Solicitation_FA853819R0001__.pdf

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

FD20601800162

5. SOLICITATION NUMBER

FA8538-19-R-0001

6. SOLICITATION ISSUE DATE

b. TELEPHONE NUMBER (No collect calls)

(478 ) 926 -3230 ext.

2. CONTRACT NO.

7. FOR SOLICITATION

INFORMATION CALL

3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

a. NAME

Aliscia L. Pitts

8. OFFER DUE DATE/LOCAL

TIME

5OCT2018 4:00PM

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 811219

VETERAN-OWNED SIZE STANDARD

SMALL BUSINESS 8 (A) $20.5 :

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

F-15, C-130, & SOF-FW, AFSC/PZAAB

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 926 3980

ROBINS AFB GA 31098-1670

BUYER: Aliscia L. Pitts/AFSC/PZAAB aliscia.pitts@us.af.mil Phone: (478) 327- 2271 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.

FA8538

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 120 days.

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

X X

X

X

25. ACCOUNTING AND APPROPRIATION DATA SEE FUNDS SCHEDULE

X

SCD:B

EFT:T

Total

4 SEPT 2018

STANDARD FORM 1449 (REV. 2/2012) BACK

COMPUTER GENERATED 9/4/2018, 10:33 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

FA8538-19-R-0001

SUPPLIES OR SERVICES AND PRICES/COSTS

Note 1:

This is a Firm-Fixed price requirements type contract for the repair of the C-5 Battery Charger Electronic Module NSN: 6130-01-535-7275UC .

Note 2:

The Period of Performance is for One Basic Year and One Ordering Period.

BASIC CONTRACT PERIOD: 14 July 2019 -- 13 July 2020 ORDERING PERIOD I: 14 July 2020 -- 13 July 2021

Note 3:

BEST ESTIMATED QUANTITIES (BEQ) ARE ONLY AN ESTIMATE.

Basic Contract Period: 14 July 2019 -- 13 July 2020

TESTED AND NO FAULT FOUND--BATTERY CAHRGER

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Battery Electronic Charger Aluminum Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes

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 PAB RIC FLB D4M REPAIR

TESTED AND NO FAULT FOUND--BATTERY CAHRGER

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

Req No / Pri

Required Delivery

A SW3119 1 EA *30 Calendar Days

Proposed Delivery

A SW3119 1 EA

REPAIR OF BATTERY CHARGER

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

38 EA

CLIN ACRN ACRN Total

0002 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Recharge aircraft battery Electronic Equipment Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes Physical Item Markings:

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 PAB RIC FLB D4M REPAIR

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

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

REPAIR OF BATTERY CHARGER

A SW3119 38 EA *60 Calendar Days

Proposed Delivery

A SW3119 38 EA

BEYOND ECONOMICAL REPAIR (BER)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0003 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Condemnation/BER IAW PWS OF BASIC CONTRACT Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes Physical Item Markings:

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 PAB RIC FLB D4M REPAIR

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

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *60 Calendar Days

Proposed

A SW3119 1 EA

OVER AND ABOVE IN REPAIR OF BATTERY CHARGER

Item No.

To Be Negotiated Best Estimated Qty

U/I Unit Price

1 LO TBN

CLIN ACRN ACRN Total

0004 AA

NSN: 6130-01-535-7275

OVER AND ABOVE

IAW PWS OF BASIC CONTRACT

Manufacturer Part Number

716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes

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 RIC FLB D4M REPAIR

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

Required Delivery

A SW3119 1 LO TBD

Proposed Delivery

A SW3119 1 LO

DATA

Item No.

Contract Data Requirements Listing (CDRL) A001-A006 OF BASIC CONTRACT CDRLs A001-A005 Priority: R

Inspection: Destination Acceptance: Destination

DATA

Quality Assurance: Standard Inspection

DATA

COMMERCIAL ASSET VISIBILITY AF (CAV AF)

Item No.

0005AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A001

CAV AF

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

CONTRACT DEPOT MAINTENANCE (CDM) PRODUCTION REPORT

Item No.

0005AB

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A002

CDM PRODUCTION REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

ANNUAL PHYSICAL INVENTORY REPORT

Item No.

