Elevator Mx Solicitation.doc

DOC document 647 KB Posted

Attached to
Elevator Maintenance Federal contract opportunity
Solicitation number
FA4659-12-R-0009
Issued by
Department of the Air Force Air Mobility Command

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Solicitation

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WD 86 Elevator Mx.doc DOC document
MEMORANDUM FOR PROSPECTIVE OFFERORS.docx DOCX document
ELEVATOR PWS FY12 —
Elev Mx-PAST AND PRESENT PERFORMANCE QUESTIONNAIRE.doc DOC document

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Text version

Section SF 1449 - CONTINUATION SHEET

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

Base Yr Elevator Maintenance

FFP

Provide all labor, brushes, lubricants, tools and materials necessary to perform Elevator Maintenance services at Grand Forks AFB North Dakota for the period 1 October 2012 – 30 September 2013 in accordance with the Performance Work Statement (PWS).

FOB: Destination

PURCHASE REQUEST NUMBER: F2A3E22044A001

SIGNAL CODE: A

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AA

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in Bldg 109, Dental Clinic--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AB

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in Bldg 541, AMU--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AC

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in Bldg 542, AMU--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AD

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in BLDG 629, AMU--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AE

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in Bldg 631, AMU--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AF

12
Months

Inspect, Test and Maintain Elevators

Inspect, Test and Maintain Elevator in Bldg 699, Control Tower--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AG

1
Each

Inspect, Test and Maintain Lift

Inspect, Test and Maintain Lift in Bldg 308, Fitness Center--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AH

1
Each

Inspect, Test and Maintain LIFT

Inspect, Test and Maintain Lift in Bldg, 418, CES Operations--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

0001AJ

1
Lump Sum

Reimbursable Parts and Service

Reimbursable Parts and Service NTE $5,000 Per 12 month Period of Performance--O&M

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1st Option Yr Elevator Mx

Provide all labor, brushes, lubricants, tools and materials necessary to perform Elevator Maintenance services at Grand Forks AFB North Dakota for the period 1 October 2013 – 30 September 2014 in accordance with the Performance Work Statement (PWS).

FOB: Destination

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AA

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 109, Dental Clinic--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AB

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 541, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AC

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 542, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AD

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in BLDG 629, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AE

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 631, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AF

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 699, Control Tower--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AG

1
Each
OPTION
Inspect, Test and Maintain Lift

FFP

Inspect, Test and Maintain Lift in Bldg 308, Fitness Center--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AH

1
Each
OPTION
Inspect, Test and Maintain LIFT

FFP

Inspect, Test and Maintain Lift in Bldg, 418, CES Operations--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

1001AJ

1
Lump Sum
OPTION
Reimbursable Parts and Service

FFP

Reimbursable Parts and Service NTE $5,000 Per 12 month Period of Performance--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2nd Option Yr Elevator Mx

Provide all labor, brushes, lubricants, tools and materials necessary to perform Elevator Maintenance services at Grand Forks AFB North Dakota for the period 1 October 2014 – 30 September 2015 in accordance with the Performance Work Statement (PWS).

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AA

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 109, Dental Clinic--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AB

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 541, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AC

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 542, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AD

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in BLDG 629, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AE

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 631, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AF

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 699, Control Tower--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AG

1
Each
OPTION
Inspect, Test and Maintain Lift

FFP

Inspect, Test and Maintain Lift in Bldg 308, Fitness Center--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AH

1
Each
OPTION
Inspect, Test and Maintain LIFT

FFP

Inspect, Test and Maintain Lift in Bldg, 418, CES Operations--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

2001AJ

1
Lump Sum
OPTION
Reimbursable Parts and Service

FFP

Reimbursable Parts and Service NTE $5,000 Per 12 month Period of Performance--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3rd Option Yr Elevator Mx

Provide all labor, brushes, lubricants, tools and materials necessary to perform Elevator Maintenance services at Grand Forks AFB North Dakota for the period 1 October 2015 – 30 September 2016 in accordance with the Performance Work Statement (PWS).

