FA8526-22-Q-0019 - 19May22.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.

FA8526-22-Q-0019

2. DATE ISSUED

19 MAY 2022

3. REQUISITION/PURCHASE REQUEST NO.

MULTIPLE

4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

DO: A1

5a. ISSUED BY CODE: FA8526

C-17 SUSTAINMENT, AFLCMC/WLMKA

660 11TH ST

CML PHN 478 222 0122

ROBINS AFB GA 31098-2428

BUYER: Philip E. Earthly/WLMK philip.earthly.1@us.af.mil Phone: (478) 000- 0000 Fax: (478) 926-6578 No Collect Calls

6. DELIVERY BY (Date)

SEE SCHEDULE

SCD:B

5b. FOR INFORMATION CALL (NO COLLECT CALLS)

NAME

Philip E Earthly

b. COMPANY

TELEPHONE NUMBER

AREA CODE

(478 )

NUMBER

000 -0000

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)

20 JUN 2022

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 30 days.

NAICS CODE: 333914

SIZE STD: 750

This requirement consists of PRs FD20602230245 & FD20602230251

This is a 100% SB SetAside

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. FA852622Q0019

DUE: 20 -JUN -2022

FROM: AFFIX

STAMP

HERE

TO:

ATTN: Philip E Earthly/WLMK

C-17 SUSTAINMENT, AFLCMC/WLMKA

660 11TH ST

CML PHN 478 222 0122

ROBINS AFB GA 31098-2428

FA8526-22-Q-0019

SUPPLIES OR SERVICES AND PRICES/COSTS

NOTE: RELEASE OF C17 UNIT PRICES TO SUPPORT CONTRACTOR

MANAGEMENT OF C17 AIRCRAFT (OCT 2011)

The Boeing Company (CAGE 88277) has been assigned as the Product Support Integrator (PSI) for the Air Force's C17 weapon system. As PSI, Boeing is responsible for managing all sustainment issues for the aircraft. This includes the assignment as contractor Inventory Control Point (ICP) manager. In order for Boeing to accomplish their PSI responsibilities, C17 contract unit prices and delivery information must be made available. The information required is usually on the DD Form 250 shipping document or Wide Area Workflow (WAWF) Receiving Report. This notice is to inform you contract unit prices and delivery information of C17 items will be provided to Boeing (via DD Form 250 or WAWF Receiving Report) for purpose of accomplishing C17 PSI and contractor ICP responsibilities. Your offer in response to this solicitation or acceptance of any subsequent contract award constitutes consent to provide this information to Boeing for the purposes outlined herein.

ELECTRONIC RESPONSES ARE AUTHORIZED (MAR 2003)

(IAW FAR 13.003(F))

In accordance with FAR 13.003(f), electronic commerce method to receive proposals, modifications, and revisions is permitted and preferred. Buyer and Contracting Officer's email addresses for submissions are listed on the front page of this document.

For First Article Waiver Information see "First Article Applicability and/or Conditions for Waiver" on page 37. Bid A is for offerors who are required to produce the First Article; Bid B is for offerors who are exempt from production of a First Article according to the expressed terms in paragraph (f) on page 37.

Note 1 to Contractors: In order to be determined responsive and have your proposal accepted, interested contractors must submit their proposals using the attached C17 PSE Solicitation Template, carefully adhering to the CONTRACTOR INSTRUCTIONS in the first tab of the spreadsheet. Offerors must ensure they annotate the proposed labor hours and rates for each applicable line item, carefully following the examples and guidance within each tab. The spreadsheet is tailorable to an extent in order to accommodate adding more rows and columns as necessary so that contractors can propose properly. Failure to submit your proposal in accordance with the guidance in this template could render your proposal being ineligible for award.

Note 2 to Contractors: Determination of Responsiveness In addition to ensuring responsiveness by submitting your proposal in accordance with the abovementioned PSE Solicitation Template, contractors MUST also ensure they fully annotate their proposed prices within this solicitation document on the applicable CLINs and complete all representations and certifications listed in the Representations, Instructions and Evaluations section in the back pages of this document. Failure to properly and accurately document your proposed prices on the applicable CLINs and annotate the certifications and representation requested in this solicitation package could result in an interested offeror being determined nonresponsive and, therefore, ineligible for award. Contractors must also complete and sign the front page of this solicitation document, ensuring all applicable information (Name, Address, and CAGE) is documented, and ensure it is submitted with your proposal package.

