FA4654-14-B-0001_Medical_Services_Grissom_ARB _IN_31_Jan_2014.pdf

434 CONF/LGC

1900 W MUSTANG AVE

GRISSOM ARB IN 46971-1622

1-765-688-3101

1-765-688-2803

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE A DDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

(No Collect Call s)

$10.0M

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

X

CODE

FA 4654-14-B-0001 31-Jan-2014

b. TELEPHONE NUM BER

765 688-2807

8. OFF ER DUE DAT E/LOCAL T IM E

02:00 PM 21 Feb 2014

5. SOLICIT ATION NUM BER 6. SOLICITAT ION ISSUE DAT E

A UTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescr ibed by GSA

FA R (48 CFR) 53.212

( TYP E O R P RIN T)

(S IGNAT URE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Us e 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 REMITTA NCE IS DIFFERENT A ND PUT

BELOW IS CHECKED

TEL.

FA 4654

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

18b. SUBMIT INVOICES TO A DDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

7. FOR SOLICITATION

INFORM AT ION CALL:

a. NAM E

DON A ROQUE

2. CONTRACT NO. 3. AWARD/EFF ECTIVE DATE 4. ORDER NUM BER

(TYPE OR PRINT)

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

30a. SIGNA TURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

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

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISIT ION NUM BER

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

SEE SCHEDULE

621111

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

F5D3093352A001

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:

0 COPIES

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

.OFFER DATED Y OUR OFFER ON SOLICITATION

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

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 PAY MENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM /DD) 42d. TOTAL CONTAINERS

STANDA RD FORM 1449 (REV 3/2005) BA CK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCA L REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

FA4654-14-B-0001

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 150 Lot

Medical Examination Services

FFP

Contactor in accordance with the Statement of work shall provide all labor, facilities, material, equipment, labs and necessary medical testing and supervision necessary to perform examinations for applicants/employees, to include but not limited to: -Pre-employment physicals -Fitness-for-duty physicals - Occupational and occupational annual exams -Post-exposure evaluations - Employment termination physicals -Overseas employment physicals -Vision and hearing exams as specified on Standard Form 78, Certificate of Medical Examination, or other designated forms.

FOB: Destination

PURCHASE REQUEST NUMBER: F5D3093352A001

NET AMT

1001 150 Lot

OPTION Option Year 1

FFP

Option Year 1

Contactor in accordance with the Statement of work shall provide all labor, facilities, material, equipment, labs and necessary medical testing and supervision necessary to perform examinations for applicants/employees, to include but not limited to: -Pre-employment physicals -Fitness-for-duty physicals - Occupational and occupational annual exams -Post-exposure evaluations - Employment termination physicals -Overseas employment physicals -Vision and hearing exams as specified on Standard Form 78, Certificate of Medical Examination, or other designated forms.

2001 150 Lot

OPTION Option Year 2

FFP

Option Year 2

Contactor in accordance with the Statement of work shall provide all labor, facilities, material, equipment, labs and necessary medical testing and supervision necessary to perform examinations for applicants/employees, to include but not limited to: -Pre-employment physicals -Fitness-for-duty physicals - Occupational and occupational annual exams -Post-exposure evaluations - Employment termination physicals -Overseas employment physicals -Vision and hearing exams as specified on Standard Form 78, Certificate of Medical Examination, or other designated forms.

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government 1001 N/A N/A N/A Government 2001 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 POP 01-APR-2014 TO

31-MAR-2015

N/A N/A

1001 POP 01-APR-2015 TO

31-MAR-2016

2001 POP 01-APR-2016 TO

31-MAR-2017

PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT (PWS)

PHYSICAL EXAMINATIONS FOR NEW APPOINTMENTS, TRANSFER ELIGIBLES,

FITNESS FOR DUTY, OVERSEAS EMPLOYMENT AND OTHER MISCELLANEOUS

PHYSICALS OR TESTING FOR FEDERALLY EMPLOYED CIVILIANS

GRISSOM AIR RESERVE BASE, INDIANA

JANUARY 2014

1. Introduction

1.1 Scope. The Contract Physician shall provide all labor, facilities, material, equipment, labs and necessary medical testing and supervision necessary to perform examinations for applicants/employees, to include but not limited to: pre-employment physicals, fitness-for-duty physicals, occupational and occupational annual exams, post-exposure evaluations, employment termination physicals, overseas employment physicals, and vision and hearing exams as specified on Standard Form 78, Certificate of Medical Examination, or other designated forms.

