HDEC0412R0024.doc

Section SF 1449 - CONTINUATION SHEET

ADDENDUM TO 52.212-1

INSTRUCTIONS TO OFFERORS – COMMERCIAL ITEMS

I. SUBMISSION OF OFFERS: [(Reference Paragraph (b)]

a. The proposals are to be submitted to the Defense Commissary Agency, Supply/Equipment Acquisition Division, Attn: LEAE, 1300 E. Ave, Fort Lee, VA 23801-1800. Faxed, scanned or e-mailed copies will be accepted. You may send to the fax number: 804-734-8009 (Press pause button 2 times) then 76196. The complete proposal with authorized representative’s signature must be received by the closing date and time. Offerors are also required to be registered in the Central Contractor’s Registration (CCR) database at http://ccr.gov.

b. Product Information: The Offerors shall submit descriptive literature, a matrix, or other information that demonstrates that the proposed products meet or exceed all the required generalized operating specifications of Commissary Equipment Descriptions (CED). See pages 60 and 61.

c. Offerors must have updated on-line representations completed via ORCA, http://orca.bpn.gov. The offerors only need to complete paragraph (b) (2) of FAR 52.212-3 and submit with their proposal. North American Industry Classification System (NAICS) Code applicable to this solicitation is 333415 and the Size Standard is 750. Per FAR 4.1201(a): Prospective contractors SHALL complete electronic annual representations and certifications (Reps & Certs) at http://orca.bpn.gov in conjunction with required registration in the Central Contractor Registration (CCR) database. Your Reps and Certs must include the NAICS applicable to this solicitation document and indicate your organization’s business size status.

Per 13 CFR 121.106 – If the size determination is based on the number of employees, the method for determining business size status is based on the average number of employees of the concern (including part-time and full-time employees of its domestic and foreign affiliates), which is based upon the number of employees for each of the pay periods for the preceding completed 12 calendar months. [Additional definition is available by searching 13 CFR.121 at http://www.gpoaccess.gov/cfr/index.html]

d. Past Performance References: Submit at least 3 references; companies that you have conducted business with over the last five years for delivery of products that are similar to those listed in this solicitation. Provide by fax the following information for each reference to Willie Moye at 804-734-8009, press pause at least twice and then dial 76196 no later than June 1, 2012:

(1) Company Name and Address

(2) Point of Contact Name and Title

(3) Phone Number

(4) Facsimile Number

(5) E-Mail Address

(6) Description of Product Delivered

The references will be asked to provide information on your company’s past performance with regard to timeliness of delivery, quality, and business relations. The contracting officer will contact the references provided to obtain this information. Any other past performance information available to the contracting officer will also be considered.

e. Price: Provide your best price for each line item and enter the total price for the maximum quantity for each line item. Enter all pricing for the base and option years. Offerors shall propose FOB destination pricing only.

f. Shipping Costs: DO NOT price shipping CLINs. We will use $1,000.00 as a place holder for systems purposes once the contract is awarded. Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill attached to the invoice in Wide Area Workflow (WAWF).

II. The period for acceptance of offers is changed to 90 days.

ADDENDUM TO 52.212-4

TERMS AND CONDITIONS – COMMERCIAL ITEMS

The following paragraphs have been changed/added to FAR 52.212-4 Terms and Conditions – Commercial Items.

1. Administrative Modifications:

The government may issue unilateral written modifications that do not affect the substantive rights of the parties. Examples of administrative modifications are corrections in the payment office address or changes to the accounting and appropriation data.

2. Payment Procedures:

a. Funding will be provided on individual delivery orders. Payment will be made by Defense Finance and Accounting Service (DFAS). Contract payments will be processed electronically via EFT through the Defense Finance and Accounting Service (DFAS). Prior to DFAS releasing any contract payment, the contractor must submit an invoice COMBO using Wide Area Work Flow (WAWF) electronic commerce. An invoice COMBO is used to invoice for supplies or services and enables the vendor to create a separate invoice and receiving report from the same data entry session, eliminating the need to re-key data. After an invoice COMBO is received, a Government representative will acknowledge acceptance and receipt of the service via WAWF. After all items are properly submitted, the contract payment will be processed via DFAS electronically.

b. The contractor must access the WAWF Vendor Tools on the DFAS website and complete the requirements to obtain an active WAWF account. This will allow the contractor to submit invoices via WAWF so that payments can be processed electronically through EFT.

c. For additional WAWF information, see clause 252.232-7003 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS AND RECEIVING REPORTS (MAR 2008).

d. Clause FAR 52.213-1, FAST PAYMENT PROCEDURE (MAY 2006), applies only to shipments destined for locations outside the continental U.S. (See 5 below.)