Note 3 to Contractors: The Technical Data Package (TDP) associated with this requirement contains data proprietary to The Boeing Company. In order to receive access to the TDP, interested offerors must complete and sign the attached nondisclosure agreement (NDA) which must be emailed to the PCO and Buyer. Upon receipt of the NDA, the PCO or Buyer will email a link where you can download the TDP via the DODSafe website.

Additional Quality Standard Information: As an addendum to the Quality Assurance Standard listed in the Schedule, at a minimum, the contractor shall comply with ISO 9001, AS9100, NATO AQAP 2070 or an equivalent quality management standard for inhouse quality management. For quality management systems that are not certified or that are equivalent to ISO 9001, AS9100, or NATO AQAP 2070, a DCMA auditor is required to verify the contractor's quality management system.

First Article Required

Cable Assembly, Special Purpose, Electrical Item No.

First Article Required

Cable Assembly, Special Purpose, Electrical

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Manufacturer Part Number 88277 17G550555-1 Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standard under which they qualify.

Buy American Act/Balance of Payments Program IUID Required: Yes Physical Item Markings:

Serial Number Required

Bid A - First Article Required

First Article Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 EA

FA

First Article Associated Document(s) Line Item(s)

FD20602230245 0001

Priority: R ROUTINE

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE5621 DESTINATION

Class I ODS Substance Application/Use Quantity

NONE

None Type / Ship To PACRN Mark For A FE5621 PAA C-17 AMC - Spangdahlem AB Type / Ship To Quantity (U/I) *ARO Approval of

FATP

_ Req No / Pri

Required Delivery

A FE5621 1 EA *270 Calendar Days FE562111180154 / PRI:

R

Proposed Delivery

A FE5621 1 EA

Note to Contractor: Shipment of First Article is NOT authorized until the First Article has been approved and authorization is granted by the Procuring Contracting Officer.

Accelerated delivery is acceptable if at no additional cost to the Government.

Bid A - First Article Required

Production Units - Charlotte ANG Item No.

0001AB

Firm Fixed Price Quantity U/I Unit Price Amount

3 EA

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Associated Document(s) Line Item(s)

FD20602230251 0001

Priority: R ROUTINE Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE6331 DESTINATION

Type / Ship To PACRN Mark For A FE6331 PAA C-17 ANG - Charlotte ANG A FE6331 PAA C-17 ANG - Charlotte ANG A FE6331 PAA C-17 ANG - Charlotte ANG Type / Ship To Quantity (U/I) *ARO Approval of

First Article _ Req No / Pri

Required Delivery

A FE6331 1 EA *120 Calendar Days FE633111400274 / PRI:

R

A FE6331 1 EA *120 Calendar Days FE633111400275 / PRI:

R

A FE6331 1 EA *120 Calendar Days FE633111400276 / PRI:

R

Proposed Delivery

A FE6331 1 EA

A FE6331 1 EA

A FE6331 1 EA

Accelerated delivery is acceptable if at no additional cost to the Government.

Bid A - First Article Required

Data in Support of CLIN 0001 Item No.

DATA

Bid A - First Article Required

Data in Support of CLIN 0001 Data in Support of CLIN 0001 IAW attached DD Forms 1423

Limitations of Liability: Other Than High Value Item

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

Bid A - First Article Required

First Article Test Plan Item No.

0002AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

FATP

First Article Test Plan

IAW CDRL A001

Associated Document(s) Line Item(s)

FD20602230245 0002

Priority: R ROUTINE Exhibit: A Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

I FA8526 1 LO *60 Calendar Days

Proposed Delivery

I FA8526 1 LO

Bid A - First Article Required

First Article Test Report Item No.

0002AB

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

FATR

First Article Test Report

IAW CDRL A002

Associated Document(s) Line Item(s)

FD20602230245 0003

Priority: R ROUTINE Exhibit: A Type / Ship To Quantity (U/I) *ARO Approval of

First Article _ Req No / Pri

Required Delivery

I FA8526 1 LO *60 Calendar Days

Bid A - First Article Required

First Article Test Report Proposed Delivery

I FA8526 1 LO

Bid B - First Article NOT Required

Cable Assembly, Special Purpose, Electrical Item No.

