FA811822R0035.pdf

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1447 (REV. 8/2016)

PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.214(d)

23. ACCOUNTING AND APPROPRIATION DATA

SEE SCHEDULE

24. TOTAL AWARD AMOUNT (For Government Use Only)

TELEPHONE NUMBER

UNIQUE ENTITY

IDENTIFIER

CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

NO COLLECT CALLS

4. SOLICITATION NUMBER

FA8118-22-R-0035

X

X

6.SOLICITATION ISSUE DATE

18 MAY 2022

8. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: 100 % FOR

SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

HUBZONE SMALL

BUSINESS EDWOSB

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS NAICS: 336413

8(A) SIZE STANDARD: 1,250

DATE SIGNED

28. UNITED STATES OF AMERICA (Signature of Contracting Officer)

26. AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION NUMBER

SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS OR CHANGES WHICH

ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

THIS IS A TOTAL SMALL BUSINESS SET-ASIDE.

Subject to the terms and conditions stated herein, the Contractor agrees to hold its offered prices firm for 120 days.

5-Year (3-Yr Basic + 2 1-Yr Options) Indefinite Delivery Requirements Contract for Remanufacture of B-52 Electro-Mechanical Actuator:

Basic Year I September 2022 - September 2023 $ TBD Basic Year II September 2023 - September 2024 $ TBD Basic Year III September 2024 - September 2025 $ TBD Option Year I September 2025 - September 2026 $ TBD Option Year II September 2026 - September 2027 $ TBD Total Estimated Amount $ TBD

SEE LINE ITEM SCHEDULE

22.

AMOUNT

16. AUTHORITY FOR USING OTHER THAN 10 USC 2304 41 USC 253

FULL AND OPEN COMPETITION (c) ( ) (c) ( )

DATE SIGNED

27. SIGNATURE OF OFFEROR/CONTRACTOR

20.

UNIT

21.

UNIT PRICE

19.

QUANTITY

13. CONTRACTOR OFFEROR CODE FACILITY CODE

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT WITHIN * ___ CALENDAR DAYS (60 CALENDAR DAYS UNLESS OFFEROR

INSERTS A DIFFERENT PERIOD) FROM THE DATE SET FORTH IN BLOCK 9 ABOVE, THE CONTRACTOR AGREES TO HOLD

ITS OFFERED PRICES FIRM FOR THE ITEMS SOLICITED HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO

THE TERMS AND CONDITIONS STATED HEREIN. *120

RATING

DO: A1

3. AWARD/EFFECTIVE DATE

FA8118

2. CONTRACT NUMBER

X

17.

ITEM NUMBER

12. ADMINISTERED BY CODE

Total

SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK: 14 EFT:T

SCD:B

NAME AND TITLE OF SIGNER (Type or Print) NAME OF CONTRACTING OFFICER

5. SOLICITATION TYPE

SEALED BIDS NEGOTIATED

(IFB) (RFP)

15. PROMPT PAYMENT DISCOUNT

25. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SETFORTH OR OTHERWISE

IDENTIFIED ABOVE AND ON ANY CONTINUATION SHEETS SUBJECT

THE TERMS AND CONDITIONS SPECIFIED HEREIN.

10. ITEMS TO BE PURCHASED (Brief Description)

SUPPLIES SERVICES Other Aircraft Part and Auxiliary Equipment Manufacturing

9. (Agency Use) LATE OFFERS ARE SUBJECT TO LATE PROPOSAL PROVISIONS INCORPORATED HEREIN. ALL OFFERS ARE SUBJECT TO SUCH PROVISIONS, REPRESENTATIONS, CERTIFICATIONS AND SPECIFICATIONS AS ARE ATTACHED OR INCORPORATED BY REFERENCE. SOLICITATION: OFFERS WILL BE RECEIVED AT THE ISSUING OFFICE

UNTIL

30-JUN-2022 3:00PM

18.

SCHEDULE OF SUPPLIES/SERVICES

14. PAYMENT WILL BE MADE BY CODE

(SEE ESP CLAUSE 252.232-7003.)

X

7. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, AFSC PZABB

3001 STAFF DR STE 1AC4 99A

TINKER AFB OK 73145-3303

BUYER: Dayra Cole/AFSC/PZABB dayra.cole@us.af.mil Phone: (405) 739- 5457

X

1. THIS CONTRACT IS A RATED ORDER UNDER DPAS

(15 CFR 700)SOLICITATION/CONTRACT

BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27.

J

STANDARD FORM 1447 (REV. 8/2016) BACK

NO RESPONSE FOR REASONS CHECKED

TYPE OR PRINT NAME AND TITLE OF SIGNER

SIGNATURENAME AND ADDRESS OF FIRM (Include Zip Code)

WE DO NOT DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF

ITEMS INVOLVED

WE DO

OTHER (Specify)

UNABLE TO IDENTIFY THE ITEM(S)

CANNOT COMPLY WITH SPECIFICATIONS CANNOT MEET DELIVERY REQUIREMENT

DO NOT REGULARILY MANUFACTURE OR SELL THE TYPE OF ITEMS

INVOLVED

DATE AND LOCAL TIME 30 JUN 2022 3:00 PM

SOLICITATION NUMBER FA811822R0035

FROM: AFFIX

STAMP

HERE

TO:

ATTN: Dayra Cole/AFSC/PZABB

DEPARTMENT OF THE AIR FORCE, AFSC PZABB

3001 STAFF DR STE 1AC4 99A

TINKER AFB OK 73145-3303

FA8118-22-R-0035

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

In accordance with the attached CAV AF Reporting Requirements (see the document listed in Section J), the Contractor shall include a DD1348-1 when assets are shipped. DCMA Quality Assurance Representatives (QARs) will not approve or sign the DD1348-1, but will ensure a DD1348-1 is included with each returned asset. If a DD1348-1 is not included with each returned asset, DCMA will not sign the receiving report (DD250).

