FA8601-12-R-0044.pdf

AFLCMC/PKOA - TECHNOLOGY SUPPORT BRANCH

POC: LAURA BURNETTE

1940 ALLBROOK DRIVE, STE 3

WRIGHT-PATTERSON AFB OH 45433-5309

937-522-4581

937-656-1412

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE ADDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

(No Collect Calls)

$30.0M

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

X

CODE

FA8601-12-R-0044 30-Jul-2012

b. TELEPHONE NUMBER

937-522-4581

8. OFFER DUE DATE/LOCAL TIME

10:00 AM 30 Aug 2012

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescribed by GSA

FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

22. UNIT 23. UNIT PRICE 24. AMOUNT21. QUANTITY

CODE 10. THIS ACQUISITION IS

UNRESTRICTED

FAX:

NAICS:

TEL:

CODE 18a. PAYMENT WILL BE MADE BYOFFEROR

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TEL.

FA8601

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

15. DELIVER TO CODE F4F4AC 16. ADMINISTERED BY

88 MDSS SGSRB

NO CONTACT IDENTIFIED

4881 SUGAR MAPLE DR BLDG 830

WRIGHT-PATTERSON AFB OH 45433-5529

TEL: FAX:

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

LAURA BURNETTE

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES

SEE SCHEDULE

812331

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.

SB

HUBZONE SB

SET ASIDE: % FOR

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

TEL: EMAIL:

2 COPIES

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

.OFFER DATED YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 29. AWARD OF CONTRACT: REFERENCE

X

8(A)

SVC-DISABLED VET-OWNED SB

EMERGING SB

X

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

SEE SCHEDULE

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY 22. UNIT 24. AMOUNT

PAGE 2 OF

23. UNIT PRICE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

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

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

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

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

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV 3/2005) BACK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

FA8601-12-R-0044

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES MAX

QUANTITY

UNIT UNIT PRICE MAX AMOUNT

0001 3,350 Each Gown Pack

FFP

Gown Pack (LG) Level 4: 1-gown(LG), 1-24‖x24‖ wrapper, 1-duraweave like cloth towel 17‖x30‖

FOB: Destination

SIGNAL CODE: A

MAX

NET AMT

UNIT UNIT PRICE MAX AMOUNT

0002 3,250 Each Four Towel Pack

FFP

Four Towel Pack: 1-Level 4 mayo cover 24‖x24‖, 4-duraweave like cloth towel

17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

0003 350 Each Basic Pack

FFP

Basic Pack: 1-Level 4 mayo cover 22‖X54‖, 2-Level 4 LG/XLG gowns, 10 duraweave like cloth towels 17‖x36‖, 2-X/LONG cloth towels, 1-60‖x90‖ Level 4 back table cover.

UNIT UNIT PRICE MAX AMOUNT

0004 100 Each Laparotomy Pack

FFP

Laparotomy Pack:: 1-60‖x90‖ Level 4, back table cover, 1-108‖x130‖ fenestrated laparotomy drape with 6‖x14‖ fenestration, 2-LG/XLG gowns, 10 duraweave-like cloth towels 17‖x30‖,2-X/LONG cloth towels, 1-mayo cover 22‖x54‖. (ALL

DRAPES GOWNS, TABLE COVERS AND MAYO COVERS TO BE LEVEL

4)

UNIT UNIT PRICE MAX AMOUNT

0005 370 Each Lithotomy Pack

FFP

Lithotomy Pack:: 1-60‖X90‖ BACK TABLE COVER, Level 4, 1-108‖X100 laparotomy/lithotomy fenestrated drape with 10‖x10‖ fenestration, 2-30‖x50‖ leggings, 1-30‖x48‖ under buttocks drape with 12‖ cuff, 1-60‖x87‖ drape sheet, 2-LG/XLG gowns, 6 duraweave like cloth towels 17‖x30‖. ‖. (ALL DRAPES