NSN: 5995-01-565-8771 BA

Manufacturer Part Number 88277 17G460235-1

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standard under which they qualify.

Buy American Act/Balance of Payments Program IUID Required: Yes Physical Item Markings:

Serial Number Required

Bid B - First Article NOT Required

Production - Spangdahlem AB Item No.

0003AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 EA

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Associated Document(s) Line Item(s)

FD20602230245 0001

Priority: R ROUTINE Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE5621 DESTINATION

Type / Ship To PACRN Mark For

A FE5621 PAA C-17 AMC

Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

A FE5621 1 EA *120 Calendar Days FE562111180154 / PRI:

R

Bid B - First Article NOT Required

Production - Spangdahlem AB Proposed Delivery

A FE5621 1 EA

Accelerated delivery is acceptable if at no additional cost to the Government.

Bid B - First Article NOT Required

Production - Charlotte ANG Item No.

0003AB

Firm Fixed Price Quantity U/I Unit Price Amount

3 EA

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Associated Document(s) Line Item(s)

FD20602230251 0001

Priority: R ROUTINE Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE6331 DESTINATION

Type / Ship To PACRN Mark For

A FE6331 PAA C-17 ANG

A FE6331 PAA C-17 ANG

A FE6331 PAA C-17 ANG

Type / Ship To Quantity (U/I) *ARO Approval of

First Article _ Req No / Pri

Required Delivery

A FE6331 1 EA *120 Calendar Days FE633111400274 / PRI:

R

A FE6331 1 EA *120 Calendar Days FE633111400275 / PRI:

R

A FE6331 1 EA *120 Calendar Days FE633111400276 / PRI:

R

Proposed Delivery

A FE6331 1 EA

A FE6331 1 EA

A FE6331 1 EA

Accelerated delivery is acceptable if at no additional cost to the Government.

IUID Marking Plan Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

DATA

IUID Marking Plan

IAW CDRL A003

Associated Document(s) Line Item(s)

FD20602230245 0004

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Exhibit: A Quality Assurance: Standard Inspection Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

I FA8526 1 LO *60 Calendar Days

Proposed Delivery

I FA8526 1 LO

Option I can be exercised from time to time, at any time, for a period of 365 days after award, or after approval of the First Article, whichever is later, not to exceed a quantity of three (3) each. Multiple Option periods may be exercised simultaneously. An Option is determined to have been exercised when transmitted electronically by email. Subline items may be established at the time of Option exercise.

Option I

Item No.

Firm Fixed Price From Quantity

U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 5995-01-565-8771 BA

Manufacturer Part Number 88277 17G550555-1 Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet the highest standard under which they qualify.

Buy American Act/Balance of Payments Program IUID Required: Yes

Option I

Physical Item Markings:

Serial Number Required

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A TBD DESTINATION

Type / Ship To PACRN Mark For

A TBD PAA

Type / Ship To Quantity (U/I) *ARO Exercise of

Option _ Req No / Pri

Required Delivery

A TBD 3 EA *120 Calendar Days

Proposed Delivery

A TBD 3 EA

Early delivery is authorized if at no additional cost to the Government.

Option II can be exercised from time to time, at any time, for a period of 730 days after award, or after approval of the First Article, whichever is later, not to exceed a quantity of three (3) each. Multiple Option periods may be exercised simultaneously. An Option is determined to have been exercised when transmitted electronically by email. Subline items may be established at the time of Option exercise.

Option II

Item No.

Firm Fixed Price From Quantity

U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Manufacturer Part Number 88277 17G550555-1 Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet the highest standard under which they qualify.

Buy American Act/Balance of Payments Program IUID Required: Yes Physical Item Markings:

Serial Number Required

Option II

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A TBD DESTINATION

Type / Ship To PACRN Mark For

A TBD PAA

Type / Ship To Quantity (U/I) *ARO Exercise of

Option _ Req No / Pri

Required Delivery

A TBD 3 EA *120 Calendar Days

Proposed Delivery

A TBD 3 EA

Early delivery is authorized if at no additional cost to the Government.