The Contract Physician must be Board Certified in Occupational Health to provide physicals.

Audiograms must be performed by a technician certified by the Council for Accreditation and Occupational Hearing Conservation (CAOHC). Testing for illegal drugs will not be done as part of annual medical evaluations. Additionally, the Contract Physician’s facility must have the capability to perform examinations for Firefighters and Police Officers, to include but not limited to pre-employment, occupational health and fitness-for-duty examinations in accordance with prescribed regulations and certification requirements. Physical examinations and all other procedures will be performed at the Contract Physician’s place of business. All procedures/tests will be performed during the initial visit with no return visits to be scheduled unless the Grissom Air Reserve Base (GARB) Civilian Personnel Office (434 FSMC) designated representative (Designated Representative) requests further examination/testing. If the Contract Physician believes that follow-up medical exams and/or tests are required, the Contract Physician must provide a rationale before approval of any additional testing or follow-up visits will be granted.

The Contract Physician will mail, fax, or send via electronic means (but will not provide to the applicant/employee) all medical exam results and documentation within 48 hours from completion of the examination in accordance with the Health Insurance Portability and Accountability Act (HIPPA). This includes laboratory, audiometric, radiology or diagnostic tests and immunizations. The Contract Physician will become the agent of GARB and sign off on all medical documentation as the Medical Provider and the Agency Medical Officer.

1.2 Non-personal Services: The services performed under this contract shall be non-personal services and are not inherently governmental. The prime contractor retains responsibility for any teaming partner or subcontractor and shall be accountable for their performance.

2. Definitions

Designated Representative: Any agency point of contact authorized to make appointments with the contractor. Those points of contact are:

Shari Matz Ruth Tyson Tammy Schlarf

Contract Physician: The prime contractor.

Contracting Officer: The person with authority to enter into, administer or terminate contracts, and make related determinations and findings on behalf of the Government. Note: The only individual who can legally bind the Government.

3. Purpose

A medical examination is appropriate only for a position which has specific medical standards, physical requirements or is covered by a medical evaluation program established by regulation.

Requests for fitness-for-duty, occupational and occupational annual exams, post-exposure, and termination physicals may require more extensive testing as specified on the Standard Form 78 or other designated forms. This program shall provide physicals for specific categories of applicants/employees to include Firefighters and Police Officers. This program shall also provide pre-appointment, fitness-for-duty, occupational and occupational annual exams, post-exposure evaluations, termination, and overseas employment physicals. This is to determine if applicants/employees are medically qualified for, or continue to be medically qualified for, federal employment. Any questions concerning physical examination scope, to include scheduling, for the life of this contract shall be addressed through the Designated Representative to the Contracting Officer.

4. Services Required

The Contract Physician shall perform the following services listed below, all such services to be performed in accordance with all applicable standards and requirements, as provided to the Contract Physician by the Designated Representative:

The Designated Representative will call the Contract Physician and schedule appointments in accordance with the statement of work and occupational medical requirements for each applicant/employee. Instructions will be provided to the Contract Physician by the Designated Representative for individuals to receive the specified medical examination or required testing.

Any services above and beyond the basic requirements must be requested by the Contract

Physician for prior authorization and approval from the Designated Representative before continuing additional medical assessment, testing, examination or referrals. The Contract Physician will provide to the Designated Representative any and all documentation evidencing the results of the assessment, testing, examination or referrals as required by the Designated Representative.

4.1 Pre-employment examination: The Contract Physician will be provided the Standard Form 78 (SF 78) (atch 1) and position description (PD) (atch 2) either by the individual to be examined or by facsimile or electronic transmission. The Contract Physician will review the checked items listed under “A – Functional Requirements” and “B – Environmental Factors” of the SF 78 and the physical requirements contained in the PD to ascertain if the individual is medically qualified for the position. The Contract Physician will complete Part C “To Be Completed by Examining Physician,” sections 1-4, “Part D – to be Completed by Agency Medical Officer” (Contract Physician), sections 104, and “Part F – Handicap Code” of the SF 78.

The completed form must be signed by the Contract Physician with appropriate recommendation(s) and returned to the Designated Representative within 48 hours from completion of the physical.

4.2 Periodic Examination: Tests and/or physical examination accomplished at intervals to evaluate return to duty after injury.

