Solicitation_-_FA3047-14-R-0010.pdf

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Medical Administration Support Services Federal contract opportunity
Solicitation number
FA3047-14-R-0010
Issued by
Department of the Air Force Air Education and Training Command

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Medical Administration Support Services - FA3047-14-R-0010

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502D CONTRACTING SQUADRON

1655 SELFRIDGE AVE

JBSA LACKLAND TX 78236-5253

210-671-1700

210-671-3360

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE ADDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

(No Collect Calls)

$ 7.0M

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

X

CODE

FA3047-14-R-0010 20-Mar-2014

b. TELEPHONE NUMBER

210-671-1714

8. OFFER DUE DATE/LOCAL TIME

03:00 PM 03 Apr 2014

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescribed by GSA

FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

22. UNIT 23. UNIT PRICE 24. AMOUNT21. QUANTITY

CODE 10. THIS ACQUISITION IS

UNRESTRICTED

FAX: NAICS:

TEL:

CODE 18a. PAYMENT WILL BE MADE BYOFFEROR

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TEL.

FA3047

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

SCOTT THOMAS

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE 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. REQUISITION NUMBER

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES

SEE SCHEDULE

561110

TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS

SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

SB

HUBZONE SB

SET ASIDE: 100 % FOR

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

TEL: EMAIL:

2 COPIES

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

.OFFER DATED YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 29. AWARD OF CONTRACT: REFERENCE

X

8(A)

SVC-DISABLED VET-OWNED SB

EMERGING SB

X

X

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

SEE SCHEDULE

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY 22. UNIT 24. AMOUNT

PAGE 2 OF

23. UNIT PRICE

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 PAYMENT

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

STANDARD FORM 1449 (REV 3/2005) BACK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

FA3047-14-R-0010

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES MAX

QUANTITY

UNIT UNIT PRICE MAX AMOUNT

0001 7,712 Hours Credentials Technician

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

FOB: Destination

SIGNAL CODE: A

MAX

NET AMT

UNIT UNIT PRICE MAX AMOUNT

0002 1,928 Hours Forms & Publications Administrative Tech

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0003 1,928 Hours Mail Distribution Technician

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0004 1,928 Hours General Medical Education Admin Tech

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0005 1,928 Hours Keys / MTF ID Badge Admin Tech

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0006 1,928 Hours Muse Computer System Editor

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0007 5,784 Hours Procurement Technician (Acquisitions)

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0008 1,928 Hours Risk Management Medical Admin Technician

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0009 5,784 Hours Tricare Benefits Coordinator

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0010 1,928 Hours Orthopedics Medical Admin Technician

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0011 1,928 Hours Otolaryngology(ENT) Med Admin Technician

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0012 5,784 Hours Cut & Paste Transcriptionist

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

0013 1,500 Lump

Sum

Muse Computer System Editor - Travel

FFP

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

0014 1,500 Lump

Risk Management Med Admin Tech - Travel

Period of Performance 1 May 14 - 30 Apr 15

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

1001 7,680 Hours OPTION Credentials Technician

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1002 1,920 Hours OPTION Forms & Publications Administrative Tech

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1003 1,920 Hours OPTION Mail Distribution Technician

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1004 1,920 Hours OPTION General Medical Education Admin Tech

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1005 1,920 Hours OPTION Keys / MTF ID Badge Admin Tech

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1006 1,920 Hours OPTION Muse Computer System Editor

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1007 5,760 Hours OPTION Procurement Technician (Acquisitions)

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1008 1,920 Hours OPTION Risk Management Medical Admin Technician

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1009 5,760 Hours OPTION Tricare Benefits Coordinator

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1010 1,920 Hours OPTION Orthopedics Medical Admin Technician

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1011 1,920 Hours OPTION Otolaryngology(ENT) Med Admin Technician

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1012 5,760 Hours OPTION Cut & Paste Transcriptionist

FFP

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

1013 1,500 Lump

OPTION Muse Computer System Editor - Travel

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

1014 1,500 Lump

OPTION Risk Management Med Admin Tech - Travel

Period of Performance 1 May 15 - 30 Apr 16

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

2001 7,712 Hours OPTION Credentials Technician

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2002 1,928 Hours OPTION Forms & Publications Administrative Tech

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2003 1,928 Hours OPTION Mail Distribution Technician

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2004 1,928 Hours OPTION General Medical Education Admin Tech

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2005 1,928 Hours OPTION Keys / MTF ID Badge Admin Tech