Option III can be exercised from time to time, at any time, for a period of 1,095 days after award, or after approval of the First Article, whichever is later, not to exceed a quantity of three (3) each. Multiple Option periods may be exercised simultaneously. An Option is determined to have been exercised when transmitted electronically by email. Subline items may be established at the time of Option exercise.

Option III

Item No.

Firm Fixed Price From Quantity

U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 5995-01-565-8771 BA

Cable Assembly, Special Purpose Electrical Manufacturer Part Number 88277 17G550555-1 Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet the highest standard under which they qualify.

Buy American Act/Balance of Payments Program IUID Required: Yes Physical Item Markings:

Serial Number Required

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A TBD DESTINATION

Option III

Type / Ship To PACRN Mark For

A TBD PAA

Type / Ship To Quantity (U/I) *ARO Exercise of

Option _ Req No / Pri

Required Delivery

A TBD 3 EA *120 Calendar Days

Proposed Delivery

A TBD 3 EA

Early delivery is authorized if at no additional cost to the Government.

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A FE5621

FE5621 52 FW LGTT

CP 011 49 6565 61 6110 or 6440

54529 FLUGPLATZ

BLDG 250 LRGD

SPANGDAHLEM AB, DE

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

AWARD NUMBER:

TYPE/CODE: A FE6331

FE6331 145 LRS LGRM

CML PHN 704-391-4163

4930 MINUTEMAN WAY, BLDG 63

CHARLOTTE NC 28208-5704

USA

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

AWARD NUMBER:

TYPE/CODE: A TBD

TO BE DETERMINED

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

AWARD NUMBER:

TYPE/CODE: I FA8526

C-17 GLOBEMASTER

AFLCMC/WLMKA

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 327 8694

ROBINS AFB GA 31098-1670

UNITED STATES

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

AWARD NUMBER:

CONTRACT CLAUSES

5352.2019101 OMBUDSMAN (OCT 2019)

(IAW AFFARS 5301.9103)

(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 -1088 , 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 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.

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))

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)

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 AND OTHER COVERED

ENTITIES (NOV 2021)

(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))

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

(IAW DFARS 204.404-70(b))

252.204-7006 BILLING INSTRUCTIONS (OCT 2005)

(IAW DFARS 204.7109(b))

252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT

REPORTING (DEC 2019)

(IAW DFARS 204.7304(c))

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (MAY 2016)

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

252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES (JAN 2021)

(IAW DFARS 204.2105(c))

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

(IAW DFARS 204.7304(e))

252.204-7022 EXPEDITING CONTRACT CLOSEOUT (MAY 2021)

(IAW DFARS 204.804-70)

52.209-3 FIRST ARTICLE APPROVAL--CONTRACTOR TESTING (SEP 1989)

(IAW FAR 9.308-1(a)(1), FAR 9.308-1(b)(1))

(a) The Contractor shall test ** unit(s) of Lot/Item * as specified in this contract. At least *** calendar days before the beginning of first article tests, the Contractor shall notify the Contracting Officer, in writing, of the time and location of the testing so that the Government may witness the tests.

*Lot/Item ***Calendar Days Before Test **Quantity

0001AA 30 1

(b) The Contractor shall submit the first article test report within ___**___ calendar days from the date of this contract to ___***___ marked "FIRST ARTICLE TEST REPORT: Contract No. Lot/Item No. ___*___” Within ___****___ calendar days after the Government receives the test report, the Contracting Officer shall notify the Contractor, in writing, of the conditional approval, approval, or disapproval of the first article. The notice of conditional approval or approval shall not relieve the Contractor from complying with all requirements of the specifications and all other terms and conditions of this contract. A notice of conditional approval shall state any further action required of the Contractor. A notice of disapproval shall cite reasons for the disapproval.

*Lot/Item ****Approval Days ELIN No.