0005AC

DATA

ANNUAL PHYSICAL INVENTORY REPORT

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A003

ANNUAL PHYSICAL INVENTORY REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

QUARTERLY STATUS REPORT

Item No.

0005AD

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A004

QUARTERLY STATUS REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

Item Unique Identification (IUID) Marking Plan Item No.

0005AE

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A005

IUID MARKING PLAN

Priority: R

DATA

Item Unique Identification (IUID) Marking Plan

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

Item Unique Identification (IUID) Marking Activity and Verification Report Item No.

0005AF

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A006

IUID MARKING AND ACTIVITY AND VERIFICATION REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

ORDERING PERIOD I: 14 July 2020 -- 13 July 2021

TESTED AND NO FAULT FOUND--BATTERY CAHRGER

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

1001 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Battery Electronic Charger Aluminum

TESTED AND NO FAULT FOUND--BATTERY CAHRGER

Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes

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 PAB RIC FLB D4M REPAIR

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

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 1 EA *30 Calendar Days

Proposed Delivery

A SW3119 1 EA

REPAIR OF BATTERY CHARGER

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

38 EA

CLIN ACRN ACRN Total

1002 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Recharge aircraft battery Electronic Equipment Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection

REPAIR OF BATTERY CHARGER

IUID Required: Yes Physical Item Markings:

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 PAB RIC FLB D4M REPAIR

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

Order or Reparable Assets, Whichever is Later

Req No / Pri

Required Delivery

A SW3119 38 EA *60 Calendar Days

Proposed Delivery

A SW3119 38 EA

BEYOND ECONOMICAL REPAIR (BER)

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

1003 AA

NSN: 6130-01-535-7275 UC

CHARGER,BATTERY

Condemnation/BER IAW PWS OF BASIC CONTRACT Manufacturer Part Number 19623 716110-2 22830 716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes Physical Item Markings:

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 PAB RIC FLB D4M REPAIR

BEYOND ECONOMICAL REPAIR (BER)

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

Req No / Pri

Required Delivery

A SW3119 1 EA *60 Calendar Days

Proposed Delivery

A SW3119 1 EA

OVER AND ABOVE IN REPAIR OF BATTERY CHARGER

Item No.

To Be Negotiated Best Estimated Qty

U/I Unit Price

1 LO TBN

CLIN ACRN ACRN Total

1004 AA

NSN: 6130-01-535-7275

OVER AND ABOVE

IAW PWS OF BASIC CONTRACT

Manufacturer Part Number

716110-2 Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Commercial Item Inspection IUID Required: Yes

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 RIC FLB D4M REPAIR

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

Required Delivery

A SW3119 1 LO TBD

Proposed

A SW3119 1 LO

DATA

Item No.

Contract Data Requirements Listing (CDRL) A001-A006 OF BASIC CONTRACT CDRLs A001-A005 Priority: R

Inspection: Destination Acceptance: Destination Quality Assurance: Standard Inspection

DATA

COMMERCIAL ASSET VISIBILITY AF (CAV AF)

Item No.

1005AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A001

CAV AF

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

CONTRACT DEPOT MAINTENANCE (CDM) PRODUCTION REPORT

Item No.

1005AB

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A002

CDM PRODUCTION REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

ANNUAL PHYSICAL INVENTORY REPORT

Item No.

1005AC

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A003

ANNUAL PHYSICAL INVENTORY REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

QUARTERLY STATUS REPORT

Item No.

1005AD

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A004

QUARTERLY STATUS REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

Item Unique Identification (IUID) Marking Plan Item No.

1005AE

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A005

IUID MARKING PLAN

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

DATA

Item Unique Identification (IUID) Marking Activity and Verification Report Item No.

1005AF

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Contract Data Requirements Listing (CDRL) A006

IUID MARKING AND ACTIVITY AND VERIFICATION REPORT

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: IAW DD FORM 1423-1 OF BASIC CONTRACT Quality Assurance: IAW DD FORM 1423-1 OF BASIC CONTRACT

DELIVERY IAW DD FORM 1423-1 OF BASIC CONTRACT

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET BLDG 376

ROBINS AFB GA 31098-1887

UNITED STATES

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

AWARD NUMBER:

CONTRACT CLAUSES

252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD

OFFICIALS (SEP 2011)

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

252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION (MAR 2016)

(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 http://www.acq.osd.mil/dpap/pdi/uid/iuid/equivalents.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 http://www.acq.osd.mil/dpap/pdi/uid/uii_types.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.

