FA851719Q0004.pdf

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 18 (Rev. 6-95) Previous edition not usable Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

J

THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDEX

1. REQUEST NO.

FA8517-19-Q-0004

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO.

FD20601900136

4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

DO: C9

5a. ISSUED BY CODE: FA8517

SUPPORT EQPT - AUTOMATIC TEST, AFSC/PZAAC

235 BYRON ST BLDG 300 STE 19A

ROBINS AFB GA 31098-1813

BUYER: Delayna L. Heisig/PZAAC delayna.heisig@us.af.mil Phone: (478) 222- 3758 No Collect Calls

6. DELIVERY BY (Date)

SEE SCHEDULE

SCD:C

5b. FOR INFORMATION CALL (NO COLLECT CALLS)

NAME

Delayna L Heisig

b. COMPANY

TELEPHONE NUMBER

AREA CODE

(478 )

NUMBER

222 -3758

8. TO

a. NAME

7. DELIVERY

FOB DESTINATION OTHER

(See Schedule) X

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

c. CITY

d. STATE e. ZIP CODE

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

10. PLEASE FURNISH QUOTATIONS

TO THE ISSUING OFFICE IN BLOCK

5A ON OR BEFORE CLOSE OF

BUSINESS (Date)

7 JAN 2019

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5A. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

d. CITY e. STATE

c. COUNTY

c. TITLE (Type or print) NUMBER

b. STREET ADDRESS

a. NAME OF QUOTER

CAGE:

13. NAME AND ADDRESS OF QUOTER

NOTE: Additional provisions and representations are are not attached.X

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

15. DATE OF QUOTATION

16. SIGNER

a. NAME (Type or print) b. TELEPHONE

AREA CODE

d. CALENDAR DAYS

NUMBER PERCENTAGE

c. 30 CALENDAR DAYS (%)b. 20 CALENDAR DAYS (%)a. 10 CALENDAR DAYS (%)12. DISCOUNT FOR PROMPT

PAYMENT

SEE SCHEDULE

ROUTINE

Subject to the terms and conditions stated herein, the Contractor agrees to hold its offered prices firm for 90 days.

NAICS CODE: 334418

SIZE STD: 750

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 18 (Rev. 6-95) Previous edition not usable Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

FOLD FOLD

SOLICITATION NO. FA851719Q0004

DUE: 7 -JAN -2019

FROM: AFFIX

STAMP

HERE

TO:

ATTN: Delayna L Heisig/PZAAC

SUPPORT EQPT - AUTOMATIC TEST, AFSC/PZAAC

235 BYRON ST BLDG 300 STE 19A

ROBINS AFB GA 31098-1813

FA8517-19-Q-0004

SUPPLIES OR SERVICES AND PRICES/COSTS

CIRCUIT CARD ASSEMBLY

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

11 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 5998-01-591-0221 KV

CIRCUIT CARD ASSEMBLY

Manufacturer Part Number 26401 20222875-50 Associated Document(s) Line Item(s)

FD20601900136 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Commercial Item Inspection Buy American Act/Balance of Payments Program Type / Ship To PACRN Mark For

A SW3119 PAA

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

Required Delivery

A SW3119 11 EA 29 MAR 2019

Proposed Delivery

A SW3119 11 EA

Ordering Period I The Government may increase the quantity to be delivered under the contract from time to time prior to 365 days after contract award. The total quantity ordered during this ordering period shall not exceed the maximum quantity of 2 each.

Multiple ordering periods may be exercised simultaneously. Subline items may be established for administrative purposes when issuing the mod.

CIRCUIT CARD ASSEMBLY

Item No.

Firm Fixed Price From Quantity U/I To Quantity U/I Amount

1 EA 2 EA

NSN: 5998‐01‐591‐0221 KV

CIRCUIT CARD ASSEMBLY

Manufacturer Part Number 26401 200222875‐50 Associated Document(s) Line Item(s)

FD20601900136 0001

CIRCUIT CARD ASSEMBLY

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Commercial Item Inspection Buy American Act/Balance of Payments Program Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) To be determined _ Req No / Pri

Required Delivery

A SW3119 2 EA TBD

Proposed Delivery

A SW3119 2 EA

Ordering Period II The Government may increase the quantity to be delivered under the contract from time to time prior to 730 days after contract award. The total quantity ordered during this ordering period shall not exceed the maximum quantity of 3 each.

