Attachment 9 - Representations Certifications and Other Statements of Offerors.pdf

FA8650-22-S-5002 (Amendment 3) Attachment 9

AFRL/RX Functional Materials Open BAA

Representations, Certifications and Other Statements of Offerors

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NAME OF PROPOSER

PROPOSAL TITLE

The following provisions shall be completed and provided with FAR proposals from various AFRL/PZL broad announcement solicitations (Broad Agency Announcement, Advanced Research Announcement, Multiple Authority Announcement) that supplement the annual representations and certifications from SAM.gov.

In accordance with FAR 52.252-1, Solicitation Provisions Incorporated by Reference (FEB 1998) these below provisions are incorporated by reference and available in full text at https://www.acquisition.gov/.

Completed Representations and Certifications are required to be provided with proposal for a complete offer.

1. Provisions listed below the table require Fill-in information or disclosures from the offeror, partial text is listed for ease of completing.

a. In the table provisions applicable to this requirement are listed that either have no fill-ins or fill-ins are required to be completed in SAM.gov.

b. The Contracting Officer (PCO) has inserted fill-ins within the table when applicable to that provision.

c. Below the table, please leave fill-ins blank if assertion for that provision was made in sam.gov for the

Contracting Officer to download the FAR & DFARS report.

i. Each provision assertion shall only be completed in one location (SAM.gov or noted below) unless otherwise indicated by the Offeror when additional assertions are specific to the proposal.

Any questions, please contact the Procurement Contracting Officer listed within the solicitation.

FAR / DFARS

Provision(s)

Title Applicability of the provisions to this solicitation

52.203-2 – N/A for Cost

Certificate of Independent Price Determination (Apr 1985)

Applies to All Firm Fixed Price and Fixed price contracts or Fixed-Price Contract with Economic Price Adjustment

52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions

Greater than $150K

52.204-7 – Section L/I

System for Award Management (Oct 2018) All

52.204-17 Ownership or Control of Offeror (Aug 2020) All

52.204-20 Predecessor of Offeror (Aug 2020) All

52.204-8 Annual Representations and Certifications (Feb 2024) Indicated here by the PCO:

X (i) 52.204-17, Ownership or Control of Offeror X (ii)52.204-20, Predecessor of Offeror __(vi) 52.227-6, Royalty Information __(A) Basic.

__(B) Alternate I.

__(vii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

All, Paragraph (c)(1) is applicable to this solicitation as indicated in the provision.

Paragraph (c)(2) the following are applicable as indicated by the PCO on in the left column.

52.204-16 Commercial and Government Entity Code Reporting (Aug 2020)

All

52.204-22 – Section I

Alternate Line-Item Proposal (Jan 2017) All

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021)

All

52.204-29 Federal Acquisition Supply Chain Security Act Orders— Representation and Disclosures (Dec 2023)

All

52.209-7 Information Regarding Responsibility Matters (Oct 2018) Greater than $600K

52.209-12 N/A Certification Regarding Tax Matters (Oct 2020) Greater than $5.5M

52.209-13 Violation of Arms Control Treaties or Agreements- Certification (Nov 2021)

Applies to all that exceed the SAT, and is not Commercial Products or Commercial Services

52.211-14 – Section L

Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use (Apr 2008)

Applies when award is a rated order as indicated here by the PCO:

☐ DX rated order.

☐ DO rated order

52.222-38 Compliance with Veterans’ Employment Reporting Requirements (Feb 2016)

Applies to all that exceed the SAT, and is not Commercial Products or Commercial Services

52.222-56 – Section L

Certification Regarding Trafficking in Persons Compliance Plan (Oct 2020)

Applies when at least $550K of anticipated contract value maybe performed outside US AND acquisition is not entirely for COTS items.