252.225-7012 PREFERENCE FOR CERTAIN DOMESTIC COMMODITIES (DEC 2017)

(IAW DFARS 225.7002-3(a))

252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS

(JUN 2012)

(IAW DFARS 232.7004)

(a) Definitions. As used in this clause—

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

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

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

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

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

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

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

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

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

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

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

252.232-7009 MANDATORY PAYMENT BY GOVERNMENTWIDE COMMERCIAL PURCHASE CARD

(MAY 2018)

(IAW DFARS 232.1110)

(Applicable at or below the micro-purchase threshold and Governmentwide commercial purchase card is required)

252.232-7010 LEVIES ON CONTRACT PAYMENTS (DEC 2006)

(IAW DFARS 232.7102)

(Applicable to all solicitations and contracts over the micro-purchase threshold issued hereunder)

252.237-7010 PROHIBITION ON INTERROGATION OF DETAINEES BY CONTRACTOR

PERSONNEL (JUN 2013)

(IAW DFARS 237.173-5)

252.243-7002 REQUESTS FOR EQUITABLE ADJUSTMENT (DEC 2012)

(IAW DFARS 243.205-71)

ADDENDUM TO CLAUSE 52.212-4

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

(IAW DFARS 201.602-70)

(Applicable to all orders issued hereunder)

5352.201-9101 OMBUDSMAN (JUN 2016)

(IAW AFFARS 5301.9103)

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

(Applicable to all solicitations and contracts)

52.203-3 GRATUITIES (APR 1984)

(IAW FAR 3.202)

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)

(Applicable to all solicitations and contracts)

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

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

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS

(DEC 2014)

(IAW FAR 4.1202(b))

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

DEVELOPED OR PROVIDED BY KASPERSKY LAB AND OTHER COVERED

ENTITIES (JUL 2018)

(IAW FAR 4.2004)

52.204-23 BASIC AGREEMENT APPLICABILITY (JUL 2018)

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (MAY 2016)

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

(Applicable to solicitations and contracts that involve litigation support services when 252.204-7014 is not included)

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

252.211-7007 REPORTING OF GOVERNMENT-FURNISHED PROPERTY (AUG 2012)

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

52.212-4 CONTRACT TERMS AND CONDITIONS--COMMERCIAL ITEMS (JAN 2017)

(IAW FAR 12.301(b)(3))

(Applicable to all commercial items)

52.216-19 ORDER LIMITATIONS (OCT 1995)

(IAW FAR 16.506(b))

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than 1 EACH the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor--

(1) Any order for a single item in excess of NONE

(2) Any order for a combination of items in excess of NONE; or

(3) A series of orders from the same ordering office within 30 CALENDAR days that together call for quantities exceeding the limitation in subparagraph (b)(1) or (2) of this section.

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

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 10 CALENDAR days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(The above Clause/Provision has been modified.)

(Applicable to all orders issued hereunder)

52.216-21 REQUIREMENTS (OCT 1995)

(IAW FAR 16.506(d)(1))

(f) the Contractor shall not be required to make any deliveries under this contract after 13-JUL-2021

(Applicable to all orders issued hereunder)

252.216-7006 ORDERING (MAY 2011)

(IAW DFARS 216.506(a))

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the contract schedule. Such orders may be issued from 14-JUL-2019 through 13-JUL-2021.

(Applicable to solicitations and contracts when a definite-quantity contract, a requirements contract, or an indefinite-quantity contract is contemplated)

252.217-7028 OVER AND ABOVE WORK (DEC 1991)

(IAW DFARS 217.7702)

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

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

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

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

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

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

(IAW FAR 22.103-5(a), AFFARS 5322.101-1) (IAW FAR 22.101-1(e), Applicable when the head of the contracting activity designates programs or requirements for which it is necessary that contractors be required to notify the Government of actual or potential labor disputes that are delaying or threaten to delay the timely contract performance (see 22.103-5(a)).

