FA5215-16-R-0002_(Maui_BOS).pdf

SEE ADDENDUM

(No Collect Calls)

FA5215-16-R-0002 03-Oct-2016

b. TELEPHONE NUMBER

808-448-2971

8. OFFER DUE DATE/LOCAL TIME

08:00 AM 03 Nov 2016

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

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

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

FA52159. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

2LT COURTNEY DEARTH

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

(TYPE OR PRINT)

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

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

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

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

766 SPECIALIZED CONTRACTING SQDN FA5215

90 G STREET BLDG 1201

JB PEARL HARBOR-HICKAM HI 96853-5320

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE F2KBAH 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

AFRL

MICHAEL A. HOLLOWAY

550 LIPOA PARKWAY

KIHEI HI 97653

TEL: (808) 891-7740 FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

X 8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$38.5M

NAICS:

561210

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF71

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

FA5215-16-R-0002

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 2 Months

PHASE-IN / TRANSITION PERIOD

FFP

Contractor shall provide all necessary non-personal services to manage and support phase-in / transition to assume full operational capability in accordance with the

PWS and as described in Section 10.1.

Period of Performance: 01 July 2017 - 31 August 2017

FOB: Destination

SIGNAL CODE: A

NET AMT

0002 10 Months

FACILITIES OPERATION AND SUSTAINMENT

FFP

Contractor shall perform all facilities operation & sustainment of the AMOS sites located at Mt. Haleakala and Kihei, Maui. Furnish all labor and services required to comply with the PWS and as identified in Sections 1, 2, 5, 6, 7.1-7.13, 7.16-

7.17, 7.19-7.22, and 10.

Period of Performance: 1 September 2017 - 30 June 2018

0003 10 Months

SECURITY

FFP

Contractor shall perform all security services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Sections 3 and 7.18.

Period of Performance: 1 September 2017 - 30 June 2018

0004 10 Months

LOGISTICS

FFP

Contractor shall perform all logistics services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Section 4.

Period of Performance: 1 September 2017 - 30 June 2018

0005 10 Months

ENVIRONMENTAL

FFP

Contractor shall perform all environmental services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS Section 9.

Period of Performance: 1 September 2017 - 30 June 2018

0006 1 Lot

OVER AND ABOVE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all Over and Above services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS and as identified in

Table 7.1 and Section 7.3.3.1. Ref: Appendix 27.

Period of Performance: 1 September 2017 - 30 June 2018

Contractor is NOT required to provide a bid amount on this CLIN, and any amount identified on this CLIN will not be used during evaluation of the total evaluated price.

0007 1 Lot

SUBSISTENCE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all subsistence services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with the PWS Sections 7.14, 7.15, and 8.

price.

0008 1 Lot

PROJECT MATERIALS

FFP

NOT TO EXCEED (NTE)

Contractor shall acquire project materials when and as directed by the CO in support of BOS services for the AMOS sites located at Mt. Haleakala and Kihei, Maui. In addition, facility and infrastructure projects and materials required to complete approved Work Orders as defined in PWS Table 7.1; and as validated by the Site CE and approved by the CO through the Work Order Review Board as detailed in PWS Section 7.5.5.

price.

1002 12 Months

OPTION FACILITIES OPERATION AND SUSTAINMENT

FFP

Contractor shall perform all facilities operation & sustainment of the AMOS sites located at Mt. Haleakala and Kihei, Maui. Furnish all labor and services required to comply with the PWS and as identified in Sections 1, 2, 5, 6, 7.1-7.13, 7.16-

7.17, 7.19-7.22, and 10.

Option 1 Period of Performance: 1 July 2018 - 30 June 2019

1003 12 Months

OPTION SECURITY

FFP

Contractor shall perform all security services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Sections 3 and 7.18.

Option 1 Period of Performance: 1 July 2018 - 30 June 2019

1004 12 Months

OPTION LOGISTICS

FFP

Contractor shall perform all logistics services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Section 4.

Option 1 Period of Performance: 1 July 2018 - 30 June 2019

1005 12 Months

OPTION ENVIRONMENTAL

FFP

Contractor shall perform all environmental services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS Section 9.