52.225-20 Prohibition on Conducting Restricted Business Operations in Sudan-Certification (Aug 2009)

Applies to all that are not Commercial Products or Commercial Services

52.225-25 Prohibition on Contracting With Entities Engaging in Certain Activities or Transactions Relating to Iran— Representation and Certifications (Jun 2020)

All

52.227-7 Patents-Notice of Government Licensee (Apr 1984) Applies when patent royalties are involved in the prospective contract as indicated here by the PCO:

Patent Number: ______________

Royalty Rate: _______________

52.229-11 Tax on Certain Foreign Procurements—Notice and Representation (Jun 2020)

All

52.230-1 Cost Accounting Standards Notices and Certification (Jun 2020)

Proposed contracts subject to CAS

52.230-7 Proposal Disclosure-Cost Accounting Practice Changes (Apr 2005)

Only when applicable to contracts subject to CAS as specified in 48 CFR 9903.201

52.233-2 – Section L

Service of Protest (Sept 2006) Greater than the SAT

52.252-5 – Section L

Authorized Deviations in Provisions (Nov 2020) All

252.203-7005 Representation Relating to Compensation of Former DoD Officials (Sep 2022)

All

252.204-7007 Alternate A, Annual Representations and Certifications (Nov 2023) Indicated here by the PCO:

X (i) 252.209-7002, Disclosure of Ownership or Control by a Foreign Government __ (ii)252.225-7000, Balance of Payments Program Certificate.

X (iii) 252.225-7020, Trade Agreements Certificate.

X Use with Alternate I.

X (iv) 252.225-7031, Secondary Arab Boycott of Israel.

X (v) 252.225-7035, Buy American –Free Trade Agreements—Balance of Payments Program Certificate.

__ (vii) 252.232-7015, Performance -Based Payments – Representation.

All Paragraph (d)(1) is applicable to this solicitation as indicated in the provision.

Paragraph (d)(2) the following are applicable as indicated by the PCO on in the left column

252.204-7008 Compliance with Safeguarding Covered Defense Information Controls (Oct 2016)

All

252.204-7016 Covered Defense Telecommunications Equipment or Services—Representation (Dec 2019)

All unless commercial products or commercial services

252.204-7017 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services— Representation (May 2021)

Not required if answers "does not" in 252.204-7016

252.204-7019 – Section L

Notice of NIST SP 800–171 DoD Assessment Requirements (Nov 2023)

All. Shall be completed in SPRS in accordance with provision procedures.

252.209-7011 Representation for Restriction on the Use of Certain Institutions of Higher Education (Oct 2023)

Only applies for acquisitions to an institution of higher education

252.215-7013 – Section L

Supplies and Services provided by Nontraditional Defense Contractors (Jan 2023)

All

252.219-7000 Advancing Small Business Growth (Jun 2023) Applies when the estimated annual value of the contract is expected to exceed the small business size standard or $70M if small business size standard is expressed as #’s of employees for the NASIC Code in this solicitation

252.225-7003 Report of Intended Performance Outside the United States and Canada – Submission with Offer (Oct 2020)

Applies if anticipated contract value will exceed $15M

252.225-7010 Commercial Derivative Military Article – Specialty Metals Compliance Certificate (Jul 2009)

Required as applicable to the requirement

252.225-7055 Representation Regarding Business Operations with the Maduro Regime (May 2022)

All

252.225-7057 Preaward Disclosure of Employment of Individuals Who Work in the People’s Republic of China (Aug 2022)

All

252.225-7059 Prohibition on Certain Procurements from the Xinjiang Uyghur autonomous region–representation (Jun 2023)

All

252.225-7966 Prohibition regarding Russian fossil fuel business operations— Representation (DEVIATION 2024-O0006, revision 1) (Mar 2024)

All unless Exemption applies

252.225-7973 Prohibition on the Procurement of Foreign-Made Unmanned Aircraft Systems—Representation.