0001AA 60 A002

FA Test Report Item ***Type/Location **Calendar Days

0002AB IFA8526 60

52.209-3 FIRST ARTICLE APPROVAL--CONTRACTOR TESTING -- ALTERNATE I (JAN 1997)

(IAW FAR 9.308-1(a)(2), FAR 9.308-1(b)(2))

52.209-3 FIRST ARTICLE APPROVAL--CONTRACTOR TESTING -- ALTERNATE II (SEP 1989)

(IAW FAR 9.308-1(a)(3), FAR 9.308-1(b)(3))

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)

FIRST ARTICLE TEST, CERTIFICATION AND DISPOSITION REQUIREMENTS

(FEB 1998)

(IAW FAR 9.308-2)

Test criteria are as follows:

Lot/Item Government Test/Inspection Requirements

Lot/Item Contractor Test/Inspection Requirements 0001AA (See Below)

Contractor Testing Requirements Performance or other characteristics which the First Articles must meet are:

Dimensional Conformance, Material and Process Verification, Workmanship, Proof Load Test

The detailed technical requirements for First Article approval tests are contained in Drawing 17G460235 and associated lists.

Disposition of the First Article shall be as follows:

Lot/Item Approved 0001AA Forwarded to: Ship To Code on CLIN 0001

Lot/Item Disapproved 0001AA Returned to the contractor

52.2115 MATERIAL REQUIREMENTS (AUG 2000)

(IAW FAR 11.304)

52.211-8 TIME OF DELIVERY (JUN 1997)

(IAW FAR 11.404(a)(2))

DELIVERY FOR EACH ITEM IS ANNOTATED IN THE SCHEDULE (PART I SECTION B) UNDER EACH LINE

ITEM.

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).

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

(IAW DFARS 211.274-6(a)(1), DFARS 212.301(f)(xii))

(a) Definitions. As used in this clause—

“DoD recognized unique identification equivalent” means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html.

“Unique item identifier type” means a designator to indicate which method of uniquely identifying a part has been used. The current list of accepted unique item identifier types is maintained at https://www.acq.osd.mil/asda/dpc/ce/ds/unique-id.html.

(c) Unique item identifier.

(1) The Contractor shall provide a unique item identifier for the following:

(i) Delivered items for which the Government’s unit acquisition cost is $5,000 or more, except for the following line items:

Contract Line, Subline, or Exhibit Line Item Number

Item Description

See Schedule as Applicable

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

Contract Line, Subline, or Exhibit Line Item Number

Item Description

*Items less than $5000, which require UID, will be specifically identified in the schedule.

See Schedule as Applicable

(iii) Subassemblies, components, and parts embedded within delivered items, items with warranty requirements, DoD serially managed reparables and DoD serially managed nonreparables as specified in Attachment Number _____( or See Schedule as Applicable).

(iv) Any item of special tooling or special test equipment as defined in FAR 2.101 that have been designated for preservation and storage for a Major Defense Acquisition Program as specified in Attachment Number _____( or See Schedule as Applicable).

(v) Any item not included in paragraphs (c)(1)(i), (ii), (iii), or (iv) of this clause for which the contractor creates and marks a unique item identifier for traceability.

(f) The Contractor shall submit the information required by paragraphs (d) and (e) of this clause as follows:

(1) End items shall be reported using the receiving report capability in Wide Area WorkFlow (WAWF) in accordance with the clause at 252.232-7003. If WAWF is not required by this contract, and the contractor is not using WAWF, follow the procedures at http://dodprocurementtoolbox.com/site/uidregistry/ .

(2) Embedded items shall be reported by one of the following methods—

(i) Use of the embedded items capability in WAWF;

(ii) Direct data submission to the IUID Registry following the procedures and formats at http://dodprocurementtoolbox.com/site/uidregistry/; or

(iii) Via WAWF as a deliverable attachment for exhibit line item number ______, Unique Item Identifier Report for Embedded Items, Contract Data Requirements List, DD Form 1423.

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

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES) (JAN 2022)

(IAW FAR 13.302-5(d))

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses that are incorporated by reference:

(1) The clauses listed below implement provisions of law or Executive order:

(i) 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)).

(ii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (NOV 2021) (Section 1634 of Pub. L. 115-91).

(iii) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (NOV 2021) (Section 889(a)(1)(A) of Pub. L. 115-232).

(iv) 52.222-3, Convict Labor (JUN 2003) (E.O. 11755).

(v) 52.222-21, Prohibition of Segregated Facilities (APR 2015).

(vi) 52.222-26, Equal Opportunity (SEP 2016) (E.O. 11246).

(vii) 52.225-13, Restrictions on Certain Foreign Purchases (FEB 2021) (E.O.s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

(viii) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).

