FA4460-16-T-0057_flowmeter_amendment_02.pdf

F2S3C56070A001

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

1. The purpose of this amendment is to repost the Sew er Flow Meter solicitation FA4460-16-T-0057 until 24 September 2016 at 12:00 P.M.

local to account for the changes below .

2. Change CLINS 0015,1015,2015,3015 and 4015 from contractor priced to government priced.

3. POC: Bessie White, Email: bessie.w hite@us.af.mil, Phone: 501 987-3728.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 26-Aug-2016

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X FA4460-16-T-0057

X 9B. DATED (SEE ITEM 11)

26-Aug-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X is extended, is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

26-Aug-2016

CODE

19TH CONTRACTING SQUADRON - FA4460

642 THOMAS AVE

LITTLE ROCK AFB AR 72099

FA4460 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

SEE ADDENDUM

(No Collect Calls)

FA4460-16-T-0057 26-Aug-2016

b. TELEPHONE NUMBER

501-987-3728

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 24 Sep 2016

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

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

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

FA44609. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

BESSIE WHITE

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

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

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

F2S3C56070A001

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:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

19TH CONTRACTING SQUADRON - FA4460

642 THOMAS AVE

LITTLE ROCK AFB AR 72099

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 F2S3C5 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

19 CES/CEIAR - F2S3C5

MIKE MINICK

528 THOMAS AVENUE RM 600

LITTLE ROCK AFB AR 72099

TEL: 501-987-7187 FAX:

501-987-8119FAX:

TEL: 501-987-3303 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$14m

NAICS:

238220

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. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF73

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. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

FA4460-16-T-0057

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 4 Each

MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 11, MANHOLE 40 (Quarterly) FOB: Destination

PURCHASE REQUEST NUMBER: F2S3C56070A001

SIGNAL CODE: A

NET AMT

0002 4 Each

MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 12, MANHOLE 39 (Quarterly) FOB: Destination

0003 4 Each

MAINTAIN FLOWMETER

FFP

BLDG 13, MANHOLE 1 JACKSONVILLE ANIMAL CONTROL (Quarterly) FOB: Destination

0004 4 Each

MAINTAIN FLOWMETER

FFP

SAMPLER BLDG 14, MANHOLE #00 OUTFALL

PARSHALLFLUME(QUARTERLY)

FOB: Destination

0005 4 Each

MAINTAIN FLOWMETER

FFP

BLDG 5, MANHOLE #427 BASE GOLF COURSE (QUARTERLY)

FOB: Destination

0006 4 Each

MAINTAIN FLOWMETER

FFP

BLDG 6, MANHOLE #410 BASE GOLF COURSE (QUARTERLY)

FOB: Destination

0007 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 1, MANHOLE #800 MILITARY FAMILY HOUSING (ANNUAL)

FOB: Destination

0008 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 2, MANHOLE #600, MILITARY FAMILY HOUSING (ANNUAL)

FOB: Destination

0009 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 3, MANHOLE #700 MILITARY FAMILY HOUSING (ANNUAL)

FOB: Destination

0010 1 Each

MAINTAIN FLOWMETER BLDG 4, MANHOLE 420

FFP

BLDG 4, MANHOLE #420, MILITARY FAMILY HOUSING (ANNUAL)

FOB: Destination

0011 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 7, MANHOLE# 405, BASE GOLF COURSE (ANNUAL)

FOB: Destination

0012 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 8, MANHOLE #214,#207(ANNUAL)

FOB: Destination

0013 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 9, MANHOLE# 231,#239 (ANNUAL)

FOB: Destination

0014 1 Each

MAINTAIN FLOWMETER

FFP

BLDG 10, MANHOLE #201 FLIGHT LINE LIFT STATION (ANNUAL)

FOB: Destination

0015 20,000 Each

ALTERATION / REPAIR COSTS

FFP

ALTERATION / REPAIR COSTS

NOTE: DO NOT PRICE. THIS LINE ITEM IS A NON-BID ITEM. THE

GOVERNMENT WILL FUND TO A SET AMOUNT EACH YEAR.