(DEVIATION 2020-O0015) (May 2020)

All, unless

(1) Counter-unmanned aircraft system surrogate testing and training; or

(2) Intelligence, electronic warfare, and information warfare operations, texting, analysis, and training; or

(b) A waiver has been granted by the

Secretary of Defense in accordance with section 848 of the National Defense Authorization Act for Fiscal Year 2020 (Pub. L. 116-92)

252.227-7017 Identification and Assertion of Use, Release, or Disclosure Restrictions (Jan 2023)

All

252.227-7028 – Section L

Technical Data or Computer Software Previously Delivered to the Government (Jun 1995)

All

252.227-7040 Additional Preaward Requirements for Small Business Technology Transfer Program (Jan 2025)

Applicable for acquisitions under the STTR program

252.239-7009 Representation of Use of Cloud Computing (Sep 2015) As applicable to requirement

252.239-7098 Prohibition on Contracting to Maintain or Establish a Computer Network Unless Such Network is Designed to Block Access to Certain Websites – Representation (Deviation 2021-O0003) (April 2021)

Applicable when using funds made available by the Consolidated Appropriations Act, 2021, or any other Act that extends to fiscal year 2021 funds

52.203-2 Certificate of Independent Price Determination (Apr 1985) (b)(2)(i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to paragraphs (a)(1) through (a)(3) of this provision

Full name of person(s) Title of position in offeror’s organization

52.204-3 Taxpayer Identification (Oct 1998) (d)Taxpayer Identification Number (TIN).

☐ TIN: __________________.

☐ TIN has been applied for.

☐ TIN is not required because:

☐ Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

☐ Offeror is an agency or instrumentality of a foreign government;

☐ Offeror is an agency or instrumentality of the Federal Government.

(e)Type of organization.

☐ Sole proprietorship;

☐ Partnership;

☐ Corporate entity (not tax-exempt);

☐ Corporate entity (tax-exempt);

☐ Government entity (Federal, State, or local);

☐ Foreign government;

☐ International organization per 26 CFR 1.6049-4;

☐ Other__________________.

(f)Common parent.

☐ Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

☐ Name and TIN of common parent:

☐ Name__________________.

☐ TIN__________________.

52.204-8 Annual Representations and Certifications (Mar 2025)(Deviation 2025- O0003 and 2025-O0004)

(d) 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.

FAR Clause # / Title / Date: Change:

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 on SAM.

52.204-17 Ownership or Control of Offeror (Aug 2020)

(b) The Offeror represents that it ☐ has or ☐ does not have an immediate owner.

(c) If the Offeror indicates "has" in paragraph (b) of this provision, enter the following information:

Immediate owner CAGE code

Immediate owner legal name (Do not use a "doing business as" name)

Is the immediate owner owned or controlled by another entity: ☐ Yes or ☐ No.

(d) If the Offeror indicates "yes" in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest-level owner CAGE code:

Highest-level owner legal name:

(Do not use a "doing business as" name)

52.204-20 Predecessor of Offeror (Aug 2020)

(b) The Offeror represents that it ☐ is or ☐ is not a successor to a predecessor that held a Federal contract or grant within the last three years.

(c) If the Offeror has indicated "is" in paragraph (b) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order):

Predecessor CAGE code: (or mark "Unknown").

Predecessor legal name (Do not use a "doing business as" name).

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021)

(d) Representation. The Offeror represents that—

(1) It ☐ will, ☐ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation.

The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that— It ☐ does, ☐ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable);

or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment—

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services—

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable);

or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

52.204-26 Covered Telecommunications Equipment or Services—Representation (Oct 2020)

(c)(1)Representation. The Offeror represents that it ☐ does, ☐ does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2)After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it ☐ does, ☐ does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

52.204-29 Federal Acquisition Supply Chain Security Act Orders—Representation and Disclosures (Dec 2023)

(e) Disclosures.

(1) Name of the product or service provided to the Government;

(2) Name of the covered article or source subject to a FASCSA order;

(3) If applicable, name of the vendor, including the Commercial and Government Entity code and unique entity identifier (if known), that supplied the covered article or the product or service to the Offeror;

(4) Brand;

(5) Model number (original equipment manufacturer number, manufacturer part number, or wholesaler number);

(6) Item description;

(7) Reason why the applicable covered article or the product or service is being provided or used;

52.209-2 Prohibition on Contracting with Inverted Domestic Corporations— Representation (Nov 2015)

(c)Representation. The Offeror represents that- (1)It ☐ is, ☐ is not an inverted domestic corporation; and (2)It ☐ is, ☐ is not a subsidiary of an inverted domestic corporation.