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2006 1,928 Hours OPTION Muse Computer System Editor

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2007 5,784 Hours OPTION Procurement Technician (Acquisitions)

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2008 1,928 Hours OPTION Risk Management Medical Admin Technician

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2009 5,784 Hours OPTION Tricare Benefits Coordinator

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2010 1,928 Hours OPTION Orthopedics Medical Admin Technician

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2011 1,928 Hours OPTION Otolaryngology(ENT) Med Admin Technician

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2012 5,784 Hours OPTION Cut & Paste Transcriptionist

FFP

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

2013 1,500 Lump

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

2014 1,500 Lump

Period of Performance 1 May 16 - 30 Apr 17

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

3001 7,712 Hours OPTION Credentials Technician

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3002 1,928 Hours OPTION Forms & Publications Administrative Tech

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3003 1,928 Hours OPTION Mail Distribution Technician

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3004 1,928 Hours OPTION General Medical Education Admin Tech

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3005 1,928 Hours OPTION Keys / MTF ID Badge Admin Tech

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3006 1,928 Hours OPTION Muse Computer System Editor

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3007 5,784 Hours OPTION Procurement Technician (Acquisitions)

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3008 1,928 Hours OPTION Risk Management Medical Admin Technician

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3009 5,784 Hours OPTION Tricare Benefits Coordinator

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3010 1,928 Hours OPTION Orthopedics Medical Admin Technician

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3011 1,928 Hours OPTION Otolaryngology(ENT) Med Admin Technician

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3012 5,784 Hours OPTION Cut & Paste Transcriptionist

FFP

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Estimated

UNIT UNIT PRICE MAX AMOUNT

3013 1,500 Lump

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Not to Exceed

UNIT UNIT PRICE MAX AMOUNT

3014 1,500 Lump

Period of Performance 1 May 17 - 30 Apr 18

Quantities are Not to Exceed

ORDERING PROCEDURES

Orders shall be placed by Warranted Contracting Officers at the 502 Contracting Squadron, Joint Base San Antonio

– Lackland, Texas. Taks orders will be executed as funding becomes available.

CONTRACT MINIMUM/MAXIMUM QUANTITY AND CONTRACT VALUE

The minimum quantity and contract value for all orders issued against this contract shall not be less than the minimum quantity and contract value stated in the following table. The maximum quantity and contract value for all orders issued against this contract shall not exceed the maximum quantity and contract value stated in the following table.