REMANUFACTURE

A 5-YEAR (THREE-YEAR BASIC AND 2 ONE-YEAR OPTION PERIODS) FIRM FIXED PRICE REQUIREMENTS TYPE CONTRACT IS

CONTEMPLATED.

IT IS ANTICIPATED THAT PRICING OF THIS ACTION WILL BE BASED ON ADEQUATE PRICE COMPETITION; THEREFORE, OFFERORS ARE NOT REQUIRED TO SUBMIT CERTIFIED COST OR PRICING DATA AT THE TIME OF PROPOSAL. HOWEVER, IF AFTER RECEIPT OF PROPOSALS, IT IS DETERMINED THAT ADEQUATE PRICE COMPETITION DOES NOT EXIST, CERTIFIED COST OR PRICING DATA

WILL BE REQUIRED.

(a) A Pre-Award Survey and/or Initial Production Evaluation (IPE) is required. Details are provided in Appendix A, paragraphs

1.2 and 1.3 respectively.

(b) The contractor shall furnish all material, plant facilities, labor, parts, equipment, and expertise necessary to perform the remanufacture required to restore the end item to a like-new condition. The contractor shall also accomplish ALL necessary packing and preservation and packaging. ALL work shall be completed in accordance with the requirements specified herein (including attachments hereto) and at the unit price(s) established at the time of award.

(c) Qualification requirements apply. Interested vendors that have not been previously qualified for this acquisition must submit a Source Approval Request (SAR) package to the Source Development, Small Business Office @ 405-739-7243.

As prescribed in FAR 9.202(e), the contracting officer need not delay a proposed award in order to provide a potential offeror with an opportunity to demonstrate its ability to meet the standards specified for qualification.

(d) In order to receive any technical data related to this acquisition, offerors must send an email request to Dayra Cole at dayra.cole@us.af.mil. Release of any data is subject to applicable data rights. The request shall include the applicable solicitation number, the specific data needed (including TO(s)), and a copy of the current, approved DD Form 2345. The form, including instructions for completing the form, is available at:

http://www.dtic.mil/whs/directives/infomgt/forms/forminfo/forminfopage2220.html. The Government is not responsible for incomplete, misdirected, or untimely requests.**

In order to receive drawings contractors will need to request all needed drawings through the JEDMICS website:

https://jedmics.af.mil/webjedmics/index.jsp. Contractors who need an account will need to complete the instructions at the following link: https://jedmics.af.mil/webjedmics/splash/training/NEWCTR2875.pdf

(e) GOVERNMENT PROPERTY FURNISHED FOR REPAIR (FAR 16.503(c)) Failure of the Government to furnish such items in the amounts or quantities described in the Schedule as “estimated” or “maximum” will not entitle the contractor to any equitable adjustment in price under the Government Property clause of the contract.

(f) END ITEMS BEYOND REMANUFACTURE

"Reparable End Items" are defined as end items which can be restored to a serviceable condition, in accordance with applicable requirements. Some units of items listed in Section B may, upon disassembly and/or inspection, be determined to be beyond the overhaul limits specified in the Work Specification and/or Technical Orders. Any cost for work performed by the Contractor prior to determination that such equipment is beyond these limits, shall be included in the unit price(s) of the listed item(s).

(g) If the contractor estimates that any item is not reparable (i.e. beyond overhaul), the Contractor shall promptly notify the administrative contracting officer in writing and shall not perform further overhaul on any such items except at the direction of the administrative contracting officer (ACO). Upon written confirmation from the ACO that a particular item is not reparable, the contractor shall dispose of the unit in the manner directed by the ACO.

Contractors are cautioned that until a contract is executed, any effort performed in support of the anticipated effort is performed strictly at their own risk and expense. There is no authorization to begin performance until the contractor has received a duly authorized contract signed by the Contracting Officer. Also, this request for proposal is not to be construed to mean that the award of a contract is assured, as the availability of funds, timely submission of all requested documents, and acceptance by both parties are prerequisite to any contract award.

(h) Condemned units shall not be counted as production.

(i) In the event there are component part(s) with long lead times, the awardee is responsible for securing necessary parts to meet the Government’s required delivery schedule.

(j) In the event that DFARS clause 252.217-7001, Surge Option, is invoked, quantities and prices will be negotiated at that time.

The fill-in data in Clause 252.217-7001 will be TBD until a surge is known and negotiations are necessary.

(l) Item Unique Identification (IUID) marking is required in accordance with DFARS 252.211-7003. Contractor determined location and method of marking is acceptable.

(m) Dates listed in clauses 252.216‐7006, 52.216-19 and 52.216‐21 are based on the estimated award date. These dates will be revised prior to award based on the actual award date.

(n) Some units of items listed in Section B may, upon disassembly and/or inspection, be determined to be beyond the remanufacture limits specified in the Work Specification and/or Technical Orders. Any cost for work performed by the Contractor prior to determination that such equipment is beyond these limits, shall be included in the unit price(s) of the listed item(s).

Remanufacture of B-52 Electro-Mechanical Actuator - Basic Year I Item No.0001 Firm Fixed PriceBest Estimated Qty U/I Unit Price Estimated Total Price

12 EA

CLIN ACRN ACRN Total0001 AANSN: 1680-00-540-9532 RKACTUATOR,ELECTRO-MEActuator used to adjust ejection seats in horizontal position.Aluminum and steelManufacturer Part Number1A821 R1514M1-129242 R1514M1-158078 R1514M1-181039 R1514M1-181205 10-2605-3Associated Document(s) Line Item(s)

Remanufacture of B-52 Electro-Mechanical Actuator - Basic Year I FD20302102428 0001Priority: E Inspection: OriginAcceptance: OriginInspection/Acceptance Report: WAWFQuality Assurance: Standard InspectionApplicability: None ;

Buy American Act/Balance of Payments ProgramIUID Required: Yes

Transportation From Continental United States CONUS (CONUS) SourcesTYPE / SHIP TO CODE F.O.B.

