FA8524-24-R-0007.pdf

PDF 396 KB Posted May 14, 2024

Attached to: Repair of the Internal Aircraft Fuel Tank System (IAFTS) applicable to the HH-60G Helicopter
Solicitation number: FA852424R0007
Issued by: Department of the Air Force Materiel Command Air Force Sustainment Center

About this file

Written by GovTribe AI · May 14, 2024

This document is a solicitation for the repair of the Internal Aircraft Fuel Tank System (IAFTS) NSN 1560-01-391-8409GC, P/N HM-020-008 applicable to the HH-60G Helicopter. The solicitation is issued by the Department of the Air Force Materiel Command Air Force Sustainment Center and has a solicitation number of FA8524-24-R-0007.

The contract will be a 3-year contract, consisting of a 1-year basic ordering period followed by two 1-year ordering periods. The contractor shall furnish all necessary supplies and services for the repair of the IAFTS in accordance with the attached Performance Work Statement. The solicitation includes specific line items for No Fault Found, Major Overhaul, Intermediate Overhaul, Minor Overhaul, and Beyond Economic Repair, each with estimated quantities. The solicitation is set-aside for small business. Offers are due by the stated offer due date and time. Early delivery is acceptable at no additional cost to the government.

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AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV.2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 J

1. REQUISITION NUMBER

FD20602300062

5. SOLICITATION NUMBER

FA8524-24-R-0007

6. SOLICITATION ISSUE DATE

b. TELEPHONE NUMBER (No collect calls) (478 ) 926 -2765 ext.

2. CONTRACT NO.

7. FOR SOLICITATION

INFORMATION CALL

3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

a. NAME Andrew J. Harth

8. OFFER DUE DATE/LOCAL

TIME

12. DISCOUNT TERMS11. DELIVERY FOR FOB DEST.

UNLESS BLOCK IS MARKED

SEE SCHEDULE

10. THIS ACQUISITION IS UNRESTRICTED SET ASIDE: % FOR:

SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS

HUBZONE SMALL (WOSB)ELIGIBLE UNDER THE WOMEN-OWNED

BUSINESS SMALL BUSINESS PROGRAM

NAICS CODE:

SERVICE-DISABLED EDWOSB 336411

VETERAN-OWNED SIZE STANDARD

SMALL BUSINESS 8 (A) 1,500 :

13a. THIS CONTRACT IS A

RATED ORDER

UNDER DPAS

(15 CFR 700)

13b. RATING

DO: A1 52.211-14, 52.211-15

14. METHOD OF SOLICITATION

RFQ IFB RFP

9. ISSUED BY CODE

SOF - FIXED WING/ROTARY WING, AFSC/PZAAA

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 327 3661

ROBINS AFB GA 31098-1670

BUYER: Andrew J. Harth andrew.harth@us.af.mil Phone: (478) 926- 2765 Fax: (000) 000-0000 No Collect Calls

15. DELIVER TO CODE

SEE LINE ITEM SCHEDULE

16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR FACILITY

CODE CODE

18a. PAYMENT WILL BE MADE BY CODE

(SEE ESP CLAUSE 252.232-7003.)

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS

CHECKED. SEE ELECTRONIC SUBMISSION OF PAYMENT REQUESTS, CLAUSE 252.232-7003.

FA8524

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

ROUTINE

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

Early delivery is acceptable at no additional cost to the Government.

SEE LINE ITEM SCHEDULE

(Attach Additional Sheets as Necessary)

26. AWARD AMOUNT (For Gov’t use only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 COPIES TO ISSUING

OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS

SPECIFIED HEREIN.