Multiple ordering periods may be exercised simultaneously. Subline items may be established for administrative purposes when issuing the mod

CIRCUIT CARD ASSEMBLY

Item No.

Firm Fixed Price From Quantity U/I To Quantity U/I Amount

1 EA 3 EA

NSN: 5998‐01‐591‐0221 KV

CIRCUIT CARD ASSEMBLY

Manufacturer Part Number 26401 20222875‐50 Associated Document(s) Line Item(s)

FD20601900136 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Commercial Item Inspection Buy American Act/Balance of Payments Program Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) To be determined _ Req No / Pri

Required Delivery

A SW3119 3 EA TBD

Proposed Delivery

A SW3119 3 EA

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET BLDG 376

ROBINS AFB GA 31098‐1887

UNITED STATES

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

AWARD NUMBER:

Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB: Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

CONTRACT CLAUSES

252.203‐7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS (SEP 2011) (IAW DFARS 203.171‐4(a), DFARS 212.301(f)(ii))

52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS--COMMERCIAL ITEMS (AUG 2018)

(IAW FAR 12.301(b)(4))

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

(1) 52.203‐19,Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113‐235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.209‐10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015).

(3) 52.233‐3, Protest After Award (Aug 1996)(31 U.S.C 3553).

(4) 52.233‐4, Applicable Law for Breach of Contract Claim (Oct 2004)(Public Laws 108‐77 and 108‐78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.] __ __ (1) 52.203‐6, Restrictions on Subcontractor Sales to the Government (Sep 2006), with

Alternate I (Oct 1995)(41 U.S.C. 4704 and 10 U.S.C. 2402).

__ __ (2) 52.203‐13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

__ __ (3) 52.203‐15, Whistleblower Protections Under the American Recovery and Reinvestment

Act of 2009 (Jun 2010) (Section 1553 of Pub. L. 111‐5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.)

__X __ (4) 52.204‐10, Reporting Executive Compensation and First‐Tier Subcontract Awards (Oct

2016) (Pub. L. 109‐282) (31 U.S.C. 6101 note).

(5) [Reserved]

__ __ (6) 52.204‐14, Service Contract Reporting Requirements (Oct 2016) (Pub. L. 111‐117, section 743 of Div. C).

__ __ (7) 52.204‐15, Service Contract Reporting Requirements for Indefinite‐Delivery Contracts

(Oct 2016) (Pub. L. 111‐117, section 743 of Div. C).

__X __ (8) 52.209‐6, Protecting the Government’s Interest When Subcontracting with Contractors

Debarred, Suspended, or Proposed for Debarment (Oct 2015) (31 U.S.C. 6101 note).

__ __ (9) 52.209‐9, Updates of Publicly Available Information Regarding Responsibility Matters

(Jul 2013) (41 U.S.C. 2313).

____ (10) [Reserved}

__ __ (11) (i) 52.219‐3, Notice of HUBZone Set‐Aside or Sole‐Source Award (Nov 2011)(15 U.S.C.

657a).

__ __ (11) (ii) Alternate I (Nov 2011) of 52.219‐3.

__ __ (12) (i) 52.219‐4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns

(Oct 2014) (if the offeror elects to waive the preference, it shall so indicate in its offer)(15 U.S.C. 657a).

__ _ (12) (ii) Alternate I (Jan 2011) of 52.219‐4.

(13) [Reserved]

__ __ (14) (i) 52.219‐6, Notice of Total Small Business Set‐Aside (Nov 2011)(15 U.S.C. 644).

__ __ (14) (ii) Alternate I (Nov 2011).

__ __ (14) (iii) Alternate II (Nov 2011).

__ __ (15) (i) 52.219‐7, Notice of Partial Small Business Set‐Aside (June 2003)(15 U.S.C. 644).

__ __ (15) (ii) Alternate I (Oct 1995) of 52.219‐7.

__ __ (15) (iii) Alternate II (Mar 2004) of 52.219‐7.

__ __ (16) 52.219‐8, Utilization of Small Business Concerns (Nov 2016) (15 U.S.C. 637(d)(2) and

(3)).

(17) (i) 52.219‐9, Small Business Subcontracting Plan (Aug 2018) (15 U.S.C. 637(d)(4)).