B SW3211 ORIGINClass I ODS Substance Application/Use QuantityNONEType / Ship To PACRN Mark ForB SW3211 PAC ACCT 09Type / Ship To Quantity (U/I) 2 ea per month ARO reps Req No / Pri

Required Delivery B SW3211 1 EA 2 ea per month ARO repsProposed Delivery B SW3211 1 EA

Early delivery is acceptable.

Over and Above Item No.0002 To Be NegotiatedQuantity U/I Unit Price1 LO TBN

Over and Above DESCRIPTION

“Over and above work” means work discovered during the course of performing overhaul, maintenance, and repair efforts that is –

(i) Within the general scope of the contract;

(ii) Not covered by the line item(s) for the basic work under the contract; and

(iii) Necessary in order to satisfactorily complete the contract.

“Over and above work” shall be performed IAW the Appendix A and DFARS clause 252.217-7028. The Government

Over and Above shall be the sole authority to determine whether over and above work is appropriate. When over and above work is required a subCLIN shall be established on the order for authorization and funding. Delivery will be as negotiated between the Contractor and ACO/PCO.

FIXED PRICED ITEMS

At any time during contract performance, when sufficient data becomes available on a repetitive task being performed, either the Contractor or the Contracting Officer (Administrative or Procuring) may request a negotiation to establish a firm-fixed-price for that item for the remaining life of the contract.

Fixed priced items shall be defined as they are negotiated.

Associated Document(s) Line Item(s)FD20302102428 0002Priority: E

TBD

Data

Item No.0003 Not Separately PricedQuantity U/I Unit Price1 LO NSP DataData

Data In accordance with the Requirements set forth on the DD Form 1423.

EXHIBIT

ITEM

NO.

RELATED

LINE ITEM

NO.

DATA ITEM DECRIPTION QTY FREQ

UNIT

PRICE

TOTAL

PRICE

A A001 0001 Report of Shipping (Item) and Packaging Discrepancy

1 AS REQ NSP NSP

A A002 0001 Commercial Asset Visibility (CAV) Reporting 1 SEE CDRL

BLOCK 16

NSP NSP

A A003 0001 Contract Depot Maintenance (CDM) Monthly Production Report

1 MTHLY NSP NSP

A A004 0001 Government Property (GP) Inventory Report 1 ANNLY NSP NSP A A005 0001 Production Surge Plan 1 SEE CDRL

BLOCK 16

NSP NSP

NSP = NOT SEPARATELY PRICED

SEE DFARS 252.204-7002, Payment for Subline Items Not Separately Priced

The award of any or all reports shall be at the sole discretion of the Government. The Government reserves the right to delete each line item of data and/or reports that the Government does not desire prior to and after final award.

Associated Document(s) Line Item(s)FD20302102428 0003Priority: E IAW CDRL(s).

Remanufacture of B-52 Electro-Mechanical Actuator - Basic Year II Item No.1001 Firm Fixed PriceBest Estimated Qty U/I Unit Price Estimated Total Price

12 EA

CLIN ACRN ACRN Total1001 AANSN: 1680-00-540-9532 RKACTUATOR,ELECTRO-MEActuator used to adjust ejection seats in horizontal position.Aluminum and steelManufacturer Part Number1A821 R1514M1-129242 R1514M1-158078 R1514M1-181039 R1514M1-181205 10-2605-3Associated Document(s) Line Item(s)FD20302102428 0001Priority: E Inspection: OriginAcceptance: OriginInspection/Acceptance Report: WAWFQuality Assurance: Standard InspectionApplicability: None ;

Buy American Act/Balance of Payments ProgramIUID Required: Yes

Transportation From Continental United States CONUS (CONUS) SourcesTYPE / SHIP TO CODE F.O.B.

B SW3211 ORIGINClass I ODS Substance Application/Use QuantityNONEType / Ship To PACRN Mark ForB SW3211 PAC ACCT 09Type / Ship To Quantity (U/I) 2 ea per month ARO reps Req No / Pri

Required Delivery B SW3211 1 EA 2 ea per month ARO repsProposed Delivery B SW3211 1 EA

Early delivery is acceptable.

Over and Above Item No.1002 To Be NegotiatedQuantity U/I Unit Price1 LO TBN

Over and Above DESCRIPTION

“Over and above work” means work discovered during the course of performing overhaul, maintenance, and repair efforts that is –

(i) Within the general scope of the contract;

(ii) Not covered by the line item(s) for the basic work under the contract; and

(iii) Necessary in order to satisfactorily complete the contract.

“Over and above work” shall be performed IAW the Appendix A and DFARS clause 252.217-7028. The Government shall be the sole authority to determine whether over and above work is appropriate. When over and above work is required a subCLIN shall be established on the order for authorization and funding. Delivery will be as negotiated between the Contractor and ACO/PCO.

FIXED PRICED ITEMS

At any time during contract performance, when sufficient data becomes available on a repetitive task being performed, either the Contractor or the Contracting Officer (Administrative or Procuring) may request a negotiation to establish a firm-fixed-price for that item for the remaining life of the contract.

Fixed priced items shall be defined as they are negotiated.

Associated Document(s) Line Item(s)FD20302102428 0002Priority: E

TBD

Data

Item No.1003 Not Separately PricedQuantity U/I Unit Price1 LO NSP DataData

Data In accordance with the Requirements set forth on the DD Form 1423.

