FA812125Q0021.pdf

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER) X

FA8121-25-Q-0021 TO BE CITED DO: A1

FA8121

DEPARTMENT OF THE AIR FORCE, AFSC PZAAA

3001 STAFF DR STE 1AF1 98C

TINKER AFB OK 73145-3303

BUYER:

(Date)

SEE SCHEDULE

SCD:B

(NO COLLECT CALLS)

Dedrian Parmer

(405 ) 406 -2827

(See Schedule)

(Date)

15 JUL 2025

(Include applicable Federal, State and local taxes)

(Type or print)

X

(Type or print)

SEE SCHEDULE

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

SOLICITATION NO. FA812125Q0021

DUE: 15 -JUL -2025

FROM: AFFIX

STAMP

HERE

TO:

ATTN:

SUPPLIES OR SERVICES AND PRICES/COSTS

Shroud Segment, Turb

Item No.

Estimated Quantity

U/I Unit Price

NSN:

Manufacturer Part Number

Associated Document(s) Line Item(s)

Priority:

Inspection:

Acceptance:

Quality Assurance:

Title Number Date Tailoring

IUID Required:

Physical Item Markings:

Transportation From Continental United States CONUS (CONUS) Sources

Type / Ship To PACRN Mark For

Type / Ship To Quantity (U/I) On or Before Req No / Pri Required Delivery

Proposed Delivery

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE:

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

CONTRACT CLAUSES

5352.201-9101 OMBUDSMAN

AFSC/PZC 405 736 3273 000 000 0000

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS

252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT

AWARDS

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS

52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

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

DEVELOPED OR PROVIDED BY KASPERSKY LAB COVERED ENTITIES

52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT

52.204-27 PROHIBITION ON A BYTEDANCE COVERED APPLICATION

52.204-30 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS- PROHIBITION

252.204-7003 CONTROL OF GOVERNMENT PERSONNEL WORK PRODUCT

252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT

REPORTING DEVIATION 2024-O0013, REVISION 1

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT

252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES

252.204-7020 NIST SP 800-171 DOD ASSESSMENT REQUIREMENTS

252.204-7022 EXPEDITING CONTRACT CLOSEOUT

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS

252.209-7004 SUBCONTRACTING WITH FIRMS THAT ARE OWNED OR CONTROLLED BY THE

GOVERNMENT OF A COUNTRY THAT IS A STATE SPONSOR OF TERRORISM

52.211-5 MATERIAL REQUIREMENTS

52.211-15 DEFENSE PRIORITY AND ALLOCATION REQUIREMENTS

252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION

Definitions

Unique item identifier.

52.213-4 TERMS AND CONDITIONS--SIMPLIFIED ACQUISITIONS (OTHER THAN

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES) (DEVIATION 2025-O0003

and 2025-O0004)

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION

[Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]

[Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]

[Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]

[Complete only if the Contractor represented itself as a veteran-owned small business concern in paragraph (h)(6) of this clause.]

[Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.]

[Contractor to sign and date and insert authorized signer’s name and title.]

52.223-23 SUSTAINABLE PRODUCTS AND SERVICES (DEVIATION 2025-O0004)

252.223-7008 PROHIBITION OF HEXAVALENT CHROMIUM

252.223-7009 PROHIBITION OF PROCUREMENT OF FLUORINATED AQUEOUS FILM-FORMING

FOAM FIRE-FIGHTING AGENT FOR USE ON MILITARY INSTALLATIONS

52.224-3 PRIVACY TRAINING

252.225-7001 BUY AMERICAN AND BALANCE OF PAYMENTS PROGRAM--BASIC

252.225-7002 QUALIFYING COUNTRY SOURCES AS SUBCONTRACTORS

252.225-7048 EXPORT-CONTROLLED ITEMS

252.225-7061 RESTRICTION ON THE ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT

AND CERTAIN OTHER ITEMS FROM NON-ALLIED FOREIGN NATIONS

252.225-7972 PROHIBITION ON THE PROCUREMENT OF FOREIGN-MADE UNMANNED AIRCRAFT

SYSTEMS (AUG 2024) (DEVIATION 2024-O0014)

52.226-7 DRUG-FREE WORKPLACE

52.226-8 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING WHILE

DRIVING

52.229-3 FEDERAL, STATE, AND LOCAL TAXES

52.232-17 INTEREST

52.232-23 ASSIGNMENT OF CLAIMS

52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS

252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS

e.g.

252.232-7004 DOD PROGRESS PAYMENT RATES (DEVIATION 2020-O0010, Revision 2)

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS

WAWF payment instructions

Document type

(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.)

Inspection/acceptance location

(Contracting Officer: Insert inspection and acceptance locations or “Not applicable.”) Document routing

Field Name in WAWF Data to be entered in WAWF

(*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)

Payment request and supporting documentation.

e.g WAWF email notifications

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

WAWF point of contact.

(Contracting Officer: Insert applicable information or “Not applicable.”)