__ __ (17) (ii) Alternate I (Nov 2016) of 52.219‐9.

__ __ (17) (iii) Alternate II (Nov 2016) of 52.219‐9.

__ __ (17) (iv) Alternate III (Nov 2016) of 52.219‐9.

(17) (v) Alternate IV (Aug 2018) of 52.219‐9.

__ (18) 52.219‐13, Notice of Set‐Aside of Orders (Nov 2011) (15 U.S.C. 644(r)).

__ (19) 52.219‐14, Limitations on Subcontracting (Jan 2017)(15 U.S.C. 637(a)(14)).

__ __ (20) 52.219‐16, Liquidated Damages—Subcontracting Plan (Jan 1999) (15 U.S.C.

637(d)(4)(F)(i)).

__ __ (21) 52.219‐27, Notice of Total Service‐Disabled Veteran‐Owned Small Business Set‐Aside

(Nov 2011)(15 U.S.C. 657 f).

__X __ (22) 52.219‐28, Post Award Small Business Program Rerepresentation (Jul 2013) (15 U.S.C.

632(a)(2)).

__ __ (23) 52.219‐29, Notice of Set‐Aside for, or Sole source Award to, Economically

Disadvantaged Women‐Owned Small Business Concerns (Dec 2015) (1 U.S.C.

637(m)).

__ __ (24) 52.219‐30, Notice of Set‐Aside for, or Sole source Award to, Women‐Owned Small

Business Concerns Eligible Under the Women‐Owned Small Business Program

(Dec 2015) (15 U.S.C. 637(m)).

__ __ (25) 52.222‐3, Convict Labor (June 2003)(E.O. 11755).

__X __ (26) 52.222‐19, Child Labor—Cooperation with Authorities and Remedies (Oct 2016) (E.O.

13126).

__X __ (27) 52.222‐21, Prohibition of Segregated Facilities (Apr 2015).

__X __ (28) (i) 52.222‐26, Equal Opportunity (Sept 2016) (E.O. 11246

(28) (ii) Alternate I (Feb 1999) of 52.222‐26.

__ __ (29) (i) 52.222‐35, Equal Opportunity for Veterans (Oct 2015)(38 U.S.C. 4212).

(29) (ii) Alternate I (July 2014) of 52.222‐35.

__X __ (30) (i) 52.222‐36, Equal Opportunity for Workers with Disabilities (Jul

2014) (29 U.S.C. 793).

(30) (ii) Alternate I (July 2014) of 52.222‐36.

__ __ (31) 52.222‐37, Employment Reports on Veterans (Feb 2016)(38 U.S.C. 4212).

__ __ (32) 52.222‐40, Notification of Employee Rights Under the National Labor relations Act (Dec

2010) E.O. 13496).

__X __ (33) (i) 52.222‐50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and

E.O. 13627).

__ __ (33) (ii) Alternate I (Mar 2015) of 52.222‐50 (22 U.S.C. chapter 78 and E.O. 13627).

__ __ (34) 52.222‐54, Employment Eligibility Verification (Oct 2015). (E. O. 12989). (Not applicable to the acquisition of commercially available off‐the‐shelf items or certain other types of commercial items as prescribed in 22.1803.)

__ __ (35) (i) 52.223‐9, Estimate of Percentage of Recovered Material Content for EPA‐Designated

Items (May 2008)(42 U.S.C. 6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off‐the‐shelf items.)

__ _ (35) (ii) Alternate I (May 2008) of 52.223‐9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off‐the‐shelf items.)

__ __ (36) 52.223‐11, Ozone‐Depleting Substances and High Global Warming Potential

Hydrofluorocarbons (June 2016) (E.O. 13693).

__ __ (37) 52.223‐12, Maintenance, Service, repair, or Disposal of Refrigeration Equipment and Air

Conditioners (June 2016) (E.O.13693).

__ _ (38) (i) 52.223‐13, Acquisition of EPEAT®‐Registered Imaging Equipment (Jun 2014) (E.O.s

13423 and 13514).

__ _ (38) (ii) Alternate I (Oct 2015) of 52.223‐13.

__ _ (39) (i) 52.223‐14, Acquisition of EPEAT®‐Registered Televisions (Jun 2014) (E.O.s 13423 and

13514).