EXHIBIT

ITEM

NO.

RELATED

LINE ITEM

NO.

DATA ITEM DECRIPTION QTY FREQ

UNIT

PRICE

TOTAL

PRICE

B B001 1001 Report of Shipping (Item) and Packaging

Discrepancy

1 AS REQ NSP NSP

B B002 1001 Commercial Asset Visibility (CAV) Reporting 1 SEE CDRL

BLOCK 16

NSP NSP

B B003 1001 Contract Depot Maintenance (CDM) Monthly 1 MTHLY NSP NSP

Production Report B B004 1001 Government Property (GP) Inventory Report 1 ANNLY NSP NSP B B005 1001 Production Surge Plan 1 SEE CDRL

BLOCK 16

NSP NSP

NSP = NOT SEPARATELY PRICED

SEE DFARS 252.204-7002, Payment for Subline Items Not Separately Priced

The award of any or all reports shall be at the sole discretion of the Government. The Government reserves the right to delete each line item of data and/or reports that the Government does not desire prior to and after final award.

Associated Document(s) Line Item(s)FD20302102428 0003Priority: E IAW CDRL(s).

Remanufacture of B-52 Electro-Mechanical Actuator - Basic Year III

Item No.2001 Firm Fixed PriceBest Estimated Qty U/I Unit Price Estimated Total Price

12 EA

CLIN ACRN ACRN Total2001 AANSN: 1680-00-540-9532 RKACTUATOR,ELECTRO-MEActuator used to adjust ejection seats in horizontal position.Aluminum and steelManufacturer Part Number1A821 R1514M1-129242 R1514M1-158078 R1514M1-181039 R1514M1-181205 10-2605-3Associated Document(s) Line Item(s)FD20302102428 0001Priority: E Inspection: OriginAcceptance: OriginInspection/Acceptance Report: WAWFQuality Assurance: Standard InspectionApplicability: None ;

Buy American Act/Balance of Payments ProgramIUID Required: Yes

Transportation From Continental United States CONUS (CONUS) SourcesTYPE / SHIP TO CODE F.O.B.

B SW3211 ORIGINClass I ODS Substance Application/Use QuantityNONEType / Ship To PACRN Mark ForB SW3211 PAC ACCT 09

Remanufacture of B-52 Electro-Mechanical Actuator - Basic Year III Type / Ship To Quantity (U/I) 2 ea per month ARO reps Req No / Pri

Required Delivery B SW3211 1 EA 2 ea per month ARO repsProposed Delivery B SW3211 1 EA

Early delivery is acceptable.

Over and Above Item No.2002 To Be NegotiatedQuantity U/I Unit Price1 LO TBN

Over and Above DESCRIPTION

“Over and above work” means work discovered during the course of performing overhaul, maintenance, and repair efforts that is –

(i) Within the general scope of the contract;

(ii) Not covered by the line item(s) for the basic work under the contract; and

(iii) Necessary in order to satisfactorily complete the contract.

“Over and above work” shall be performed IAW the Appendix A and DFARS clause 252.217-7028. The Government shall be the sole authority to determine whether over and above work is appropriate. When over and above work is required a subCLIN shall be established on the order for authorization and funding. Delivery will be as negotiated between the Contractor and ACO/PCO.

FIXED PRICED ITEMS

At any time during contract performance, when sufficient data becomes available on a repetitive task being performed, either the Contractor or the Contracting Officer (Administrative or Procuring) may request a negotiation to establish a firm-fixed-price for that item for the remaining life of the contract.

Fixed priced items shall be defined as they are negotiated.

Associated Document(s) Line Item(s)FD20302102428 0002Priority: E

TBD

Data Item No.2003 Not Separately PricedQuantity U/I Unit Price1 LO NSP

DataData Data In accordance with the Requirements set forth on the DD Form 1423.

EXHIBIT

ITEM

NO.

RELATED

LINE ITEM

NO.

DATA ITEM DECRIPTION QTY FREQ

UNIT

PRICE

TOTAL

PRICE

C C001 2001 Report of Shipping (Item) and Packaging Discrepancy

1 AS REQ NSP NSP

C C002 2001 Commercial Asset Visibility (CAV) Reporting 1 SEE CDRL

BLOCK 16

NSP NSP

C C003 2001 Contract Depot Maintenance (CDM) Monthly Production Report

1 MTHLY NSP NSP

C C004 2001 Government Property (GP) Inventory Report 1 ANNLY NSP NSP C C005 2001 Production Surge Plan 1 SEE CDRL

BLOCK 16

NSP NSP

NSP = NOT SEPARATELY PRICED

SEE DFARS 252.204-7002, Payment for Subline Items Not Separately Priced

The award of any or all reports shall be at the sole discretion of the Government. The Government reserves the right to delete each line item of data and/or reports that the Government does not desire prior to and after final award.

Associated Document(s) Line Item(s)FD20302102428 0003Priority: E IAW CDRL(s).

Remanufacture of B-52 Electro-Mechanical Actuator - Option Year I

Item No.3001 Firm Fixed PriceBest Estimated Qty U/I Unit Price Estimated Total Price

12 EA

CLIN ACRN ACRN Total3001 AANSN: 1680-00-540-9532 RKACTUATOR,ELECTRO-MEActuator used to adjust ejection seats in horizontal position.Aluminum and steelManufacturer Part Number1A821 R1514M1-129242 R1514M1-158078 R1514M1-181039 R1514M1-181205 10-2605-3

Remanufacture of B-52 Electro-Mechanical Actuator - Option Year I Associated Document(s) Line Item(s)FD20302102428 0001Priority: E Inspection: OriginAcceptance: OriginInspection/Acceptance Report: WAWFQuality Assurance: Standard InspectionApplicability: None ;

Buy American Act/Balance of Payments ProgramIUID Required: Yes

Transportation From Continental United States CONUS (CONUS) SourcesTYPE / SHIP TO CODE F.O.B.