29. AWARD OF CONTRACT: REF. OFFER DATED - - . YOUR OFFER ON

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

X X

25. ACCOUNTING AND APPROPRIATION DATA SEE FUNDS SCHEDULE

SCD:B

EFT:T

Estimated

STANDARD FORM 1449 (REV. 2/2012) BACK

COMPUTER GENERATED 5/14/2024, 9:13 AM

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOV’T REPRESENTATIVE

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

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

32c. DATE

41c. DATE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL FINAL

37. CHECK NUMBER36. PAYMENT

COMPLETE PARTIAL FINAL

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

SEE LINE ITEM SCHEDULE

(Attach Additional Sheets as Necessary)

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

FA8524-24-R-0007

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

This contract will be a 3year contract, consisting of a 1year basic ordering period followed by two 1year ordering periods.

BASIC ORDERING PERIOD: Applicable to orders placed during the 12-month period immediately following Contract Award.

SPECIAL INSTRUCTIONS APPLICABLE TO GFP FOR REPAIR REQUIREMENTS

CONTRACTS (JUL 1999)

In accordance with FAR 16.503(c), this is to advise that failure of the Government to furnish Government property items in the amounts or quantities described in the Schedule as "estimated" of "maximum" will not entitle the contractor to any equitable adjustment in price under the Government Property clause of the contract.

The contractor shall furnish all necessary supplies and services for the repair of the items listed below in accordance with attached Performance Statement of Work (PWS). The Best Estimated Quantity (BEQ) represents the best-estimated annual quantity for each Contract Line Item and is only an estimation.

No Fault Found (NFF)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Address Code: 1T765 Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

No Fault Found (NFF)

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *360 Calendar Days

Proposed Delivery

A SW3119 1 EA

MAJOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

0002 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Buy American Act/Balance of Payments Program

MAJOR OVERHAUL

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

INTERMEDIATE OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

0003 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC

INTERMEDIATE OVERHAUL

Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

MINOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

0004 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

MINOR OVERHAUL

Proposed Delivery

A SW3119 6 EA

Beyond Economic Repair (BER)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0005 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *120 Calendar Days

Proposed Delivery

A SW3119 1 EA

DATA

DELIVER IAW DD FORM 1423

Item No.

Firm Fixed Price

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

Data

ELINS A001 - A005

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423 Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

ELIN A001

IAW DD FORM 1423

Item No.

0006AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Contract Depot Maintenance Production Report

DI-PSSS-81995

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN A002

IAW DD FORM 1423

Item No.

0006AB

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Commercial Asset Visibility (CAV) Reporting

ELIN A002

IAW DD FORM 1423

DI-MGMT-81838

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN A003

IAW DD FORM 1423

Item No.

0006AC

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Government Property Inventory Report

DI-MGMT-80441D

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN A004

IAW DD FORM 1423

Item No.

0006AD

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Quality Program Plan

DI-QCIC-81722

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Delivery IAW DD FORM 1423

ELIN A005

IAW DD FORM 1423

Item No.

0006AE

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Accident/Incident Report

DI-SAFT-81563

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ORDERING PERIOD I: Applicable to orders placed during the 12month period immediately following the basic ordering period.

SPECIAL INSTRUCTIONS APPLICABLE TO GFP FOR REPAIR REQUIREMENTS

CONTRACTS (JUL 1999)

No Fault Found (NFF)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

1001 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

No Fault Found (NFF)

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *360 Calendar Days

Proposed Delivery

A SW3119 1 EA

MAJOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

1002 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Address Code: 1T765 Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required

MAJOR OVERHAUL

Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

ISO 9001-2008 2008

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

INTERMEDIATE OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

1003 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

INTERMEDIATE OVERHAUL

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

MINOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

1004 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC

MINOR OVERHAUL

Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

Beyond Economic Repair (BER)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

1005 AA

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 9001-2008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded

Order or Reparable Assets, Whichever is Later

Req No / Pri

Beyond Economic Repair (BER)

Required Delivery

A SW3119 1 EA *360 Calendar Days

Proposed Delivery

A SW3119 1 EA

DATA

DELIVER IAW DD FORM 1423

Item No.

Firm Fixed Price

NSN: 1560-01-391-8409 GC

TANK,FUEL,AIRCRAFT

Data

ELINS B001 - B005

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423 Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

ELIN B001

IAW DD FORM 1423

Item No.