Option 1 Period of Performance: 1 July 2018 - 30 June 2019

1006 1 Lot

OPTION OVER AND ABOVE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all Over and Above services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS and as identified in

Option 1 Period of Performance: 1 July 2018 - 30 June 2019 price.

1007 1 Lot

OPTION SUBSISTENCE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all subsistence services at the AMOS sites located at Mt.

price.

1008 1 Lot

OPTION PROJECT MATERIALS

FFP

NOT TO EXCEED (NTE)

Contractor shall acquire project materials when and as directed by the CO in support of BOS services for the AMOS sites located at Mt. Haleakala and Kihei, Maui. In addition, facility and infrastructure projects and materials required to complete approved Work Orders as defined in PWS Table 7.1; and as validated by the Site CE and approved by the CO through the Work Order Review Board as price.

2002 12 Months

OPTION FACILITY OPERATION AND SUSTAINMENT

FFP

Contractor shall perform all facilities operation & sustainment of the AMOS sites located at Mt. Haleakala and Kihei, Maui. Furnish all labor and services required to comply with the PWS and as identified in Sections 1, 2, 5, 6, 7.1-7.13, 7.16-

7.17, 7.19-7.22, and 10.

Option 2 Period of Performance: 1 July 2019 - 30 June 2020

2003 12 Months

OPTION SECURITY

FFP

Contractor shall perform all security services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Sections 3 and 7.18.

Option 2 Period of Performance: 1 July 2019 - 30 June 2020

2004 12 Months

OPTION LOGISTICS

FFP

Contractor shall perform all logistics services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Section 4.

Option 2 Period of Performance: 1 July 2019 - 30 June 2020

2005 12 Months

OPTION ENVIRONMENTAL

FFP

Contractor shall perform all environmental services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS Section 9.

Option 2 Period of Performance: 1 July 2019 - 30 June 2020

2006 1 Lot

OPTION OVER AND ABOVE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all Over and Above services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS and identified in Table

7.1 and Section 7.3.3.1. Ref: Appendix 27.

Option 2 Period of Performance: 1 July 2019 - 30 June 2020 price.

2007 1 Lot

OPTION SUBSISTENCE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all subsistence services at the AMOS sites located at Mt.

price.

2008 1 Lot

OPTION PROJECT MATERIALS

FFP

NOT TO EXCEED (NTE)

Contractor shall acquire project materials when and as directed by the CO in support of BOS services for the AMOS sites located at Mt. Haleakala and Kihei, Maui. In addition, facility and infrastructure projects and materials required to complete approved Work Orders as defined in PWS Table 7.1; and as validated by the Site CE and approved by the CO through the Work Order Review Board as price.

3002 12 Months

OPTION FACILITIES OPERATION AND SUSTAINMENT

FFP

Contractor shall perform all facilities operation & sustainment of the AMOS sites located at Mt. Haleakala and Kihei, Maui. Furnish all labor and services required to comply with the PWS and as identified in Sections 1, 2, 5, 6, 7.1-7.13, 7.16-

7.17, 7.19-7.22, and 10.

Option 3 Period of Performance: 1 July 2020 - 30 June 2021

3003 12 Months

OPTION SECURITY

FFP

Contractor shall perform all security services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Sections 3 and 7.18.

Option 3 Period of Performance: 1 July 2020 - 30 June 2021

3004 12 Months

OPTION LOGISTICS

FFP

Contractor shall perform all logistics services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Section 4.

Option 3 Period of Performance: 1 July 2020 - 30 June 2021

3005 12 Months

OPTION ENVIRONMENTAL

FFP

Contractor shall perform all environmental services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS Section 9.

Option 3 Period of Performance: 1 July 2020 - 30 June 2021

3006 1 Lot

OPTION OVER AND ABOVE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all Over and Above services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS and as identified in

Option 3 Period of Performance: 1 July 2020 - 30 June 2021 price.

3007 1 Lot

OPTION SUBSISTENCE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all subsistence services at the AMOS sites located at Mt.

price.

3008 1 Lot

OPTION PROJECT MATERIALS

FFP

NOT TO EXCEED (NTE)

Contractor shall acquire project materials when and as directed by the CO in support of BOS services for the AMOS sites located at Mt. Haleakala and Kihei, Maui. In addition, facility and infrastructure projects and materials required to complete approved Work Orders as defined in PWS Table 7.1; and as validated by the Site CE and approved by the CO through the Work Order Review Board as price.