52.209-5 Certification Regarding Responsibility Matters (Aug 2020)

(a)(1)The Offeror certifies, to the best of its knowledge and belief, that— (i)The Offeror and/or any of its Principals–

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

(B)Have ☐ have not ☐, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks "have", the offeror shall also see 52.209-7, if included in this solicitation);

(C)Are ☐ are not ☐ presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision;

(D)Have ☐, have not ☐, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) for which the liability remains unsatisfied.

(ii)The Offeror has ☐ has not ☐, within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

52.209-7 Information Regarding Responsibility Matters (Oct 2018)

b) The offeror ☐ has ☐ does not have current active Federal contracts and grants with total value greater than $10,000,000.

52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016)

(b)The Offeror represents that– (1)It is ☐ is not ☐ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and (2)It is ☐ is not ☐ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

52.209-12 Certification Regarding Tax Matters (Oct 2020)

(b) (1) Has ☐ filed all Federal tax returns required during the three years preceding the certification;

(2) Has not ☐ been convicted of a criminal offense under the Internal Revenue Code of 1986; and

(3) Has not ☐, more than 90 days prior to certification, been notified of any unpaid Federal tax assessment for which the liability remains unsatisfied, unless the assessment is the subject of an installment agreement or offer in compromise that has been approved by the Internal Revenue Service and is not in default, or the assessment is the subject of a non-frivolous administrative or judicial proceeding.

52.209-13 Violation of Arms Control Treaties or Agreements-Certification (Nov 2021)

(b)Certification [Offeror shall check either (1) or (2).] ☐(1) The Offeror certifies that –

(i) It does not engage and has not engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; and

(ii) No entity owned or controlled by the Offeror has engaged in any activity that contributed to or was a significant factor in the President's or Secretary of State's determination that a foreign country is in violation of its obligations undertaken in any arms control, nonproliferation, or disarmament agreement to which the United States is a party, or is not adhering to its arms control, nonproliferation, or disarmament commitments in which the United States is a participating state. The determinations are described in the most recent unclassified annual report provided to Congress pursuant to section 403 of the Arms Control and Disarmament Act ( 22 U.S.C. 2593a). The report is available at https://www.state.gov/bureaus-offices/under-secretary-for-arms-control-and-international-security-affairs/bureau-of-arms-control-verification-and-compliance/; or ☐(2) The Offeror is providing separate information with its offer in accordance with paragraph (d)(2) of this provision.

52.215-06 Place of Performance (Oct 1997)

(a)The offeror or respondent, in the performance of any contract resulting from this solicitation, ☐ intends, ☐ does not intend [check applicable block] to use one or more plants or facilities located at a different address from the address of the offeror or respondent as indicated in this proposal or response to request for information.

(b)If the offeror or respondent checks "intends" in paragraph (a) of this provision, it shall insert in the following spaces the required information:

Place of Performance (Street Address, City, State, County, ZIP Code)

Name and Address of Owner and Operator of the Plant or Facility if Other than Offeror or Respondent

52.219-01 Small Business Program Representations – Alternate I (Feb 2024)

(b) (1)The North American Industry Classification System (NAICS) code for this acquisition is ________ [insert NAICS code].

(2)The small business size standard is _______ [insert size standard].

(3)The small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce (i.e., nonmanufacturer), is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition— (i)Is set aside for small business and has a value above the simplified acquisition threshold;

(ii)Uses the HUBZone price evaluation preference regardless of dollar value, unless the offeror waives the price evaluation preference; or (iii)Is an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

(c)Representations.