1006AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Contract Depot Maintenance Production Report

DI-PSSS-81995

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Delivery IAW DD FORM 1423

ELIN B002

IAW DD FORM 1423

Item No.

1006AB

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Commercial Asset Visibility (CAV) Reporting

DI-MGMT-81838

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN B003

IAW DD FORM 1423

Item No.

1006AC

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Government Property Inventory Report

DI-MGMT-80441D

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN B004

IAW DD FORM 1423

Item No.

1006AD

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Quality Program Plan

DI-QCIC-81722

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

ELIN B004

IAW DD FORM 1423

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN B005

IAW DD FORM 1423

Item No.

1006AE

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560-01-391-8409 GC

Accident/Incident Report

DI-SAFT-81563

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ORDERING PERIOD II: Applicable to orders placed during the 12month period immediately following ordering period I.

SPECIAL INSTRUCTIONS APPLICABLE TO GFP FOR REPAIR REQUIREMENTS

CONTRACTS (JUL 1999)

The contractor shall furnish all necessary supplies and services for the repair of the items listed below in accordance with attached Performance Statement of Work (PWS). The Best Estimated Quantity (BEQ) represents the bestestimated annual quantity for each Contract Line Item and is only an estimation.

No Fault Found (NFF)

Item No.

Firm Fixed Price

No Fault Found (NFF)

Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

2001 AA

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 90012008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *360 Calendar Days

Proposed Delivery

A SW3119 1 EA

MAJOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

2002 AA

MAJOR OVERHAUL

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Priority: R

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 90012008 2008

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

INTERMEDIATE OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

2003 AA

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

INTERMEDIATE OVERHAUL

Limitations of Liability: Other Than High Value Item

Title Number Date Tailoring

ISO 90012008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

MINOR OVERHAUL

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

6 EA

CLIN ACRN ACRN Total

2004 AA

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

MINOR OVERHAUL

Title Number Date Tailoring

ISO 90012008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For A SW3119 PAA Mark for FLB/RIC Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 6 EA *360 Calendar Days

Proposed Delivery

A SW3119 6 EA

Beyond Economic Repair (BER)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

2005 AA

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

CONTAINER USED TO HOLD FUEL SUPPLIED TO THE ENGINE.

SELF SEALING RUBBER BLADDER

Beyond Economic Repair (BER)

Title Number Date Tailoring

ISO 90012008 2008

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA

Type / Ship To Quantity (U/I) *ARO Funded Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *360 Calendar Days

Proposed Delivery

A SW3119 1 EA

DATA

DELIVER IAW DD FORM 1423

Item No.

Firm Fixed Price

NSN: 1560013918409 GC

TANK,FUEL,AIRCRAFT

Data

ELINS C001 C005

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423 Quality Assurance: Standard Inspection

DATA

DELIVER IAW DD FORM 1423

Buy American Act/Balance of Payments Program

ELIN C001

IAW DD FORM 1423

Item No.

2006AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560013918409 GC

Contract Depot Maintenance Production Report

DIPSSS81995

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN C002

IAW DD FORM 1423

Item No.

2006AB

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560013918409 GC

Commercial Asset Visibility (CAV) Reporting

DIMGMT81838

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN C003

IAW DD FORM 1423

Item No.

2006AC

Not Separately Priced Quantity U/I Unit Price

ELIN C003

IAW DD FORM 1423

1 LO NSP

NSN: 1560013918409 GC

Government Property Inventory Report

DIMGMT80441D

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN C004

IAW DD FORM 1423

Item No.

2006AD

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560013918409 GC

Quality Program Plan

DIQCIC81722

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

ELIN C005

IAW DD FORM 1423

Item No.