B SW3211 ORIGINClass I ODS Substance Application/Use QuantityNONEType / Ship To PACRN Mark ForB SW3211 PAC ACCT 09Type / Ship To Quantity (U/I) 2 ea per month ARO reps Req No / Pri

Required Delivery B SW3211 1 EA 2 ea per month ARO repsProposed Delivery B SW3211 1 EA

Early delivery is acceptable.

Over and Above Item No.3002 To Be NegotiatedQuantity U/I Unit Price1 LO TBN

Over and Above DESCRIPTION

“Over and above work” means work discovered during the course of performing overhaul, maintenance, and repair efforts that is –

(i) Within the general scope of the contract;

(ii) Not covered by the line item(s) for the basic work under the contract; and

(iii) Necessary in order to satisfactorily complete the contract.

Over and Above

“Over and above work” shall be performed IAW the Appendix A and DFARS clause 252.217-7028. The Government shall be the sole authority to determine whether over and above work is appropriate. When over and above work is required a subCLIN shall be established on the order for authorization and funding. Delivery will be as negotiated between the Contractor and ACO/PCO.

FIXED PRICED ITEMS

At any time during contract performance, when sufficient data becomes available on a repetitive task being performed, either the Contractor or the Contracting Officer (Administrative or Procuring) may request a negotiation to establish a firm-fixed-price for that item for the remaining life of the contract.

Fixed priced items shall be defined as they are negotiated.

Associated Document(s) Line Item(s)FD20302102428 0002Priority: E

TBD

Data

Item No.3003 Not Separately PricedQuantity U/I Unit Price1 LO NSP DataData

Data In accordance with the Requirements set forth on the DD Form 1423.

EXHIBIT

ITEM

NO.

RELATED

LINE ITEM

NO.

DATA ITEM DECRIPTION QTY FREQ

UNIT

PRICE

TOTAL

PRICE

D D001 3001 Report of Shipping (Item) and Packaging Discrepancy

1 AS REQ NSP NSP

D D002 3001 Commercial Asset Visibility (CAV) Reporting 1 SEE CDRL

BLOCK 16

NSP NSP

D D003 3001 Contract Depot Maintenance (CDM) Monthly Production Report

1 MTHLY NSP NSP

D D004 3001 Government Property (GP) Inventory Report 1 ANNLY NSP NSP D D005 3001 Production Surge Plan 1 SEE CDRL

BLOCK 16

NSP NSP

NSP = NOT SEPARATELY PRICED

SEE DFARS 252.204-7002, Payment for Subline Items Not Separately Priced

The award of any or all reports shall be at the sole discretion of the Government. The Government reserves the right to delete each line item of data and/or reports that the Government does not desire prior to and after final award.

Remanufacture of B-52 Electro-Mechanical Actuator - Option Year II Item No.4001 Firm Fixed PriceBest Estimated Qty U/I Unit Price Estimated Total Price

12 EA

CLIN ACRN ACRN Total4001 AANSN: 1680-00-540-9532 RKACTUATOR,ELECTRO-MEActuator used to adjust ejection seats in horizontal position.Aluminum and steelManufacturer Part Number1A821 R1514M1-129242 R1514M1-158078 R1514M1-181039 R1514M1-181205 10-2605-3Associated Document(s) Line Item(s)FD20302102428 0001Priority: E Inspection: OriginAcceptance: OriginInspection/Acceptance Report: WAWFQuality Assurance: Standard InspectionApplicability: None ;

Buy American Act/Balance of Payments ProgramIUID Required: Yes

Transportation From Continental United States CONUS (CONUS) SourcesTYPE / SHIP TO CODE F.O.B.

B SW3211 ORIGINClass I ODS Substance Application/Use QuantityNONEType / Ship To PACRN Mark ForB SW3211 PAC ACCT 09Type / Ship To Quantity (U/I) 2 ea per month ARO reps Req No / Pri

Required Delivery B SW3211 1 EA 2 ea per month ARO repsProposed Delivery B SW3211 1 EA

Early delivery is acceptable.

Over and Above Item No.4002 To Be NegotiatedQuantity U/I Unit Price1 LO TBN

Over and Above DESCRIPTION

“Over and above work” means work discovered during the course of performing overhaul, maintenance, and repair efforts that is –

(i) Within the general scope of the contract;

(ii) Not covered by the line item(s) for the basic work under the contract; and

(iii) Necessary in order to satisfactorily complete the contract.

“Over and above work” shall be performed IAW the Appendix A and DFARS clause 252.217-7028. The Government shall be the sole authority to determine whether over and above work is appropriate. When over and above work is required a subCLIN shall be established on the order for authorization and funding. Delivery will be as negotiated between the Contractor and ACO/PCO.

FIXED PRICED ITEMS

At any time during contract performance, when sufficient data becomes available on a repetitive task being performed, either the Contractor or the Contracting Officer (Administrative or Procuring) may request a negotiation to establish a firm-fixed-price for that item for the remaining life of the contract.

Fixed priced items shall be defined as they are negotiated.

Associated Document(s) Line Item(s)FD20302102428 0002Priority: E

TBD

Data

Item No.4003 Not Separately PricedQuantity U/I Unit Price1 LO NSP DataData

Data In accordance with the Requirements set forth on the DD Form 1423.

EXHIBIT

ITEM

NO.

RELATED

LINE ITEM

NO.