(1)The offeror represents as part of its offer that— (i)it ☐ is, ☐ is not a small business concern; or (ii)It ☐ is, ☐ is not a small business joint venture that complies with the requirements of 13 CFR 121.103(h) and 13 CFR 125.8(a) and (b). [ The offeror shall enter the name and unique entity identifier of each party to the joint venture: __.] (2)[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 small disadvantaged business concern as defined in 13 CFR 124.1001.

(3)[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 women-owned small business concern.

(4)Women-owned small business (WOSB) joint venture eligible under the WOSB Program. The offeror represents as part of its offer that it ☐ is, ☐ is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c).

[ The offeror shall enter the name and unique entity identifier of each party to the joint venture: __.] (5)Economically disadvantaged women-owned small business (EDWOSB) joint venture. The offeror represents as part of its offer that it ☐ is, ☐ is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [ The offeror shall enter the name and unique entity identifier of each party to the joint venture: __.]

(6)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.

(7)SDVOSB concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(6) of this provision.] The offeror represents as part of its offer that it ☐ is, ☐ is not an SDVOSB concern.

(8)SDVOSB joint venture eligible under the SDVOSB Program. [Complete only if the offeror represented itself as a SDVOSB concern in paragraph (c)(7) of this provision]. The offeror represents as part of its offer that it ☐ is, ☐ is not a SDVOSB joint venture eligible under the SDVOSB Program that complies with the requirements of 13 CFR 128.402. [ The offeror shall enter the name and unique entity identifier of each party to the joint venture:__.] (9)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—

(10) [Complete if offeror represented itself as disadvantaged in paragraph (c)(2) of this provision.] The offeror shall check the category in which its ownership falls:

☐ Black American.

☐ Hispanic American.

☐ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).

☐ Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).

☐ Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal).

☐ Individual/concern, other than one of the preceding.

(i)It ☐ is, ☐ is not a HUBZone small business concern listed, on the date of this representation, as having been certified by SBA as a HUBZone small business concern in the Dynamic Small Business Search and SAM, and will attempt to maintain an employment rate of HUBZone residents of 35 percent of its employees during performance of a HUBZone contract (see 13 CFR 126.200(e)(1)); and (ii)It ☐ is, ☐ is not a HUBZone joint venture that complies with the requirements of 13 CFR 126.616(a) through (c). [ The offeror shall enter the name and unique entity identifier of each party to the joint venture: __.] Each HUBZone small business concern participating in the HUBZone joint venture shall provide representation of its HUBZone status.

52.227-7 Patents-Notice of Government Licensee (Apr 1984)

If the offeror is the owner of, or a licensee under, the patent, indicate below:

☐ Owner ☐ Licensee

52.227-15 Representation of Limited Rights Data and Restricted Computer Software (Dec 2007)

(b) By completing the remainder of this paragraph, the offeror represents that it has reviewed the requirements for the delivery of technical data or computer software and states [offeror check appropriate block]- ☐ None of the data proposed for fulfilling the data delivery requirements qualifies as limited rights data or restricted computer software; or ☐ Data proposed for fulfilling the data delivery requirements qualify as limited rights data or restricted computer software and are identified as follows:

52.229-11 Tax on Certain Foreign Procurements—Notice and Representation (Jun 2020) - incorp by reference

(d) (1) It ☐ is ☐ is not a foreign person; and

(2) If the Offeror indicates "is" in paragraph (d)(1) of this provision, then the Offeror represents that—I am claiming on the IRS Form W-14 ☐ a full exemption, or ☐ partial or no exemption [Offeror shall select one] from the excise tax.

52.230-1 Cost Accounting Standards Notices and Certification (Jun 2020)

(c) Check the appropriate box below:

(1) ☐ Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows:

(i) Original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and

(ii) One copy to the cognizant Federal auditor.

(Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable. Forms may be obtained from the cognizant ACO or Federal official.)