2006AE

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

NSN: 1560013918409 GC

Accident/Incident Report

DISAFT81563

Priority: R ROUTINE

ELIN C005

IAW DD FORM 1423

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Delivery IAW DD FORM 1423

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET BLDG 376

ROBINS A F B GA 310981887

ROBINS A F B GA 310981887 GA 310981887

USA

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

AWARD NUMBER:

PART I THE SCHEDULE

SECTION E

INSPECTION AND ACCEPTANCE

52.2464 INSPECTION OF SERVICESFIXEDPRICE (AUG 1996)

(IAW FAR 46.304)

52.246-11 HIGHER-LEVEL CONTRACT QUALITY REQUIREMENT (DEC 2014)

(IAW FAR 46.311, DFARS 246.202-4(1))

(a) The Contractor shall comply with the higherlevel quality standard(s) listed below. [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 (APR 1984)

(IAW FAR 46.316)

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 FILLIN]

Item No(s): See schedule for items with the following code(s) listed below :

Inspection Code and Address:

Government Contract Quality Assurance Inspection and Acceptance will be at destination(s) specified herein (Final).

Item No(s): 0006, 0006AA, 0006AB, 0006AC, 0006AD, 0006AE, 1006, 1006AA, 1006AB, 1006AC, 1006AD, 1006AE, 2006, 2006AA, 2006AB, 2006AC, 2006AD, 2006AE

PART I THE SCHEDULE

SECTION F

DELIVERIES OR PERFORMANCE

52.242-15 STOP-WORK ORDER (AUG 1989)

(IAW FAR 42.1305(b)(1))

52.247-29 F.O.B. ORIGIN (FEB 2006)

(IAW FAR 47.303-1(c))

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

(IAW FAR 47.303-17(f))

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 FILLIN]

PART I THE SCHEDULE

SECTION G

CONTRACT ADMINISTRATION DATA

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(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” (standalone) and “Receiving Report” (standalone) 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 backup 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 email 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 8666185988.

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA TO BE CITED ON EACH INDIVIDUAL ORDER $0.00

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

ACRN TOTAL $ 0.00

PART II CONTRACT CLAUSES

SECTION I

CONTRACT CLAUSES

252.201-7000 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 1991)

(IAW DFARS 201.602-70)

5352.201-9101 OMBUDSMAN (JUN 2023)

(IAW DAFFARS 5301.9103)

(a) An ombudsman has been appointed to hear and facilitate the resolution of concerns from offerors, potential offerors, and others for this acquisition. When requested, the ombudsman will maintain strict confidentiality as to the source of the concern.

The existence of the ombudsman does not affect the authority of the program manager, contracting officer, or source selection official. Further, the ombudsman does not participate in the evaluation of proposals, the source selection process, or the adjudication of protests or formal contract disputes. The ombudsman may refer the interested party to another official who can resolve the concern.

(b) Before consulting with an ombudsman, interested parties must first address their concerns, issues, disagreements, and/or recommendations to the contracting officer for resolution. Consulting an ombudsman does not alter or postpone the timelines for any other processes (e.g., agency level bid protests, GAO bid protests, requests for debriefings, employeeemployer actions, contests of OMB Circular A76 competition performance decisions).

(c) If resolution cannot be made by the contracting officer, the interested party may contact the ombudsman, Thomas (Tom) Eller, D.B.A. at 478 222 4097 , FAX 000 000 0000 , email thomas.eller.1@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 Department of the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 203301060, phone number (571) 2562395, facsimile number (571) 2562431.

(d) The ombudsman has no authority to render a decision that binds the agency.

(e) Do not contact the ombudsman to request copies of the solicitation, verify offer due date, or clarify technical requirements.

Such inquiries shall be directed to the contracting officer.

