RFP_FA301618R0023.pdf
PDF 346 KB Posted
- Attached to
- Ancillary Support Services Federal contract opportunity
- Solicitation number
- FA301618R0023
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Questions_&_Answers_Amendment_0002_FA301618R0023.pdf | ||
| Amendment_0002_RFP_FA301618R0023.pdf | ||
| PWS_Ancillary_Support_Svc_31Jan18.pdf | ||
| Amendment_0001_RFP_FA301618R0023.pdf | ||
| Questions_&_Answers_Amendment_0001_FA301618R0023.pdf | ||
| PWS_Ancillary_20Support_20Svc_14Dec17.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
SEE A DDENDUM
(No Collect Call s)
FA 301618R0023 19-Jan-2018
b. TELEPHONE NUM BER
210-652-8961
8. OFF ER DUE DAT E/LOCAL T IM E
03:00 PM 02 Feb 2018
5. SOLICIT ATION NUM BER 6. SOLICITAT ION ISSUE DAT E
A UTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STA NDARD FORM 1449 (REV . 2/2012)
Prescribed by GSA – FAR (48 CFR) 53.212
(TYPE O R PRIN T)
(SIGNAT URE OF CONTRACTING OFFICER)
ADDENDA X ARE
26. TOTAL AWARD AMOUNT (For Gov t. Us e Only )
23.
CODE 10. THIS ACQUISITION IS
SUCH ADDRESS IN OFFER
17b. CHECK IF REMITTA NCE IS DIFFERENT A ND PUT
BELOW IS CHECKED
TELEPHONE NO.
FA 30169. ISSUED BY
18b. SUBMIT INVOICES TO A DDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK
7. FOR SOLICITATION
INFORM AT ION CALL:
a. NAM E
RACHEL E. DEMONE
2. CONTRACT NO. 3. AWARD/EFF ECTIVE DATE 4. ORDER NUM BER
(TYPE OR PRINT)
30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER
30a. SIGNA TURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA
27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X
25. ACCOUNTING AND APPROPRIATION DATA
1. REQUISIT ION NUM BER
20.
ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
ARE NOT ATTACHED
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED
(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE
SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:
. Y OUR OFFER ON SOLICITATION
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
% FOR:SET ASIDE:UNRESTRICTED OR X
SMALL BUSINESS
17a.CONTRACTOR/ CODE FACILITY
OFFEROR CODE
502D CONTRACTING SQUADRON
1655 SELFRIDGE AVE
JBSA LACKLAND TX 78236-5253
18a. PAYMENT WILL BE MADE BY CODE
RATED ORDER UNDER
DPAS (15 CFR 700)
13a. THIS CONTRACT IS A
13b. RATING
CODE15. DELIVER TO CODE F2M TW4 16. ADMINISTERED BY
12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-
TION UNLESS BLOCK IS
MARKED
SEE SCHEDULE
14. METHOD OF SOLICITATION
RFQ IFB RFPX
59 M DWL/M SLE F2M TW4
CONT RACT SERVICES
2200 BERQUIST DR
LACKLAND AF B T X 78236
T EL: 210-292-8375 FAX:
FAX:
TEL: SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
X 8(A)
HUBZONE SMALL
BUSINESS
SIZE STANDARD:
$7,500,000
NAICS:
561110
X
OFFER DATED
29. AWARD OF CONTRACT: REF.
DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY
COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND
EMAIL:
TEL:
31c. DATE SIGNED
SEE SCHEDULE
SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUA NTITY UNIT UNIT PRICE AMOUNT
24.22.21.19.
WOM EN-OWNED SM ALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOMEN-OWNED
SM ALL BUSINESS PROGRAM
EDWOSB
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
(CONTINUED)
PAGE 2 OF74
ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED
32b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
37. CHECK NUMBER
FINALPARTIALCOMPLETE
36. PAYMENT35. AMOUNT VERIFIED
CORRECT FOR
34. VOUCHER NUMBER
FINAL
33. SHIP NUMBER
PARTIAL
38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAY MENT
41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE
42a. RECEIVED BY (Print)
42b. RECEIVED AT (Location)
42c. DATE REC'D (YY/MM /DD) 42d. TOTAL CONTAINERS
STANDA RD FORM 1449 (REV. 2/2012) BA CK
Prescribed by GSA – FAR (48 CFR) 53.212
AUTHORIZED FOR LOCA L REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
SEE SCHEDULE
20.
SCHEDULE OF SUPPLIES/ SERVICES
21.
QUA NTITY UNIT
22. 23.