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AA

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 109, Dental Clinic--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AB

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 541, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AC

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 542, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AD

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in BLDG 629, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AE

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 631, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AF

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 699, Control Tower--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AG

1
Each
OPTION
Inspect, Test and Maintain Lift

FFP

Inspect, Test and Maintain Lift in Bldg 308, Fitness Center--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AH

1
Each
OPTION
Inspect, Test and Maintain LIFT

FFP

Inspect, Test and Maintain Lift in Bldg, 418, CES Operations--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

3001AJ

1
Lump Sum
OPTION
Reimbursable Parts and Service

FFP

Reimbursable Parts and Service NTE $5,000 Per 12 month Period of Performance--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4th Option Yr Elevator Mx

Provide all labor, brushes, lubricants, tools and materials necessary to perform Elevator Maintenance services at Grand Forks AFB North Dakota for the period 1 October 2016 – 30 September 2017 in accordance with the Performance Work Statement (PWS).

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AA

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 109, Dental Clinic--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AB

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 541, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AC

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 542, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AD

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in BLDG 629, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AE

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 631, AMU--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AF

12
Months
OPTION
Inspect, Test and Maintain Elevators

FFP

Inspect, Test and Maintain Elevator in Bldg 699, Control Tower--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AG

1
Each
OPTION
Inspect, Test and Maintain Lift

FFP

Inspect, Test and Maintain Lift in Bldg 308, Fitness Center--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AH

1
Each
OPTION
Inspect, Test and Maintain LIFT

FFP

Inspect, Test and Maintain Lift in Bldg, 418, CES Operations--O&M

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

4001AJ

1
Lump Sum
OPTION
Reimbursable Parts and Service

FFP

Reimbursable Parts and Service NTE $5,000 Per 12 month Period of Performance--O&M

NET AMT

RECAPITULATION

RECAPITULATION

Basic Period (1 Oct 2012 – 30 Sep 2013):

$----------------(EST)

First Option Period (1 Oct 2013 –30 Sep 2014):

$----------------(EST)

Second Option Period 1 Oct (2014 – 30 Sep 2015):

$----------------(EST)

Third Option Period (1 Oct 2015 – 30 Sep 2016):

$--------------- (EST)

Fourth Option Period (1 Oct 2016 – 30 Sep 2017):

$---------------- (EST)

Grand Total Amount (Items 0001AA – 4001AJ):

$---------------- (EST)

(End of Summary of Changes)

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
0001AA
Destination
Government
Destination
Government
0001AB
Destination
Government
Destination
Government
0001AC
Destination
Government
Destination
Government
0001AD
Destination
Government
Destination
Government
0001AE
Destination
Government
Destination
Government
0001AF
Destination
Government
Destination
Government
0001AG
Destination
Government
Destination
Government
0001AH
Destination
Government
Destination
Government
0001AJ
Destination
Government
Destination
Government
1001
N/A
N/A
N/A
Government
1001AA
Destination
Government
Destination
Government
1001AB
Destination
Government
Destination
Government
1001AC
Destination
Government
Destination
Government
1001AD
Destination
Government
Destination
Government
1001AE
Destination
Government
Destination
Government
1001AF
Destination
Government
Destination
Government
1001AG
Destination
Government
Destination
Government
1001AH
Destination
Government
Destination
Government
1001AJ
Destination
Government
Destination
Government
2001
N/A
N/A
N/A
Government
2001AA
Destination
Government
Destination
Government
2001AB
Destination
Government
Destination
Government
2001AC
Destination
Government
Destination
Government
2001AD
Destination
Government
Destination
Government
2001AE
Destination
Government
Destination
Government
2001AF
Destination
Government
Destination
Government
2001AG
Destination
Government
Destination
Government
2001AH
Destination
Government
Destination
Government
2001AJ
Destination
Government
Destination
Government
3001
N/A
N/A
N/A
Government
3001AA
Destination
Government
Destination
Government
3001AB
Destination
Government
Destination
Government
3001AC
Destination
Government
Destination
Government
3001AD
Destination
Government
Destination
Government
3001AE
Destination
Government
Destination
Government
3001AF
Destination
Government
Destination
Government
3001AG
Destination
Government
Destination
Government
3001AH
Destination
Government
Destination
Government
3001AJ
Destination
Government
Destination
Government
4001
N/A
N/A
N/A
Government
4001AA
Destination
Government
Destination
Government
4001AB
Destination
Government
Destination
Government
4001AC
Destination
Government
Destination
Government
4001AD
Destination
Government
Destination
Government
4001AE
Destination
Government
Destination
Government
4001AF
Destination
Government
Destination
Government
4001AG
Destination
Government
Destination
Government
4001AH
Destination
Government
Destination
Government
4001AJ
Destination
Government
Destination
Government