4002 12 Months

OPTION FACILITIES OPERATION AND SUSTAINMENT

FFP

Contractor shall perform all facilities operation & sustainment of the AMOS sites located at Mt. Haleakala and Kihei, Maui. Furnish all labor and services required to comply with the PWS and as identified in Sections 1, 2, 5, 6, 7.1-7.13, 7.16-

7.17, 7.19-7.22, and 10.

Option 4 Period of Performance: 1 July 2021 - 30 June 2022

4003 12 Months

OPTION SECURITY

FFP

Contractor shall perform all security services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Sections 3 and 7.18.

Option 4 Period of Performance: 1 July 2021 - 30 June 2022

4004 12 Months

OPTION LOGISTICS

FFP

Contractor shall perform all logistics services at the AMOS sites located at Mt.

Haleakala and Kihei, Maui in accordance with PWS, Section 4.

Option 4 Period of Performance: 1 July 2021 - 30 June 2022

4005 12 Months

OPTION ENVIRONMENTAL

FFP

Contractor shall perform all environmental services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS Section 9.

Option 4 Period of Performance: 1 July 2021 - 30 June 2022

4006 1 Lot

OPTION OVER AND ABOVE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all Over and Above services at the AMOS sites located at

Mt. Haleakala and Kihei, Maui in accordance with the PWS and as identified in

Option 4 Period of Performance: 1 July 2021 - 30 June 2022 price.

4007 1 Lot

OPTION SUBSISTENCE

FFP

NOT TO EXCEED (NTE)

Contractor shall perform all subsistence services at the AMOS sites located at Mt.

price.

4008 1 Lot

OPTION PROJECT MATERIALS

FFP

NOT TO EXCEED (NTE)

Contractor shall acquire project materials when and as directed by the CO in support of BOS services for the AMOS sites located at Mt. Haleakala and Kihei, Maui. In addition, facility and infrastructure projects and materials required to complete approved Work Orders as defined in PWS Table 7.1; and as validated by the Site CE and approved by the CO through the Work Order Review Board as price.

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government

0003 Destination Government Destination Government

0004 Destination Government Destination Government

0005 Destination Government Destination Government

0006 Destination Government Destination Government

0007 Destination Government Destination Government

0008 Destination Government Destination Government

1002 Destination Government Destination Government

1003 Destination Government Destination Government

1004 Destination Government Destination Government

1005 Destination Government Destination Government

1006 Destination Government Destination Government

1007 Destination Government Destination Government

1008 Destination Government Destination Government

2002 Destination Government Destination Government

2003 Destination Government Destination Government

2004 Destination Government Destination Government

2005 Destination Government Destination Government

2006 Destination Government Destination Government

2007 Destination Government Destination Government

2008 Destination Government Destination Government

3002 Destination Government Destination Government

3003 Destination Government Destination Government

3004 Destination Government Destination Government

3005 Destination Government Destination Government

3006 Destination Government Destination Government

3007 Destination Government Destination Government

3008 Destination Government Destination Government

4002 Destination Government Destination Government

4003 Destination Government Destination Government

4004 Destination Government Destination Government

4005 Destination Government Destination Government

4006 Destination Government Destination Government

4007 Destination Government Destination Government

4008 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 POP 01-JUL-2017 TO

31-AUG-2017

N/A AFRL

MICHAEL A. HOLLOWAY

550 LIPOA PARKWAY

KIHEI HI 97653

(808) 891-7740

F2KBAH

0002 POP 01-SEP-2017 TO

30-JUN-2018

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

0005 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

0006 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

0007 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

0008 POP 01-SEP-2017 TO

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 01-JUL-2018 TO

30-JUN-2019

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1004 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1005 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1006 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1007 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1008 POP 01-JUL-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-JUL-2019 TO

30-JUN-2020

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2004 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2005 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2006 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2007 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2008 POP 01-JUL-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-JUL-2020 TO

30-JUN-2021

N/A (SAME AS PREVIOUS LOCATION)