4.3 Fitness-for-Duty Examination: A fitness for duty examination may be required whenever there is a question about an employee’s continued capacity to meet the physical, mental or medical requirement of the position. A medical examination may be requested in any situation where additional medical documentation is needed to make an informed management decision.

The examination will be based on the SF 78 and PD, and any existing medical documentation from the employee’s personal civilian physician. The completed SF 78 must be signed by the Contract Physician with appropriate recommendation(s) and returned to the Designated Representative within 48 hours from completion of the physical examination.

4.4 Physical Requirements for Annual Occupational Exam: The Designated Representative will provide the medical requirements needed for each occupational medical exam via information provided on the AF Form 2755, Master Workplace Exposure Data Summary (atch 3), and the required tests as identified on the AF Form 2766, Clinical Occupational Health Examination Requirements (atch 4). One of each of these forms will be provided to the contractor for each Industrial Workcenter whose personnel require occupational physical examinations. The medical reports and supporting documentation will be provided to the Designated Representative within 48 hours from completion of the annual examination. Results of the annual exam are to be filed in the employee’s civilian medical records file. In addition to the SF 78, the Contract Physician must provide a previous workplace exposure history, SF 600 (atch 5).

4.5 Post-Exposure Exam: The Designated Representative will provide the medical requirements needed for each medical exam. If the Contract Physician deems further evaluation/medical testing is necessary, he/she is to contact the Designated Representative for approval prior to proceeding with further testing. Medical evaluation documentation is to include the Contract Physician’s written medical opinion of exposure, written physical exam, all radiological, laboratory testing and any other medical testing completed to make a determination of the exposure. These reports are to be provided to the Designated Representative within 48 hours from completion of the medical post exposure exam. In addition to the SF 78, the Contract Physician must provide a previous workplace exposure history, SF 600.

4.6 Overseas Employment Physical: An overseas employment physical will be required whenever an applicant or employee has been selected for overseas employment. The Contract Physician will be provided the SF 78 and PD either by the individual to be examined or by facsimile or electronic transmission. These documents will be used to conduct the examination in order to determine the individual’s fitness for employment in the oversea area. The Contract Physician will review the job description and checked items listed under “A– Functional Requirements” and “B – Environmental Factors” of the Standard Form 78 to ascertain if the individual is medically qualified. The Contract Physician will complete “Part C – to be completed by Examining Physician,” sections 1-4 and “Part – D to be completed by Agency Medical Officer (Contractor),” sections 1-4 and “Part F – Handicap Code” of the Standard Form

78. The completed Standard Form 78 and supporting documentation must be signed by the Contract Physician with appropriate recommendations and returned to the Designated Representative within 48 hours from completion of the examination. In addition to the Standard Form 78, the Contract Physician must provide a previous workplace exposure history, SF 600.

4.7. For Firefighters: All examinations must be conducted in accordance with National Fire Protection Association Codes (NFPA), Technical Implementation Guide (TIG) 1582 (atch 6), Occupational Safety and Health Administration (OSHA) 29 CFR § 1910, DoD 6055.05-M, and Air Force Standards.

The Contract Physician will perform examinations as part of the National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.

4.8 For Police Officers: All examinations and testing will be conducted in accordance with the requirements of Air Force Instruction 31-122, Department of the Air Force Civilian Police/Security Guard (DAF CP/SG) Program, and with all applicable regulations, laws and standards set forth therein. These examinations will include, but not be limited to, pre-employment exams, fitness-for-duty exams, periodic occupational health and injury compensation examinations, and medical clearance for the Physical Agility Testing (PAT) (atch 7).

4.9 For Personnel Requiring the Use of Tight-Fitting Respirators: Contractor shall review both Initial and Annual Respirator Medical Evaluation Questionnaires (atch 8, 9), as well as the AF Form 2755 associated with the employee’s Industrial Workcenter, in order to evaluate, make appropriate recommendations based on findings, and indicate whether an employee is physically able to perform their work while wearing the prescribed respiratory protection. If additional testing is required, notify the Designated Representative.

5. Hours of Operation

All appointments will be scheduled/performed during the predetermined hours of operation developed by GARB and the Contract Physician on a recurring schedule. The schedule will be flexible to meet the needs of GARB. Business hours at GARB are Monday through Friday, 0730-1600 hours; except Federal Holidays. Requests for exceptions to this requirement will be coordinated with the Designated Representative.