GOWNS, TABLE COVERS, AND LEGGINGS ARE TO BE MADE OF LEVEL

4 MATERIAL)

UNIT UNIT PRICE MAX AMOUNT

0006 3,200 Each Bulk Hand Towels

FFP

Bulk Hand Towels: Lint free, 17‖x30‖, duraweave like cloth, any color

UNIT UNIT PRICE MAX AMOUNT

0007 2,400 Each Bulk Hamper Bags

FFP

Bulk Hamper Bags: 1-compel like colored hamper bag 25‖

UNIT UNIT PRICE MAX AMOUNT

0008 240 Each Wrap 24 x 24

FFP

24‖x24‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

0009 180 Each Wrap 36 x 36

FFP

36‖x36‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

0010 120 Each Wrap 48 x 48

FFP

48‖x48‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

0011 360 Each Wrap 54 x 54

FFP

54‖x54‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

1001 3,350 Each OPTION Gown Pack - Option Period I

FFP

Gown Pack (LG) Level 4: 1-gown(LG), 1-24‖x24‖ wrapper, 1-duraweave like cloth towel 17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

1002 3,250 Each OPTION Four Towel Pack - Option Period I

FFP

Four Towel Pack: 1-Level 4 mayo cover 24‖x24‖, 4-duraweave like cloth towel

17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

1003 350 Each OPTION Basic Pack - Option Period I

FFP

Basic Pack: 1-Level 4 mayo cover 22‖X54‖, 2-Level 4 LG/XLG gowns, 10 duraweave like cloth towels 17‖x36‖, 2-X/LONG cloth towels, 1-60‖x90‖ Level 4 back table cover.

UNIT UNIT PRICE MAX AMOUNT

1004 100 Each OPTION Laparotomy Pack - Option Period I

FFP

Laparotomy Pack:: 1-60‖x90‖ Level 4, back table cover, 1-108‖x130‖ fenestrated laparotomy drape with 6‖x14‖ fenestration, 2-LG/XLG gowns, 10 duraweave-like cloth towels 17‖x30‖,2-X/LONG cloth towels, 1-mayo cover 22‖x54‖. (ALL

DRAPES GOWNS, TABLE COVERS AND MAYO COVERS TO BE LEVEL

4)

UNIT UNIT PRICE MAX AMOUNT

1005 370 Each OPTION Lithotomy Pack - Option Period I

FFP

Lithotomy Pack:: 1-60‖X90‖ BACK TABLE COVER, Level 4, 1-108‖X100 laparotomy/lithotomy fenestrated drape with 10‖x10‖ fenestration, 2-30‖x50‖ leggings, 1-30‖x48‖ under buttocks drape with 12‖ cuff, 1-60‖x87‖ drape sheet, 2-LG/XLG gowns, 6 duraweave like cloth towels 17‖x30‖. ‖. (ALL DRAPES

GOWNS, TABLE COVERS, AND LEGGINGS ARE TO BE MADE OF LEVEL

4 MATERIAL)

UNIT UNIT PRICE MAX AMOUNT

1006 3,200 Each OPTION Bulk Hand Towels - Option Period I

FFP

Bulk Hand Towels: Lint free, 17‖x30‖, duraweave like cloth, any color

UNIT UNIT PRICE MAX AMOUNT

1007 2,400 Each OPTION Bulk Hamper Bags - Option Period I

FFP

Bulk Hamper Bags: 1-compel like colored hamper bag 25‖

UNIT UNIT PRICE MAX AMOUNT

1008 240 Each OPTION Wrap 24 x 24 - Option Period I

FFP

24‖x24‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

1009 180 Each OPTION Wrap 36 x 36 - Option Period I

FFP

36‖x36‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

1010 120 Each OPTION Wrap 48 x 48 - Option Period I

FFP

48‖x48‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

1011 360 Each OPTION Wrap 54 x 54 - Option Period I

FFP

54‖x54‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

2001 3,350 Each OPTION Gown Pack - Option Period II

FFP

UNIT UNIT PRICE MAX AMOUNT

2002 3,250 Each OPTION Four Towel Pack - Option Period II

FFP

Four Towel Pack: 1-Level 4 mayo cover 24‖x24‖, 4-duraweave like cloth towel

17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

2003 350 Each OPTION Basic Pack - Option Period II

FFP

Basic Pack: 1-Level 4 mayo cover 22‖X54‖, 2-Level 4 LG/XLG gowns, 10 duraweave like cloth towels 17‖x36‖, 2-X/LONG cloth towels, 1-60‖x90‖ Level 4 back table cover.