3. Period of Performance:

Base Year:

August 1, 2012 through July 31, 2013

Option Year 1:

August 1, 2013 through July 31, 2014

Option Year 2:

August 1, 2014 through July 31, 2015

Option Year 3: August 1, 2015 through July 31, 2016 Option Year 4: August 1, 2016 through July 31, 2017

4. Delivery:

Delivery orders will be issued and accessed through the Electronic Document Access System (EDA) http://eda.ogden.disa.mil. Contractors must complete the on-line registration available at the website in order to retrieve documents displayed there.

Delivery is required 30 days after receipt of delivery order. Delivery to commissaries shall be made between the hours of 7:00 am and 3:00 pm local time, Monday through Friday, excluding official Government Holidays. Delivery orders will contain the delivery location and any other necessary delivery instructions. The contractor can find the delivery address and points of contact information for each store at www.commissaries.com

5. Shipping:

Some delivery locations may require packaging and preparation for overseas shipment, but the contractor is responsible only for shipment to the port. Equipment destined for overseas shipment will be wrapped, blocked, and braced using best commercial practices so that the equipment arrives at destination without damage. Each Outside Continental United States (OCONUS) delivery order will include packing and marking instructions to the shipping port specified in the order. The contractor shall mark each shipment with the name of the contractor, contract number, and requisition number.

6. Be advised that this contract will be posted on http://www.commissaries.com/business/contracting.cfm at two distinct points during the procurement cycle:

(1) RECENT CONTRACT AWARDS - The first posting will take place immediately after the contract is awarded and will contain only the base year pricing.

(2) HISTORICAL PRICING – The second posting will take place when it is time for re-solicitation of an existing contract and will contain all CLINs and Sub-CLINs prices of the base period and all exercised options of the contract which is about to expire and is being re-solicited.

7. Be advised that this solicitation will result in one requirements contract where quantities are estimates. See clause 52.216-21, REQUIREMENTS, (OCT 1995) for more details.

CED 4IFNIS, 4IFWT1, 4IFWT2, Ice Flakers

FFP

Base Year: August 1, 2012 through July 31, 2013

FOB: Destination

NET AMT

0001AA

CED 4IFNIS, Ice Flaker

Low Volume

Minimum 1300 pounds production capacity

Base Year: August 1, 2012 through July 31, 2013

Make:

Model:

Warranty Period:

Warranty POC:

ESTIMATED

NET AMT

0001AB

CED 4IFWT1, Ice Flaker

One Mobile Cart

Minimum 1300 pounds production capacity

Base Year: August 1, 2012 through July 31, 2013

Make:

Model:

Warranty Period:

ESTIMATED

0001AC

CED 4IFWT2, Ice Flaker

Two Mobile Carts

Minimum 2200 pounds production capacity

Base Year: August 1, 2012 through July 31, 2013

Make:

Model:

Warranty Period:

ESTIMATED

0001AD

Shipping Charges - Do Not Price

Base Year: August 1, 2012 through July 31, 2013

In accordance with the addendum to 52.212-1 - Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill.

ESTIMATED

FFP

Option Year 1: August 1, 2013 through July 31, 2014

NET AMT

1001AA

FFP

Low Volume

Minimum 1300 pounds production capacity

Option Year 1: August 1, 2013 through July 31, 2014

Make:

Model:

Warranty Period:

ESTIMATED

1001AB

FFP

One Mobile Cart

Minimum 1300 pounds production capacity

Option Year 1: August 1, 2013 through July 31, 2014

Make:

Model:

Warranty Period:

ESTIMATED

1001AC

FFP

Two Mobile Carts

Minimum 2200 pounds production capacity

Option Year 1: August 1, 2013 through July 31, 2014

Make:

Model:

Warranty Period:

ESTIMATED

1001AD

FFP

Option Year 1: August 1, 2013 through July 31, 2014

In accordance with the addendum to 52.212-1 - Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill.