DATA ITEM DECRIPTION QTY FREQ

UNIT

PRICE

TOTAL

PRICE

E E001 4001 Report of Shipping (Item) and Packaging

Discrepancy

1 AS REQ NSP NSP

E E002 4001 Commercial Asset Visibility (CAV) Reporting 1 SEE CDRL

BLOCK 16

NSP NSP

E E003 4001 Contract Depot Maintenance (CDM) Monthly 1 MTHLY NSP NSP

Production Report E E004 4001 Government Property (GP) Inventory Report 1 ANNLY NSP NSP E E005 4001 Production Surge Plan 1 SEE CDRL

BLOCK 16

NSP NSP

NSP = NOT SEPARATELY PRICED

SEE DFARS 252.204-7002, Payment for Subline Items Not Separately Priced

The award of any or all reports shall be at the sole discretion of the Government. The Government reserves the right to delete each line item of data and/or reports that the Government does not desire prior to and after final award.

SHIP TO / PLACE OF PERFORMANCETYPE/CODE: B SW3211DLA DISTRIBUTION DEPOT OKLAHOMA3301 F AVE CEN RECBLDG 506 DR 22TINKER AFB OK 73145-8000 MARK FOR: (See Individual Line Item)REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item) AWARD NUMBER:

PART I - THE SCHEDULESECTION EINSPECTION AND ACCEPTANCE

52.246-2 INSPECTION OF SUPPLIES--FIXED-PRICE (AUG 1996)

(IAW FAR 46.302)(Applicable for supplies, services furnishing of supplies, fixed-price and exceeds the simplified acquisition threshold)

52.246-16 RESPONSIBILITY FOR SUPPLIES (APR 1984)

(IAW FAR 46.316)(Applicable to the furnishing of supplies, services involving the furnishing of supplies, or research and development, when a fixed-price contract is contemplated and the contract amount is expected to exceed the simplified acquisition threshold)

INSPECTION AND ACCEPTANCE (SEP 1999)

(IAW FAR 46.401(b), FAR 46.503)(Applicable to all orders issued hereunder) Government Contract Quality Assurance Inspection and Acceptance will be at (Final):[CONTRACTOR FILL-IN]Item No(s): See schedule for items with the following code(s) listed below :

Inspection Code and Address:

PART I - THE SCHEDULESECTION FDELIVERIES OR PERFORMANCE

52.211-17 DELIVERY OF EXCESS QUANTITIES (SEP 1989)

(IAW FAR 11.703(b))(Applicable when fixed-price supplies are furnished)

52.242-15 STOP-WORK ORDER (AUG 1989)

(IAW FAR 42.1305(b)(1))(Applicable for supplies, services, or research and development)

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

(IAW FAR 42.1305(c))(Applicable to fixed-price for supplies other than commercial or modified-commercial items)

52.247-30 F.O.B. ORIGIN, CONTRACTOR'S FACILITY (FEB 2006)

(IAW FAR 47.303-2(c))(Applicable to f.o.b. origin at contractor's facility)

52.247-55 F.O.B. POINT FOR DELIVERY OF GOVERNMENT-FURNISHED PROPERTY

(JUN 2003)

(IAW FAR 47.305-12(a)(2))(Applicable when Government property is furnished and Government will be responsible for transportation arrangements and cost)

52.247-65 F.O.B. ORIGIN, PREPAID FREIGHT--SMALL PACKAGE SHIPMENTS (JAN 1991)

(IAW FAR 47.303-17(f))(Applicable when specifying f.o.b. origin)

F.O.B. ORIGIN (OCT 1993)

(IAW FAR 47.305(b))Any supply item applicable to this document shall be delivered F.O.B. at:

F.O.B. Address [CONTRACTOR FILL-IN]

(Applicable when delivery term is f.o.b. origin)

PART I - THE SCHEDULESECTION GCONTRACT ADMINISTRATION DATA

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (DEC 2018)

(IAW DFARS 232.7004(b), PGI 232.7004(b)(1), DFARS 212.301(f)(liii))(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:(1) Document type. The Contractor shall use the following document type(s).________________________________________________________________(Contracting Officer: Insert applicable document type(s).Note: If a “Combo” document type is identified but not supportable by the Contractor’s business systems, an “Invoice” (stand-alone) and “Receiving Report” (stand-alone) document type may be used instead.) (2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.________________________________________________________________(Contracting Officer: Insert inspection and acceptance locations or “Not applicable.”)(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table*Field Name in WAWF Data to be entered in WAWFPay Official DoDAACIssue By DoDAACAdmin DoDAACInspect By DoDAACShip To CodeShip From CodeMark For CodeService Approver (DoDAAC)Service Acceptor (DoDAAC)Accept at Other DoDAACLPO DoDAACDCAA Auditor DoDAACOther DoDAAC(s)(*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptancelocations apply, or “Not applicable.”)(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.(5) WAWF email notifications. The Contractor shall enter the e-mail address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

______________________________________________________________________________________________________________________________(Contracting Officer: Insert applicable email addresses or “Not applicable.”)

(g) WAWF point of contact.(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity’s WAWF point of contact._______________________________________________________________(Contracting Officer: Insert applicable information or “Not applicable.”)(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

(Applicable in solicitations and contracts or task or delivery orders, including solicitations and contracts using FAR part 12 procedures for the acquisition of commercial items, when 252.232-7003 is used and none of the exceptions at 232.7002(b)(1) apply. See PGI 232.7004 for instructions on completing the clause)

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation ChargeableACRN Funds Citation Amount Chargeable

AA TO BE CITED ON EACH INDIVIDUAL ORDER $0.00

ACRN TOTAL $ 0.00

ACTIVITY ADDRESS CODE/ROUTING IDENTIFIER CODE (RIC) (MAR 2010)

(IAW AFI 24-230, DoD 4000.25-6M)(a) The Contractor shall identify any existing Activity Address Code with the designated activity type (EB, ED, EJ, EP, EY or EZ) code, which applies to Contractor's approved F.O.B point when receiving, taking custody, issuing, or shipping DoDassets. Include existing Routing Identifier Code (RIC), which may be required for accessing Government Data Systems.