__ _ (39) (ii) Alternate I (Jun 2014) of 52.223‐14.

__ __ (40) 52.223‐15, Energy Efficiency in Energy‐Consuming Products (Dec 2007) (42.U.S.C.

8259b).

__ __ (41) (i) 52.223‐16, Acquisition of EPEAT®‐Registered Personal Computer Products (Oct 2015)

(E.O.s 13423 and 13514).

__ _ (41) (ii) Alternate I (Oct 2015) of 52.223‐16.

__X __ (42) 52.223‐18, Encouraging Contractor Policies to Ban Text Messaging While Driving (Aug

2011) (E.O.13513).

__ __ (43) 52.223‐20, Aerosols (Jun 2016) (E.O. 13693)

__ __ (44) 52.223‐21, Foams (Jun 2016) (E.O. 13693).

__X __ (45) (i) 52.224‐3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

___ (45) (ii) Alternate I, (Jan 2017) of 52.244‐3.

__ __ (46) 52.225‐1, Buy American‐‐Supplies (May 2014) (41 U.S.C. chapter 83).

__ __ (47) (i) 52.225‐3, Buy American‐‐Free Trade Agreements‐‐Israeli Trade Act (May 2014) (41

U.S.C. chapter 83, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, Pub. L. 103‐182, 108‐77, 108‐78, 108‐286, 108‐302, 109‐53, 109‐169, 109‐283, 110‐138, 112‐41, 112‐42, and 112‐43).

__ _ (47) (ii) Alternate I (May 2014) of 52.225‐3.

__ _ (47) (iii) Alternate II (May 2014) of 52.225‐3.

__ _ (47) (iv) Alternate III (May 2014) of 52.225‐3.

__ __ (48) 52.225‐5, Trade Agreements (Aug 2018) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note).

__X __ (49) 52.225‐13, Restrictions on Certain Foreign Purchases (Jun 2008) (E.O.s, proclamations, and statutes administered by the Office of Foreign Assets Control of the

Department of Treasury).

__ __ (50) 52.225‐26, Contractors Performing Private Security Functions Outside the United States

(Oct 2016) (Section 862, as amended, of the National Defense Authorization

Act for Fiscal Year 2008; 10 U.S.C. 2302 Note).

__ __ (51) 52.226‐4, Notice of Disaster or Emergency Area Set‐Aside (Nov 2007)(42 U.S.C. 5150).

__ __ (52) 52.226‐5, Restrictions on Subcontracting Outside Disaster or Emergency Area (Nov

2007)(42 U.S.C. 5150).

__ __ (53) 52.232‐29, Terms for financing of Purchases of Commercial Items (Feb 2002)(41 U.S.C.

4505, 10 U.S.C. 2307(f)).

__ __ (54) 52.232‐30, Installment Payments for Commercial Items (Jan 2017)(41 U.S.C. 4505, 10

U.S.C. 2307(f)).

__X __ (55) 52.232‐33, Payment by Electronic Funds Transfer—System for Award Management (Jul

2013)(31.U.S.C. 3332).

__ __ (56) 52.232‐34, Payment by Electronic Funds Transfer—Other than System for Award

Management (Jul 2013)(31.U.S.C. 3332).

__ __ (57) 52.232‐36, Payment by Third Party (May 2014) (31 U.S.C. 3332).

__ __ (58) 52.239‐1, Privacy or Security Safeguards (Aug 1996) (5 U.S.C. 552a).

__ __ (59) 52.242‐5, Payment to Small Business Subcontractors (Jan 2017) (15 U.S.C. 637(d)(12)).

__ __ (60) (i) 52.247‐64, Preference for Privately Owned U.S.‐Flag Commercial Vessels (Feb 2006)

(46 U.S.C. Appx. 1241(b) and 10 U.S.C. 2631).

__ _ (60) (ii) Alternate I (Apr 2003) of 52.247‐64.

(60) (iii) Alternate II (Feb 2006) of 52.247‐64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial items:

[Contracting Officer check as appropriate.] __ __ (1) 52.222‐17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495).

