HDEC05-11-R-0006.doc

Section SF 1449 - CONTINUATION SHEET

REQUIREMENT

This requirement is for Defense Commissary Agency (DeCA) approved miscellaneous operating supplies for DeCA stores in five geographical areas (East CONUS, West CONUS, Pacific Theater, Alaska, and Hawaii), with one award anticipated for each area for a total of up to five (5) awards. Orders for supplies are to be placed through a contractor maintained internet-based ordering system, using numerous commissary Government Purchase Cards (GPC) issued to multiple cardholders per commissary so individual orders may be placed as needed. Individual contracts will have period of performance effective dates of 30 days after contract award, with the base year going through July 31, 2012. The contracts will be for a base period plus four (4) possible one-year option periods.

DeCA encourages participation of small businesses as possible prime contractors as well as subcontractors for any possible award resulting from this solicitation.

Lot

Misc Operating Supplies - East CONUS

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Base Period of Performance: No Later Than 30 days after Date of Award – July 31, 2012

See store locations at Attachment 2.

FOB: Destination

ESTIMATED

NET AMT

Lot

Misc Operating Supplies – West CONUS

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Base Period of Performance: No Later Than 30 days after Date of Award – July 31, 2012

ESTIMATED

Lot

Misc Operating Supplies – Alaska

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Base Period of Performance: No Later Than 30 days after Date of Award – July 31, 2012

ESTIMATED

Lot

Misc Operating Supplies – Hawaii

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Base Period of Performance: No Later Than 30 days after Date of Award – July 31, 2012

ESTIMATED

Lot

Misc Operating Supplies– Pacific Theater

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Base Period of Performance: No Later Than 30 days after Date of Award – July 31, 2012

See delivery locations in Addendum to 52.212-4 (Below).

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 1: August 1, 2012 – July 31, 2013

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 1: August 1, 2012 – July 31, 2013

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 1: August 1, 2012 – July 31, 2013

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 1: August 1, 2012 – July 31, 2013

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 1: August 1, 2012 – July 31, 2013

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 2: August 1, 2013 – July 31, 2014

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 2: August 1, 2013 – July 31, 2014

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 2: August 1, 2013 – July 31, 2014

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 2: August 1, 2013 – July 31, 2014

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 2: August 1, 2013 – July 31, 2014

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 3: August 1, 2014 – July 31, 2015

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 3: August 1, 2014 – July 31, 2015

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 3: August 1, 2014 – July 31, 2015

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 3: August 1, 2014 – July 31, 2015

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 3: August 1, 2014 – July 31, 2015

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 4: August 1, 2015 – July 31, 2016

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Period 4: August 1, 2015 – July 31, 2016

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 4: August 1, 2015 – July 31, 2016

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 4: August 1, 2015 – July 31, 2016

ESTIMATED

Lot

FFP

See attached spreadsheet for unit/item pricing and estimated quantities on Attachment 1. Option Year 4: August 1, 2015 – July 31, 2016

ESTIMATED

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.204-4500

INSTALLATION ACCESS REQUIREMENTS (DEC 2001)

The contractor is responsible for ensuring compliance with installation access procedures for both personnel and vehicles.

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 (JAN 2011)

(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 at http://www.ccr.gov (see 52.204-7).

(End of provision)

52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters ALTERNATE I (JAN 2011)

(a)(1) The Contractor shall update the information in the Federal Awardee Performance and Integrity Information System (FAPIIS) on a semi-annual basis, throughout the life of the contract, by posting the required information in the Central Contractor Registration database at http://www.ccr.gov.

(2) At the first semi-annual update on or after April 15, 2011, the Contractor shall post again any required information that the Contractor posted prior to April 15, 2011

(b)(1) The Contractor will receive notification when the Government posts new information to the Contractor's record.

(2) The Contractor will have an opportunity to post comments regarding information that has been posted by the Government. The comments will be retained as long as the associated information is retained, i.e., for a total period of 6 years. Contractor comments will remain a part of the record unless the Contractor revises them.

(3)(i) Public requests for system information posted prior to April 15, 2011, will be handled under Freedom of Information Act procedures, including, where appropriate, procedures promulgated under E.O. 12600.