(b) Offeror shall insert the existing Activity Address Code and RIC Code, or identify that the Contracting Officer will need to obtain an Activity Address Code and/or Routing Identifier Code (RIC) on contractor’s behalf.

Existing Activity Address Code __________________ Existing Routing Identifier Code (RIC) ________________ [ ] I currently do not possess an Activity Address Code for the designated activity type. Use the following address to obtain the Activity Address Code:________________________________________________________________________________________ [ ] I currently do not possess a Routing Identifier Code (RIC) for the designated activity type.

PART II - CONTRACT CLAUSESSECTION ICONTRACT CLAUSES

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS (JAN 2017)

(IAW FAR 3.909-3 (b))

(Applicable in all solicitations and resultant contracts other than personal services contracts with individuals)

252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS

(SEP 2011)

(IAW DFARS 203.171-4(a), DFARS 212.301(f)(ii))(Applicable to all solicitations and contracts)

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)(Applicable to all solicitations and contracts)

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT

AWARDS (JUN 2020)

(IAW FAR 4.1403(a))(Applicable over $30,000, unless not required to be reported in FPDS)

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)

(IAW FAR 4.1105(b))(Applicable to solicitations that contain the provision at 52.204-7, and resulting contracts)

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (AUG 2020)

(IAW FAR 4.1804(c), FAR 12.301(d))(Applicable when there is a requirement to be registered in SAM or to have a DUNS Number)

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS

(DEC 2014)

(IAW FAR 4.1202(b))(Applicable to all solicitations and contracts)

52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

(NOV 2021)

(IAW FAR 4.1903)(Applicable to all solicitations and contracts, except COTs, when a contractor’s system may contain Federal contract information)

52.204-23 PROHIBITION ON CONTRACTING FOR HARDWARE, SOFTWARE, AND SERVICES

DEVELOPED OR PROVIDED BY KASPERSKY LAB AND OTHER COVERED

ENTITIES (NOV 2021)

(IAW FAR 4.2004)(Applicable in all contracts and solicitations)

52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

(IAW 4.2105(b))

252.204-7002 PAYMENT FOR SUBLINE ITEMS NOT SEPARATELY PRICED (APR 2020)

(IAW DFARS 204.7109(a))(Applicable to all not separately priced subline items)

252.204-7003 CONTROL OF GOVERNMENT PERSONNEL WORK PRODUCT (APR 1992)

(IAW DFARS 204.404-70(b))(Applicable to all orders issued hereunder)

252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT

REPORTING (DEC 2019)

(IAW DFARS 204.7304(c))(Applicable to all solicitations and contracts, including commercial except when solely for commercial-off-the-shelf items)

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (MAY 2016)

(IAW DFARS 204.7403(b), DFARS 212.301(f)(i)(F))(Applicable to solicitations and contracts that involve litigation support services when 252.204-7014 is not included)

252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES (JAN 2021)

(IAW DFARS 204.2105(c))(Applicable to all soliciations.)

252.204-7020 NIST SP 800-171 DOD ASSESSMENT REQUIREMENTS (MAR 2022)

(IAW DFARS 204.7304(e))

(Applicable in all solicitations and contracts, task orders, or delivery orders, including those using FAR part 12 procedures for the acquisition of commercial items, except for those that are solely for the acquisition of COTS items)

252.204-7022 EXPEDITING CONTRACT CLOSEOUT (MAY 2021)

(IAW DFARS 204.804-70)(Applicable in solicitations and contracts when the contracting officer intends to expedite contract closeout through the mutual waiver of entitlement to a residual dollar amount of $1,000 or less determined at the time of contract closeout)

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH

CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT

(IAW FAR 9.409)(Applicable when exceeding $35,000)

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS

(NOV 2015)

(IAW FAR 9.108-5(b))(Applicable to all solicitations and contracts for the acquisition of products and services (including construction) unless waived IAW FAR 9.108-4)

52.211-5 MATERIAL REQUIREMENTS (AUG 2000)

(IAW FAR 11.304)(Applicable to supplies that are not commercial items)

52.211-15 DEFENSE PRIORITY AND ALLOCATION REQUIREMENTS (APR 2008)

(IAW FAR 11.604(b))This is a rated order certified for national defense, emergency preparedness, and energy program use, and the Contractor shall follow all the requirements of the Defense Priorities and Allocations System regulation (15 CFR 700).(Applicable to all rated orders)

252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION (MAR 2022)

(IAW DFARS 211.274-6(a)(1), DFARS 212.301(f)(xii))(a) Definitions. As used in this clause—

“DoD recognized unique identification equivalent” means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html.“Unique item identifier type” means a designator to indicate which method of uniquely identifying a part has been used. The current list of accepted unique item identifier types is maintained at https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html.

(c) Unique item identifier.(1) The Contractor shall provide a unique item identifier for the following:(i) Delivered items for which the Government’s unit acquisition cost is $5,000 or more, except for the following line items:

Contract Line, Subline, orExhibit Line Item Number Item Description See Schedule as Applicable

(ii) Items for which the Government’s unit acquisition cost is less than $5,000 that are identified in the Schedule or the following table:

Contract Line, Subline, orExhibit Line Item Number Item Description *Items less than $5000, which require UID, will be specifically identified in the schedule. See Schedule as Applicable

(iii) Subassemblies, components, and parts embedded within delivered items, items with warranty requirements, DoD serially managed reparables and DoD serially managed nonreparables as specified in Attachment Number _____( or See Schedule as Applicable).(iv) Any item of special tooling or special test equipment as defined in FAR 2.101 that have been designated for preservation and storage for a Major Defense Acquisition Program as specified in Attachment Number _____( or See Schedule as Applicable).(v) Any item not included in paragraphs (c)(1)(i), (ii), (iii), or (iv) of this clause for which the contractor creates and marks a unique item identifier for traceability.