3003 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3004 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3005 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3006 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3007 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3008 POP 01-JUL-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-JUL-2021 TO

30-JUN-2022

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4004 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4005 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4006 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4007 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4008 POP 01-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.203-3 Gratuities APR 1984

52.203-5 Covenant Against Contingent Fees MAY 2014

52.203-6 Alt I Restrictions On Subcontractor Sales To The Government

(Sep 2006) -- Alternate I

OCT 1995

52.203-7 Anti-Kickback Procedures MAY 2014

52.203-11 Certification And Disclosure Regarding Payments To

Influence Certain Federal Transactions

SEP 2007

52.203-12 Limitation On Payments To Influence Certain Federal

Transactions

OCT 2010

52.203-17 Contractor Employee Whistleblower Rights and Requirement

To Inform Employees of Whistleblower Rights

APR 2014

52.204-2 Security Requirements AUG 1996

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

Content Paper

MAY 2011

52.204-7 System for Award Management JUL 2013

52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011

52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

OCT 2015

52.204-13 System for Award Management Maintenance JUL 2013

52.204-14 Service Contract Reporting Requirements JAN 2014

52.204-16 Commercial and Government Entity Code Reporting JUL 2015

52.204-17 Ownership or Control of Offeror NOV 2014

52.204-18 Commercial and Government Entity Code Maintenance JUL 2015

52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.209-2 Prohibition on Contracting with Inverted Domestic

Corporations--Representation

NOV 2015

52.209-6 Protecting the Government's Interest When Subcontracting

With Contractors Debarred, Suspended, or Proposed for

Debarment

OCT 2015

52.209-9 Updates of Publicly Available Information Regarding

Responsibility Matters

JUL 2013

52.209-10 Prohibition on Contracting With Inverted Domestic

Corporations

NOV 2015

52.211-13 Time Extensions SEP 2000

52.212-1 Instructions to Offerors--Commercial Items OCT 2015

52.212-2 Evaluation - Commercial Items OCT 2014

52.212-4 Contract Terms and Conditions--Commercial Items MAY 2015

52.215-1 Instructions to Offerors--Competitive Acquisition JAN 2004

52.215-14 Integrity of Unit Prices OCT 2010

52.217-5 Evaluation Of Options JUL 1990

52.219-6 Notice Of Total Small Business Set-Aside NOV 2011

52.219-14 Limitations On Subcontracting NOV 2011

52.219-28 Post-Award Small Business Program Rerepresentation JUL 2013

52.222-1 Notice To The Government Of Labor Disputes FEB 1997

52.222-3 Convict Labor JUN 2003

52.222-6 Construction Wage Rate Requirements MAY 2014

52.222-7 Withholding of Funds MAY 2014

52.222-8 Payrolls and Basic Records MAY 2014

52.222-9 Apprentices and Trainees JUL 2005

52.222-10 Compliance with Copeland Act Requirements FEB 1988

52.222-11 Subcontracts (Labor Standards) MAY 2014

52.222-12 Contract Termination-Debarment MAY 2014

52.222-13 Compliance With Construction Wage Rate Requirements and

Related Regulations

MAY 2014

52.222-14 Disputes Concerning Labor Standards FEB 1988

52.222-15 Certification of Eligibility MAY 2014

52.222-16 Approval of Wage Rates MAY 2014

52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation FEB 1999

52.222-27 Affirmative Action Compliance Requirements for

Construction

APR 2015

52.222-32 Construction Wage Rate Requirements--Price Adjustment

(Actual Method)

MAY 2014

52.222-43 Fair Labor Standards Act And Service Contract Labor

Standards - Price Adjustment (Multiple Year And Option

Contracts)

MAY 2014

52.222-50 Combating Trafficking in Persons MAR 2015

52.223-3 Hazardous Material Identification And Material Safety Data JAN 1997

52.223-5 Alt I Pollution Prevention and Right-to-Know Information (May

2011) Alternate I

MAY 2011

52.223-6 Drug-Free Workplace MAY 2001

52.223-10 Waste Reduction Program MAY 2011

52.223-12 Refrigeration Equipment and Air Conditioners MAY 1995

52.223-15 Energy Efficiency in Energy-Consuming Products DEC 2007

52.223-16 Acquisition of EPEAT (R) - Registered Personal Computer

Products

OCT 2015

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

52.223-19 Compliance with Environmental Management Systems MAY 2011

52.224-1 Privacy Act Notification APR 1984

52.224-2 Privacy Act APR 1984

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008

52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran-- Representation and Certifications.