(ix) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub. L. 108-77, 108-78 (19 U.S.C. 3805 note).

(2) Listed below are additional clauses that apply:

(i) 52.232-1, Payments (APR 1984).

(ii) 52.232-8, Discounts for Prompt Payment (FEB 2002).

(iii) 52.232-11, Extras (APR 1984).

(iv) 52.232-25, Prompt Payment (JAN 2017).

(v) 52.232-39, Unenforceability of Unauthorized Obligations (JUN 2013).

(vi) 52.232-40, Providing Accelerated Payments to Small Business Subcontractors (NOV 2021).

(vii) 52.233-1, Disputes (MAY 2014).

(viii) 52.244-6, Subcontracts for Commercial Products and Commercial Services (JAN 2022)

(ix) 52.253-1, Computer Generated Forms (Jan 1991).

(b) The Contractor shall comply with the following FAR clauses, incorporated by reference, unless the circumstances do not apply:

(1) The clauses listed below implement provisions of law or Executive order:

(i) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUN 2020) (Pub.

L. 109-282) (31 U.S.C. 6101 note) (Applies to contracts valued at or above the threshold specified in FAR 4.1403(a) on the date of award of this contract).

(ii) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (JAN 2022) (E.O. 13126) (Applies to contracts for supplies exceeding the micro-purchase threshold, as defined in FAR 2.101 on the date of award of this contract).

(iii) 52.222-20, Contracts for Materials, Supplies, Articles, and Equipment (JUN 2020) (41 U.S.C.

chapter 65) (Applies to supply contracts over the threshold specified in FAR 22.602 on the date of award of this contract, in the United States, Puerto Rico, or the U.S. Virgin Islands).

(iv) 52.222-35, Equal Opportunity for Veterans (JUN 2020) (38 U.S.C. 4212) (Applies to contracts valued at or above the threshold specified in FAR 22.1303(a) on the date of award of this contract).

(v) 52.222-36, Equal Employment for Workers with Disabilities (JUN 2020) (29 U.S.C. 793) (Applies to contracts over the threshold specified in FAR 22.1408(a) on the date of award of this contract, unless the work is to be performed outside the United States by employees recruited outside the United States). (For purposes of this clause, “United States” includes the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and Wake Island.)

(vi) 52.222-37, Employment Reports on Veterans (JUN 2020)(38 U.S.C. 4212) (Applies to contracts valued at or above the threshold specified in FAR 22.1303(a) on the date of award of this contract).

(vii) 52.222-41, Service Contract Labor Standards (AUG 2018) (41 U.S.C. chapter 67) (Applies to service contracts over $2,500 that are subject to the Service Contract Labor Standards statute and will be performed in the United States, District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, Johnston Island, Wake Island, or the outer Continental Shelf).

(viii)(A) 52.222-50, Combating Trafficking in Persons (NOV 2021) (22 U.S.C. chapter 78 and E.O.

13627) (Applies to all solicitations and contracts).

(B) Alternate I (MAR 2015) (Applies if the Contracting Officer has filled in the following information with regard to applicable directives or notices: Document title(s), source for obtaining document(s), and contract performance location outside the United States to which the document applies).

(ix) 52.222-55, Minimum Wages for Contractor Workers Under Executive Order 14026 (JAN 2022) (Applies when 52.222–6 or 52.222–41 are in the contract and performance in whole or in part is in the United States (the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, Johnston Island, Wake Island, and the outer Continental Shelf as defined in the Outer Continental Shelf Lands Act (43 U.S.C. 1331, et seq.))).

(x) 52.222-62, Paid Sick Leave Under Executive Order 13706 (JAN 2022) (E.O. 13706) (Applies when 52.222-6 or 52.222-41 are in the contract and performance in whole or in part is in the United States (the 50 States and the District of Columbia.))

(xi) 52.223-5, Pollution Prevention and Right-to-Know Information (MAY 2011) (E.O. 13423) (Applies to services performed on Federal facilities).

(xii) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (JUN 2016) (E.O. 13693)(applies to contracts for products as prescribed at FAR 23.804(a)(1)).

(xiii) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (JUN 2016) (E.O. 13693) (Applies to maintenance, service, repair, or disposal of refrigeration equipment and air conditioners).