DELIVERY INFORMATION

CLIN
DELIVERY DATE
QUANTITY
SHIP TO ADDRESS
UIC
0001
N/A
N/A
N/A
N/A
0001AA
POP 01-OCT-2012 TO

30-SEP-2013

N/A
319 CES/CEO - F2A3E2

DAN LEMLER

575 TUSKEGEE AIRMEN BLVD, BLDG 410, RM 15

GRAND FORKS AFB ND 58205-6219

701-747-4781

F2A3E2

0001AB
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AC
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AD
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AE
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AF
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AG
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AH
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

0001AJ
POP 01-OCT-2012 TO

30-SEP-2013

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001
N/A
N/A
N/A
N/A
1001AA
POP 01-OCT-2013 TO

01-SEP-2014

N/A
319 CES/CEO - F2A3E2

DAN LEMLER

575 TUSKEGEE AIRMEN BLVD, BLDG 410, RM 15

GRAND FORKS AFB ND 58205-6219

701-747-4781

F2A3E2

1001AB
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AC
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AD
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AE
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AF
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AG
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AH
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

1001AJ
POP 01-OCT-2013 TO

30-SEP-2014

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001
N/A
N/A
N/A
N/A
2001AA
POP 01-OCT-2014 TO

30-SEP-2015

N/A
319 CES/CEO - F2A3E2

DAN LEMLER

575 TUSKEGEE AIRMEN BLVD, BLDG 410, RM 15

GRAND FORKS AFB ND 58205-6219

701-747-4781

F2A3E2

2001AB
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AC
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AD
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AE
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AF
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AG
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AH
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

2001AJ
POP 01-OCT-2014 TO

30-SEP-2015

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001
N/A
N/A
N/A
N/A
3001AA
POP 01-OCT-2015 TO

30-SEP-2016

N/A
319 CES/CEO - F2A3E2

DAN LEMLER

575 TUSKEGEE AIRMEN BLVD, BLDG 410, RM 15

GRAND FORKS AFB ND 58205-6219

701-747-4781

F2A3E2

3001AB
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AC
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AD
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AE
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AF
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AG
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AH
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

3001AJ
POP 01-OCT-2015 TO

30-SEP-2016

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001
N/A
N/A
N/A
N/A
4001AA
POP 01-OCT-2016 TO

30-SEP-2017

N/A
319 CES/CEO - F2A3E2

DAN LEMLER

575 TUSKEGEE AIRMEN BLVD, BLDG 410, RM 15

GRAND FORKS AFB ND 58205-6219

701-747-4781

F2A3E2

4001AB
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AC
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AD
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AE
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AF
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AG
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AH
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

4001AJ
POP 01-OCT-2016 TO

30-SEP-2017

N/A
(SAME AS PREVIOUS LOCATION)