252.225-7013 DUTY-FREE ENTRY (MAY 2016)

(IAW DFARS 225.1101(4))

(Applicable to contracts requiring duty free entry of goods into the United States)

252.225-7048 EXPORT-CONTROLLED ITEMS (JUN 2013)

(IAW DFARS 225.7901-4)

52.229-4 FEDERAL, STATE, AND LOCAL TAXES (STATE AND LOCAL ADJUSTMENTS)

(FEB 2013)

(IAW FAR 29.401-3(b))

(Applicable when the simplified acquisition threshold is exceeded and fixed-price noncompetitive, and performed wholly or partly within the United States, its possessions or territories, Puerto Rico or the Northern Mariana Islands)

52.232-39 UNENFORCEABILITY OF UNAUTHORIZED OBLIGATIONS (JUN 2013)

(IAW FAR 32.706-3)

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (DEC 2013)

(IAW FAR 32.009-2)

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

(IAW DFARS 232.7004(b), PGI 232.7004(b)(1), DFARS 212.301(f)(liii))

(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

(Contracting Officer: Insert applicable document type(s).

Note: If a “Combo” document type is identified but not supportable by the Contractor’s business systems, an “Invoice” (stand-alone) and “Receiving Report” (stand-alone) document type may be used instead.)

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.

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

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table* Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC Issue By DoDAAC Admin DoDAAC Inspect By DoDAAC Ship To Code Ship From Code

Mark For Code Service Approver (DoDAAC) Service Acceptor (DoDAAC) Accept at Other DoDAAC LPO DoDAAC DCAA Auditor DoDAAC Other DoDAAC(s) (*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the e-mail address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

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

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity’s WAWF point of contact.

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

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

(Applicable when 252.232-7003 is used and neither 232.7003(b) nor (c) apply)

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA TO BE CITED ON INDIVIDUAL ORDERS $0.00

ACRN TOTAL $ 0.00

(Applicable to solicitations and contracts for the provision of services)

52.245-1 GOVERNMENT PROPERTY (JAN 2017)

(IAW FAR 45.107(a), DFARS 237.7003(c), DFARS 245.107)

(Applicable in cost reimbursement, time-and-material, and labor-hour; and fixed-price when the Government will provide Government property. Also commercial where Government property exceeds $100,000)

(Applicable when FAR 52.245-1 is included)

252.245-7001 TAGGING, LABELING, AND MARKING OF GOVERNMENT-FURNISHED PROPERTY

(APR 2012)

(IAW DFARS 245.107(2))

(Applicable to solicitations and contracts containing FAR clause 52.245-1, Government Property)

252.245-7002 REPORTING LOSS OF GOVERNMENT PROPERTY (DEC 2017)

(IAW DFARS 245.107(3))

(Applicable to solicitations and contracts containing FAR clause 52.245-1, Government Property)

252.245-7003 CONTRACTOR PROPERTY MANAGEMENT SYSTEM ADMINISTRATION (APR 2012)

(IAW DFARS 245.107(4))

(Applicable to solicitations and contracts containing the clause at FAR 52.245-1, Government Property)

252.245-7004 REPORTING, REUTILIZATION, AND DISPOSAL (DEC 2017)

(IAW DFARS 245.107(5))

(Applicable to solicitations and contracts containing the clause at FAR 52.245-1, Government Property)

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

(IAW AFI 24-230, DoD 4000.25-6M)

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

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

Existing Activity Address Code __________________

Existing Routing Identifier Code (RIC) ________________

[ ] I currently do not possess an Activity Address Code for the designated activity type. Use the following address to obtain the Activity Address Code:

[ ] I currently do not possess a Routing Identifier Code (RIC) for the designated activity type.

INSPECTION AND ACCEPTANCE (SEP 1999)

(IAW FAR 46.401(b), FAR 46.503)

(Applicable to all orders issued hereunder)

Government Contract Quality Assurance Inspection and Acceptance will be at (Final):

[CONTRACTOR FILL-IN]

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

Inspection Code and Address:

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

Item No(s): 0005, 0005AA, 0005AB, 0005AC, 0005AD, 0005AE, 0005AF, 1005, 1005AA, 1005AB, 1005AC, 1005AD, 1005AE, 1005AF

52.247-1 COMMERCIAL BILL OF LADING NOTATIONS (FEB 2006)

(IAW FAR 47.104-4(a), FAR 47.104-4(b))