UNIT PRICE
24.
AMOUNT
19.
ITEM NO.
FA301618R0023
Section SF 1449 - CONTINUATION SHEET
MP5332.7 NOTICE TO OFFERORS
Notice to Offeror(s)/Supplier(s): Funds are not presently available for this effort. No award will be made under this solicitation until funds are available. The Government reserves the right to cancel this solicitation, either before or after the closing date. In the event the Government cancels this solicitation, the Government has no obligation to reimburse an offeror for any costs.
ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
0001 7,680 Hours Credentials/Privileging Specialist
FFP
PWS Appendix A-1 FOB: Destination
NET AMT
0002 1,920 Hours Credential Specialist - GME
FFP
Credential Specialist - Graduated Medical Education PWS Appendix A-2
0003 1,920 Hours Keys/MTF I.D. Badge Admin Tech
FFP
Keys/MTF Identification Badge Administrative Technician PWS Appendix A-3
0004 1,920 Hours Cardiac Systems Imaging Manager
FFP
PWS Appendix A-4
0005 3,840 Hours Procurement Technician
FFP
PWS Appendix A-5
0006 1,920 Hours Risk Management Specialist
FFP
PWS Appendix A-6
0007 3,840 Hours TRICARE Beneficiary Counselor
FFP
TRICARE Benefciary Counselor and Debt Collection Assistance Officer (TRICARE Benefits Coordinator) PWS Appendix A-7
0008 7,680 Hours Transcription C&P, Scanning Technician
FFP
Transcription Cut and Paste, Scanning Technician PWS Appendix A-8
0009 1 Lot Travel - Risk Management Specialist
FFP
Travel required by and IAW the PWS. Firm-fixed Price Not To Exceed ( NTE $1,500). CLIN for travel performed by Risk Management Specialist.
PWS 3.8
1001 7,680 Hours OPTION Credentials/Privileging Specialist
FFP
1002 1,920 Hours OPTION Credential Specialist - GME
FFP
Credential Specialist - Graduated Medical Education
1003 1,920 Hours OPTION Keys/MTF I.D. Badge Admin Tech
FFP
Keys/MTF Identification Badge Administrative Technician
1004 1,920 Hours OPTION Cardiac Systems Imaging Manager
FFP
1005 3,840 Hours OPTION Procurement Technician
FFP
1006 1,920 Hours OPTION Risk Management Specialist
FFP
1007 3,840 Hours OPTION TRICARE Beneficiary Counselor
FFP
TRICARE Benefciary Counselor and Debt Collection Assistance Officer (TRICARE Benefits Coordinator)
1008 7,680 Hours OPTION Transcription C&P, Scanning Technician
FFP
Transcription Cut and Paste, Scanning Technician PWS
1009 1 Lot OPTION Travel - Risk Management Specialist
FFP
Travel required by and IAW the PWS. Firm-fixed Price Not To Exceed ( NTE $1,500). CLIN for travel performed by Risk Management Specialist.
2001 7,680 Hours OPTION Credentials/Privileging Specialist
FFP
2002 1,920 Hours OPTION Credential Specialist - GME
FFP
Credential Specialist - Graduated Medical Education
2003 1,920 Hours OPTION Keys/MTF I.D. Badge Admin Tech
FFP
Keys/MTF Identification Badge Administrative Technician
2004 1,920 Hours OPTION Cardiac Systems Imaging Manager
FFP
2005 3,840 Hours OPTION Procurement Technician
FFP
2006 1,920 Hours OPTION Risk Management Specialist
FFP
2007 3,840 Hours OPTION TRICARE Beneficiary Counselor
FFP
TRICARE Benefciary Counselor and Debt Collection Assistance Officer (TRICARE Benefits Coordinator)
2008 7,680 Hours OPTION Transcription C&P, Scanning Technician
FFP
Transcription Cut and Paste, Scanning Technician PWS
2009 1 Lot OPTION Travel - Risk Management Specialist
FFP
Travel required by and IAW the PWS. Firm-fixed Price Not To Exceed ( NTE $1,500). CLIN for travel performed by Risk Management Specialist.