F2A3E2

CLAUSES INCORPORATED BY REFERENCE

52.204-7
Central Contractor Registration
FEB 2012
52.204-9
Personal Identity Verification of Contractor Personnel
JAN 2011
52.204-10
Reporting Executive Compensation and First-Tier Subcontract Awards
FEB 2012
52.209-6
Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment
DEC 2010
52.212-1
Instructions to Offerors--Commercial Items
FEB 2012
52.212-4
Contract Terms and Conditions--Commercial Items
FEB 2012
52.215-1
Instructions to Offerors--Competitive Acquisition
JAN 2004
52.217-5
Evaluation Of Options
JUL 1990
52.222-1
Notice To The Government Of Labor Disputes
FEB 1997
52.222-3
Convict Labor
JUN 2003
52.222-19
Child Labor -- Cooperation with Authorities and Remedies
MAR 2012
52.222-21
Prohibition Of Segregated Facilities
FEB 1999
52.222-25
Affirmative Action Compliance
APR 1984
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
52.222-41
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
52.223-2
Affirmative Procurement of Biobased Products Under Service and Construction Contracts
DEC 2007
52.223-3
Hazardous Material Identification And Material Safety Data
JAN 1997
52.223-4
Recovered Material Certification
MAY 2008
52.223-5
Pollution Prevention and Right-to-Know Information
MAY 2011
52.223-6
Drug-Free Workplace
MAY 2001
52.223-17
Affirmative Procurement of EPA-Designated Items in Service and Construction Contracts
MAY 2008
52.223-18
Encouraging Contractor Policies To Ban Text Messaging While Driving
AUG 2011
52.225-13
Restrictions on Certain Foreign Purchases
JUN 2008
52.226-1
Utilization Of Indian Organizations And Indian-Owned Economic Enterprises
JUN 2000
52.232-18
Availability Of Funds
APR 1984
52.232-19
Availability Of Funds For The Next Fiscal Year
APR 1984
52.232-23
Assignment Of Claims
JAN 1986
52.232-28
Invitation to Propose Performance-Based Payments
MAR 2000
52.232-33
Payment by Electronic Funds Transfer--Central Contractor Registration
OCT 2003
52.233-1
Disputes
JUL 2002
52.233-3
Protest After Award
AUG 1996
52.233-4
Applicable Law for Breach of Contract Claim
OCT 2004
52.237-1
Site Visit
APR 1984
52.237-2
Protection Of Government Buildings, Equipment, And Vegetation
APR 1984
52.237-3
Continuity Of Services
JAN 1991
52.242-15
Stop-Work Order
AUG 1989
52.242-17
Government Delay Of Work
APR 1984
52.246-1
Contractor Inspection Requirements
APR 1984
52.246-4
Inspection Of Services--Fixed Price
AUG 1996
52.246-20
Warranty Of Services
MAY 2001
52.247-34
F.O.B. Destination
NOV 1991
52.249-1
Termination For Convenience Of The Government (Fixed Price) (Short Form)
APR 1984
52.253-1
Computer Generated Forms
JAN 1991
252.201-7000
Contracting Officer's Representative
DEC 1991
252.203-7000
Requirements Relating to Compensation of Former DoD Officials
SEP 2011
252.203-7002
Requirement to Inform Employees of Whistleblower Rights
JAN 2009
252.204-7000
Disclosure Of Information
DEC 1991
252.204-7003
Control Of Government Personnel Work Product
APR 1992
252.204-7004 Alt A
Central Contractor Registration Alternate A
SEP 2007
252.223-7006
Prohibition On Storage And Disposal Of Toxic And Hazardous Materials
APR 1993
252.225-7001
Buy American And Balance Of Payments Program
JUN 2012
252.225-7002
Qualifying Country Sources As Subcontractors
JUN 2012
252.225-7012
Preference For Certain Domestic Commodities
JUN 2010
252.232-7003
Electronic Submission of Payment Requests and Receiving Reports
MAR 2008
252.232-7010
Levies on Contract Payments
DEC 2006
252.237-7010
Prohibition on Interrogation of Detainees by Contractor Personnel
NOV 2010
252.243-7001
Pricing Of Contract Modifications
DEC 1991
252.246-7000
Material Inspection And Receiving Report
MAR 2008
252.247-7023 Alt III
Transportation of Supplies by Sea (May 2002) Alternate III
MAY 2002

52.212-1 ADDENDUM

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS

Addendum to 52.212-1(c), Period for Acceptance of Offers. The paragraph is tailored as follows: “The offeror agrees to hold the prices in its offer firm for 90 calendar days from the date specified for receipt of offers.”

ADDENDUM TO 52.212-1 PROPOSAL PREPARATION INSTRUCTIONS

A. To assure timely and equitable evaluation of the proposal, the offeror must follow the instructions contained herein. The proposal must be complete, self-sufficient, and respond directly to the requirements of this solicitation. The response shall consist of three (3) separate parts; Part I – Price Proposal, Part II – Past Performance Information.