52.202-1 DEFINITIONS (JUN 2020)

(IAW FAR 2.201)

52.203-3 GRATUITIES (APR 1984)

(IAW FAR 3.202)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

(IAW FAR 3.404)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT (JUN 2020)

(IAW FAR 3.503-2)

52.203-7 ANTI-KICKBACK PROCEDURES (JUN 2020)

(IAW FAR 3.502-3)

52.203-8 CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS FOR ILLEGAL OR

IMPROPER ACTIVITY (MAY 2014)

(IAW FAR 3.104-9(a))

52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY (MAY 2014)

(IAW FAR 3.104-9(b))

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS

(JUN 2020)

(IAW FAR 3.808(b))

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS (JAN 2017)

(IAW FAR 3.909-3 (b))

252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS

(SEP 2011)

(IAW DFARS 203.171-4(a), DFARS 212.301(f)(ii))

252.203-7001 PROHIBITION ON PERSONS CONVICTED OF FRAUD OR OTHER

DEFENSE-CONTRACT-RELATED FELONIES (JAN 2023)

(IAW DFARS 203.570-3)

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(DEC 2022)

(IAW DFARS 203.970)

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON RECYCLED PAPER (MAY 2011)

(IAW FAR 4.303)

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT

AWARDS (JUN 2020)

(IAW FAR 4.1403(a))

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

(IAW FAR 4.1105(b))

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

(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))

52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

(NOV 2021)

(IAW FAR 4.1903)

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

DEVELOPED OR PROVIDED BY KASPERSKY LAB COVERED ENTITIES

(DEC 2023)

(IAW FAR 4.2004)

52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

(IAW 4.2105(b))

52.204-27 PROHIBITION ON A BYTEDANCE COVERED APPLICATION (JUN 2023)

(IAW FAR 4.2203)

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

(DEC 2023)

(IAW FAR 4.2306(c))

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

(IAW DFARS 204.7109(a))

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

(IAW DFARS 204.404-70(b))

252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT

REPORTING (JAN 2023)

(IAW DFARS 204.7304(c))

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (JAN 2023)

(IAW DFARS 204.7403(b), DFARS 212.301(f)(i)(F))

252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES (JAN 2023)

(IAW DFARS 204.2105(c))

252.204-7020 NIST SP 800-171 DOD ASSESSMENT REQUIREMENTS (NOV 2023)

(IAW DFARS 204.7304(e))

252.204-7022 EXPEDITING CONTRACT CLOSEOUT (MAY 2021)

(IAW DFARS 204.804-70)

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

CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT

(NOV 2021)

(IAW FAR 9.409)

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (OCT 2018)

(IAW FAR 9.104-7(c))

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS

(NOV 2015)

(IAW FAR 9.108-5(b))

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

GOVERNMENT OF A COUNTRY THAT IS A STATE SPONSOR OF TERRORISM

(MAY 2019)

(IAW DFARS 209.409)

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).

52.215-2 AUDIT AND RECORDS--NEGOTIATION (JUN 2020)

(IAW FAR 15.209(b)(1))

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

(IAW FAR 15.209(h))

52.219-4 NOTICE OF PRICE EVALUATION PREFERENCE FOR HUBZONE SMALL BUSINESS

CONCERNS (OCT 2022)

(IAW FAR 19.1309(b))

(b) Waiver of evaluation preference.

__ Offeror elects to waive the evaluation preference.

52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS (DEVIATION 2023-O0002)

(DEC 2022)

(IAW Deviation 2023-O0002, Revision 1)

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN (SEP 2023)

(IAW FAR 19.708(b))

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN - ALTERNATE III (JUN 2020)

(IAW FAR 19.708(b)(1))

52.219-16 LIQUIDATED DAMAGES--SUBCONTRACTING PLAN (SEP 2021)

(IAW FAR 19.708(b)(2))

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (SEP 2023)

(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 womenowned small business concern.

(4) Womenowned small business (WOSB) joint venture eligible under the WOSB Program. The Contractor represents that it [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _______.]

(5) Economically disadvantaged womenowned small business (EDWOSB) joint venture. The Contractor represents that it [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR 127.506(a) and through (c). [The Contractor shall enter the name and unique entity identifier of each party to the joint venture: _______.]