(f) The Contractor shall submit the information required by paragraphs (d) and (e) of this clause as follows:(1) End items shall be reported using the receiving report capability in Wide Area WorkFlow (WAWF) in accordance with the clause at 252.232-7003. If WAWF is not required by this contract, and the contractor is not using WAWF, follow the procedures at http://dodprocurementtoolbox.com/site/uidregistry/ .(2) Embedded items shall be reported by one of the following methods—(i) Use of the embedded items capability in WAWF;(ii) Direct data submission to the IUID Registry following the procedures and formats at http://dodprocurementtoolbox.com/site/uidregistry/; or(iii) Via WAWF as a deliverable attachment for exhibit line item number ______, Unique Item Identifier Report for Embedded Items, Contract Data Requirements List, DD Form 1423.

(Applicable when delivery of one or more “items” as defined at 252.211-7003(c) is required)

252.211-7007 REPORTING OF GOVERNMENT-FURNISHED PROPERTY (MAR 2022)

(IAW DFARS 211.274-6(b), DFARS 212.301(f)(iv))(Applicable when FAR 52.245-1, Government Property, is used)

52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT (OCT 1997)

(IAW FAR 15.209(h), AFFARS 53.15.209(h))(Applicable when using uniform contract format that is not commercial or for construction)

52.216-18 ORDERING (AUG 2020)

(IAW FAR 16.506(a))(a) Such orders may be issued from .

(Applicable to all orders issued hereunder)

52.216-19 ORDER LIMITATIONS (OCT 1995)

(IAW FAR 16.506(b))(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than , the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor--(1) Any order for a single item in excess of ;(2) Any order for a combination of items in excess of ; or(3) A series of orders from the same ordering office within days that together call for quantities exceeding the limitation in subparagraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(Applicable to all orders issued hereunder)

52.216-21 REQUIREMENTS (OCT 1995)

(IAW FAR 16.506(d)(1))(f) the Contractor shall not be required to make any deliveries under this contract after (Applicable to all orders issued hereunder)

52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(IAW FAR 17.208(g))(a) The Government may extend the term of this contract by written notice to the Contractor within anytime prior to the expiration of the contract ; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 30 days before the contract expires.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 3-year basic + 2 1-year options .

(Applicable when the inclusion of an option is appropriate and it is necessary to include any or all of the following: 1. A requirement that the Government must give the contractor a preliminary written notice of its intent to extend the contract; 2. A statement that an extension of the contract includes an extension of the option; 3. A specified limitation on the total duration of the contract.)

252.217-7001 SURGE OPTION (DEC 2018)

(IAW DFARS 217.208-70(b))(a) General. The Government has the option to--(1) Increase the quantity of supplies or services called for under this contract by no more than percent;

(Applicable when a surge option is needed in support of industrial capability production planning)

252.217-7028 OVER AND ABOVE WORK (DEC 1991)

(IAW DFARS 217.7702)(Applicable when containing requirements for over and above work, except as provided for in Subpart 217.71)

52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE (NOV 2020)

(IAW FAR 19.507(c))(Applicable to all orders issued hereunder)

52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE -- ALTERNATE I (MAR 2020)

(IAW FAR 19.507(c))(Applicable when Small Business Administration has waived the non-manufacturer rule)

52.219-13 NOTICE OF SET-ASIDE OF ORDERS (MAR 2020)

(IAW FAR 19.507(f)(1))(Applicable to solicitations and contracts if an order or orders are to be set aside for any of the small business concerns identified in 19.000(a)(3))

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (SEP 2021)

(IAW FAR 19.309(c))(h) If the Contractor does not have representations and certifications in SAM, or does not have a representation in SAM for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

(1) The Contractor represents that it [ ] is, [ ] is not a small business concern under NAICS Code ________ assigned to contract number _______________.

(2) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]The Contractor represents that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002.

(3) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]The Contractor represents that it [ ] is, [ ] is not a women-owned small business concern.

(4) Women-owned small business (WOSB) concern eligible under the WOSB Program. [Complete only if the Contractor represented itself as a women-owned small business concern in paragraph (h)(3) of this clause.]The Contractor 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 is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(4)(i) of this clause is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture.[The Contractor 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.

(5) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the Contractor represented itself as a women-owned small business concern eligible under the WOSB Program in (h)(4) of this clause.] The Contractor represents that—

(i) It [ ] is, [ ] is not an EDWOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(5)(i) of this clause is accurate for each EDWOSB concern participating in the joint venture. [The Contractor 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.

(6) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]The Contractor represents that it [ ] is, [ ] is not a veteran-owned small business concern.

(7) [Complete only if the Contractor represented itself as a veteran-owned small business concern in paragraph (h)(6) of this clause.] The Contractor represents that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern.

(8) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]The Contractor represents 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 (h)(8)(i) of this clause is accurate for each HUBZone small business concern participating in the HUBZone joint venture.[The Contractor 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.

[Contractor to sign and date and insert authorized signer’s name and title.] (Applicable in solicitations and contracts exceeding the micro-purchase threshold when the contract will be performed in the United States or its outlying areas)

52.222-19 CHILD LABOR COOPERATION WITH AUTHORITIES AND REMEDIES (DEVIATION

2020-O0019) (JAN 2022)

(IAW Deviation 2020-O0019 Rev.