B. The contracting officer has determined there is a high probability of adequate price competition in this acquisition. Upon examination of the initial offers, the contracting officer will review this determination and if, in the contracting officer’s opinion, adequate price competition exists no additional cost information will be requested, and certification under FAR 15.406-2 will not be required. However, if at any time during this competition the contracting officer determines that adequate price competition no longer exists offerors may be required to submit information other than cost or pricing data to support a determination of price reasonableness.

C. Specific Instructions:

1. PART I – PRICE PROPOSAL - Submit original and one (1) copy

(a) Complete blocks 12, 17a, and 30a, b, and c of the SF1449. In doing so, the offeror accedes to the contract terms and conditions as written in the solicitation, with attachments. The solicitation constitutes the model contract.

(b) Insert proposed unit and extended prices in the Pricing Schedule. The extended amount must equal the whole dollar unit price multiplied by the number of units. The proposal(s) must be submitted for a base year plus four (4) option years.

(c) Complete the necessary fill-ins and certifications in provisions. The provisions FAR 52.212-3 shall be returned along with the proposal.

2. PART II – PAST PERFORMANCE INFORMATION - Only references for same or similar type contracts are desired. Submit original and three (3) copies.

(a) Quality and Satisfaction Rating for Contracts Completed in the Past Three Years: Provide information currently available (letters, metrics, customer surveys, independent surveys, etc.) which demonstrates customer satisfaction with overall job performance and quality of completed product for same or similar type contract. In addition, explain corrective actions taken in the past, if any, for substandard performance and any current performance problems such as cost overruns, extended performance periods, numerous warranty calls, etc.

(b) Past Performance Surveys: The government will evaluate the quality and extent of offeror’s performance deemed relevant to the requirements of this solicitation. The government will use information submitted by the offeror and other sources, such as other Federal government offices and commercial sources, to assess performance. Provide a list of no more than five (5) of the most relevant contracts performed for Federal agencies and commercial customers within the last three years. Relevant contracts include Elevator maintenance services similar or greater in scope, magnitude, and complexity than the effort described in this solicitation. The evaluation of past performance information will take into account past performance information regarding predecessor companies, key personnel who have relevant experience, or subcontractors that will perform major or critical aspects of the requirement when such information is relevant to the instant acquisition. Furnish the following information for each contract referenced:

(i) Company/Division name

(ii) Product/Service

(iii) Contracting Agency/Customer

(iv) Contract Number

(v) Contract Dollar Value

(vi) Period of Performance

(vii) Verified, up-to-date name, address, FAX and telephone number of the contracting officer

(viii) Comments regarding compliance with contract terms and conditions

(ix) Comments regarding any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions.

If a teaming arrangement is contemplated, provide complete information as to the arrangement, including any relevant and recent past/present performance information on previous teaming arrangements with same partner. If this is a first-time joint effort, each party to the arrangement must provide a list of past and present relevant contracts, and have Past and Present Performance Questionnaires completed and submitted to the 319th Contracting Flight as stated in paragraph 3(c) below.

(c) Offerors must forward the attached Past and Present Performance Questionnaire (Attachment 3) to each of the points of contact identified for the contracts listed. In turn, the evaluating agencies shall submit the completed questionnaire directly to the 319th Contracting Flight no later than the proposal closing date and time. No questionnaire submittals will be accepted from the offeror being evaluated. Once the questionnaires are completed by the evaluator, the information shall be considered sensitive and shall not be released to the offeror. Offerors are responsible for ensuring that the questionnaires are completed and sent directly to the 319th Contracting Flight.

(d) Subcontractor Consent: Past performance information pertaining to a subcontractor cannot be disclosed to the prime offeror without the subcontractor’s consent. Provide with the proposal a letter from all subcontractors that will perform major or critical aspects of the requirement, consenting to the release of their past performance information to the prime contractor.

(e) Financial Data: Complete the attached Financial Institution Reference Sheet. Information obtained from the institution(s) identified will be used to determine whether a contractor has adequate financial resources to perform the contract or the ability to obtain them.