(xiv) 52.223-15, Energy Efficiency in Energy-Consuming Products (MAY 2020) (42 U.S.C. 8259b) (Unless exempt pursuant to 23.204, applies to contracts when energy-consuming products listed in the ENERGY STAR® Program or Federal Energy Management Program (FEMP) will be—

(A) Delivered;

(B) Acquired by the Contractor for use in performing services at a Federally-controlled facility;

(C) Furnished by the Contractor for use by the Government; or

(D) Specified in the design of a building or work, or incorporated during its construction, renovation, or maintenance).

(xv) 52.223-20, Aerosols (JUN 2016) (E.O. 13693) (Applies to contracts for products that may contain high global warming potential hydrofluorocarbons as a propellant or as a solvent; or contracts for maintenance or repair of electronic or mechanical devices).

(xvi) 52.223-21, Foams (JUN 2016) (E.O. 13693) (Applies to contracts for products that may contain high global warming potential hydrofluorocarbons or refrigerant blends containing hydrofluorocarbons as a foam blowing agent; or contracts for construction of buildings or facilities.

(xvii) 52.225-1, Buy American—Supplies (NOV 2021) (41 U.S.C. chapter 67) (Applies to contracts for supplies, and to contracts for services involving the furnishing of supplies, for use in the United States or its outlying areas, if the value of the supply contract or supply portion of a service contract exceeds the micro-purchase threshold, as defined in FAR 2.101 on the date of award of this contract, and the acquisition—

(A) Is set aside for small business concerns; or

(B) Cannot be set aside for small business concerns (see 19.502-2), and does not exceed $25,000).

(xviii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (JUN 2020) (42 U.S.C.

1792) (Applies to contracts greater than the threshold specified in FAR 26.404 on the date of award of this contract, that provide for the provision, the service, or the sale of food in the United States).

(xix) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (OCT 2018) (Applies when the payment will be made by electronic funds transfer (EFT) and the payment office uses the System for Award Management (SAM) as its source of EFT information).

(xx) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (JUL 2013) (Applies when the payment will be made by EFT and the payment office does not use the SAM database as its source of EFT information.)

(xxi) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (NOV 2021) (46 U.S.C.

55305) (Applies to supplies transported by ocean vessels (except for the types of subcontracts listed at 47.504(d).)

(2) Listed below are additional clauses that may apply:

(i) 52.204-21, Basic Safeguarding of Covered Contractor Information Systems (NOV 2021) (Applies to contracts when the contractor or a subcontractor at any tier may have Federal contract information residing in or transiting through its information system).

(ii) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (NOV 2021) (Applies to contracts over the threshold specified in FAR 9.405-2(b) on the date of award of this contract).

(iii) 52.211-17, Delivery of Excess Quantities (SEP 1989) (Applies to fixed-price supplies).

(iv) 52.247-29, F.o.b. Origin (FEB 2006) (Applies to supplies if delivery is f.o.b. origin).

(v) 52.247-34, F.o.b. Destination (NOV 1991) (Applies to supplies if delivery is f.o.b. destination).

(c) FAR 52.252-2, Clauses Incorporated by Reference (FEB 1998). This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far https://www.acquisition.gov/dfars https://www.acquisition.gov/affars

(d) Inspection/Acceptance. The Contractor shall tender for acceptance only those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. The Government must exercise its postacceptance rights—

(1) Within a reasonable period of time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(e) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence, such as acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(f) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges that the Contractor can demonstrate to the satisfaction of the Government, using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred that reasonably could have been avoided.

(g) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience.

(h) Warranty. The Contractor warrants and implies that the items delivered hereunder are merchantable and fit for use for the particular purpose described in this contract.

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

(IAW FAR 19.507(c))

52.219-14 LIMITATIONS ON SUBCONTRACTING (DEVIATION 2021-O0008) (SEP 2021)

(IAW Deviation 2021-O0008)

(a) This clause does not apply to the unrestricted portion of a partial set-aside.

(b) Definition. “Similarly situated entity,” as used in this clause, means a first-tier subcontractor, including an independent contractor, that—

(1) Has the same small business program status as that which qualified the prime contractor for the award (e.g., for a small business set-aside contract, any small business concern, without regard to its socioeconomic status); and

(2) Is considered small for the size standard under the North American Industry Classification System (NAICS) code the prime contractor assigned to the subcontract.