(ii) As required by section 3010 of Public Law 111-212, all information posted in FAPIIS on or after April 15, 2011, except past performance reviews, will be publicly available.

(End of clause)

CLAUSES INCORPORATED BY FULL TEXT

52.211-11 LIQUIDATED DAMAGES--SUPPLIES, SERVICES, OR RESEARCH AND DEVELOPMENT (SEP 2000)

(a) If the Contractor fails to deliver the supplies within the time specified in this contract, and a separate order has to be placed with another company, the Contractor shall, in place of actual damages, pay to the Government liquidated damages equal to the difference in the cost of the item(s) plus $21.00 per order. Liquidated damages shall be assessed and credited on the next order placed by the same store.

(b) If the Government terminates this contract in whole or in part under the Default--Fixed-Price Supply and Service clause, the Contractor is liable for liquidated damages accruing until the Government reasonably obtains delivery or performance of similar supplies or services. These liquidated damages are in addition to excess costs of repurchase under the Termination clause.

(c) The Contractor will not be charged with liquidated damages when the delay in delivery or performance is beyond the control and without the fault or negligence of the Contractor as defined in the Default--Fixed-Price Supply and Service clause in this contract.

(End of clause)

52.212-1 Addendum to Instruction to Offerors – Commercial Items

The following paragraphs are altered as follows:

(a) North American Industry Classification System (NAICS) Code: 322223.

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

(1) The solicitation number: HDEC05-11-R-0006;

(2) The time specified in the solicitation for receipt of offers: July 11, 2011 at 4:00 pm EDT;

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

(4) Terms of any express warranty;

(5) Price: Complete Line Item Spreadsheet (Attachment 1). Offerors may provide pricing for all or any combination of regional areas. For a given regional area, all line items must be priced for all years except for items marked as “NSP.” Unit pricing must be rounded to the nearest penny. If prices are not rounded to the nearest penny, the Government will round unit prices as part of the evaluation process. Option year items that are indicated with “NSP” (Not Separately Priced) shall not be priced in the option years. “NSP” items will be evaluated by extending the base year pricing into each option year. If awarded the contract, the offeror’s base year pricing will be adjusted periodically in accordance with the schedule of Economic Price Adjustment (EPA) included in clause 52.216-4506. Proposed “Quoted Unit of Issue,” “Quoted Case Pack,” and item pricing columns (base year for all, and option year for non NSP items) are available for offeror’s input. Note that case pack or unit of issue changes must be identified by the offeror with the reason(s) for the proposed change on a separate page. The government reserves the right to reject proposed case pack or unit of issue changes. Identify all proposed case pack changes on the spreadsheet in the appropriate columns. (If the case pack quoted is not a change, the “Quoted Unit of Issue” and “Quoted Case Pack” blocks may be left blank.) Any proposed change in case pack will result in a change in the estimated quantity. The revised estimated quantity will be re-calculated by the Contract Specialist and changed on spreadsheet for evaluation. When a fractional estimated quantity results from a case pack change, the quantity will be rounded to the next higher whole case. The resulting total number of units (Estimated Quantity X Case Pack) must equal or exceed the original total or units as required on solicitation.

The following is provided for clarification purposes:

(6) “Remit to” address, if different than mailing address;

(7) A completed copy of the representations and certifications at FAR 52.212-3 (http://farsite.hill.af.mil). This requirement can be completed electronically at http://orca.bpn.gov.

(8) Signed acknowledgment of any issued Solicitation Amendments;

(9) Past Performance Survey reference information, to include the names, companies, and contact information for those individuals asked to complete and submit surveys. A minimum of three (3) references are required as follows :

Reference #1

Reference Company:

Name:

Title:

Telephone:

Email:

Reference #2

Reference Company:

Name:

Title:

Telephone:

Email:

Reference #3

Reference Company:

Name:

Title:

Telephone:

Email:

References should represent previous work of similar scope to the requirements in this solicitation and should be current or prior customers (within the past three (3) years).

NOTE: The Government reserves the right to contact the references; therefore, the references should be able to provide information concerning timeliness of deliveries, quality of products delivered, compliance with specifications, and contract terms, customer satisfaction and response level on taking corrective action when a delivery problem or non-conformance problem occurs.