__ __ (2) 52.222‐41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67).

__ __ (3) 52.222‐42, Statement of Equivalent Rates for Federal Hires (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

__ __ (4) 52.222‐43, Fair Labor Standards Act and Service Contract Labor Standards‐‐Price

Adjustment (Multiple Year and Option Contracts) (Aug 2018) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

__ __ (5) 52.222‐44, Fair Labor Standards Act and Service Contract Labor Standards ‐ Price Adjustment (May 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

__ __ (6) 52.222‐51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (May 2014) (41 U.S.C. chapter 67).

__ __ (7) 52.222‐53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services—Requirements (May 2014)(41 U.S.C. chapter 67).

__ __ (8) 52.222‐55, Minimum Wages Under Executive Order 13658 (Dec 2015).

__ __ (9) 52.222‐62, Paid Sick Leave Under Executive Order 13706. (Jan 2017) (E.O. 13706).

__ __ (10) 52.226‐6, Promoting Excess Food Donation to Nonprofit Organizations. (May 2014) (42

U.S.C. 1792).

__ __ (11) 52.237‐11, Accepting and Dispensing of $1 Coin (Sep 2008) (31 U.S.C. 5112(p)(1)).

(d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, and does not contain the clause at 52.215‐2, Audit and Records‐‐Negotiation.

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c) and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in paragraphs (e)(1) of this paragraph in a subcontract for commercial items. Unless otherwise indicated below, the extent of the flow down shall be as required by the clause—

(i) 52.203‐13, Contractor Code of Business Ethics and Conduct (Oct 2015) (41 U.S.C. 3509).

(ii) 52.203‐19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113‐235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(iii) 52.204‐23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (Jul 2018) (Section 1634 of Pub. L. 115‐91).

(iv) 52.219‐8, Utilization of Small Business Concerns (Nov 2016) (15 U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further subcontracting opportunities. If the subcontract (except subcontracts to small business concerns) exceeds $700,000 ($1.5 million for construction of any public facility), the subcontractor must include 52.219‐8 in lower tier subcontracts that offer subcontracting opportunities.

(v) 52.222‐17, Nondisplacement of Qualified Workers (May 2014) (E.O. 13495). Flow Down required in accordance with paragraph (l) of FAR clause 52.222‐17.

(vi) 52.222‐21, Prohibition of Segregated Facilities (Apr 2015).

(vii) 52.222‐26, Equal Opportunity (Sept 2016) (E.O. 11246

(viii) 52.222‐35, Equal Opportunity for Veterans (Oct 2015) (38 U.S.C. 4212).

(ix) 52.222‐36, Equal Opportunity for Workers with Disabilities (Jul 2014) (29 U.S.C. 793).

(x) 52.222‐37, Employment Reports on Veterans (Feb 2016) (38 U.S.C. 4212).

(xi) 52.222‐40, Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) (E.O. 13496). Flow down required in accordance with paragraph (f) of FAR clause 52.222‐40.

(xii) 52.222‐41, Service Contract Labor Standards (Aug 2018) (41 U.S.C. chapter 67).

(xiii) __X __ (A) 52.222‐50, Combating Trafficking in Persons (Mar 2015) (22 U.S.C. chapter 78 and E.O. 13627).

__ __(B) Alternate I (Mar 2015) of 52.222‐50 (22 U.S.C. chapter 78 and E.O. 13627).

(xiv) 52.222‐51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (May 2014) (41 U.S.C. chapter 67).

(xv) 52.222‐53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services—Requirements (May 2014) (41 U.S.C. chapter 67).

(xvi) 52.222‐54, Employment Eligibility Verification (Oct 2015) (E. O. 12989).

(xvii) 52.222‐55,Minimum Wages Under Executive Order 13658 (Dec 2015).

(xviii) 52.222‐62, Paid sick Leave Under Executive Order 13706 (Jan 2017) (E.O. 13706).

(xix) (A) 52.224‐3, Privacy Training (Jan 2017) (5 U.S.C. 552a).

(B) Alternate I (Jan 2017) of 52.224‐3.

(xxi) 52.225‐26, Contractors Performing Private Security Functions Outside the United States (Oct 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008;

10 U.S.C. 2302 Note).

(xxi) 52.226‐6, Promoting Excess Food Donation to Nonprofit Organizations (May 2014) (42 U.S.C.

1792). Flow down required in accordance with paragraphs (e) of FAR clause 52.226‐6.

(xxii) 52.247‐64, Preference for Privately Owned U.S.‐Flag Commercial Vessels (Feb 2006) (46 U.S.C. Appx 1241(b) and 10 U.S.C. 2631). Flow down required in accordance with paragraph (d) of FAR clause 52.247‐64.

