CBOC.pdf PDF
Attachment 1. Past Performance Questionnaire. Ashtabula County, OH.pdf PDF
Exhibit I Building Security Unit Price List FSL II Jun. 2022.xlsx XLSX spreadsheet
Exhibit O Government Typical Layout.pdf PDF
EXHIBIT R SPACE PLAN - DEFINING SPACE REQUIREMENT.pdf PDF
Exhibit G. Form 1217 - Lessor_s Annual Cost Statement.pdf PDF
Exhibit H Prelease FPLS Evaluation Form 12000 Part A Part B May 2015.pdf PDF
Exhibit C VA LEASE SECURITY REQUIREMENTS FOR FSL II.pdf PDF
Exhibit D 3516 Solicitation Provisions Oct. 2023.pdf PDF
Global Request for Lease Proposal RLP R100 March 2025- Ashtabula CBOC Final.pdf PDF
36C24424R0066_1.docx DOCX document
Exhibit E 3517B General Clauses Oct. 2023.pdf PDF
Exhibit J DOL Wage Determination.pdf PDF
Exhibit N - Contract Submittal Schedule.pdf PDF
Exhibit L - Unit Price List.xlsx XLSX spreadsheet
Exhibit K Addendum to SAM Rep and Cert.pdf PDF
Global Lease Template L100- Ashtabula CBOC- final Mar. 2025.pdf PDF
Exhibit Q Interior and Exterior Signage.pdf PDF
Exhibit F Form 1364 Proposal to Lease Space Jan. 2023 REVISED 2024.pdf PDF
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Text version

Exhibit P. Page 1 of 4

RLP NO. 36C24424R0066

LEASE NO. 36C24425L0001

Representation Regarding Certain Telecommunications and Video

Surveillance Services or Equipment

REV (11/21)

Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment

See instructions within the representation regarding whether or not completion of this form is required If required, complete appropriate boxes, sign the form, and return form, along with any other required disclosure information, to LCO or his/her designee.

NOTE: The "Offeror," as used on this form, is the owner of the property offered, not an individual or agent representing the owner.

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications- Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision—

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_26 https://www.acquisition.gov/far/part-52#FAR_52_212_3 https://www.acquisition.gov/far/part-52#FAR_52_204_25

Exhibit P. Page 2 of 4

Surveillance Services or Equipment

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract.

Nothing in the prohibition shall be construed to—

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".

(d) Representation. The Offeror represents that—

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—

It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services.

The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

https://www.sam.gov/

Exhibit P. Page 3 of 4

Surveillance Services or Equipment

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number;

and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number;

and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

Exhibit P. Page 4 of 4

Surveillance Services or Equipment

(End of provision)

OFFEROR OR

LEGALLY

AUTHORIZED

REPRESENTATIVE

NAME, ADDRESS (INCLUDING ZIP CODE)

TELEPHONE NUMBER

Signature

Date

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