UNIT UNIT PRICE MAX AMOUNT

2004 100 Each OPTION Laparotomy Pack - Option Period II

FFP

Laparotomy Pack:: 1-60‖x90‖ Level 4, back table cover, 1-108‖x130‖ fenestrated laparotomy drape with 6‖x14‖ fenestration, 2-LG/XLG gowns, 10 duraweave-like cloth towels 17‖x30‖,2-X/LONG cloth towels, 1-mayo cover 22‖x54‖. (ALL

DRAPES GOWNS, TABLE COVERS AND MAYO COVERS TO BE LEVEL

4)

UNIT UNIT PRICE MAX AMOUNT

2005 370 Each OPTION Lithotomy Pack - Option Period II

FFP

Lithotomy Pack:: 1-60‖X90‖ BACK TABLE COVER, Level 4, 1-108‖X100 laparotomy/lithotomy fenestrated drape with 10‖x10‖ fenestration, 2-30‖x50‖ leggings, 1-30‖x48‖ under buttocks drape with 12‖ cuff, 1-60‖x87‖ drape sheet, 2-LG/XLG gowns, 6 duraweave like cloth towels 17‖x30‖. ‖. (ALL DRAPES

GOWNS, TABLE COVERS, AND LEGGINGS ARE TO BE MADE OF LEVEL

4 MATERIAL)

UNIT UNIT PRICE MAX AMOUNT

2006 3,200 Each OPTION Bulk Hand Towels - Option Period II

FFP

Bulk Hand Towels: Lint free, 17‖x30‖, duraweave like cloth, any color

UNIT UNIT PRICE MAX AMOUNT

2007 2,400 Each OPTION Bulk Hamper Bags - Option Period II

FFP

Bulk Hamper Bags: 1-compel like colored hamper bag 25‖

UNIT UNIT PRICE MAX AMOUNT

2008 240 Each OPTION Wrap 24 x 24 - Option Period II

FFP

24‖x24‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

2009 180 Each OPTION Wrap 36 x 36 - Option Period II

FFP

36‖x36‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

2010 120 Each OPTION Wrap 48 x 48 - Option Period II

FFP

48‖x48‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

2011 360 Each OPTION Wrap 54 x 54 - Option Period II

FFP

54‖x54‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

3001 3,350 Each OPTION Gown Pack - Option Period III

FFP

UNIT UNIT PRICE MAX AMOUNT

3002 3,250 Each OPTION Four Towel Pack - Option Period III

FFP

Four Towel Pack: 1-Level 4 mayo cover 24‖x24‖, 4-duraweave like cloth towel

17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

3003 350 Each OPTION Basic Pack - Option Period III

FFP

Basic Pack: 1-Level 4 mayo cover 22‖X54‖, 2-Level 4 LG/XLG gowns, 10 duraweave like cloth towels 17‖x36‖, 2-X/LONG cloth towels, 1-60‖x90‖ Level 4 back table cover.

UNIT UNIT PRICE MAX AMOUNT

3004 100 Each OPTION Laparotomy Pack - Option Period III

FFP

Laparotomy Pack:: 1-60‖x90‖ Level 4, back table cover, 1-108‖x130‖ fenestrated laparotomy drape with 6‖x14‖ fenestration, 2-LG/XLG gowns, 10 duraweave-like cloth towels 17‖x30‖,2-X/LONG cloth towels, 1-mayo cover 22‖x54‖. (ALL

DRAPES GOWNS, TABLE COVERS AND MAYO COVERS TO BE LEVEL

4)

UNIT UNIT PRICE MAX AMOUNT

3005 370 Each OPTION Lithotomy Pack - Option Period III

FFP

Lithotomy Pack:: 1-60‖X90‖ BACK TABLE COVER, Level 4, 1-108‖X100 laparotomy/lithotomy fenestrated drape with 10‖x10‖ fenestration, 2-30‖x50‖ leggings, 1-30‖x48‖ under buttocks drape with 12‖ cuff, 1-60‖x87‖ drape sheet, 2-LG/XLG gowns, 6 duraweave like cloth towels 17‖x30‖. ‖. (ALL DRAPES