FOB: Destination

1001 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 11, MANHOLE 40 (Quarterly) FOB: Destination

1002 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 12, MANHOLE 39 (Quarterly)

1003 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 13, MANHOLE 1 JACKSONVILLE ANIMAL CONTROL (Quarterly)

1004 4 Each

OPTION MAINTAIN FLOWMETER

FFP

SAMPLER BLDG 14, MANHOLE #00 OUTFALL

PARSHALLFLUME(QUARTERLY)

1005 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 5, MANHOLE #427 BASE GOLF COURSE (QUARTERLY)

1006 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 6, MANHOLE #410 BASE GOLF COURSE (QUARTERLY)

1007 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 1, MANHOLE #800 MILITARY FAMILY HOUSING (ANNUAL)

1008 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 2, MANHOLE #600, MILITARY FAMILY HOUSING (ANNUAL)

1009 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 3, MANHOLE #700 MILITARY FAMILY HOUSING (ANNUAL)

1010 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 4, MANHOLE #420, MILITARY FAMILY HOUSING (ANNUAL)

1011 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 7, MANHOLE# 405, BASE GOLF COURSE (ANNUAL)

1012 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 8, MANHOLE #214,#207(ANNUAL)

1013 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 9, MANHOLE# 231,#239 (ANNUAL)

1014 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 10, MANHOLE #201 FLIGHT LINE LIFT STATION (ANNUAL)

1015 20,000 Each

OPTION ALTERATION / REPAIR COSTS

FFP

ALTERATION / REPAIR COSTS

NOTE: DO NOT PRICE. THIS LINE ITEM IS A NON-BID ITEM. THE

GOVERNMENT WILL FUND TO A SET AMOUNT EACH YEAR.

2001 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 11, MANHOLE 40 (Quarterly)

2002 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 12, MANHOLE 39 (Quarterly)

2003 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 13, MANHOLE 1 JACKSONVILLE ANIMAL CONTROL (Quarterly)

2004 4 Each

OPTION MAINTAIN FLOWMETER

FFP

SAMPLER BLDG 14, MANHOLE #00 OUTFALL

PARSHALLFLUME(QUARTERLY)

2005 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 5, MANHOLE #427 BASE GOLF COURSE (QUARTERLY)

2006 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 6, MANHOLE #410 BASE GOLF COURSE (QUARTERLY)

2007 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 1, MANHOLE #800 MILITARY FAMILY HOUSING (ANNUAL)

2008 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 2, MANHOLE #600, MILITARY FAMILY HOUSING (ANNUAL)

2009 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 3, MANHOLE #700 MILITARY FAMILY HOUSING (ANNUAL)

2010 1 Each

OPTION MAINTAIN FLOWMETER BLDG 4, MANHOLE 420

FFP

BLDG 4, MANHOLE #420, MILITARY FAMILY HOUSING (ANNUAL)

2011 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 7, MANHOLE# 405, BASE GOLF COURSE (ANNUAL)

2012 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 8, MANHOLE #214,#207(ANNUAL)

2013 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 9, MANHOLE# 231,#239 (ANNUAL)

2014 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 10, MANHOLE #201 FLIGHT LINE LIFT STATION (ANNUAL)

2015 20,000 Each

OPTION ALTERATION / REPAIR COSTS

FFP

ALTERATION / REPAIR COSTS

NOTE: DO NOT PRICE. THIS LINE ITEM IS A NON-BID ITEM. THE

GOVERNMENT WILL FUND TO A SET AMOUNT EACH YEAR.

3001 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 11, MANHOLE 40 (Quarterly)

3002 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 12, MANHOLE 39 (Quarterly)

3003 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 13, MANHOLE 1 JACKSONVILLE ANIMAL CONTROL (Quarterly)

3004 4 Each

OPTION MAINTAIN FLOWMETER

FFP

SAMPLER BLDG 14, MANHOLE #00 OUTFALL

PARSHALLFLUME(QUARTERLY)

3005 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 5, MANHOLE #427 BASE GOLF COURSE (QUARTERLY)

3006 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 6, MANHOLE #410 BASE GOLF COURSE (QUARTERLY)

3007 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 1, MANHOLE #800 MILITARY FAMILY HOUSING (ANNUAL)

