Attachment_1_-_Contractor_Submittal_Form_with_CO_comments.docx

Pool Maintenance Peterson AFB, CO

FA2517-16-Q-5004

Contract Line Item Number (CLIN) Information Instructions:

For CLINs 0001, 1001 & 2001 enter FFP for monthly service IAW PWS. This amount shall include all G&A and Profit.

For CLINs 0002, 1002 & 2002 enter FFP hourly labor rate which will be used when invoicing. This amount shall be a fully burdened labor rate (including all G&A, overhead, and profit).

For CLINs 0003, 1003 & 2003 enter FFP hourly labor rate which will be used when invoicing. This amount shall be a fully burdened labor rate (including all G&A, overhead, and profit).

For CLINs 0004, 1004 & 2004 Attachment 4 of the RFQ shall be completed and shall be used when invoicing against this CLIN.

For CLIN 0005: This CLIN is reserved for potential early termination cost. It is anticipated that this contract will be incrementally funded in accordance with DFARS 252.232-7007-Limitation of Government's Obligation (May 2006). In the event of incremental funding, and full funding is not received the contract may be terminated up to the point at which it has been funded. If terminated early due to lack of funds the contractor will be entitled to the funding allocated under this CLIN to cover any termination cost. If the contract becomes fully funded for the remainder of the contract period, the funds will be removed from this CLIN.

Quantity

Cost Total Amount

10 months

Total Annual Price (sum of CLINs 0001-0004 DO NOT INCULDE CLIN 0005 IN THE TOTAL AMOUNT) Base Period

Quantity

Cost Total Amount

12 months

Total Annual Price (sum of CLINs 1001-1004) Option 1

Quantity

Cost Total Amount

Total Annual Price (sum of CLINs 2001-2004) Option 2

Total Contract Price Sum of Base and all options periods

The contractor shall complete the following:

DFARS 252.209-7999 Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law.

(a) In accordance with sections 8113 and 8114 of the Department of Defense Appropriations Act, 2014, and sections 414 and 415 of the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2014 (Public Law 113-76, Divisions C and J), none of the funds made available by those divisions (including Military Construction funds) may be used to enter into a contract with any corporation that-

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless the agency has considered suspension or debarment of the corporation and made a determination that this further action is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless the agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that-

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability,

(2) It is [ ]is not [ ]a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

Company Name

Name

Title

DFARS 252.225-7000, Buy American--Balance of Payments Program Certificate (30 Dec 2015)

(a) Definitions. “Commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “foreign end product,” “qualifying country,” “qualifying country end product,” and “United States” have the meanings given in the Buy American and Balance of Payments Program clause of this solicitation.

(b) Evaluation. The Government—

(1) Will evaluate offers in accordance with the policies and procedures of Part 225 of the Defense Federal Acquisition Regulation Supplement; and

(2) Will evaluate offers of qualifying country end products without regard to the restrictions of the Buy American statute or the Balance of Payments Program.

(c) Certifications and identification of country of origin.

(1) For all line items subject to the Buy American and Balance of Payments Program clause of this solicitation, the offeror certifies that—

(i) Each end product, except those listed in paragraphs (c)(2) or (3) of this provision, is a domestic end product; and

(ii) For end products other than COTS items, components of unknown origin are considered to have been mined, produced, or manufactured outside the United States or a qualifying country.

(2) The offeror certifies that the following end products are qualifying country end products:

Line Item Number

Country of Origin

(3) The following end products are other foreign end products, including 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 (ii) of the definition of “domestic end product”:

Line Item Number

Country of Origin (If known)

(End of provision) ATTACHMENT 1 – Contractor Submittal Form