3001 7,680 Hours OPTION Credentials/Privileging Specialist
FFP
3002 1,920 Hours OPTION Credential Specialist - GME
FFP
Credential Specialist - Graduated Medical Education
3003 1,920 Hours OPTION Keys/MTF I.D. Badge Admin Tech
FFP
Keys/MTF Identification Badge Administrative Technician
3004 1,920 Hours OPTION Cardiac Systems Imaging Manager
FFP
3005 3,840 Hours OPTION Procurement Technician
FFP
3006 1,920 Hours OPTION Risk Management Specialist
FFP
3007 3,840 Hours OPTION TRICARE Beneficiary Counselor
FFP
TRICARE Benefciary Counselor and Debt Collection Assistance Officer (TRICARE Benefits Coordinator)
3008 7,680 Hours OPTION Transcription C&P, Scanning Technician
FFP
Transcription Cut and Paste, Scanning Technician PWS
3009 1 Lot OPTION Travel - Risk Management Specialist
FFP
Travel required by and IAW the PWS. Firm-fixed Price Not To Exceed ( NTE $1,500). CLIN for travel performed by Risk Management Specialist.
4001 7,680 Hours OPTION Credentials/Privileging Specialist
FFP
4002 1,920 Hours OPTION Credential Specialist - GME
FFP
Credential Specialist - Graduated Medical Education
4003 1,920 Hours OPTION Keys/MTF I.D. Badge Admin Tech
FFP
Keys/MTF Identification Badge Administrative Technician
4004 1,920 Hours OPTION Cardiac Systems Imaging Manager
FFP
4005 3,840 Hours OPTION Procurement Technician
FFP
4006 1,920 Hours OPTION Risk Management Specialist
FFP
4007 3,840 Hours OPTION TRICARE Beneficiary Counselor
FFP
TRICARE Benefciary Counselor and Debt Collection Assistance Officer (TRICARE Benefits Coordinator)
4008 7,680 Hours OPTION Transcription C&P, Scanning Technician
FFP
Transcription Cut and Paste, Scanning Technician PWS
4009 1 Lot OPTION Travel - Risk Management Specialist
FFP
Travel required by and IAW the PWS. Firm-fixed Price Not To Exceed ( NTE $1,500). CLIN for travel performed by Risk Management Specialist.
INSPECTION AND ACCEPTANCE TERMS
Supplies/services will be inspected/accepted at:
CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY
0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 1001 Destination Government Destination Government 1002 Destination Government Destination Government 1003 Destination Government Destination Government 1004 Destination Government Destination Government 1005 Destination Government Destination Government 1006 Destination Government Destination Government 1007 Destination Government Destination Government 1008 Destination Government Destination Government 1009 Destination Government Destination Government 2001 Destination Government Destination Government 2002 Destination Government Destination Government 2003 Destination Government Destination Government 2004 Destination Government Destination Government 2005 Destination Government Destination Government 2006 Destination Government Destination Government 2007 Destination Government Destination Government 2008 Destination Government Destination Government
2009 Destination Government Destination Government 3001 Destination Government Destination Government 3002 Destination Government Destination Government 3003 Destination Government Destination Government 3004 Destination Government Destination Government 3005 Destination Government Destination Government 3006 Destination Government Destination Government 3007 Destination Government Destination Government 3008 Destination Government Destination Government 3009 Destination Government Destination Government 4001 Destination Government Destination Government 4002 Destination Government Destination Government 4003 Destination Government Destination Government 4004 Destination Government Destination Government 4005 Destination Government Destination Government 4006 Destination Government Destination Government 4007 Destination Government Destination Government 4008 Destination Government Destination Government 4009 Destination Government Destination Government
DELIVERY INFORMATION
CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /
CAGE
0001 POP 01-MAY-2018 TO
30-APR-2019
N/A 59 MDWL/MSLE F2MTW4
CONTRACT SERVICES
2200 BERQUIST DR
LACKLAND AFB TX 78236
210-292-8375
F2MTW4
0002 POP 01-MAY-2018 TO
30-APR-2019
N/A (SAME AS PREVIOUS LOCATION)
0003 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0004 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0005 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0006 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0007 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0008 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
0009 POP 01-MAY-2018 TO
N/A (SAME AS PREVIOUS LOCATION)
1001 POP 01-MAY-2019 TO
30-APR-2020
N/A (SAME AS PREVIOUS LOCATION)
1002 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1003 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1004 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1005 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1006 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1007 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1008 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
1009 POP 01-MAY-2019 TO
N/A (SAME AS PREVIOUS LOCATION)
2001 POP 01-MAY-2020 TO
30-APR-2021
N/A (SAME AS PREVIOUS LOCATION)
2002 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2003 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2004 POP 01-APR-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2005 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2006 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2007 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2008 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
2009 POP 01-MAY-2020 TO
N/A (SAME AS PREVIOUS LOCATION)
3001 POP 01-MAY-2021 TO
30-APR-2022
N/A (SAME AS PREVIOUS LOCATION)