3008 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 2, MANHOLE #600, MILITARY FAMILY HOUSING (ANNUAL)

3009 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 3, MANHOLE #700 MILITARY FAMILY HOUSING (ANNUAL)

3010 1 Each

OPTION MAINTAIN FLOWMETER BLDG 4, MANHOLE 420

FFP

BLDG 4, MANHOLE #420, MILITARY FAMILY HOUSING (ANNUAL)

3011 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 7, MANHOLE# 405, BASE GOLF COURSE (ANNUAL)

3012 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 8, MANHOLE #214,#207(ANNUAL)

3013 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 9, MANHOLE# 231,#239 (ANNUAL)

3014 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 10, MANHOLE #201 FLIGHT LINE LIFT STATION (ANNUAL)

3015 20,000 Each

OPTION ALTERATION / REPAIR COSTS

FFP

ALTERATION / REPAIR COSTS

NOTE: DO NOT PRICE. THIS LINE ITEM IS A NON-BID ITEM. THE

GOVERNMENT WILL FUND TO A SET AMOUNT EACH YEAR.

4001 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 11, MANHOLE 40 (Quarterly)

4002 4 Each

OPTION MAINTAIN FLOWMETER

FFP

MAINTAIN FLOWMETER BLDG 12, MANHOLE 39 (Quarterly)

4003 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 13, MANHOLE 1 JACKSONVILLE ANIMAL CONTROL (Quarterly)

4004 4 Each

OPTION MAINTAIN FLOWMETER

FFP

SAMPLER BLDG 14, MANHOLE #00 OUTFALL

PARSHALLFLUME(QUARTERLY)

4005 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 5, MANHOLE #427 BASE GOLF COURSE (QUARTERLY)

4006 4 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 6, MANHOLE #410 BASE GOLF COURSE (QUARTERLY)

4007 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 1, MANHOLE #800 MILITARY FAMILY HOUSING (ANNUAL)

4008 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 2, MANHOLE #600, MILITARY FAMILY HOUSING (ANNUAL)

4009 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 3, MANHOLE #700 MILITARY FAMILY HOUSING (ANNUAL)

4010 1 Each

OPTION MAINTAIN FLOWMETER BLDG 4, MANHOLE 420

FFP

BLDG 4, MANHOLE #420, MILITARY FAMILY HOUSING (ANNUAL)

4011 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 7, MANHOLE# 405, BASE GOLF COURSE (ANNUAL)

4012 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 8, MANHOLE #214,#207(ANNUAL)

4013 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 9, MANHOLE# 231,#239 (ANNUAL)

4014 1 Each

OPTION MAINTAIN FLOWMETER

FFP

BLDG 10, MANHOLE #201 FLIGHT LINE LIFT STATION (ANNUAL)

4015 20,000 Each

OPTION ALTERATION / REPAIR COSTS

FFP

ALTERATION / REPAIR COSTS

NOTE: DO NOT PRICE. THIS LINE ITEM IS A NON-BID ITEM. THE

GOVERNMENT WILL FUND TO A SET AMOUNT EACH YEAR.

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 0015 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 1015 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 2015 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 3015 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 4010 Destination Government Destination Government 4011 Destination Government Destination Government 4012 Destination Government Destination Government 4013 Destination Government Destination Government 4014 Destination Government Destination Government 4015 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 POP 01-OCT-2016 TO

30-SEP-2017

N/A 19 CES/CEIAR - F2S3C5

MIKE MINICK

528 THOMAS AVENUE RM 600

LITTLE ROCK AFB AR 72099

501-987-7187

F2S3C5

0002 POP 01-OCT-2016 TO

30-SEP-2017

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0005 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0006 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0007 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0008 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0009 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0010 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0011 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0012 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0013 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0014 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

0015 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 01-OCT-2017 TO

30-SEP-2018

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1004 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1005 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1006 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1007 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1008 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1009 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1010 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1011 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1012 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1013 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1014 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1015 POP 01-OCT-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-OCT-2018 TO

30-SEP-2019

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2004 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2005 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2006 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2007 POP 01-OCT-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2008 POP 01-OCT-2018 TO