GOWNS, TABLE COVERS, AND LEGGINGS ARE TO BE MADE OF LEVEL

4 MATERIAL)

UNIT UNIT PRICE MAX AMOUNT

3006 3,200 Each OPTION Bulk Hand Towels - Option Period III

FFP

Bulk Hand Towels: Lint free, 17‖x30‖, duraweave like cloth, any color

UNIT UNIT PRICE MAX AMOUNT

3007 2,400 Each OPTION Bulk Hamper Bags - Option Period III

FFP

Bulk Hamper Bags: 1-compel like colored hamper bag 25‖

UNIT UNIT PRICE MAX AMOUNT

3008 240 Each OPTION Wrap 24 x 24 - Option Period III

FFP

24‖x24‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

3009 180 Each OPTION Wrap 36 x 36 - Option Period III

FFP

36‖x36‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

3010 120 Each OPTION Wrap 48 x 48 - Option Period III

FFP

48‖x48‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

3011 360 Each OPTION Wrap 54 x 54 - Option Period III

FFP

54‖x54‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

4001 3,350 Each OPTION Gown Pack - Option Period IV

FFP

UNIT UNIT PRICE MAX AMOUNT

4002 3,250 Each OPTION Four Towel Pack - Option Period IV

FFP

Four Towel Pack: 1-Level 4 mayo cover 24‖x24‖, 4-duraweave like cloth towel

17‖x30‖

UNIT UNIT PRICE MAX AMOUNT

4003 350 Each OPTION Basic Pack - Option Period IV

FFP

Basic Pack: 1-Level 4 mayo cover 22‖X54‖, 2-Level 4 LG/XLG gowns, 10 duraweave like cloth towels 17‖x36‖, 2-X/LONG cloth towels, 1-60‖x90‖ Level 4 back table cover.

UNIT UNIT PRICE MAX AMOUNT

4004 100 Each OPTION Laparotomy Pack - Option Period IV

FFP

Laparotomy Pack:: 1-60‖x90‖ Level 4, back table cover, 1-108‖x130‖ fenestrated laparotomy drape with 6‖x14‖ fenestration, 2-LG/XLG gowns, 10 duraweave-like cloth towels 17‖x30‖,2-X/LONG cloth towels, 1-mayo cover 22‖x54‖. (ALL

DRAPES GOWNS, TABLE COVERS AND MAYO COVERS TO BE LEVEL

4)

UNIT UNIT PRICE MAX AMOUNT

4005 370 Each OPTION Lithotomy Pack - Option Period IV

FFP

Lithotomy Pack:: 1-60‖X90‖ BACK TABLE COVER, Level 4, 1-108‖X100 laparotomy/lithotomy fenestrated drape with 10‖x10‖ fenestration, 2-30‖x50‖ leggings, 1-30‖x48‖ under buttocks drape with 12‖ cuff, 1-60‖x87‖ drape sheet, 2-LG/XLG gowns, 6 duraweave like cloth towels 17‖x30‖. ‖. (ALL DRAPES

GOWNS, TABLE COVERS, AND LEGGINGS ARE TO BE MADE OF LEVEL

4 MATERIAL)

UNIT UNIT PRICE MAX AMOUNT

4006 3,200 Each OPTION Bulk Hand Towels - Option Period IV

FFP

Bulk Hand Towels: Lint free, 17‖x30‖, duraweave like cloth, any color

UNIT UNIT PRICE MAX AMOUNT

4007 2,400 Each OPTION Bulk Hamper Bags - Option Period IV

FFP

Bulk Hamper Bags: 1-compel like colored hamper bag 25‖

UNIT UNIT PRICE MAX AMOUNT

4008 240 Each OPTION Wrap 24 x 24 - Option Period IV

FFP

24‖x24‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

4009 180 Each OPTION Wrap 36 x 36 - Option Period IV

FFP

36‖x36‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

4010 120 Each OPTION Wrap 48 x 48 - Option Period IV

FFP

48‖x48‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

UNIT UNIT PRICE MAX AMOUNT

4011 360 Each OPTION Wrap 54 x 54 - Option Period IV

FFP

54‖x54‖ INFUSED POLYESTER WITH 1% CARBON YARN WRAPPERS

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government

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DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 POP 01-OCT-2012 TO

30-SEP-2013

N/A 88 MDSS SGSRB

NO CONTACT IDENTIFIED

4881 SUGAR MAPLE DR BLDG 830

WRIGHT-PATTERSON AFB OH 45433-5529

F4F4AC

0002 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0005 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0006 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0007 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0008 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0009 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0010 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