3002 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3003 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3004 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3005 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3006 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3007 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3008 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
3009 POP 01-MAY-2021 TO
N/A (SAME AS PREVIOUS LOCATION)
4001 POP 01-MAY-2022 TO
30-APR-2023
N/A (SAME AS PREVIOUS LOCATION)
4002 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4003 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4004 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4005 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4006 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4007 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4008 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
4009 POP 01-MAY-2022 TO
N/A (SAME AS PREVIOUS LOCATION)
CLAUSES INCORPORATED BY REFERENCE
52.203-3 Gratuities APR 1984 52.203-6 Alt I Restrictions On Subcontractor Sales To The Government
(Sep 2006) -- Alternate I
OCT 1995
52.203-12 Limitation On Payments To Influence Certain Federal Transactions
OCT 2010
52.203-13 Contractor Code of Business Ethics and Conduct OCT 2015 52.203-16 Preventing Personal Conflicts of Interest DEC 2011 52.203-17 Contractor Employee Whistleblower Rights and Requirement
To Inform Employees of Whistleblower Rights
APR 2014
52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements
JAN 2017
52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper
MAY 2011
52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-10 Reporting Executive Compensation and First-Tier
Subcontract Awards
OCT 2016
52.204-14 Service Contract Reporting Requirements OCT 2016 52.204-16 Commercial and Government Entity Code Reporting JUL 2016 52.204-17 Ownership or Control of Offeror JUL 2016 52.204-18 Commercial and Government Entity Code Maintenance JUL 2016 52.209-6 Protecting the Government's Interest When Subcontracting
With Contractors Debarred, Suspended, or Proposed for Debarment
OCT 2015
52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters
JUL 2013
52.209-10 Prohibition on Contracting With Inverted Domestic Corporations
NOV 2015
52.212-1 Instructions to Offerors--Commercial Items JAN 2017 52.212-2 Evaluation - Commercial Items OCT 2014 52.212-4 Contract Terms and Conditions--Commercial Items JAN 2017 52.219-8 Utilization of Small Business Concerns NOV 2016 52.219-14 Limitations On Subcontracting JAN 2017 52.219-28 Post-Award Small Business Program Rerepresentation JUL 2013 52.222-3 Convict Labor JUN 2003 52.222-17 Nondisplacement of Qualified Workers MAY 2014 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity SEP 2016 52.222-35 Equal Opportunity for Veterans OCT 2015 52.222-36 Equal Opportunity for Workers with Disabilities JUL 2014 52.222-37 Employment Reports on Veterans FEB 2016 52.222-40 Notification of Employee Rights Under the National Labor
Relations Act
DEC 2010
52.222-41 Service Contract Labor Standards MAY 2014
52.222-43 Fair Labor Standards Act And Service Contract Labor Standards - Price Adjustment (Multiple Year And Option Contracts)
MAY 2014
52.222-50 Combating Trafficking in Persons MAR 2015 52.222-54 Employment Eligibility Verification OCT 2015 52.222-55 Minimum Wages Under Executive Order 13658 DEC 2015 52.222-62 Paid Sick Leave Under Executive Order 13706 JAN 2017 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011 52.223-18 Encouraging Contractor Policies To Ban Text Messaging
While Driving
AUG 2011
52.224-1 Privacy Act Notification APR 1984 52.224-2 Privacy Act APR 1984 52.224-3 Privacy Training JAN 2017 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.225-25 Prohibition on Contracting with Entities Engaging in Certain
Activities or Transactions Relating to Iran-- Representation and Certifications.
OCT 2015
52.228-5 Insurance - Work On A Government Installation JAN 1997 52.232-18 Availability Of Funds APR 1984 52.232-33 Payment by Electronic Funds Transfer--System for Award
Management
JUL 2013
52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business
Subcontractors
DEC 2013
52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.237-2 Protection Of Government Buildings, Equipment, And
Vegetation
APR 1984
52.237-3 Continuity Of Services JAN 1991 52.242-13 Bankruptcy JUL 1995 52.242-15 Stop-Work Order AUG 1989 52.253-1 Computer Generated Forms JAN 1991 252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7000 Requirements Relating to Compensation of Former DoD
Officials
SEP 2011
252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.203-7005 Representation Relating to Compensation of Former DoD
Officials
NOV 2011
252.204-7003 Control Of Government Personnel Work Product APR 1992 252.209-7004 Subcontracting With Firms That Are Owned or Controlled By
The Government of a Country that is a State Sponsor of Terrorism
OCT 2015
252.225-7012 Preference For Certain Domestic Commodities DEC 2016 252.226-7001 Utilization of Indian Organizations and Indian-Owned
Economic Enterprises, and Native Hawaiian Small Business Concerns
SEP 2004
252.232-7003 Electronic Submission of Payment Requests and Receiving Reports
JUN 2012
252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991 252.243-7002 Requests for Equitable Adjustment DEC 2012
CLAUSES INCORPORATED BY FULL TEXT
52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN
FEDERAL TRANSACTIONS (SEP 2007)
(a) Definitions. As used in this provision--``Lobbying contact'' has the meaning provided at 2 U.S.C. 1602(8). The terms ``agency,'' ``influencing or attempting to influence,'' ``officer or employee of an agency,'' ``person,'' ``reasonable compensation,'' and ``regularly employed'' are defined in the FAR clause of this solicitation entitled ``Limitation on Payments to Influence Certain Federal Transactions'' (52.203-12).