6. Quality Assurance Evaluation (QAE)

434 SG will perform QAE surveillance over the work being provided by the Contract Physician within 30 days of the contract being executed and on an ongoing basis during the duration of the contract. All applicable regulations and guidance shall be provided to the Contract Physician by the QAE so that the Contract Physician may comply with the requirements thereof.

7. Contractor Requirements

The Contract Physician is responsible for providing his/her own facility and all machines and equipment to conduct physical/medical exams and testing.

8. Location

All work to be performed will take place at the Contract Physician’s offices within a 30-mile radius of Grissom Air Reserve Base.

9. Government Points of Contact

Shari Matz – Provided Post Award Ruth Tyson – Tammy Schlarf –

10. Attachments

1. Certificate of Medical Examination – Standard Form 78

2. Position Description (PD)

3. Master Workplace Exposure Data Summary – AF-2755

4. Clinical Occupational Health Examination Requirements – AF-2766

5. Chronological Record of Medical Care – Standard Form 600

6. Technical Implementation Guide (TIG)

7. AFI 31-122, Air Force Civilian Police/Security Guard (DAF CP/SG) Program, and Medical Clearance for Physical

8. Initial Respirator Medical Evaluation Questionnaire

9. Annual Respirator Medical Evaluation Questionnaire

Projected number of exams on a yearly basis:

Pre-employment 5

Periodic 15-25

Fitness for duty 6

Annual Firefighters 50-60 Police officers 18-20

PAT 18-20

Post-exposure 1

Overseas employment 1

Termination 2

Courtesy 5

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions NOV 2013 52.203-3 Gratuities APR 1984 52.203-5 Covenant Against Contingent Fees APR 1984 52.203-6 Restrictions On Subcontractor Sales To The Government SEP 2006 52.203-7 Anti-Kickback Procedures OCT 2010 52.203-8 Cancellation, Rescission, and Recovery of Funds for Illegal or

Improper Activity

JAN 1997

52.203-10 Price Or Fee Adjustment For Illegal Or Improper Activity JAN 1997 52.203-12 Limitation On Payments To Influence Certain Federal

Transactions

OCT 2010

52.203-16 Preventing Personal Conflicts of Interest DEC 2011 52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber

Content Paper

MAY 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

52.209-10 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 52.219-6 Notice Of Total Small Business Set-Aside NOV 2011 52.219-8 Utilization of Small Business Concerns JUL 2013 52.219-25 Small Disadvantaged Business Participation Program--

Disadvantaged Status and Reporting

JUL 2013

52.219-26 Small Disadvantaged Business Participation Program-- Incentive Subcontracting

OCT 2000

52.222-1 Notice To The Government Of Labor Disputes FEB 1997 52.222-3 Convict Labor JUN 2003 52.222-4 Contract Work Hours and Safety Standards Act - Overtime

Compensation

JUL 2005

52.222-15 Certification of Eligibility FEB 1988 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 52.222-51 Exemption from Application of the Service Contract act to

Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Requirements

NOV 2007

52.222-54 Employment Eligibility Verification AUG 2013 52.223-3 Hazardous Material Identification And Material Safety Data JAN 1997 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011 52.223-6 Drug-Free Workplace MAY 2001 52.223-9 Estimate of Percentage of Recovered Material Content for

EPA-Designated Items

MAY 2008

52.223-11 Ozone-Depleting Substances MAY 2001 52.223-15 Energy Efficiency in Energy-Consuming Products DEC 2007 52.223-16 IEEE 1680 Standard for the Environmental Assessment of

Personal Computer Products

DEC 2007

52.223-18 Encouraging Contractor Policies To Ban Text Messaging While Driving

AUG 2011

52.223-19 Compliance with Environmental Management Systems MAY 2011 52.225-3 Buy American Act--Free Trade Agreement--Israeli Trade Act NOV 2012 52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.225-19 Contractor Personnel in a Designated Operational Area or

Supporting a Diplomatic or Consular Mission Outside the United States

MAR 2008

52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-- Representation and Certifications.