(2) While not required, the Contractor may include in its subcontracts for commercial items a minimal number of additional clauses necessary to satisfy its contractual obligations.

252.223-7008 PROHIBITION OF HEXAVALENT CHROMIUM (JUN 2013)

(IAW DFARS 223.7306, DFARS 212.301(f)(xxi))

252.225-7001 BUY AMERICAN AND BALANCE OF PAYMENTS PROGRAM--BASIC (DEC 2017)

(IAW DFARS 225.1101(2)(i) and (2)(ii))

252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS

(JUN 2012)

(IAW DFARS 232.7004)

(a) Definitions. As used in this clause—

(1) “Contract financing payment” and “invoice payment” have the meanings given in section 32.001 of the Federal Acquisition Regulation.

(2) “Electronic form” means any automated system that transmits information electronically from the initiating system to all affected systems. Facsimile, e‐mail, and scanned documents are not acceptable electronic forms for submission of payment requests. However, scanned documents are acceptable when they are part of a submission of a payment request made using Wide Area WorkFlow (WAWF) or another electronic form authorized by the Contracting Officer.

(3) “Payment request” means any request for contract financing payment or invoice payment submitted by the Contractor under this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests and receiving reports using WAWF, in one of the following electronic formats that WAWF accepts: Electronic Data Interchange, Secure File Transfer Protocol, or World Wide Web input. Information regarding WAWF is available on the Internet at https://wawf.eb.mil/ .

(c) The Contractor may submit a payment request and receiving report using other than WAWF only when—

(1) The Contracting Officer authorizes use of another electronic form. With such an authorization, the Contractor and the Contracting Officer shall agree to a plan, which shall include a timeline, specifying when the Contractor will transfer to WAWF;

(2) DoD is unable to receive a payment request or provide acceptance in electronic form;

(3) The Contracting Officer administering the contract for payment has determined, in writing, that electronic submission would be unduly burdensome to the Contractor. In such cases, the Contractor shall include a copy of the Contracting Officer’s determination with each request for payment; or

(4) DoD makes a payment for commercial transportation services provided under a Government rate tender or a contract for transportation services using a DoD‐approved electronic third party payment system or other exempted vendor payment/invoicing system (e.g., PowerTrack, Transportation Financial Management System, and Cargo and Billing System).

(d) The Contractor shall submit any non‐electronic payment requests using the method or methods specified in Section G of the contract.

(e) In addition to the requirements of this clause, the Contractor shall meet the requirements of the appropriate payment clauses in this contract when submitting payment requests.

252.232-7010 LEVIES ON CONTRACT PAYMENTS (DEC 2006)

(IAW DFARS 232.7102)

252.244-7000 SUBCONTRACTS FOR COMMERCIAL ITEMS (JUN 2013)

(IAW DFARS 244.403)

252.247-7023 TRANSPORTATION OF SUPPLIES BY SEA--BASIC (APR 2014)

(IAW DFARS 247.574(b))

ADDENDUM TO CLAUSE 52.212‐4

5352.201-9101 OMBUDSMAN (JUN 2016)

(IAW AFFARS 5301.9103)

(c) If resolution cannot be made by the contracting officer, the interested party may contact the ombudsman, Timothy R.

Inman at 478 222 ‐4097 , FAX 000 000 ‐0000 , email timothy.inman@us.af.mil . Concerns, issues, disagreements, and recommendations that cannot be resolved at the Center/MAJCOM/DRU/SMC ombudsman level, may be brought by the interested party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330‐1060, phone number (571) 256‐2395, facsimile number (571) 256‐2431.

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (JUL 2016)

(IAW FAR 4.1804(c), FAR 12.301(d))

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS

(DEC 2014)

(IAW FAR 4.1202(b))

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

DEVELOPED OR PROVIDED BY KASPERSKY LAB AND OTHER COVERED

ENTITIES (JUL 2018)

(IAW FAR 4.2004)

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (MAY 2016)

(IAW DFARS 204.7403(c), DFARS 212.301(f)(ix))

52.212-4 CONTRACT TERMS AND CONDITIONS--COMMERCIAL ITEMS (OCT 2018)

(IAW FAR 12.301(b)(3))

THE FOLLOWING IS FILL‐IN DATA FOR CLAUSE 52.212‐5 PARA (b)(22):

52.219‐28 POST‐AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (JUL 2013)

(g) 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:

The Contractor represents that it [ ] is, [ ] is not a small business concern under NAICS Code _____________ assigned to contract number ______________________________.