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2009 POP 01-OCT-2018 TO

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2010 POP 01-OCT-2018 TO

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2011 POP 01-OCT-2018 TO

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2012 POP 01-OCT-2018 TO

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2013 POP 01-OCT-2018 TO

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2014 POP 01-OCT-2018 TO

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2015 POP 01-OCT-2018 TO

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3001 POP 01-OCT-2019 TO

30-SEP-2020

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-OCT-2019 TO

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3003 POP 01-OCT-2019 TO

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3004 POP 01-OCT-2019 TO

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3005 POP 01-OCT-2019 TO

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3006 POP 01-OCT-2019 TO

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3007 POP 01-OCT-2019 TO

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3008 POP 01-OCT-2019 TO

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3009 POP 01-OCT-2019 TO

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3010 POP 01-OCT-2019 TO

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3011 POP 01-OCT-2019 TO

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3012 POP 01-OCT-2019 TO

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3013 POP 01-OCT-2019 TO

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3014 POP 01-OCT-2019 TO

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3015 POP 01-OCT-2019 TO

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4001 POP 01-OCT-2020 TO

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4002 POP 01-OCT-2020 TO

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4003 POP 01-OCT-2020 TO

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4004 POP 01-OCT-2020 TO

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4005 POP 01-OCT-2020 TO

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4006 POP 01-OCT-2020 TO

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4007 POP 01-OCT-2020 TO

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4008 POP 01-OCT-2020 TO

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4009 POP 01-OCT-2020 TO

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4010 POP 01-OCT-2020 TO

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4011 POP 01-OCT-2020 TO

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4012 POP 01-OCT-2020 TO

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4013 POP 01-OCT-2020 TO

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4014 POP 01-OCT-2020 TO

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4015 POP 01-OCT-2020 TO

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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

52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights

APR 2014

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

OCT 2015

52.204-13 System for Award Management Maintenance JUL 2013 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 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment

OCT 2015

CLAUSES INCORPORATED BY FULL TEXT

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations. (NOV 2015)

(a) Definitions. As used in this clause--

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).

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.

(b) If the contractor reorganizes as an inverted domestic corporation or becomes a subsidiary of an inverted domestic corporation at any time during the period of performance of this contract, the Government may be prohibited from paying for Contractor activities performed after the date when it becomes an inverted domestic corporation or subsidiary. The Government may seek any available remedies in the event the Contractor fails to perform in accordance with the terms and conditions of the contract as a result of Government action under this clause.

(c) Exceptions to this prohibition are located at 9.108-2.

(d) In the event the Contractor becomes either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation during contract performance, the Contractor shall give written notice to the Contracting Officer within five business days from the date of the inversion event.

(End of clause)

CLAUSES INCORPORATED BY REFERENCE

52.212-1 Instructions to Offerors--Commercial Items OCT 2015 52.219-6 Notice Of Total Small Business Set-Aside NOV 2011 52.219-8 Utilization of Small Business Concerns OCT 2014 52.219-14 Limitations On Subcontracting NOV 2011 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 APR 2015 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 52.222-55 Minimum Wages Under Executive Order 13658 DEC 2015 52.222-56 Certification Regarding Trafficking in Persons Compliance

Plan.

MAR 2015

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

52.225-1 Buy American--Supplies MAY 2014 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 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 52.237-1 Site Visit APR 1984 52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.242-13 Bankruptcy JUL 1995 52.244-5 Competition In Subcontracting DEC 1996 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 FEB 2014 252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

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

252.223-7006 Prohibition On Storage, Treatment, and Disposal of Toxic or Hazardous Materials

SEP 2014

252.225-7001 Buy American And Balance Of Payments Program-- Basic (Nov 2014)

NOV 2014

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2012 252.225-7012 Preference For Certain Domestic Commodities FEB 2013 252.225-7048 Export-Controlled Items JUN 2013 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 252.247-7024 Notification Of Transportation Of Supplies By Sea MAR 2000

CLAUSES INCORPORATED BY FULL TEXT

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.

(End of provision)

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

Price

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (APR 2016)

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 accessed through http://www.acquisition.gov . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (r) 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 (q) 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. 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.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American – Supplies, is included in this solicitation.)

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the…