ESTIMATED

FFP

Option Year 2: August 1, 2014 through July 31, 2015

NET AMT

2001AA

FFP

Low Volume

Minimum 1300 pounds production capacity

Option Year 2: August 1, 2014 through July 31, 2015

Make:

Model:

Warranty Period:

ESTIMATED

2001AB

FFP

One Mobile Cart

Minimum 1300 pounds production capacity

Option Year 2: August 1, 2014 through July 31, 2015

Make:

Model:

Warranty Period:

ESTIMATED

2001AC

FFP

Two Mobile Carts

Minimum 2200 pounds production capacity

Option Year 2: August 1, 2014 through July 31, 2015

Make:

Model:

Warranty Period:

ESTIMATED

2001AD

FFP

Option Year 2: August 1, 2014 through July 31, 2015

In accordance with the addendum to 52.212-1 - Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill.

ESTIMATED

FFP

Option Year 3: August 1, 2015 through July 31, 2016

NET AMT

3001AA

FFP

Low Volume

Minimum 1300 pounds production capacity

Option Year 3: August 1, 2015 through July 31, 2016

Make:

Model:

Warranty Period:

ESTIMATED

3001AB

FFP

One Mobile Cart

Minimum 1300 pounds production capacity

Option Year 3: August 1, 2015 through July 31, 2016

Make:

Model:

Warranty Period:

ESTIMATED

3001AC

FFP

Two Mobile Carts

Minimum 2200 pounds production capacity

Option Year 3: August 1, 2015 through July 31, 2016

Make:

Model:

Warranty Period:

ESTIMATED

3001AD

FFP

Option Year 3: August 1, 2015 through July 31, 2016

In accordance with the addendum to 52.212-1 - Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill.

ESTIMATED

FFP

Option Year 4: August 1, 2016 through July 31, 2017

NET AMT

4001AA

FFP

Low Volume

Minimum 1300 pounds production capacity

Option Year 4: August 1, 2016 through July 31, 2017

Make:

Model:

Warranty Period:

ESTIMATED

4001AB

FFP

One Mobile Cart

Minimum 1300 pounds production capacity

Option Year 4: August 1, 2016 through July 31, 2017

Make:

Model:

Warranty Period:

ESTIMATED

4001AC

FFP

Two Mobile Carts

Minimum 2200 pounds production capacity

Option Year 4: August 1, 2016 through July 31, 2017

Make:

Model:

Warranty Period:

ESTIMATED

4001AD

FFP

Option Year 4: August 1, 2016 through July 31, 2017

In accordance with the addendum to 52.212-1 - Prior to placing delivery orders, the Government will contact the vendor for shipping cost for specific location(s). The vendor will be paid for actual shipping charges supported by a copy of the prepaid freight/shipping bill.

ESTIMATED

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.204-4500

INSTALLATION ACCESS REQUIREMENTS (JAN 31 2012)

The contractor shall be responsible for ensuring full compliance with all installation access procedures. Installation access includes, but is not limited to, obtaining applicable installation passes and inspections for vehicles and personnel. Contractor employees may also be subject to background security checks/clearances in order to obtain credentials for passes. Some installations are using programs, such as RAPIDGate, which may result in a cost to the contractor. Any costs associated with such programs or with obtaining passes, will not be reimbursed separately and should be included in the contractor's proposed pricing for the product or services being acquired.

CLAUSES INCORPORATED BY FULL TEXT

52.207-4 ECONOMIC PURCHASE QUANTITY--SUPPLIES (AUG 1987)

(a) Offerors are invited to state an opinion on whether the quantity(ies) of supplies on which bids, proposals or quotes are requested in this solicitation is (are) economically advantageous to the Government. _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

Each offeror who believes that acquisitions in different quantities would be more advantageous is invited to recommend an economic purchase quantity. If different quantities are recommended, a total and a unit price must be quoted for applicable items. An economic purchase quantity is that quantity at which a significant price break occurs. If there are significant price breaks at different quantity points, this information is desired as well.

OFFEROR RECOMMENDATIONS

PRICE

ITEM

QUANTITY

QUOTATION

TOTAL _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________

(c) The information requested in this provision is being solicited to avoid acquisitions in disadvantageous quantities and to assist the Government in developing a data base for future acquisitions of these items. However, the Government reserves the right to amend or cancel the solicitation and resolicit with respect to any individual item in the event quotations received and the Government's requirements indicate that different quantities should be acquired.

