08-T-0162.doc

Section SF 1449 - CONTINUATION SHEET

Web Based Texting (48th MDG)

FFP

- Monthly subscription for web based texting - Period of Performance (Base Period) 01 Oct 2008 - 30 Sept 2009

FOB: Destination

NSN: S113-P1-MED-PAGE

PURCHASE REQUEST NUMBER: F2P4MD8169AL02

SIGNAL CODE: A

NET AMT

Tone Pager (48th MDG)

- Monthly rental, up to 4 alerts, group call capable, up to 3 group calls, national area - A minimum of 1 and a maximum of 5 tone pager for use by the Medical Group as per attached Statement of Work (SOW) - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Numeric Pager (48th MDG)

- Monthly Rental, up to 4 alerts, group call capable, up to 6 group calls, national area - A minimum of 1 and a maximum of 2 numeric pagers for use by the Medical Group as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Mesage Pager (48th MDG)

- Monthly rental, 2 lines up to 4 alerts, group call capable, up to 6 group calls, national areas - A minimum of 1 and a maximum of 160 message pagers for use by the Medical Group as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Pager Group Call (48th MDG)

- Monthly rental, pager group call feature, message pager - A minimum of 1 and a maximum of 5 pagers group call for use by the Medical Group as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Lost Tone Pager (48th MDG)

- Cost to replace lost tone pager

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Lost Numeric Pager (48th MDG)

- Cost to replace lost numeric pager

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Lost Message Pager (48th MDG)

- Cost to replace lost message pager

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

Tone Pager (100 CS/SCXR)

- Monthly rental, up to 4 alerts, no group calls, national areas - A minimum of 1 and a maximum of 7 tone pagers for use by the 100 CS/SCXR as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MIL-PAGE

PURCHASE REQUEST NUMBER: F3B3C18232AC01

NET AMT

Numeric Pager (100 CS/SCXR)

- Monthly rental, up to 4 alerts, no group calls, national areas

- A minimum of 1 and a maximum of 50 numeric pagers for use by the 100 CS/SCXR as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Message Pager (100 CS/SCXR)

- Montly rental, up to 4 alerts, group call capable, up to 6 group calls - A minimum of 1 and a maximum of 26 message pagers for use by the 100 CS/SCXR as per attached SOW - Period of performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Group Call (100 CS/SCXR)

- Monthly rental of pager group call feature for message pager - Period of Performance (Base Period): 01 Oct 2008 - 30 Sep 2009

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Lost Tone Pager (100 CS/SCXR)

- Cost to replace lost tone pager

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Lost Numeric Pager (100 CS/SCXR)

- Cost to replace lost numeric pagers

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Lost Message Pager (100 CS/SCXR)

- Cost to replace lost message pager

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

Tone Pager (48th CS/SCOT)

- Monthly rental, Up to 4 alerts - A maximum of 12 tone pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 through 30 Sep 2009

FOB: Destination

NSN: S113-P1-LAK-PAGE

PURCHASE REQUEST NUMBER: F2P3C18241AC01

NET AMT

Numeric Pager (48th CS/SCOT)

- Monthly rental, Up to 4 alerts - A minimum of 1 and maximum of 30 numeric pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 through 30 Sep 2009

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Numeric Pager (48th CS/SCOT)

- Monthly rental and group call capable - A minimum of 1 and maximum of 12 numeric pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 through 30 Sep 2009

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Message Pager (48th CS/SCOT)

- Monthly rental, up to 4 alerts - A minimum of 1 and a maximum of 60 message pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 through 30 Sep 2009

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Message Pager (48th CS/SCOT)

- Monthly charge and group call feature - A minimum of 1 and a maximum of 10 message pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Base Period): 01 Oct 2008 through 30 Sep 2009

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Replace Tone Pager (48th CS/SCOT)

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Replace Numeric Pager (48th CS/SCOT)

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

Replace Message Pager (48th CS/SCOT)

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

FFP

- Monthly subscription for web based texting - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NSN: S113-P1-MED-PAGE

NET AMT

FFP

- Monthly rental, up to 4 alerts, group call capable, up to 3 group calls, national area - A minimum of 1 and a maximum of 5 tone pager for use by the Medical Group as per attached Statement of Work (SOW) - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly Rental, up to 4 alerts, group call capable, up to 6 group calls, national area - A minimum of 1 and a maximum of 2 numeric pagers for use by the Medical Group as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly rental, 2 lines up to 4 alerts, group call capable, up to 6 group calls, national areas - A minimum of 1 and a maximum of 160 message pagers for use by the Medical Group as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly rental, pager group call feature, message pager - A minimum of 1 and a maximum of 5 pagers group call for use by the Medical Group as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Cost to replace lost tone pager

FOB: Destination

NET AMT

FFP

- Cost to replace lost numeric pager

FOB: Destination

NET AMT

FFP

- Cost to replace lost message pager

FOB: Destination

NET AMT

FFP

- Monthly rental, up to 4 alerts, no group calls, national areas - A minimum of 1 and a maximum of 7 tone pagers for use by the 100 CS/SCXR as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NSN: S113-P1-MIL-PAGE

NET AMT

FFP

- Monthly rental, up to 4 alerts, no group calls, national areas

- A minimum of 1 and a maximum of 50 numeric pagers for use by the 100 CS/SCXR as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Montly rental, up to 4 alerts, group call capable, up to 6 group calls - A minimum of 1 and a maximum of 26 message pagers for use by the 100 CS/SCXR as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly rental of pager group call feature for message pager - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Cost to replace lost tone pager