(f) Documents submitted in response to this solicitation must be fully responsive to and consistent with the following:

1. Requirements of the solicitation (Item Numbers) and Performance Work Statement (PWS), and government standards and regulations pertaining to the PWS.

2. Evaluation Factors for Award.

D. General Information

1. Information Regarding Submission of Proposal

(a) Offerors may not submit electronic proposals. Only handcarried or mailed proposals will be accepted. Proposals may be mailed to 319th Contracting Flight/LGCA, 575 Tuskegee Airmen Blvd, Grand Forks AFB ND 58205-6436. Handcarried proposals must be delivered to a representative of the 319th Contracting Flight, 575 Tuskegee Airmen Blvd, Grand Forks AFB ND, located in Building 418. The sealed envelope or package used to submit the proposal must show on the outside the time and date specified for receipt, the solicitation number, and the name and address of the offeror. This will make administrative personnel aware that they are in receipt of a proposal.

(b) Offerors are cautioned that Grand Forks AFB has visitor control procedures requiring individuals not affiliated with the installation to obtain a visitor pass prior to entrance. Some delay should be anticipated when handcarrying proposals. Offerors should allow sufficient time to obtain a visitor pass and arrive at the 319th Contracting Flight prior to the time specified for receipt. Late proposals will be processed in accordance with FAR 52.212-10(f), Late Submission, Modifications, Revisions, and Withdrawals of Offers.

2. Federal Holidays: The following Federal holidays are observed by this base:

New Year’s Day

1 January

Martin Luther King’s Birthday Third Monday in January

Presidents’ Day

Third Monday in February

Memorial Day

Last Monday in May

Independence Day

4 July

Labor Day

First Monday in September

Columbus Day

Second Monday in October

Veterans’ Day

11 November

Thanksgiving Day

Fourth Thursday in November

Christmas Day

25 Dec

3. Joint Venture Agreements. A joint venture may submit an offer on a HUBZone contract if it meets the requirements of 13 CFR Part 126.

CLAUSES INCORPORATED BY FULL TEXT

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:

(i) price; (ii) past performance

(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.

(End of provision)

Addendum to FAR 52.212-2:

BASIS FOR CONTRACT AWARD: This is a competitive selection in which competing offerors’ past and present performance history will be evaluated on a basis approximately equal to price. By submission of its offer in accordance with the instructions provided in clause FAR 52.212-1, Instructions to Offerors, the offeror accedes to the terms of this model contract and all such offers shall be treated equally except for their prices and performance records. The evaluation process shall proceed as follows:

A. Initially offers shall be ranked according to price, including option prices. An offeror’s proposed prices will be determined by multiplying the quantities identified in the Pricing Schedule by the unit price for each item to confirm the extended amount for each.

B. Using questionnaires, the contracting officer shall seek relevant performance information on all offerors based on (1) the references provided by the offeror and (2) data independently obtained from other government and commercial sources. Relevant performance includes performance of efforts involving Elevator maintenance services that are similar or greater in scope, magnitude, and complexity than the effort described in this solicitation. The government reserves the right to seek information on higher priced offerors if none of the lower priced offerors receive a “Substantial Confidence” performance assessment rating. The purpose of the past performance evaluation is to allow the government to assess the offeror’s ability to perform the effort described in the solicitation, based on the offeror’s demonstrated present and past performance. The assessment process will result in an overall performance confidence assessment rating of Substantial Confidence, Satisfactory Confidence, Limited Confidence, No Confidence, or Unknown Confidence. Past performance regarding predecessor companies, key personnel who have relevant experience, or subcontractors that will perform major or critical aspects of the requirement will be considered as highly as past performance information for the principal offeror. Offerors with no relevant past or present performance history or the offeror’s performance record is so limited that no confidence assessment rating can be reasonably assigned shall receive the rating “Unknown Confidence,” meaning the rating is treated neither favorably nor unfavorably. Confidence assessment ratings are defined as follows:

Substantial Confidence – Based on the offeror's performance record, the government has a high expectation that the offeror will successfully perform the required effort.

Satisfactory Confidence – Based on the offeror's performance record, the government has an expectation that the offeror will successfully perform the required effort.