OCT 2015

52.227-1 Authorization and Consent DEC 2007

52.227-2 Notice And Assistance Regarding Patent And Copyright

Infringement

DEC 2007

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

52.229-3 Federal, State And Local Taxes FEB 2013

52.232-1 Payments APR 1984

52.232-4 Payments Under Transportation Contracts and

Transportation-Related Services Contracts

APR 1984

52.232-5 Payments under Fixed-Price Construction Contracts MAY 2014

52.232-8 Discounts For Prompt Payment FEB 2002

52.232-9 Limitation On Withholding Of Payments APR 1984

52.232-11 Extras APR 1984

52.232-17 Interest MAY 2014

52.232-18 Availability Of Funds APR 1984

52.232-23 Assignment Of Claims MAY 2014

52.232-27 Prompt Payment for Construction Contracts MAY 2014

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

Management

JUL 2013

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-1 Disputes MAY 2014

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

52.242-13 Bankruptcy JUL 1995

52.242-14 Suspension of Work APR 1984

52.242-15 Stop-Work Order AUG 1989

52.243-1 Changes--Fixed Price AUG 1987

52.243-1 Alt II Changes--Fixed-Price (Aug 1987) - Alternate II APR 1984

52.243-4 Changes JUN 2007

52.245-1 Government Property APR 2012

52.245-9 Use And Charges APR 2012

52.246-2 Inspection Of Supplies--Fixed Price AUG 1996

52.246-4 Inspection Of Services--Fixed Price AUG 1996

52.246-12 Inspection of Construction AUG 1996

52.246-13 Inspection--Dismantling, Demolition, or Removal of

Improvements

AUG 1996

52.246-20 Warranty Of Services MAY 2001

52.246-25 Limitation Of Liability--Services FEB 1997

52.247-12 Supervision, Labor, or Materials APR 1984

52.247-14 Contractor Responsibility for Receipt of Shipment APR 1984

52.247-15 Contractor Responsibility for Loading and Unloading APR 1984

52.247-17 Charges APR 1984

52.247-21 Contractor Liability for Personal Injury and/or Property

Damage

APR 1984

52.247-22 Contractor Liability for Loss of and/or Damage to Freight

Other Than Household Goods

APR 1984

52.247-27 Contract Not Affected by Oral Agreement APR 1984

52.247-34 F.O.B. Destination NOV 1991

52.247-68 Report of Shipment (REPSHIP) FEB 2006

52.249-2 Termination For Convenience Of The Government (Fixed-

Price)

APR 2012

52.249-2 Alt I Termination for Convenience of the Government (Fixed-

Price) (Apr 2012) - Alternate I

SEP 1996

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

52.249-10 Default (Fixed-Price Construction) APR 1984

52.253-1 Computer Generated Forms JAN 1991

252.201-7000 Contracting Officer's Representative DEC 1991

252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013

252.203-7003 Agency Office of the Inspector General DEC 2012

252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7000 Disclosure Of Information AUG 2013

252.204-7003 Control Of Government Personnel Work Product APR 1992

252.204-7004 Alt A System for Award Management Alternate A FEB 2014

252.204-7006 Billing Instructions OCT 2005

252.205-7000 Provision Of Information To Cooperative Agreement Holders DEC 1991

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

The Government of a Country that is a State Sponsor of

Terrorism

OCT 2015

252.209-7999 (Dev) Representation by Corporations Regarding an Unpaid

Delinquent Tax Liability or a Felony Conviction under any

Federal Law (Deviation)

JAN 2012

252.211-7003 Item Unique Identification and Valuation DEC 2013

252.211-7008 Use of Government-Assigned Serial Numbers SEP 2010

252.219-7011 Notification to Delay Performance JUN 1998

252.223-7001 Hazard Warning Labels DEC 1991

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

Hazardous Materials

SEP 2014

252.225-7001 Buy American And Balance Of Payments Program-- Basic

(Nov 2014)