FOB: Destination

NET AMT

FFP

- Cost to replace lost numeric pagers

FOB: Destination

NET AMT

FFP

- Cost to replace lost message pager

FOB: Destination

NET AMT

FFP

- Monthly rental, Up to 4 alerts - A maximum of 12 tone pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NSN: S113-P1-LAK-PAGE

NET AMT

FFP

- Monthly rental, Up to 4 alerts - A minimum of 1 and maximum of 30 numeric pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly rental and group call capable - A minimum of 1 and maximum of 12 numeric pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly rental, up to 4 alerts - A minimum of 1 and a maximum of 60 message pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

- Monthly charge and group call feature - A minimum of 1 and a maximum of 10 message pagers for use by the 48th CS/SCOT as per attached SOW - Period of Performance (Option Period One) 01 Oct 2009 - 30 Sept 2010

FOB: Destination

NET AMT

FFP

FOB: Destination

NET AMT

FFP

FOB: Destination

NET AMT

FFP

FOB: Destination

NET AMT

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

30-SEP-2009

DONNA HAMPTON

BLDG 930

UNIT 5210, BOX 230

APO AE 09461

226-8542

FOB: Destination

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

F2P4MD

30-SEP-2009

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL IP28 8NG

01638 543495

F3B3C1

30-SEP-2009

F3B3C1

30-SEP-2009

F3B3C1

30-SEP-2009

F3B3C1

30-SEP-2009

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL

SUFFOLK

IP28 8NG UNITED KINGDOM

01638 543495

F3B3C1

30-SEP-2009

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL IP28 8NG

01638 543495

F3B3C1

30-SEP-2009

F3B3C1

30-SEP-2009

JUDY GALLOP

BLDG 1495

APO AE 09461

226-3338

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2009

F2P3C1

30-SEP-2010

DONNA HAMPTON

BLDG 930

UNIT 5210, BOX 230

APO AE 09461

226-8542

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

F2P4MD

30-SEP-2010

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL IP28 8NG

01638 543495

F3B3C1

30-SEP-2010

F3B3C1

30-SEP-2010

F3B3C1

30-SEP-2010

F3B3C1

30-SEP-2010

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL

SUFFOLK

IP28 8NG UNITED KINGDOM

01638 543495

F3B3C1

30-SEP-2010

MSGT CHRISTOPHER ALLEN

BLDG# 591

RAF MILDENHALL IP28 8NG

01638 543495

F3B3C1

30-SEP-2010

F3B3C1

30-SEP-2010

JUDY GALLOP

BLDG 1495

APO AE 09461

226-3338

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

30-SEP-2010

F2P3C1

CLAUSES INCORPORATED BY REFERENCE

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

(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 clause)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (JUN 2008) ALTERNATE I (APR 2002)

An offeror shall complete only paragraph (k) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.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.

“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 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.

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.

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 on the Online Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website at http://orca.bpn.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 (m) 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: Complete paragraphs (c)(6) and (c)(7) only if this solicitation is expected to exceed the simplified acquisition threshold.

(6) 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.

(7) 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:

(8) 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

(9) (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 database maintained by the Small Business Administration (PRO-Net), and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); or

(B) It ( ) has, ( )( has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

(ii) Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(9)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. (The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ____________.)

(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 change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR part 126; and

(ii) It ( ) is, ( ) is not a 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 the HUBZone small business concern or concerns that are participating in the joint venture. (The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture:____________.) Each HUBZone small business concern participating in the 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) or (c)(9) 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, U.S. Trust Territory of the Pacific Islands (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) Certifications and 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 either to the Equal Opportunity clause of this solicitation, the 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 Subparts 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 $100,000.) 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 Act--Balance of Payments Program Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act--Balance of Payments Program--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 the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products. The terms ``component,'' ``domestic end product,'' ``end product,'' ``foreign end product,'' and ``United States'' are defined in the clause of this solicitation entitled ``Buy American Act--Supplies.''

(2) Foreign End Products:

Line Item No.:---------------------------------------------------------

Country of Origin:-----------------------------------------------------

(List as necessary)

(3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(g)

(1) Buy American Act -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American Act -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian or Moroccan end product,” “component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American Act--Free Trade Agreements--Israeli Trade Act.”

(ii) ) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian or Moroccan end products) or Israeli end products as defined in the clause of this solicitation entitled ``Buy American Act--Free Trade Agreements--Israeli Trade Act'':

Free Trade Agreement Country End Products (Other than Bahrainian or Moroccan End Products) or Israeli End Products:

Line Item No.

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) or this provision) as defined in the clause of this solicitation entitled “Buy American Act—Free Trade Agreements—Israeli Trade Act.” The offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products.

Other Foreign End Products:

[List as necessary]

(iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(2) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled “Buy American Act—Free Trade Agreements—Israeli Trade Act”:

Canadian End Products:

Line Item No.:

[List as necessary]

(3) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled ``Buy American Act--Free Trade Agreements--Israeli Trade Act'':

Canadian or Israeli End Products:

(4) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(4)(ii) of this provision, is a U.S.-made or designated country end product as defined in the clause of this solicitation entitled “Trade Agreements.”

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American Act. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals--

(1) ( ) Are, ( ) are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; and

(2) ( ) Have, ( ) have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; and

(3) ( ) Are, ( ) are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) [ballot] Have, [ballot] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples.

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). (The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).)

(1) Listed End Product

Listed End Product Listed Countries of Origin:

(2) Certification. (If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.)

( )(i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

( ) (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) ( )In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) ( ) Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) (The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.)

( ) (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror ( ) does ( ) does not certify that--

(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

( ) (2) Certain services as described in FAR 22.1003-4(d)(1). The offeror ( ) does ( ) does not certify that--

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a…