Limited Confidence – Based on the offeror's performance record, the government has a low expectation that the offeror will successfully perform the required effort.

No Confidence – Based on the offeror's performance record, the government has no expectation that the offeror will be able to successfully perform the required effort.

Unknown Confidence – No performance record is identifiable or the offeror's performance record is so limited that no confidence assessment rating can be reasonably assigned.

C In evaluating past performance, the government reserves the right to give greater consideration to information on those contracts deemed most relevant to the effort described in this solicitation.

D. If the lowest priced evaluated technically acceptable offer is judged to have a “Substantial Confidence” performance assessment rating and is determined to be responsible, that offer represents the best value for the government, and the evaluation process stops at this point. Award shall be made to that offeror without further consideration of any other offers.

E. If the lowest priced offeror is not judged to have a “Substantial Confidence” performance confidence assessment, the next lowest priced offeror will be evaluated, and the process will continue (in order by price) until an offeror is judged to have a “Substantial Confidence” performance assessment or until all offerors are evaluated. The Source Selection Authority shall then make an integrated assessment best value award decision.

F. Offerors are cautioned to submit sufficient information and in the format specified in the proposal preparation instructions to permit a meaningful assessment of past performance. Offerors may be asked to clarify certain aspects of their proposal or respond to adverse past performance information to which the offeror has not previously had an opportunity to respond. Adverse past performance is defined as past performance information that supports a less than satisfactory rating on any evaluation element or any unfavorable comments received from sources without a formal rating system. Communication conducted to resolve minor or clerical errors will not constitute discussions, and the contracting officer reserves the right to award a contract without the opportunity for proposal revision.

H. The government intends to award a contract without discussions with respective offerors. The government, however, reserves the right to conduct discussions if deemed in its best interest.

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (MAR 2012) ALTERNATE I (APR 2011)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via https://www.acquisition.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (b) through (i) of this provision.

(a) Definitions. As used in this provision:

"Emerging small business" means a small business concern whose size is no greater than 50 percent of the numerical size standard for the NAICS code designated.

"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 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 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.

(b) (1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted electronically on the Online Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website accessed through https://www.acquisition.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications--Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ----------.

(Offeror to identify the applicable paragraphs at (c) through (n) 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 on ORCA.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

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

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, for general statistical purposes, that it ( ) is, ( ) is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ) is, ( ) is not a women-owned small business concern.

Note to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that--

(i) It * is, * is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It ( ) 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 in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern or concerns that are participating in the joint venture: .] Each WOSB concern 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 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)(7)(ii) of this provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns 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) Small Business Size for the Small Business Competitiveness Demonstration Program and for the Targeted Industry Categories under the Small Business Competitiveness Demonstration Program. (Complete only if the offeror has represented itself to be a small business concern under the size standards for this solicitation.)

(i) (Complete only for solicitations indicated in an addendum as being set-aside for emerging small businesses in one of the designated industry groups (DIGs).) The offeror represents as part of its offer that it ( ) is, ( ) is not an emerging small business.

(ii) (Complete only for solicitations indicated in an addendum as being for one of the targeted industry categories (TICs) or designated industry groups (DIGs).) Offeror represents as follows:

(A) Offeror's number of employees for the past 12 months (check the Employees column if size standard stated in the solicitation is expressed in terms of number of employees); or

(B) Offeror's average annual gross revenue for the last 3 fiscal years (check the Average Annual Gross Number of Revenues column if size standard stated in the solicitation is expressed in terms of annual receipts).

(Check one of the following):

Average Annual

Number of Employees Gross Revenues

___ 50 or fewer ___ $1 million or less

___ 51 - 100 ___ $1,000,001 - $2 million

___ 101 - 250 ___ $2,000,001 - $3.5 million

___ 251 - 500 ___ $3,500,001 - $5 million

___ 501 - 750 ___ $5,000,001 - $10 million

___ 751 - 1,000 ___ $10,000,001 - $17 million

___ Over 1,000 ___ Over $17 million

(11) (Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns or FAR 52.219-25, Small Disadvantaged Business Participation Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.)

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

(A) It ( ) is, ( ) is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the CCR Dynamic Small Business Search Database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into…

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