(Applicable when fixed-price f.o.b. origin or Cost-reimbursement are specified)

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

(IAW FAR 47.303-1(c)) (Applicable when specifying f.o.b. origin)

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

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

F.O.B. ORIGIN (OCT 1993)

(IAW FAR 47.305(b))

Any supply item applicable to this document shall be delivered F.O.B. at:

F.O.B. Address

[CONTRACTOR FILL-IN]

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

52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (APR 1984)

(IAW FAR 52.107(f))

(Applicable to all orders issued hereunder)

TRANSPORTATION APPROPRIATION CHARGEABLE

The Transportation Allotment Identification (TAI) relates directly to the above ACRN(s). For example the TAI "TAA" is for the same line item(s) as ACRN "AA".

FMS TRANSPORTATION ALLOTMENT SHALL BE USED ONLY WHEN SHIPMENT ON GOVERNMENT

BILL OF LADING IS AUTHORIZED

Insert 3 if movement via surface mode or 2 if movement via airlift in place of any "#" shown.

Insert last digit of current fiscal year in place of any asterisk "*" shown when material is shipped.

TAI ATAC FMS ALLOTMENT/ NOTE

TAA F6RS

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

Form Number Description/File Name Date Number of Pages

ATTACHMENT #1 SGFP

SCHEDULED GOVERNMENT FURNISHED

PROPERTY

15AUG2018 1

ATTACHMENT #2 PWS 31JUL2018 13

PERFORMANCE WORK STATEMEMT

DD 1423-1 ATTACHMENT #3 CDRLs A001-A006

CONTRACT DATA REQUIREMENTS LIST

A001-A006

09AUG2018 6

ATTACHMENT #4 CAVAF

CAV AF

01FEB2018 7

AFMC 158 ATTACHMENT #5 PACKAGING

REQUIREMENT

PACKAGING REQUIREMENTS

10AUG2018 2

ATTACHMENT #6 WAGE DETERMINATION

WAGE DETERMINATION

27JUL2018 1

DD 1653 ATTACHMENT #7 TRANSPORTATION DATA

REPORT

TRANSPORTATION DATA REPORT

10AUG2018 3

DD 2875 ATTACHMENT #8 DD2875 SAAR.

SYSTEM AUTHORIZATION ACCESS

REQUEST (SAAR)

01AUG2009 3

ATTACHMENT #9 Instructions for DD2875

SAAR INSTRUCTIONS

15MAY2014 2

AF 4394 ATTACHMENT #10 AF Form 4394 User Agreement Statement

AIR FORCE USER AGREEMENT

STATEMENT

21JUN2013 1

SOLICITATION PROVISIONS

REPRESENTATIONS, INSTRUCTIONS AND EVALUATIONS

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS

(NOV 2017)

(IAW FAR 12.301(b)(2))

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

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

(c) Check all that apply.

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

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

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

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

(5) [ ] is, [ ] is not a women-owned small business concern.

Note: Complete paragraphs (c)(6) and (c)(7) only if this solicitation is expected to exceed the simplified acquisition threshold.

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

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

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

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

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

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

______________]. Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

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

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

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

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

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

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

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

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

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

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

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

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

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

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Supplies.”

(2) Foreign End Products:

Line Item No. Country Of Origin

[List as necessary]

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

(g)(1) Buy American--Free Trade Agreement—Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American--Free Trade Agreement--Israeli Trade Act, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act.”

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

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

Line Item No. Country Of Origin

[List as necessary]

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

Other Foreign End Products:

Line Item No. Country Of Origin

[List as necessary]

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

(2) Buy American--Free Trade Agreements--Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled “Buy American--Free Trade Agreement--Israeli Trade Act":

Canadian End Products:

Line Item No.

[List as necessary]

(3) Buy American--Free Trade Agreements--Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled “Buy American--Free Trade Agreement--Israeli Trade Act":

Canadian or Israeli End Products:

Line Item No. Country Of Origin

[List as necessary]

(4) Buy Americant—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g) (1) (ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American--Free Trade Agreements--Israeli Trade Act":

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

Line Item No. Country Of Origin

[List as necessary]

(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled “Trade Agreements.”

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products:

Line Item No. Country Of Origin

[List as necessary]

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals—

(1) [ ] Are, [ ] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) [ ] Have, [ ] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or…