(End of provision)

CLAUSES INCORPORATED BY FULL TEXT

52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (FEB 2012)

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

Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

Federal contracts and grants with total value greater than $10,000,000 means--

(1) The total value of all current, active contracts and grants, including all priced options; and

(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).

Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

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

(c) If the offeror checked “has” in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(iii) In an administrative proceeding, a finding of fault and liability that results in--

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the Central Contractor Registration database via https://www.acquisition.gov (see 52.204-7).

(End of provision)

CLAUSES INCORPORATED BY FULL TEXT

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. Product Acceptability

2. Past Performance Acceptability

(a) Timeliness

(b) Quality of Products

(c) Business Relations

3. Price

(b) Award will be made to the lowest-priced technically acceptable offeror. Offerors will be determined to be technically acceptable if their proposed product complies with the Commissary Equipment Description, (CED) requirements, and by receiving at least an acceptable rating for each past performance evaluation sub-factor. For the proposed product to be acceptable, the offeror's product must meet or exceed the stated general and operational characteristics. Total evaluated price will be determined by applying each offeror’s unit price to the estimated quantity per sub-CLIN, and totaling each CLIN for a total evaluated price, for the base and four option periods. Only one award is possible.

(c) The evaluation of past performance will be an assessment based on a consideration of all relevant facts and circumstances. It will not be based on absolute standards of acceptable performance, but an offeror's overall past performance history. The Government is seeking to determine whether the offeror has consistently demonstrated a genuine concern for customer satisfaction, and timely delivery of quality goods. This determination is a matter of judgment.

(d) 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).

(e) 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

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (DEB 2012) ALTERNATE I (APR 2011)

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 (b) through (i) of this provision.

(a) Definitions. As used in this provision:

"Emerging small business" means a small business concern whose size is no greater than 50 percent of the numerical size standard for the NAICS code designated.

"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 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 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.

(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 (n) 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 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 ( ) is, ( ) is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern or concerns that are participating in the joint venture: .] Each WOSB concern participating in the joint venture shall submit a separate signed copy of the WOSB representation.

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

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

(ii) It ( ) is, ( ) is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(ii) of this provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns 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) Small Business Size for the Small Business Competitiveness Demonstration Program and for the Targeted Industry Categories under the Small Business Competitiveness Demonstration Program. (Complete only if the offeror has represented itself to be a small business concern under the size standards for this solicitation.)

(i) (Complete only for solicitations indicated in an addendum as being set-aside for emerging small businesses in one of the designated industry groups (DIGs).) The offeror represents as part of its offer that it ( ) is, ( ) is not an emerging small business.

(ii) (Complete only for solicitations indicated in an addendum as being for one of the targeted industry categories (TICs) or designated industry groups (DIGs).) Offeror represents as follows:

(A) Offeror's number of employees for the past 12 months (check the Employees column if size standard stated in the solicitation is expressed in terms of number of employees); or

(B) Offeror's average annual gross revenue for the last 3 fiscal years (check the Average Annual Gross Number of Revenues column if size standard stated in the solicitation is expressed in terms of annual receipts).

(Check one of the following):

Average Annual

Number of Employees Gross Revenues

___ 50 or fewer ___ $1 million or less

___ 51 - 100 ___ $1,000,001 - $2 million

___ 101 - 250 ___ $2,000,001 - $3.5 million

___ 251 - 500 ___ $3,500,001 - $5 million

___ 501 - 750 ___ $5,000,001 - $10 million

___ 751 - 1,000 ___ $10,000,001 - $17 million

___ Over 1,000 ___ Over $17 million

(11) (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)(9)(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: ____________.)

(12) Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) or (c)(10) 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, U.S. Trust Territory of the Pacific Islands (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.

(d) Certifications and representations required to implement provisions of Executive Order 11246--

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

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

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

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

(i) It ( ) has developed and has on file, ( ) has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR Subparts 60-1 and 60-2), or

(ii) It ( ) has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $100,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

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

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

(2) Foreign End Products:

(List as necessary)

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

(g)

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

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

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

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

[List as necessary]

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

Other Foreign End Products:

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

(2) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

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

Canadian End Products:

Line Item No.:

[List as necessary]

(3) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

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

Canadian or Israeli End Products:

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

(i) The offeror certifies that each end product, except those listed in paragraph (g)(4)(ii) of this provision, is a U.S.-made or designated country end product as defined in the clause of this solicitation entitled “Trade Agreements.”

(ii) The offeror shall list…