(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 veteranowned small business concern.

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

252.219-7003 SMALL BUSINESS SUBCONTRACTING PLAN (DoD CONTRACTS) (DEC 2019) (IAW DFARS 219.708(b)(1)(A), DFARS 219.708(b)(1)(A)(1))

252.219-7003 SMALL BUSINESS SUBCONTRACTING PLAN (DoD CONTRACTS)--ALTERNATE I

(DEC 2019)

(IAW DFARS 219.708(b)(1)(A)(2), DFARS 219.708(b)(1)(A)(1))

252.219-7004 SMALL BUSINESS SUBCONTRACTING PLAN (TEST PROGRAM) (DEC 2022)

(IAW DFARS 219.708(b)(1)(B))

52.222-1 NOTICE TO THE GOVERNMENT OF LABOR DISPUTES (FEB 1997)

(IAW FAR 22.103-5(a), DAFFARS 5322.101-1)

52.222-3 CONVICT LABOR (JUN 2003)

(IAW FAR 22.202)

52.222-21 PROHIBITION OF SEGREGATED FACILITIES (APR 2015)

(IAW FAR 22.810(a)(1))

52.222-26 EQUAL OPPORTUNITY (SEP 2016)

(IAW FAR 22.810(e))

52.222-35 EQUAL OPPORTUNITY FOR VETERANS (JUN 2020)

(IAW FAR 22.1310(a)(1), DFARS 222.1310(a)(1))

52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES (JUN 2020)

(IAW FAR 22.1408(a))

52.222-37 EMPLOYMENT REPORTS ON VETERANS (JUN 2020)

(IAW FAR 22.1310(b))

52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE NATIONAL LABOR

RELATIONS ACT (DEC 2010)

(IAW FAR 22.1605)

52.222-41 SERVICE CONTRACT LABOR STANDARDS (AUG 2018)

(IAW FAR 22.1006(a))

52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 2014)

(IAW FAR 22.1006(b))

This Statement is for Information Only:

It is not a Wage Determination

Employee Class Monetary Wage Fringe Benefits

52.222-44 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS--PRICE ADJUSTMENT (MAY 2014)

(IAW FAR 22.1006(c)(2))

52.222-50 COMBATING TRAFFICKING IN PERSONS (NOV 2021)

(IAW FAR 22.1705(a)(1))

52.222-55 MINIMUM WAGES FOR CONTRACTOR WORKERS UNDER EXECUTIVE ORDER

14026 (JAN 2022)

(IAW FAR 22.1906)

52.222-62 PAID SICK LEAVE UNDER EXECUTIVE ORDER 13706 (JAN 2022)

(IAW FAR 22.2110)

252.222-7006 RESTRICTIONS ON THE USE OF MANDATORY ARBITRATION AGREEMENTS

(JAN 2023)

(IAW DFARS 222.7405)

52.223-6 DRUG-FREE WORKPLACE (MAY 2001)

(IAW FAR 23.505)

52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING WHILE

DRIVING (JUN 2020)

(IAW FAR 23.1105)

52.223-20 AEROSOLS (JUN 2016)

(IAW FAR 23.804(a)(3))

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

FOAM FIRE-FIGHTING AGENT FOR USE ON MILITARY INSTALLATIONS

(OCT 2023)

(IAW DFARS 223.7404)

52.224-3 PRIVACY TRAINING (JAN 2017)

(IAW FAR 24.302(a))

52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES (FEB 2021)

(IAW FAR 25.1103(a))

252.225-7001 BUY AMERICAN AND BALANCE OF PAYMENTS PROGRAM--BASIC (JAN 2023)

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

252.225-7002 QUALIFYING COUNTRY SOURCES AS SUBCONTRACTORS (MAR 2022)

(IAW DFARS 225.1101(3))

252.225-7012 PREFERENCE FOR CERTAIN DOMESTIC COMMODITIES (APR 2022)

(IAW DFARS 225.7002-3(a))