NOV 2014

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2012

252.225-7004 Report of Intended Performance Outside the United States and Canada--Submission after Award

OCT 2015

252.225-7012 Preference For Certain Domestic Commodities FEB 2013

252.225-7048 Export-Controlled Items JUN 2013

252.226-7001 Utilization of Indian Organizations and Indian-Owned

Economic Enterprises, and Native Hawaiian Small Business

Concerns

SEP 2004

252.227-7033 Rights in Shop Drawings APR 1966

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006

252.239-7001 Information Assurance Contractor Training and Certification JAN 2008

252.243-7001 Pricing Of Contract Modifications DEC 1991

252.243-7002 Requests for Equitable Adjustment DEC 2012

252.244-7000 Subcontracts for Commercial Items JUN 2013

252.245-7001 Tagging, Labeling, and Marking of Government-Furnished

Property

APR 2012

252.245-7002 Reporting Loss of Government Property APR 2012

252.245-7003 Contractor Property Management System Administration APR 2012

252.245-7004 Reporting, Reutilization, and Disposal MAR 2015

252.246-7004 Safety of Facilities, Infrastructure, and Equipment for

Military Operations

OCT 2010

252.247-7003 Pass-Through of Motor Carrier Fuel Surcharge Adjustment

To The Cost Bearer

JUN 2013

252.247-7022 Representation Of Extent Of Transportation Of Supplies By

Sea

AUG 1992

252.247-7023 Transportation of Supplies by Sea APR 2014

252.247-7024 Notification Of Transportation Of Supplies By Sea MAR 2000

CLAUSES INCORPORATED BY FULL TEXT

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).

(End of provision)

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

ALTERNATE I (OCT 2014)

The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site accessed through http://www.acquisition.gov . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (r) of this provision.

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

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“Forced or indentured child labor” means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

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

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation,” means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except—

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

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

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

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

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

(8) PSC 9610, Ores;

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

(10) PSC 9630, Additive Metal Materials.

“Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

“Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

Sensitive technology—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act

(50 U.S.C. 1702(b)(3)).

“Service-disabled veteran-owned small business concern”—

(1) Means a small business concern—

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

“Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

“Small disadvantaged business concern, consistent with 13 CFR 124.1002,” means a small business concern under the size standard applicable to the acquisition, that--

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by--

(i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

“Subsidiary” means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

“Veteran-owned small business concern” means a small business concern—

(1) Not less than 51 percent of which is owned by one or more veterans(as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

“Women-owned business concern” means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

“Women-owned small business concern” means a small business concern --

(1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least

51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127),” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the

United States.

(b)

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

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ___ . [Offeror to identify the applicable paragraphs at (c) through (q) of this provision that the offeror has completed for the purposes of this solicitation only, if any. These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer. Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract is to be performed in the

United States or its outlying areas. Check all that apply.

https://www.acquisition.gov/

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

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

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

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

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

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

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

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

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB

Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___ .] Each

WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

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

(i) It [ ___ ] is, [ ___ ] is not an EDWOSB concern, has provided all the required documents to the WOSB

Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___ .] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it [ ___ ] is, a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that--

(i) It [ ___ ] is, [ ___ ] is not a HUBZone small business concern listed, on the date of this representation, on the

List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and

(ii) It [ ___ ] is, [ ___ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: ___ .] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.)

[The offeror shall check the category in which its ownership falls]:

___ Black American.

___ Hispanic American.

___ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).

___ Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana

Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).

___ Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri

Lanka, Bhutan, the Maldives Islands, or Nepal).

___ Individual/concern, other than one of the preceding.

(d) Representations required to implement provisions of Executive Order 11246 --

(1) Previous contracts and compliance. The offeror represents that --

(i) It [ ___ ] has, [ ___ ] has not, participated in a previous contract or subcontract subject to the Equal

Opportunity clause of this solicitation; and

(ii) It [ ___ ] has, [ ___ ] has not, filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that --

(i) It [ ___ ] has developed and has on file, [ ___ ] has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts

60-1 and 60-2), or

(ii) It [ ___ ] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of

Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB

Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy

American – Supplies, is included in this solicitation.)

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