(b) Prohibition. The prohibition and exceptions contained in the FAR clause of this solicitation entitled ``Limitation on Payments to Influence Certain Federal Transactions'' (52.203-12) are hereby incorporated by reference in this provision.
(c) Certification. The offeror, by signing its offer, hereby 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 employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on its behalf in connection with the awarding of this contract.
(d) Disclosure. 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.
(e) Penalty. Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by 31 U.S.C. 1352. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure.
(End of provision)
52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS--
REPRESENTATION (NOV 2015)
(a) Definitions. Inverted domestic corporation and subsidiary have the meaning given in the clause of this contract entitled Prohibition on Contracting with Inverted Domestic Corporations (52.209-10).
(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4.
(c) Representation. The Offeror represents that--
(1) It [ ___ ] is, [ ___ ] is not an inverted domestic corporation; and
(2) It [ ___ ] is, [ ___ ] is not a subsidiary of an inverted domestic corporation.
52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (OCT 2015)
(a)(1) The Offeror certifies, to the best of its knowledge and belief, that-
(i) The Offeror and/or any of its Principals-
(A) Are ( ) are not ( ) presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;
(B) 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 public (Federal, State, or local) 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 (if offeror checks “have”, the offeror shall also see 52.209-7, if included in this solicitation); and
(C) Are ( ) are not ( ) presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision.;
and
(D) Have , 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.
(1) Federal taxes are considered delinquent if both of the following criteria apply:
(i) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.
(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the 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.
(2) Examples. (i) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 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 all judicial appeal rights.
(ii) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. 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 all judicial appeal rights.
(iii) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments 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.
(iv) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).
(ii) The Offeror has ( ) has not ( ), within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.
(2) Principal, for the purposes of this certification, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager;
head of a division or business segment; and similar positions).
(b) The Offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Offeror's responsibility. Failure of the Offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the Offeror nonresponsible.
(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.
52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JULY 2013)
(a) Definitions. As used in this provision--
Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.
Federal contracts and grants with total value greater than $10,000,000 means--
(1) The total value of all current, active contracts and grants, including all priced options; and
(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).
Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).
(b) The offeror ( ) has ( ) does not have current active Federal contracts and grants with total value greater than $10,000,000.
(c) If the offeror checked “has” in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:
(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:
(i) In a criminal proceeding, a conviction.
(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.
(iii) In an administrative proceeding, a finding of fault and liability that results in--
(A) The payment of a monetary fine or penalty of $5,000 or more; or
(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.
(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.
(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.
(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management database via https://www.acquisition.gov (see 52.204-7).
52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A
FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)
(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not 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 an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment 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 an 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; and
(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.
52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2017)
ALTERNATE I (OCT 2014)
The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at https://www.sam.gov/portal . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) of this provision.
(a) Definitions. As used in this provision--
“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—
(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.
“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”—
(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
(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, 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” 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.
“Small disadvantaged business concern, consistent with 13 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 at 13 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 CFR 124.104(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.
“Veteran-owned small business concern” means a small business concern—
(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 business concern” means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.
“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 least 51 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.
“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.
(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 posted on the SAMwebsite.
(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ___ . [Offeror to identify the applicable paragraphs at (c) through (u) 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 is to 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.
(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 CFR 124.1002.
(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.
Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.
(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.
(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.
(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.)
[The offeror shall check the category in which its ownership falls]:
___ Black American.
___ Hispanic American.
___ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).
___ Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).
___ Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal).
___ Individual/concern, other than one of the preceding.
(d) Representations required to implement provisions of Executive Order 11246 --
(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 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 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.
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it.