DEC 2012

52.226-1 Utilization Of Indian Organizations And Indian-Owned Economic Enterprises

JUN 2000

52.227-1 Authorization and Consent DEC 2007 52.227-2 Notice And Assistance Regarding Patent And Copyright

Infringement

DEC 2007

52.227-5 Waiver of Indemnity APR 1984 52.229-3 Federal, State And Local Taxes FEB 2013 52.232-1 Payments APR 1984 52.232-8 Discounts For Prompt Payment FEB 2002 52.232-9 Limitation On Withholding Of Payments APR 1984 52.232-17 Interest OCT 2010 52.232-23 Assignment Of Claims JAN 1986 52.232-25 Prompt Payment JUL 2013 52.233-1 Alt I Disputes (Jul 2002) - Alternate I DEC 1991 52.233-3 Protest After Award AUG 1996 52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.237-11 Accepting and Dispensing of $1 Coin SEP 2008 52.242-13 Bankruptcy JUL 1995 52.242-15 Stop-Work Order AUG 1989 52.242-17 Government Delay Of Work APR 1984 52.244-6 Subcontracts for Commercial Items DEC 2013 52.245-1 Government Property APR 2012 52.245-2 Government Property Installation Operation Services APR 2012 52.245-9 Use And Charges APR 2012 52.246-4 Inspection Of Services--Fixed Price AUG 1996 52.246-20 Warranty Of Services MAY 2001 52.248-1 Value Engineering OCT 2010 52.249-2 Alt I Termination for Convenience of the Government (Fixed-

Price) (Apr 2012) - Alternate I

SEP 1996

52.249-4 Termination For Convenience Of The Government (Services) (Short Form)

APR 1984

52.249-8 Default (Fixed-Price Supply & Service) APR 1984 52.253-1 Computer Generated Forms JAN 1991 252.203-7001 Prohibition On Persons Convicted of Fraud or Other Defense-

Contract-Related Felonies

DEC 2008

252.204-7001 Commercial And Government Entity (CAGE) Code Reporting

AUG 1999

252.204-7004 Alt A System for Award Management Alternate A MAY 2013 252.204-7005 Oral Attestation of Security Responsibilities NOV 2001 252.219-7003 Small Business Subcontracting Plan (DOD Contracts) AUG 2012 252.223-7006 Prohibition On Storage And Disposal Of Toxic And

Hazardous Materials

APR 2012

252.225-7001 Buy American And Balance Of Payments Program DEC 2012 252.225-7012 Preference For Certain Domestic Commodities FEB 2013 252.225-7030 Restriction On Acquisition Of Carbon, Alloy, And Armor

Steel Plate

DEC 2006

252.225-7036 Buy American--Free Trade Agreement--Balance of Payments Program

DEC 2012

252.225-7036 Alt I Buy American--Free Trade Agreement--Balance of Payments Program (DEC 2012) Alternate I

JUN 2012

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 252.246-7003 Notification of Potential Safety Issues JUN 2013

CLAUSES INCORPORATED BY FULL TEXT

52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2014)

(a)(1) The North American Industry Classification System (NAICS) code for this acquisition is [insert NAICS code].

(2) The small business size standard is [insert size standard].

(3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

(b)(1) If the provision at 52.204-7, Central Contractor Registration, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the provision at 52.204-7 is not included in this solicitation, and the offeror is currently registered in CCR, and has completed the ORCA electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes:

( ) Paragraph (d) applies.

( ) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c)(1) The following representations or certifications in ORCA are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless--

(A) The acquisition is to be made under the simplified acquisition procedures in Part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, Central Contractor Registration.

(iv) 52.204-5, Women-Owned Business (Other Than Small Business).This provision applies to solicitations that--

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

(C) Are for contracts that will be performed in the United States or its outlying areas.

(v) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations--Representation. This provision applies to solicitations using funds appropriated in fiscal years 2008, 2009, 2010, or 2012.

(vi) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(vii) 52.223-5, Pollution Prevention and Right-to-Know Information (May 2011) (E.O. 13423) (Applies to services performed on Federal facilities).

(viii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

(ix) 52.219-1, Small Business Program Representations (Basic & Alternate I). This provision applies to solicitations when the contract will be performed in the United States or its outlying areas.

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(x) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas.

(xi) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

(xii) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xiii) 52.222-38, Compliance with Veterans' Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial items.

(xiv) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA-designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

(xv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA-designated items.

(xvi) 52.225-2, Buy American Act Certificate. This provision applies to solicitations containing the clause at 52.225- 1.

(xvii) 52.225-4, Buy American Act--Free Trade Agreements--Israeli Trade Act Certificate. (Basic, Alternates I, II, and III.) This provision applies to solicitations containing the clause at 52.225-3.