Date of Disclosure Statement: ______________________ Name and Address of Cognizant ACO or Federal

Official Where Filed: _______________________________________ The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

(2) ☐ Certificate of Previously Submitted Disclosure Statement. The offeror hereby certifies that the required

Disclosure Statement was filed as follows:

Date of Disclosure Statement: _________________________ Name and Address of Cognizant ACO or Federal

Official Where Filed: _______________________________________ The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

(3) ☐ Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.

(4) ☐ Certificate of Interim Exemption. The offeror hereby certifies that (i) the offeror first exceeded the monetary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR 9903.202-1, the offeror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a revised certificate to the Contracting Officer, in the form specified under paragraph (c)(1) or (c)(2) of PartI of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

Caution: Offerors currently required to disclose because they were awarded a CAS-covered prime contract or subcontract of $50 million or more in the current cost accounting period may not claim this exemption (4). Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

II. Cost Accounting Standards-Eligibility for Modified Contract Coverage If the offeror is eligible to use the modified provisions of 48 CFR 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause.

☐ The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAS-covered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.

Caution: An offeror may not claim the above eligibility for modified contract coverage if this proposal is expected to result in the award of a CAS-covered contract of $50 million or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more.

III. Additional Cost Accounting Standards Applicable to Existing Contracts The offeror shall indicate below whether award of the contemplated contract would, in accordance with paragraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts.

☐ Yes ☐ No

(End of provision) Alternate I (APR 1996). As prescribed in 30.201-3 (b), add the following paragraph (c)(5) to Part I of the basic provision:

☐ (5) Certificate of Disclosure Statement Due Date by Educational Institution. If the offeror is an educational institution that, under the transition provisions of 48 CFR 9903.202-1(f), is or will be required to submit a Disclosure Statement after receipt of this award, the offeror hereby certifies that (check one and complete):

☐ (i) A Disclosure Statement Filing Due Date of _____________ has been established with the cognizant Federal agency.

☐ (ii) The Disclosure Statement will be submitted within the 6-month period ending _________ months after receipt of this award.

Name and Address of Cognizant ACO or Federal Official Where Disclosure Statement is to be Filed:

52.230-7 Proposal Disclosure-Cost Accounting Practice Changes (Apr 2005)

The offeror shall check "yes" below if the contract award will result in a required or unilateral change in cost accounting practice, including unilateral changes requested to be desirable changes.

☐ Yes ☐ No If the offeror checked "Yes" above, the offeror shall-

(1) Prepare the price proposal in response to the solicitation using the changed practice for the period of performance for which the practice will be used; and

(2) Submit a description of the changed cost accounting practice to the Contracting Officer and the Cognizant Federal Agency Official as pricing support for the proposal.

52.233-2 Service of Protest (Sep 2006)

(a) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows) by obtaining written and dated acknowledgment of receipt from ______________________. [Contracting Officer designate the official or location where a protest may be served on the Contracting Officer.]

(b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO. (End of provision)

52.252-5 Authorized Deviations in Provisions (Nov 2020)

(a) The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the provision.

(b) The use in this solicitation of any Defense Federal Acquisition Regulation Supplement 48 CFR Chapter 2 provision with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation. (End of provision)

252.204-7007 Alternate A, Annual Representations and Certifications (Nov 2023)

(b)(2) ☐ (i) Paragraph (e) applies.

☐ (ii) Paragraph (e) does not apply and the Offeror has completed the individual representations and certifications in the solicitation.

(e) 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.

FAR/DFARS Provision # / Title / Date: Change:

Any changes provided by the Offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications located in the SAM database.

252.204-7017 Prohibition on The Acquisition Of Covered Defense Telecommunications Equipment Or Services—Representation (May 2021)

d) Representation.

The Offeror represents that it ☐ will ☐ will not provide covered defense telecommunications equipment or services as a part of its offered products or services to DoD in the performance of any award resulting from this solicitation.

(e) Disclosures.

(1) A description of all covered defense telecommunications equipment and services offered (include brand or manufacturer; product, such as model number, original equipment manufacturer (OEM) number, manufacturer part number, or wholesaler number; and item description, as applicable).

