Attachment J.4

Pool Application Pool Application and Certification Human Capital and Training Solutions (HCaTS)

Solicitation Number: GS02Q15CRR0001 Amendment Number: 00 Attachment J.4 All sections must be completed before submission.

B. Entity Size Status: If an Offeror is Other than Small Business, leave this section blank. If the Offeror is a Small Business, the Offeror shall select the applicable socio-economic subgroup(s) it certifies itself as for purposes of this Solicitation. The Offeror's SAM record shall reflect the same selections.

C. Authorized Representative: The Offeror shall indicate the individual with authority to commit and bind the Offeror for purposes of this Solicitation.

NAICS:

611430 (Professional & Management Development Training) 611699 (All Other Miscellaneous Schools and Instruction) 624310 (Vocational Rehabilitation Services) NAICS:

541611 (Administrative Management and General Management Consulting Services) 541612 (Human Resources Consulting Services) 541613 (Marketing Consulting Services) 541618 (Other Management Consulting Services) 611710 (Educational Support Services)

(Corporate HCaTS Program Manager):

(Corporate HCaTS Contract Manager):

Does the Offeror elect to be considered for cost reimbursable task orders under HCaTS?

If the Offeror's current accounting system is not audited in accordance with Section L.5.1.5, does it elect to have its accounting system audited by the DCAA?

1) Offeror accepts all Terms, Conditions, Provisions, and Clauses included in the solicitation.

2) Offeror accepts the performance standards identified in Section F.5, and acknowledges that it is the Government’s unilateral right to invoke Dormant Status or Off-Ramp procedures for failure to meet the stated standards.

3) The Price proposal reflects the Offeror's rates and estimates as of the date of proposal submission. By submitting this proposal, the Offeror grant the Contracting Officer and Authorized Representative(s) the right to examine, at any time before award, those records, which include books, documents, accounting procedures and practices, and other data, regardless of type and form or whether such supporting information is specifically referenced or included in the proposal as the basis for pricing, that will permit an adequate evaluation of the proposed price in accordance with FAR Subsection 15.403-3.

4) Offeror acknowledges that the falsification of any proposal submission, documents or statements may subject the Offeror to civil or criminal prosecution under Section 1001 of Title 18 of the United States Code.

Small Business HUBZone Small Business Service Disabled Veteran Owned Small Business 8(a) Small Business Economically Disadvantaged Woman Owned Small Business Woman Owned Small Business The Offeror identifies as small business for Pool 1.

The Offeror identifies as small business for Pool 2.

ImportSheet

Not applicable, for Evaluation purposes.

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