252.225-7013 DUTY-FREE ENTRY (NOV 2023)

(IAW DFARS 225.1101(4))

252.225-7048 EXPORT-CONTROLLED ITEMS (JUN 2013)

(IAW DFARS 225.7901-4)

252.225-7052 RESTRICTION ON THE ACQUISITION OF CERTAIN MAGNETS, TANTALUM, AND

TUNGSTEN (JAN 2023)

(IAW DFARS 225.7018-5)

252.225-7061 RESTRICTION ON THE ACQUISITION OF PERSONAL PROTECTIVE EQUIPMENT

AND CERTAIN OTHER ITEMS FROM NON-ALLIED FOREIGN NATIONS (JAN 2023)

(IAW DFARS 225.7023-4)

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

SYSTEMS (DEVIATION 2020-O0015) (MAY 2020)

(IAW Deviation 2020-O0015)

252.226-7001 UTILIZATION OF INDIAN ORGANIZATIONS, INDIAN-OWNED ECONOMIC

ENTERPRISES, AND NATIVE HAWAIIAN SMALL BUSINESS CONCERNS

(JAN 2023)

(IAW DFARS 226.104)

52.227-1 AUTHORIZATION AND CONSENT (JUN 2020)

(IAW FAR 27.201-2(a)(1))

52.227-2 NOTICE AND ASSISTANCE REGARDING PATENT AND COPYRIGHT

INFRINGEMENT (JUN 2020)

(IAW FAR 27.201-2(b))

52.229-3 FEDERAL, STATE, AND LOCAL TAXES (FEB 2013)

(IAW FAR 29.401-3(a))

52.229-12 TAX ON CERTAIN FOREIGN PROCUREMENTS (FEB 2021)

(IAW 29.402-3(b))

252.229-7014 FULL EXEMPTION FROM TWO-PERCENT EXCISE TAX ON CERTAIN FOREIGN

PROCUREMENTS. (OCT 2022)

(IAW DFARS 229-402(k))

52.232-1 PAYMENTS (APR 1984)

(IAW FAR 32.111(a)(1))

52.232-8 DISCOUNTS FOR PROMPT PAYMENT (FEB 2002)

(IAW FAR 32.111(b)(1))

52.232-11 EXTRAS (APR 1984)

(IAW FAR 32.111(c)(2))

52.232-17 INTEREST (MAY 2014)

(IAW FAR 32.611(a), FAR 32.611(b))

52.232-23 ASSIGNMENT OF CLAIMS (MAY 2014)

(IAW FAR 32.806(a)(1))

52.232-25 PROMPT PAYMENT (JAN 2017)

(IAW FAR 32.908(c))

(a) Invoice payments—

(5) Computing penalty amount. The Government will compute the interest penalty in accordance with the Office of Management and Budget prompt payment regulations at 5 CFR part 1315.

(i) For the sole purpose of computing an interest penalty that might be due the Contractor, Government acceptance is deemed to occur constructively on the 7th day (unless otherwise specified in this contract) after the Contractor delivers the supplies or performs the services in accordance with the terms and conditions of the contract, unless there is a disagreement over quantity, quality, or Contractor compliance with a contract provision. If actual acceptance occurs within the constructive acceptance period, the Government will base the determination of an interest penalty on the actual date of acceptance. The constructive acceptance requirement does not, however, compel Government officials to accept supplies or services, perform contract administration functions, or make payment prior to fulfilling their responsibilities.

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER--SYSTEM FOR AWARD

MANAGEMENT (OCT 2018)

(IAW FAR 32.1110(a)(1))

52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS (JUN 2013)

(IAW FAR 32.706-3)

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (MAR 2023)

(IAW FAR 32.009-2)

252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS

(DEC 2018)

(IAW DFARS 232.7004(a))

(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, email, and scanned documents are not acceptable electronic forms for submission of payment requests.

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File details come from the government source that posted it. Updated May 14, 2024.