(2) An explanation of the proposed use of covered defense telecommunications equipment and services and any factors relevant to determining if such use would be permissible under the prohibition referenced in paragraph (b) of this provision.

(3) For services, the entity providing the covered defense telecommunications services (include entity name, unique entity identifier, and Commercial and Government Entity (CAGE) code, if known).

(4) For equipment, the entity that produced or provided the covered defense telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known).

252.225-7010 Commercial Derivative Military Article – Specialty Metals Compliance Certificate (Jul 2009)

(b) The offeror shall list in this paragraph any commercial derivative military articles it intends to deliver under any contract resulting from this solicitation using the alternative compliance for commercial derivative military articles, as specified in paragraph (d) of the clause of this solicitation entitled “Restriction on Acquisition of Certain Articles Containing Specialty Metals” (DFARS 252.225-7009). The offeror’s designation of an item as a “commercial derivative military article” will be subject to Government review and approval.

252.225-7018 Photovoltaic Devices—Certificate (Mar 2024)

(d) Certification and identification of country of origin. [The Offeror shall check the block and fill in the blank for one of the following paragraphs, based on the estimated value and the country of origin of photovoltaic devices to be utilized in performance of the contract:] [The offeror shall check the block and fill in the blank for one of the following paragraphs, based on the estimated value and the country of origin of photovoltaic devices to be utilized in performance of the contract:] ☐ (1) No photovoltaic devices will be utilized in performance of the contract, or such photovoltaic devices have an estimated value that does not exceed the micro-purchase threshold.

(2) If more than the micro-purchase threshold but less than $100,000— ☐ (i) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a domestic photovoltaic device;

☐ (ii) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a qualifying country photovoltaic device [Offeror to specify country of origin____]; or ☐ (iii) The foreign (other than qualifying country) photovoltaic devices to be utilized in performance of the contract are the product of ___________________. [Offeror to specify country of origin, if known, and provide documentation that the cost of a domestic photovoltaic device would be unreasonable in comparison to the cost of the proposed foreign photovoltaic device, i.e. that the price of the foreign photovoltaic device plus 50 percent is less than the price of a comparable domestic photovoltaic device.]

(3) If less than $100,000— ☐ (i) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a domestic photovoltaic device;

☐ (ii) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a qualifying country photovoltaic device [Offeror to specify country of origin ____ ]; or ☐ (iii) The foreign photovoltaic devices to be utilized in performance of the contract are the product of _______________. [Offeror to specify country of origin, if known, and provide documentation that the cost of a domestic photovoltaic device would be unreasonable in comparison to the cost of the proposed foreign photovoltaic device, i.e. that the price of the foreign photovoltaic device plus 50 percent is less than the price of a comparable domestic photovoltaic device.]

(4) If $100,000 or more but less than $102,280— ☐ (i) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a domestic photovoltaic device;

☐ (ii) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a Free Trade Agreement country photovoltaic device (other than a Bahraini, Korean, Moroccan, Panamanian, or Peruvian photovoltaic device) or a qualifying country photovoltaic device [Offeror to specify country of origin______]; or ☐ (iii) The offered foreign photovoltaic devices (other than those from countries listed in paragraph (d)(4)(ii) of this provision) are the product of _______________. [Offeror to specify country of origin, if known, and provide documentation that the cost of a domestic photovoltaic device would be unreasonable in comparison to the cost of the proposed foreign photovoltaic device, i.e. that the price of the foreign photovoltaic device plus 50 percent is less than the price of a comparable domestic photovoltaic device.]

(5) If $100,000or more but less than $174,000— ☐ (i) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a domestic photovoltaic device;

☐ (ii) The Offeror certifies that each photovoltaic device to be utilized in performance of the contract is a Free Trade Agreement country photovoltaic device (other than a Bahraini, Moroccan, Panamanian, or Peruvian photovoltaic device) or a qualifying country photovoltaic device [Offeror to specify country of origin______]; or (other than a Bahrainian, Moroccan, Panamanian, or Peruvian photovoltaic device) or a qualifying country photovoltaic device [Offeror to specify country of origin____________]; or ☐ (iii) The offered foreign photovoltaic devices (other than those from countries listed in paragraph (d)(5)(ii) of this provision) are the product of ____________.