(10) A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

The following requirements for offer submissions are added:

(11) Offerors must submit an electronic copy of the spreadsheet to jason.reedy@deca.mil. Hand written portions and those including signatures may be emailed, faxed, or mailed. The following shall be in the subject line for the email submittal:

“Proposal from (company name) in response to RFP HDEC05-11-R-0006”.

(12) “Past Performance Survey” sheets completed by at least 3 (three) different current or prior customers (within the past 3 years). If possible, references should represent previous work of similar scope to the requirements in this solicitation. The Offeror’s references shall complete the survey sheets (Attachment 2) and forward them DIRECTLY to the contracting office as outlined on the survey, by the closing date of the solicitation. The Offeror is expected to make every effort to ensure that the completed “Past Performance Survey” sheets are completed and submitted. Late submission by references at no fault of the Offeror may not be cause for dismissal of the perspective proposal. The government may also use other applicable past performance information that is available from sources not identified by the offeror to evaluate past performance . Surveys may be scanned by the Government and retained as an electronic file vice a paper file.

(13) All questions of a technical and/or contractual nature concerning this solicitation shall be submitted in writing to Jason M. Reedy, Contract Specialist at jason.reedy@deca.mil no later than June 20, 2011 at 5:00 pm EDT. A consolidated list of questions and answers, if applicable, will be provided to all prospective offerors as appropriate. Answers to questions will not alter the solicitation unless and until an amendment is made to the solicitation incorporating the answers. Questions submitted with regards to Economic Price Adjustments (EPA) regarding products not considered under EPA but the offeror feels should be, should also come with a suggestion as to what index would be used for any such price adjustments.

(14) Complete all applicable clauses that require fill-ins.

(15) Provide proof of compliance with Payment Card Industry Security Standards (PCI SS) in accordance with the PCI Security Standards Council.

(c) Period of Acceptance of Offers is changed to 120 calendar days.

(d) Product Samples: Offerors may be required to provide samples of items via second day shipment at no cost to the government prior to award. However, samples will not be submitted with proposals.

(e) Multiple offers. The government anticipates that offerors will be able to negotiate more advantageous pricing as purchase volume increases. As such, the government encourages each offeror to submit an alternate proposal.

One alternate proposal may be submitted to propose alternate pricing. The pricing model must be able to be evaluated using the estimated quantities as outlined in Attachment 1. These proposals must relate to discounts given according to the number of contract awards received by the contractor providing the alternate proposal.

Examples of alternate pricing proposals are as follows (these are examples only):

Example 1:

“If awarded both the CONUS East and West contracts, we propose an across the board discount of 5% off all items on the East and West CONUS supply lists for all option years.”

Example 2:

“If awarded all 5 regional contracts, XYZ Supply Company offers tiered pricing discounts as follows for the Base Year only:

Hawaii – 1% Discount

Alaska – 2% Discount

Pacific Theater – 4% Discount

East CONUS – 3% Discount

West CONUS – 3% Discount.”

(f) The Government anticipates one award per area (East CONUS, West CONUS, Hawaii, Alaska, and Pacific Theater), to the lowest priced acceptable offeror(s) considering all offers received meeting the requirements in the RFP.

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (OCT 2010) ALTERNATE I (APR 2002)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.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 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).

“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.

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.

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 on the Online Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website at http://orca.bpn.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: Complete paragraphs (c)(6) and (c)(7) only if this solicitation is expected to exceed the simplified acquisition threshold.

(6) 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.

(7) 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:

(8) 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

(9) (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 database maintained by the Small Business Administration (PRO-Net), 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: ____________.)

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that--

(i) It ( ) is, ( ) is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR part 126; and

(ii) It ( ) is, ( ) is not a joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for the HUBZone small business concern or concerns that are participating in the joint venture. (The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture:____________.) Each HUBZone small business concern participating in the joint venture shall submit a separate signed copy of the HUBZone representation.

(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) or (c)(9) 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:

Line Item No.:---------------------------------------------------------

Country of Origin:-----------------------------------------------------

(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:

Line Item No.

[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:

[List as necessary]

(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 as other end products those end products that are not U.S.-made or designated country end products.

Other End Products

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American Act. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals--

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

(2) ( ) 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 Federal, state or local government 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; and

(3) ( ) Are, ( ) are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) [ballot] Have, [ballot] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full…