MINIMUM

AMOUNT

MAXIMUM

AMOUNT

$25,000.00 $6,500,000.00

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

0010 Destination Government Destination Government

0011 Destination Government Destination Government

0012 Destination Government Destination Government

0013 Destination Government Destination Government

0014 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

1010 Destination Government Destination Government

1011 Destination Government Destination Government

1012 Destination Government Destination Government

1013 Destination Government Destination Government

1014 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

2010 Destination Government Destination Government

2011 Destination Government Destination Government

2012 Destination Government Destination Government

2013 Destination Government Destination Government

2014 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

3010 Destination Government Destination Government

3011 Destination Government Destination Government

3012 Destination Government Destination Government

3013 Destination Government Destination Government

3014 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 POP 01-MAY-2014 TO

30-APR-2015

N/A 59 LS/MSLE F2MTW8

CONTRACT SERVICES

2200 BERQUIST DR

LACKLAND AFB TX 78236-5300

210-292-8371

F2MTW8

0002 POP 01-MAY-2014 TO

N/A 59 MDSG CCR F2MTW7

CONTRACT SERVICES

2200 BERQUIST DR RM 7

LACKLAND AFB TX 78236

210-292-6933

F2MTW7

0003 POP 01-MAY-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 01-MAY-2014 TO

N/A 59 LS/MSLE F2MTW8

CONTRACT SERVICES

2200 BERQUIST DR

LACKLAND AFB TX 78236-5300

210-292-8371

0005 POP 01-MAY-2014 TO

N/A 59 MDSG CCR F2MTW7

CONTRACT SERVICES

2200 BERQUIST DR RM 7

LACKLAND AFB TX 78236

210-292-6933

0006 POP 01-MAY-2014 TO

N/A 59 MDWL/MSLE F2MTW4

DONALD L. KOTZ

2200 BERQUIST DR

LACKLAND AFB TX 78236

210-292-8365

F2MTW4

0007 POP 01-MAY-2014 TO

N/A 59 MDSG CCR F2MTW7

CONTRACT SERVICES

2200 BERQUIST DR RM 7

LACKLAND AFB TX 78236

210-292-6933

0008 POP 01-MAY-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

0009 POP 01-MAY-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

0010 POP 01-MAY-2014 TO

N/A 59 MDWL/MSLE F2MTW4

DONALD L. KOTZ

2200 BERQUIST DR

LACKLAND AFB TX 78236

210-292-8365

0011 POP 01-MAY-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

0012 POP 01-MAY-2014 TO

N/A 59 MDSG CCR F2MTW7

CONTRACT SERVICES

2200 BERQUIST DR RM 7

LACKLAND AFB TX 78236

210-292-6933

0013 POP 01-MAY-2014 TO

N/A 59 MDWL/MSLE F2MTW4

DONALD L. KOTZ

2200 BERQUIST DR

LACKLAND AFB TX 78236

210-292-8365

0014 POP 01-MAY-2014 TO

N/A 59 LS/MSLE F2MTW8

CONTRACT SERVICES

2200 BERQUIST DR

LACKLAND AFB TX 78236-5300

210-292-8371

1001 POP 01-MAY-2015 TO

30-APR-2016

N/A N/A

1002 POP 01-MAY-2015 TO

1003 POP 01-MAY-2015 TO

1004 POP 01-MAY-2015 TO

1005 POP 01-MAY-2015 TO

1006 POP 01-MAY-2015 TO

1007 POP 01-MAY-2015 TO

1008 POP 01-MAY-2015 TO

1009 POP 01-MAY-2015 TO

1010 POP 01-MAY-2015 TO

1011 POP 01-MAY-2015 TO

1012 POP 01-MAY-2015 TO

1013 POP 01-MAY-2015 TO

1014 POP 01-MAY-2015 TO

2001 POP 01-MAY-2016 TO

30-APR-2017

2002 POP 01-MAY-2016 TO

2003 POP 01-MAY-2016 TO

2004 POP 01-MAY-2016 TO

2005 POP 01-MAY-2016 TO

2006 POP 01-MAY-2016 TO

2007 POP 01-MAY-2016 TO

2008 POP 01-MAY-2016 TO

2009 POP 01-MAY-2016 TO

2010 POP 01-MAY-2016 TO

2011 POP 01-MAY-2016 TO

2012 POP 01-MAY-2016 TO

2013 POP 01-MAY-2016 TO

2014 POP 01-MAY-2016 TO

3001 POP 01-MAY-2017 TO

30-APR-2018

3002 POP 01-MAY-2017 TO

3003 POP 01-MAY-2017 TO

3004 POP 01-MAY-2017 TO

3005 POP 01-MAY-2017 TO

3006 POP 01-MAY-2017 TO

3007 POP 01-MAY-2017 TO

3008 POP 01-MAY-2017 TO

3009 POP 01-MAY-2017 TO

3010 POP 01-MAY-2017 TO

3011 POP 01-MAY-2017 TO

3012 POP 01-MAY-2017 TO

3013 POP 01-MAY-2017 TO

3014 POP 01-MAY-2017 TO

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions NOV 2013

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

52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber

Content Paper

MAY 2011

52.204-7 System for Award Management JUL 2013

52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011

52.204-10 Reporting Executive Compensation and First-Tier Subcontract

Awards

JUL 2013

52.204-13 System for Award Management Maintenance JUL 2013

52.209-6 Protecting the Government's Interest When Subcontracting

With Contractors Debarred, Suspended, or Proposed for

Debarment

AUG 2013

52.209-9 Updates of Publicly Available Information Regarding

Responsibility Matters

JUL 2013

52.209-10 Prohibition on Contracting With Inverted Domestic

Corporations

MAY 2012

52.212-1 Instructions to Offerors--Commercial Items JUL 2013

52.212-4 Contract Terms and Conditions--Commercial Items SEP 2013

52.217-5 Evaluation Of Options JUL 1990

52.219-8 Utilization of Small Business Concerns JUL 2013

52.219-14 Limitations On Subcontracting NOV 2011

52.222-3 Convict Labor JUN 2003

52.222-17 Nondisplacement of Qualified Workers JAN 2013

52.222-19 Child Labor -- Cooperation with Authorities and Remedies JAN 2014

52.222-21 Prohibition Of Segregated Facilities FEB 1999

52.222-26 Equal Opportunity MAR 2007

52.222-35 Equal Opportunity for Veterans SEP 2010

52.222-36 Affirmative Action For Workers With Disabilities OCT 2010

52.222-37 Employment Reports on Veterans SEP 2010

52.222-40 Notification of Employee Rights Under the National Labor

Relations Act

DEC 2010

52.222-41 Service Contract Act Of 1965 NOV 2007

52.222-43 Fair Labor Standards Act And Service Contract Act - Price

Adjustment (Multiple Year And Option)