(c) Applicability. This clause applies only to—

(1) Contracts that have been set aside for any of the small business concerns identified in 19.000(a)(3);

(2) Part or parts of a multiple-award contract that have been set aside for any of the small business concerns identified in 19.000(a)(3);

(3) Contracts that have been awarded on a sole-source basis in accordance with subparts 19.8, 19.13, 19.14, and 19.15;

(4) Orders expected to exceed the simplified acquisition threshold and that are—

(i) Set aside for small business concerns under multiple-award contracts, as described in 8.405-5 and 16.505(b)(2)(i)(F); or

(ii) Issued directly to small business concerns under multiple-award contracts as described in 19.504(c)(1)(ii);

(5) Orders, regardless of dollar value, that are—

(i) Set aside in accordance with subparts 19.8, 19.13, 19.14, or 19.15 under multiple-award contracts, as described in 8.405-5 and 16.505(b)(2)(i)(F); or

(ii) Issued directly to concerns that qualify for the programs described in subparts 19.8, 19.13, 19.14, or 19.15 under multiple-award contracts, as described in 19.504(c)(1)(ii); and

(6) Contracts using the HUBZone price evaluation preference to award to a HUBZone small business concern unless the concern waived the evaluation preference.

(d) Independent contractors. An independent contractor shall be considered a subcontractor.

(e) Limitations on subcontracting. By submission of an offer and execution of a contract, the Contractor agrees that in performance of a contract assigned a North American Industry Classification System (NAICS) code for—

(1) Services (except construction), it will not pay more than 50 percent of the amount paid by the Government for contract performance, excluding certain other direct costs and certain work performed outside the United States (see paragraph (e)(1)(i)), to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor’s 50 percent subcontract amount that cannot be exceeded. When a contract includes both services and supplies, the 50 percent limitation shall apply only to the service portion of the contract. The following services may be excluded from the 50 percent limitation:

(i) Other direct costs, to the extent they are not the principal purpose of the acquisition and small business concerns do not provide the service. Examples include airline travel, work performed by a transportation or disposal entity under a contract assigned the environmental remediation NAICS code 562910), cloud computing services, or mass media purchases.

(ii) Work performed outside the United States on awards made pursuant to the Foreign Assistance Act of 1961, or work performed outside the United States required to be performed by a local contractor.

(2) Supplies (other than procurement from a nonmanufacturer of such supplies), it will not pay more than 50 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor’s 50 percent subcontract amount that cannot be exceeded. When a contract includes both supplies and services, the 50 percent limitation shall apply only to the supply portion of the contract;

(3) General construction, it will not pay more than 85 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor’s 85 percent subcontract amount that cannot be exceeded; or

(4) Construction by special trade contractors, it will not pay more than 75 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor’s 75 percent subcontract amount that cannot be exceeded.

(f) The Contractor shall comply with the limitations on subcontracting as follows:

(1) For contracts, in accordance with paragraphs (c)(1), (2), (3) and (6) of this clause –

[Contracting Officer check as appropriate.] [ ] By the end of the base term of the contract and then by the end of each subsequent option period; or [ ] By the end of the performance period for each order issued under the contract.

(2) For orders, in accordance with paragraphs (c)(4) and (5) of this clause, by the end of the performance period for the order.

(g) A joint venture agrees that, in the performance of the contract, the applicable percentage specified in paragraph

(e) of this clause will be performed by the aggregate of the joint venture participants

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

(IAW FAR 19.309(c))

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

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

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

The Contractor represents that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002.

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

(4) Women-owned small business (WOSB) concern eligible under the WOSB Program.

[Complete only if the Contractor represented itself as a women-owned small business concern in paragraph (h)(3) of this clause.] The Contractor represents that—

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

(ii) It [ ] is, [ ] is not is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(4)(i) of this clause is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture.

[The Contractor shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: _______________________________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(5) Economically disadvantaged women-owned small business (EDWOSB) concern.

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

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

(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(5)(i) of this clause is accurate for each EDWOSB concern participating in the joint venture.

[The Contractor shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture:…