(A) If the acquisition value is less than $25,000, the basic provision applies.

(B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies.

(C) If the acquisition value is $50,000 or more but is less than $79,507, the provision with its Alternate II applies.

(D) If the acquisition value is $79,507 or more but is less than $100,000, the provision with its Alternate III applies.

(xviii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xix) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan--Certification. This provision applies to all solicitations.

(xx) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran--Representation and Certifications. This provision applies to all solicitations.

(xxi) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to--

(A) Solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions; and

(B) For DoD, NASA, and Coast Guard acquisitions, solicitations that contain the clause at 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns.

(2) The following certifications are applicable as indicated by the Contracting Officer:

(Contracting Officer check as appropriate.)

(i) 52.219-22, Small Disadvantaged Business Status.

(A) Basic.

(B) Alternate I.

(ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

(iii) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification.

(iv) 52.222-52, Exemption from Application of the Service Contract Act to Contracts for Certain

Services–Certification.

(v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA–Designated Products (Alternate I only).

(vi) 52.227-6, Royalty Information.

(A) Basic.

(B) Alternate I.

(vii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

(d) The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) website accessed through https://www.acquisition.gov.

After reviewing the ORCA database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within 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 the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. 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.

FAR Clause Title Date Change

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 on SAM.

(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).

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING RESPONSIBILITY

MATTERS (JULY 2013)

(a) The Contractor shall update the information in the Federal Awardee Performance and Integrity Information System (FAPIIS) on a semi-annual basis, throughout the life of the contract, by posting the required information in the System for Award Management database via https://www.acquisition.gov.

(b) As required by section 3010 of the Supplemental Appropriations Act, 2010 (Pub. L. 111-212), all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available. FAPIIS consists of two segments--

(1) The non-public segment, into which Government officials and the Contractor post information, which can only be viewed by--

(i) Government personnel and authorized users performing business on behalf of the Government; or

(ii) The Contractor, when viewing data on itself; and

(2) The publicly-available segment, to which all data in the non-public segment of FAPIIS is automatically transferred after a waiting period of 14 calendar days, except for--

(i) Past performance reviews required by subpart 42.15;

(ii) Information that was entered prior to April 15, 2011; or

(iii) Information that is withdrawn during the 14-calendar-day waiting period by the Government official who posted it in accordance with paragraph (c)(1) of this clause.

(c) The Contractor will receive notification when the Government posts new information to the Contractor's record.

(1) If the Contractor asserts in writing within 7 calendar days, to the Government official who posted the information, that some of the information posted to the non-public segment of FAPIIS is covered by a disclosure exemption under the Freedom of Information Act, the Government official who posted the information must within 7 calendar days remove the posting from FAPIIS and resolve the issue in accordance with agency Freedom of Information procedures, prior to reposting the releasable information. The contractor must cite 52.209-9 and request removal within 7 calendar days of the posting to FAPIIS.

(2) The Contractor will also have an opportunity to post comments regarding information that has been posted by the Government. The comments will be retained as long as the associated information is retained, i.e., for a total period of 6 years. Contractor comments will remain a part of the record unless the Contractor revises them.

(3) As required by section 3010 of Pub. L. 111-212, all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available.

(d) Public requests for system information posted prior to April 15, 2011, will be handled under Freedom of Information Act procedures, including, where appropriate, procedures promulgated under E.O. 12600.

(End of clause)

52.211-2 AVAILABILITY OF SPECIFICATIONS, STANDARDS, AND DATA ITEM DESCRIPTIONS

LISTED IN THE ACQUISITION STREAMLINING AND STANDARDIZATION INFORMATION SYSTEM

(ASSIST) (JAN 2006)

(a) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites:

(1) ASSIST (http://assist.daps.dla.mil);

(2) Quick Search (http://assist.daps.dla.mil/quicksearch);

(3) ASSISTdocs.com (http://assistdocs.com).

(b) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by--

(1) Using the ASSIST Shopping Wizard (http://assist.daps.dla.mil/wizard);

(2) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(3) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone

(215) 697-2667/2179, Facsimile (215) 697-1462.

52.212-2 EVALUATION--COMMERCIAL ITEMS (JAN 1999)

(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:

Lowest Priced Bid Technically Acceptable.

(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 (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.

"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…