SEP 2009

52.222-50 Combating Trafficking in Persons FEB 2009

52.222-54 Employment Eligibility Verification AUG 2013

52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011

52.223-6 Drug-Free Workplace MAY 2001

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

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008

52.227-1 Authorization and Consent DEC 2007

52.228-5 Insurance - Work On A Government Installation JAN 1997

52.229-4 Federal, State, And Local Taxes (State and Local

Adjustments)

FEB 2013

52.232-1 Payments APR 1984

52.232-8 Discounts For Prompt Payment FEB 2002

52.232-23 Assignment Of Claims JAN 1986

52.232-25 Prompt Payment JUL 2013

52.232-33 Payment by Electronic Funds Transfer--System for Award

Management

JUL 2013

52.233-1 Disputes JUL 2002

52.233-3 Protest After Award AUG 1996

52.233-4 Applicable Law for Breach of Contract Claim OCT 2004

52.237-3 Continuity Of Services JAN 1991

52.237-10 Identification of Uncompensated Overtime OCT 1997

52.242-13 Bankruptcy JUL 1995

52.242-15 Stop-Work Order AUG 1989

52.244-5 Competition In Subcontracting DEC 1996

52.246-25 Limitation Of Liability--Services FEB 1997

52.248-1 Value Engineering OCT 2010

52.249-8 Default (Fixed-Price Supply & Service) APR 1984

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

252.204-7004 Alt A System for Award Management Alternate A MAY 2013

252.204-7006 Billing Instructions OCT 2005

252.209-7001 Disclosure of Ownership or Control by the Government of a

Terrorist Country

JAN 2009

252.209-7004 Subcontracting With Firms That Are Owned or Controlled By

The Government of a Terrorist Country

DEC 2006

252.225-7012 Preference For Certain Domestic Commodities FEB 2013

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

52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

(a) The offeror certifies that --

(1) The prices in this offer have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other offeror or competitor relating to –

(i) Those prices,

(ii) The intention to submit an offer, or

(iii) The methods of factors used to calculate the prices offered:

(2) The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

(b) Each signature on the offer is considered to be a certification by the signatory that the signatory --

(1) Is the person in the offeror's organization responsible for determining the prices offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; or

(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provison ______________________________________________________ (insert full name of person(s) in the offeror's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror's organization);

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) above have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) above; and

(iii) As an agent, has not personally participated, and will not participate, in any action contrary to subparagraphs

(a)(1) through (a)(3) of this provision.

(c) If the offeror deletes or modifies subparagraph (a)(2) of this provision, the offeror must furnish with its offer a signed statement setting forth in detail the circumstances of the disclosure.

(End of clause)

52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (APR 2010)

(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 $3,000 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.

(End of provision)

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).

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV

2013)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via http://www.acquisition.gov. If an offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) website, the offeror shall complete only paragraphs (c) through (o) 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.

https://www.acquisition.gov/ http://www.acquisition.gov/

"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.

Inverted domestic corporation, as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the United

States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 U.S.C.

395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue

Code at 26 U.S.C. 7874.

Manufactured end product means any end product in Federal Supply Classes (FSC) 1000-9999, except--

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

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

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

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

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

(8) FSC 9610, Ores;

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

(10) FSC 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.

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 stock of which 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 its stock is owned by one or more women; or

(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 electronically on the SAM website.

(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 representations 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 (o) 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 ORCA.]

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

States or its outlying areas. Check all that apply.

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

(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.

https://www.acquisition.gov/

(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, for general statistical purposes, 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 to paragraphs (c)(8) and (9): 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 [ ___ ballot] is, [ ___ ballot] 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 [ ___ ballot] is, [ ___ ballot] 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 [ ___ ballot] is, [ ___ ballot] 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) (Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns or FAR 52.219-25, Small Disadvantaged Business Participation

Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.)

(i) General. The offeror represents that either--

(A) It ( ___ ) is, ( ___ ) is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the

SAM Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13

CFR 124.104(c)(2); or

(B) It ( ___ ) has, ( ___ ) has not submitted a completed application to the Small Business Administration or a

Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart

B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

(ii) Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(10)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. (The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ____________.)

(11) 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)(11)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture.

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