[Offeror to specify country of origin, if known, and provide documentation that the cost of a domestic photovoltaic device would be unreasonable in comparison to the cost of the proposed foreign photovoltaic device, i.e. that the price of the foreign photovoltaic device plus 50 percent is less than the price of a comparable domestic photovoltaic device.]

(6) If $174,000 or more, the Offeror certifies that each photovoltaic device to be used in performance of the contract is— ☐ (i) A U.S.-made photovoltaic device; or ☐ (ii) A designated country photovoltaic device or a qualifying country photovoltaic device. [Offeror to specify country of origin_____________.]

252.225-7057 Preaward Disclosure Of Employment Of Individuals Who Work In The People’s Republic Of China (Aug 2022)

(c) Preaward disclosure requirement. At the time of submission of an offer for a covered contract, an Offeror that is a covered entity shall provide disclosures to include—

(1) The proposed use of workforce on a covered contract or subcontract, if the

Offeror employs one or more individuals who perform work in the People’s Republic of China

(2) The total number of such individuals who will perform work in the People’s Republic of China;

(3) A description of the physical presence, including street address or addresses, in the People’s Republic of China, where work on the covered contract will be performed

252.227-7017 Identification and Assertion of Use, Release, Or Disclosure Restrictions (Jan 2023)

(d) The Offeror's assertions, including the assertions of its subcontractors or suppliers or potential subcontractors or suppliers shall be submitted as an attachment to its offer in the following format, dated and signed by an official authorized to contractually obligate the Offeror:

Identification and Assertion of Restrictions on the Government's Use, Release, or Disclosure of Technical Data or Computer Software The Offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software should be restricted:

Technical Data or Computer Software to be Furnished With Restrictions*

Basis for Assertion**

Asserted Rights Category***

Name of Person Asserting Restrictions****

(LIST)***** (LIST) (LIST) (LIST)

*For technical data (other than computer software documentation) pertaining to items, components, or processes developed at private expense, identify both the deliverable technical data and each such items, component, or process.

For computer software or computer software documentation identify the software or documentation.

**Generally, development at private expense, either exclusively or partially, is the only basis for asserting restrictions.

For technical data, other than computer software documentation, development refers to development of the item, component, or process to which the data pertain. The Government's rights in computer software documentation generally may not be restricted. For computer software, development refers to the software. Indicate whether development was accomplished exclusively or partially at private expense. If development was not accomplished at private expense, or for computer software documentation, enter the specific basis for asserting restrictions.

***Enter asserted rights category (e.g., government purpose license rights from a prior contract, rights in SBIR data generated under another contract, limited, restricted, or government purpose rights under this or a prior contract, or specially negotiated licenses).

****Corporation, individual, or other person, as appropriate.

*****Enter “none” when all data or software will be submitted without restrictions.

Date _____________________ Printed Name and Title _____________________________________________ Signature _________________________________________________________ (End of identification and assertion)

(e) An offeror's failure to submit, complete, or sign the notification and identification required by paragraph (d) of this provision with its offer may render the offer ineligible for award.

(f) If the Offeror is awarded a contract, the assertions identified in paragraph (d) of this provision shall be listed in an attachment to that contract. Upon request by the Contracting Officer, the Offeror shall provide sufficient information to enable the Contracting Officer to evaluate any listed assertion.

252.239-7009 Representation of Use Of Cloud Computing (Sep 2015)

(c) Representation. The Offeror represents that it – ☐ Does anticipate that cloud computing services will be used in the performance of any contract or subcontract resulting from this solicitation.

☐ Does not anticipate that cloud computing services will be used in the performance of any contract or subcontract resulting from this solicitation.

***End of Provision Fill-Ins***

Signature below signifies accuracy and completeness of the above Representations and Certifications any assertions above…