0011 POP 01-OCT-2012 TO

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 01-OCT-2013 TO

30-SEP-2014

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1004 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1005 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1006 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1007 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1008 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1009 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1010 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

1011 POP 01-OCT-2013 TO

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-OCT-2014 TO

30-SEP-2015

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2004 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2005 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2006 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2007 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2008 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2009 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2010 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

2011 POP 01-OCT-2014 TO

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 01-OCT-2015 TO

30-SEP-2016

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3003 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3004 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3005 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3006 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3007 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3008 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3009 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3010 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

3011 POP 01-OCT-2015 TO

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 01-OCT-2016 TO

30-SEP-2017

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4004 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4005 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4006 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4007 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4008 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4009 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4010 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

4011 POP 01-OCT-2016 TO

N/A (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.212-4 Contract Terms and Conditions--Commercial Items FEB 2012

52.217-5 Evaluation Of Options JUL 1990

52.232-18 Availability Of Funds APR 1984

252.201-7000 Contracting Officer's Representative DEC 1991

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7006 Wide Area WorkFlow Payment Instructions JUN 2012

252.232-7007 Limitation Of Government's Obligation MAY 2006

CLAUSES INCORPORATED BY FULL TEXT

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (FEB 2012)

(a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code and small business size standard for this acquisition appear in Block 10 of the solicitation cover sheet (SF

1449). However, the small business size standard for a concern which submits an offer in its own name, but which proposes to furnish an item which it did not itself manufacture, is 500 employees.

(b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show--

(1) The solicitation number;

(2) The time specified in the solicitation for receipt of offers;

(3) The name, address, and telephone number of the offeror;

(4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary;

(5) Terms of any express warranty;

(6) Price and any discount terms;

(7) "Remit to" address, if different than mailing address;

(8) A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

(9) Acknowledgment of Solicitation Amendments;

(10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and

(11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

(c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 60 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation.

(d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing.

(e) Reserved

(f) Late submissions, modifications, revisions, and withdrawals of offers:

(1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the

Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due.

(2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is ―late‖ and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition; and--

(A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or

(B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or

(C) If this solicitation is a request for proposals, it was the only proposal received.

(ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the

Government, will be considered at any time it is received and may be accepted.

(3) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel.

(4) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent

Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume.

(5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers.

Oral offers in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile offers, offers may be withdrawn via facsimile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the solicitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt of offers, the identity of the person requesting withdrawal is established and the person signs a receipt for the offer.

(g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received.

(h) Multiple awards. The Government may accept any item or group of items of an offer, unless the offeror qualifies the offer by specific limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer.

(i) Availability of requirements documents cited in the solicitation. (1)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to--GSA

Federal Supply Service Specifications Section, Suite 8100, 470 East L'Enfant Plaza, SW, Washington, DC

20407, Telephone (202) 619-8925, Facsimile (202) 619-8978.

(ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision. Additional copies will be issued for a fee.

(2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites:

(i) ASSIST (http://assist.daps.dla.mil).

(ii) Quick Search (http://assist.daps.dla.mil/quicksearch).

(iii) ASSISTdocs.com (http://assistdocs.com).

(3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point

(DoDSSP) by--

(i) Using the ASSIST Shopping Wizard (http://assist.daps.dla.mil/wizard);

(ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone

(215) 697-2667/2179, Facsimile (215) 697-1462.

(4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance.

(j) Data Universal Numbering System (DUNS) Number. (Applies to all offers exceeding $3,000, and offers of

$3,000 or less if the solicitation requires the Contractor to be registered in the Central Contractor Registration (CCR) database. The offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation

―DUNS‖ or ―DUNS +4‖ followed by the DUNS or DUNS +4 number that identifies the offeror's name and address.

The DUNS +4 is the DUNS number plus a 4-character suffix that may be assigned at the discretion of the offeror to establish additional CCR records for identifying alternative Electronic Funds Transfer (EFT) accounts (see FAR

Subpart 32.11) for the same concern. If the offeror does not have a DUNS number, it should contact Dun and

Bradstreet directly to obtain one. An offeror within the United States may contact Dun and Bradstreet by calling 1-

866-705-5711 or via the internet at http://fedgov.dnb.com/webform. An offeror located outside the United States must contact the local Dun and Bradstreet office for a DUNS number. The offeror should indicate that it is an offeror for a Government contract when contacting the local Dun and Bradstreet office.