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

252.225-7002 QUALIFYING COUNTRY SOURCES AS SUBCONTRACTORS (DEC 2017)

(IAW DFARS 225.1101(3))

252.225-7048 EXPORT-CONTROLLED ITEMS (JUN 2013)

(IAW DFARS 225.7901-4)

52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS (JUN 2013)

(IAW FAR 32.706-3)

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (DEC 2013)

(IAW FAR 32.009-2)

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(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 WAWF

Pay Official DoDAAC

Issue By DoDAAC

Admin DoDAAC

Inspect By DoDAAC

Ship To Code

Ship From Code

Mark For Code

Service Approver (DoDAAC)

Service Acceptor (DoDAAC)

Accept at Other DoDAAC

LPO DoDAAC

DCAA Auditor DoDAAC

Other DoDAAC(s)

(*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations 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.

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 97X4930.FC04 649 47GR AS9999 01N000 00000 000000 503000 F03000 $0.00

PSR: K19367 FSR: 013408

ACRN TOTAL $ 0.00

252.246-7000 MATERIAL INSPECTION AND RECEIVING REPORT (MAR 2008)

(IAW DFARS 246.370)

INSPECTION AND ACCEPTANCE (SEP 1999)

(IAW FAR 46.401(b), FAR 46.503)

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:

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

Form Number Description/File Name Date Number of Pages DD 158 2674044_PKGRQMT_REPORT.pdf 28NOV2018 1

SOLICITATION PROVISIONS

REPRESENTATIONS, INSTRUCTIONS AND EVALUATIONS

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS

(OCT 2018)

(IAW FAR 12.301(b)(2))

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

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

(c) Check all that apply.

(1) [ ] is, [ ] is not a small business concern.

(2) [ ] is, [ ] is not a veteran‐owned small business concern.

(3) [ ] is, [ ] is not a service‐disabled veteran‐owned small business concern.

(4) [ ] is, [ ] is not a small disadvantaged business concern.

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

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

(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ______________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

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

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

and

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

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

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

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

(i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and

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

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

(1) Previous Contracts and Compliance. The offeror represents that‐‐

(i) [ ] has, [ ] has not participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this solicitation; and

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

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

(i) [ ] has developed and has on file, [ ] has not developed and does not have on file,

(ii) [ ] has not previously had contracts subject to the written affirmative action programs requirement

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225‐1, Buy American‐‐Supplies, is included in this solicitation.)

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the 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, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off‐the‐shelf (COTS item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—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‐‐Free Trade Agreement—Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225‐3, Buy American‐‐Free Trade Agreement‐‐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 for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States.

The terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off‐the‐shelf (COTS) item,” “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—Free Trade Agreements—Israeli Trade Act.”

(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American‐‐Free Trade Agreement‐‐Israeli Trade Act”:

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country Of Origin

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American‐‐Free Trade Agreement‐‐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, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.”

Other Foreign End Products:

Line Item No. Country Of Origin

[List as necessary]

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

(2) Buy American‐‐Free Trade Agreements‐‐Israeli Trade Act Certificate, Alternate I. 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‐‐Free Trade Agreement‐‐Israeli Trade Act":

Canadian End Products:

Line Item No.

[List as necessary]

(3) Buy American‐‐Free Trade Agreements‐‐Israeli Trade Act Certificate, Alternate II. 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‐‐Free Trade Agreement‐‐Israeli Trade Act":

Canadian or Israeli End Products:

Line Item No. Country Of Origin

[List as necessary]

(4) Buy Americant—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 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 Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American‐‐Free Trade Agreements‐‐Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line Item No. Country Of Origin

[List as necessary]

(5) 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)(5)(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:

Line Item No. Country Of Origin

[List as necessary]

(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 statute. 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

(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;

(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 criminal tax laws, or receiving stolen property;

(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) [ ] Have, [ ] have not, within a three‐year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,500 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. section 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 appear 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. section 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. section 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. section 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 (j)(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 Products.

Listed End Product Listed Countries of Origin

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

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