J.4 HCaTS SB Pool Application and Certification A01.xlsm
XLSM spreadsheet 48 KB Posted
- Solicitation number
- GS02Q15CRR0002
- Issued by
-
GSA Federal Acquisition Service
About this file
This document contains a pool application and certification form for the Human Capital and Training Solutions Small Business (HCaTS SB) contract vehicle. Key details include:
The form requests background information on the offeror such as name, address, DUNS number, and socioeconomic status. It also requests information on the offeror's authorized representatives and key personnel. Offerors must indicate which pool or pools they seek consideration for, and certify that they meet the size standards for those pools. Pool 1 has a $11 million size standard while Pool 2 has a $15 million size standard. The form also asks offerors if they elect to be considered for cost reimbursable task orders and whether their accounting system has been audited. By submitting this form, offerors agree to the terms and conditions of the solicitation and acknowledge performance standards and evaluation procedures.
The related federal contract opportunity notice provides additional context. The General Services Administration anticipates issuing requests for proposals in May 2015 for the HCaTS contract vehicle to replace the Training and Management Assistance contract. One solicitation will be unrestricted while the other will be a total small business set-aside. The draft RFP attached is for the small business set-aside known as HCaTS SB. Comments on the draft RFP are due by March 30, 2015.
HCaTS SB Attachment J.4 (Pool Application and Certification) A01
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Pool Application Pool Application and Certification Human Capital and Training Solutions Small Business (HCaTS SB)
Solicitation Number: GS02Q15CRR0002 Attachment J.4 Amendment #: 01 All sections must be completed before submission.
| SECTION I - BACKGROUND |
| A. Offeror Information: The Offeror shall provide herein this Section I its official Name, Address, and DUNS Number of the bidding entity as specified on the SF33 and for which the Offeror has a corresponding active profile at www.sam.gov. |
| Offeror Name: |
| Offeror Address: |
| DUNS Number: |
| Entity Type: |
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.
| Name: |
| Title: |
| Office Phone: |
| Mobile Phone: |
| Email: |
| D. Alternative Authorized Representative: The Offeror shall indicate an alternative point of contact who shall also have the authority to commit and bind the Offeror for purposes of this Solicitation. |
| Name: |
| Title: |
| Office Phone: |
| Mobile Phone: |
| Email: |
| SECTION II - HCaTS POOL QUALIFICATION | |
| Pool Selection: The Offeror shall indicate which Pool(s) it seeks consideration for purposes of this Solicitation. | |
| POOL 1 - Size Standard $11M | POOL 2 - Size Standard $15M |
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)
| Contractor Key Personnel #1 | ||
| (Corporate HCaTS Program Manager): | Contractor Key Personnel #1 |
(Corporate HCaTS Program Manager):
| Name: | Name: | ||
| Title: | Title: | ||
| Contractor Key Personnel #2 | |||
| (Corporate HCaTS Contract Manager): | Contractor Key Personnel #2 |
(Corporate HCaTS Contract Manager):
| Name: | Name: |
| Title: | Title: |
| SECTION III - Eligibility for Cost Reimbursable Task Orders |
| Cost Reimbursement Election: The Offeror shall indicate herein if it seeks consideration for cost reimbursement task orders. |
Does the Offeror elect to be considered for cost reimbursable task orders under HCaTS?
| Only answer the questions below, if the answer to the previous questions is yes. |
| Is the Offeror's current accounting system audited in accordance with Section L.5.1.5? |
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?
| SECTION IV - CERTIFICATIONS/AUTHORIZATIONS |
| BY SUBMITTING THIS FORM, OFFEROR AGREES TO AND ACKNOWLEDGES THE FOLLOWING TERMS AND CONDITIONS: |
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
| Offeror Name | Offeror Address | DUNS | Individual | CTA | SB | SDVOSB | EDWOSB | HUBZone | 8(a) | WOSB | Name | Title | O.Phone | M.Phone | Name | Title | O.Phone | M.Phone | Pool 1 | SB Pool1 | Pool 2 | SB Pool 2 | CKP#1 Name | CKP#1 Title | CKP#2 Name | CKP#2 Title | CKP#1 Name | CKP#1 Title | CKP#2 Name | CKP#2 Title | Yes | No | Has Audit | Needs Audit | ||
| 0 | 0 | 0 | FALSE | FALSE | FALSE | FALSE | FALSE | FALSE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | FALSE | FALSE | 0 | 0 | 0 | 0 | 0 | 0 | 0 | FALSE | FALSE | FALSE | FALSE |
Not applicable, for Evaluation purposes.
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