252.232-7010 LEVIES ON CONTRACT PAYMENTS

52.240-1 PROHIBITION ON UNMANNED AIRCRAFT SYSTEMS MANUFACTURED OR

ASSEMBLED BY AMERICAN SECURITY DRONE ACT-COVERED FOREIGN

ENTITIES

52.242-17 GOVERNMENT DELAY OF WORK

52.243-1 CHANGES--FIXED-PRICE

252.243-7001 PRICING OF CONTRACT MODIFICATIONS

252.244-7000 SUBCONTRACTS FOR COMMERCIAL ITEMS AND COMMERCIAL COMPONENTS

(DOD CONTRACTS)

52.246-2 INSPECTION OF SUPPLIES--FIXED-PRICE

52.246-11 HIGHER-LEVEL CONTRACT QUALITY REQUIREMENT

If more than one standard is listed, the offeror shall indicate its selection by checking the appropriate block.

Title Number Date Tailoring *See Individual Line Item Schedule

52.246-16 RESPONSIBILITY FOR SUPPLIES

INSPECTION AND ACCEPTANCE

[CONTRACTOR FILL-IN]

See schedule for items with the following code(s) listed below :

Inspection Code and Address:

52.247-1 COMMERCIAL BILL OF LADING NOTATIONS

52.247-30 F.O.B. ORIGIN, CONTRACTOR'S FACILITY

52.247-65 F.O.B. ORIGIN, PREPAID FREIGHT--SMALL PACKAGE SHIPMENTS

252.247-7023 TRANSPORTATION OF SUPPLIES BY SEA--BASIC

252.247-7028 APPLICATION FOR U.S. GOVERNMENT SHIPPING

DOCUMENTATION/INSTRUCTIONS

F.O.B. ORIGIN

F.O.B. Address

[CONTRACTOR FILL-IN]

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

SOLICITATION PROVISIONS

REPRESENTATIONS, INSTRUCTIONS AND EVALUATIONS

252.203-7005 REPRESENTATION RELATING TO COMPENSATION OF FORMER DOD OFFICIALS

52.204-7 SYSTEM FOR AWARD MANAGEMENT

52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (DEVIATION 2025-O0003 and 2025-O0004)

52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING

52.204-22 ALTERNATIVE LINE ITEM PROPOSAL

52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO

SURVEILLANCE SERVICES OR EQUIPMENT

Definitions.

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, substantial or essential component

Prohibition.

Procedures.

https://www.sam.gov

Representations.

Disclosures.

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES -

REPRESENTATION

Definitions.

Procedures.

Representations.

52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS -

REPRESENTATION AND DISCLOSURES

252.204-7007 ALTERNATE A, ANNUAL REPRESENTATIONS AND CERTIFICATIONS

[Contracting Officer check as appropriate.]

X

252.204-7008 COMPLIANCE WITH SAFEGUARDING COVERED DEFENSE INFORMATION

CONTROLS

252.204-7016 COVERED DEFENSE TELECOMMUNICATIONS EQUIPMENT OR SERVICES --

REPRESENTATION

252.204-7017 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION

252.204-7019 NOTICE OF NIST SP 800-171 DOD ASSESSMENT REQUIREMENTS

Summary level scores.

Basic Assessments.

Medium and High Assessments.

Accessibility.

252.204-7024 NOTICE ON THE USE OF THE SUPPLIER PERFORMANCE RISK SYSTEM

52.207-4 ECONOMIC PURCHASE QUANTITY--SUPPLIES

OFFEROR RECOMMENDATIONS

ITEM QUANTITY QUOTATION PRICE TOTAL

52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY

OR A FELONY CONVICTION UNDER ANY FEDERAL LAW

is [ ] is not [ ] is [ ] is not [ ]

252.209-7011 REPRESENTATION FOR RESTRICTION ON THE USE OF CERTAIN INSTITUTIONS

OF HIGHER EDUCATION

52.211-14 NOTICE OF PRIORITY RATING FOR NATIONAL DEFENSE, EMERGENCY

PREPAREDNESS, AND ENERGY PROGRAM USE

252.215-7013 SUPPLIES AND SERVICES PROVIDED BY NONTRADITIONAL DEFENSE

CONTRACTORS

EVALUATION CRITERIA FOR AWARD

Evaluation Factors Order of Importance Price or Cost 01 Past Performance 02 Quality 03

NOTICE FOR OPTIONS:

THE FOLLOWING IS FILL-IN DATA FOR PROVISION 52.204-8 PARA (c)(2)(iii):

52.222-18 CERTIFICATION REGARDING KNOWLEDGE OF CHILD LABOR FOR LISTED END

PRODUCTS (FEB 2021)

Listed end products

Certification

52.223-22 PUBLIC DISCLOSURE OF GREENHOUSE GAS EMISSIONS AND REDUCTION

GOALS--REPRESENTATION

Offeror is to check applicable blocks in paragraphs (b)(1) and (2) [ ] does, [ ] does not

[ ] does, [ ] does not

52.225-18 PLACE OF MANUFACTURE

[ ] In the United States

[ ] Outside the United States

252.225-7973 PROHIBITION ON THE PROCUREMENT OF FOREIGN-MADE UNMANNED AIRCRAFT

SYSTEMS-REPRESENTATION (AUG 2024) (DEVIATION 2024-O0014)

52.247-46 SHIPPING POINT(S) USED IN EVALUATION OF F.O.B. ORIGIN OFFERS

52.247-47 EVALUATION-F.O.B. ORIGIN

ITEM NO MODE OF TRANSPORTATION

52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

NOTE:

FIND regulation reference

Section L – Instructions to Offerors sole

Section M - Evaluation Factors for Award