(k) Central Contractor Registration. Unless exempted by an addendum to this solicitation, by submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the CCR database prior to award, during performance and through final payment of any contract resulting from this solicitation. If the Offeror does not become registered in the CCR database in the time prescribed by the Contracting Officer, the Contracting

Officer will proceed to award to the next otherwise successful registered Offeror. Offerors may obtain information on registration and annual confirmation requirements via the CCR database accessed through https://www.acquisition.gov or by calling 1-888-227-2423 or 269-961-5757.

(l) Debriefing. If a post-award debriefing is given to requesting offerors, the Government shall disclose the following information, if applicable:

(1) The agency's evaluation of the significant weak or deficient factors in the debriefed offeror's offer.

(2) The overall evaluated cost or price and technical rating of the successful and the debriefed offeror and past performance information on the debriefed offeror.

(3) The overall ranking of all offerors, when any ranking was developed by the agency during source selection.

(4) A summary of the rationale for award;

(5) For acquisitions of commercial items, the make and model of the item to be delivered by the successful offeror.

(6) Reasonable responses to relevant questions posed by the debriefed offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency.

(End of provision)

52.212-2 EVALUATION--COMMERCIAL ITEMS (JAN 1999)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

1) Technical Capability: Offer must clearly demonstrate that the offeror is capable of meeting the requirements of the PWS, specifically addressing the ―Additional Instructions to Offerors‖, see

Attachment 3 at the end of the solicitation.

2) Price: The total evaluated price of an offer will be calculated as the sum of the extended prices (unit quantity multiplied by unit price) for Contract Line Item Numbers (CLINs) 0001 through 4011.

Technical Capability is approximately equal to price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party.

Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

https://www.acquisition.gov/

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (APR 2012)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via https://www.acquisition.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (c) through (o) of this provision.

(a) Definitions. As used in this provision --

―Economically disadvantaged women-owned small business (EDWOSB) Concern‖ means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

"Forced or indentured child labor" means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Inverted domestic corporation, as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the United

States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 U.S.C.

395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue

Code at 26 U.S.C. 7874.

Manufactured end product means any end product in Federal Supply Classes (FSC) 1000-9999, except--

(1) FSC 5510, Lumber and Related Basic Wood Materials;

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

(5) FSC 9410, Crude Grades of Plant Materials;

(6) FSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) FSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) FSC 9610, Ores;

(9) FSC 9620, Minerals, Natural and Synthetic; and

(10) FSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the

Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment

Act of 2007) conducting the business can demonstrate--

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

Sensitive technology--

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically--

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act

(50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business concern--

(1) Means a small business concern--

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

"Small business concern" means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

Subsidiary means an entity in which more than 50 percent of the entity is owned--

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

Veteran-owned small business concern means a small business concern--

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

"Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women;

and whose management and daily business operations are controlled by one or more women.

"Women-owned small business concern" means a small business concern--

(1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least

51 percent of its stock is owned by one or more women; or

(2) Whose management and daily business operations are controlled by one or more women.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part

127)‖, means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the

United States.

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

Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website accessed through https://www.acquisition.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations 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 (o) 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 ORCA.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United

States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it ( ) is, ( ) is not a small business concern.

(2) Veteran-owned 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 it ( ) is, ( ) is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ) is, ( ) is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, for general statistical purposes, that it ( ) is, (

) is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned 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 that it ( ) is, ( ) is not a women-owned small business concern.

Note to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) 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 [ballot] is, [ballot] 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 [ballot] is, [ballot] 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 [ballot] is, [ballot] 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) (Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns or FAR 52.219-25, Small Disadvantaged Business Participation

Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.)

(i) General. The offeror represents that either--

(A) It ( ) is, ( ) is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the CCR

Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13

CFR 124.104(c)(2); or

(B) It ( ) has, ( ) has not submitted a completed application to the Small Business Administration or a Private

Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

(ii) Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(10)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. (The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ____________.)

(11) 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)(11)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture.