Amendment_2_Combined_Synopsis_Solicitation_HQ003414T0200.pdf

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COMBINED SYNOPSIS/SOLICITATION

NUMBER HQ003414T0200

WASHINGTON HEADQUARTERS SERVICES / ACQUISITION DIRECTORATE

1155 DEFENSE PENTAGON, WASHINGTON, DC 20301-1155

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation for this requirement; quotes are being requested and a written solicitation will not be issued.

This combined synapsis/solicitation HQ003414T0200 (hereby referred to as “Solicitation HQ003414T0200”), for Motion Picture and Video Production Commercial Item Services, issued as a firm-fixed-price request for quotation (RFQ), with the solicitation and its incorporated provisions and clauses in effect through Federal Acquisition Circular 2005-76 effective August 25, 2014 . For the purpose of this acquisition, this is a solicitation for a 100 percent small business set-a-side contract award under the associated North American Industrial Classification System (NAICS) code 512110, with a small business size standard of $32.5M annual gross revenue.

ITEM

NO.

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 (Labor) Video Recording Services

1 Lot

0002 Equipment 1 Lot 0003 Travel (Cost) 1 Lot $5000.00

VENDOR CAMERA CREW EXPENSES & QUOTE:

Please provide the contracting office with the following information in the quote:

a) LABOR:

1) Camera Person (estimate of 20 hours)

2) Audio Person (estimate of 20 hours)

b) EQUIPMENT:

1) Equipment to include (refer to “REQUIREMENTS a-e”): Cameras, camera accessories, monitors, lighting, and audio

c) TRAVEL COSTS:

1) $5000.00 can be estimated for travel costs

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STATEMENT OF WORK

GENERAL: This requirement is for documentary style video production footage on location, in a variety of environments for the Department of Defense (DOD) Office of Economic Adjustment (OEA), to include the capture of video and footage for documentary style productions for the OEA video success stories.

BACKGROUND: The Office of Economic Adjustment (OEA) has a requirement to produce video productions that will communicate information to its customers. These videos require the services of a 2-person camera crew to travel with an OEA project manager from the Washington, DC area to locations within the United States to shoot original footage and interviews. These are single camera video shoots. Type of productions range from videotaping formal sit-down interviews and video messages to staged scenes with professional talent to field documentary shoots where there is little to no control on the action and action is captured as it takes place.

SCOPE OF WORK: The Contractor shall provide the following services:

1. Two person professional video crew (camera person and audio person) (must be U.S.

citizens)

a) Video crew available for scheduled shoots; in addition to, equipment is required.

Local audio people will be hired in areas where qualified local audio people are available. Travel will start and end in the Washington, DC area.

2. Shooting locations will be within the United States. Contractor will be given a minimum notice of 5-days to schedule a video shoot. If contractor is not available, an experienced replacement will be identified and cleared through OEA.

3. Camera Crew will work an estimated 10 hour day which does not include time to reach a shoot location within 30 miles of residence or hotel.

4. Any Camera Crew travel and work done under this contract will take place between contracts period of performance.

PERIOD OF PERFORMANCE: The anticipated period of performance for this contract shall be for one, 12 month period; September 23, 2014 through September 22, 2015

SPECIFICATIONS:

1. Video/audio equipment shall be the responsibility of the contractor.

2. Government will be given a minimum notice of five (5) days to schedule a video shoot.

3. Travel itinerary shall include travel days for each person, to start and end in the

Washington DC area, to ensure coordination with the COR.

4. Tentative Travel Schedule:

a) September 24-27: Detroit, MI (TBD)

b) September 29-October 3, Santa Fe, NM (TBD)

c) October 6-10, Lakewood, WA (TBD)

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d) October 20-25 (TBD)

e) Other tentative dates and locations to be determined.

5. Cancellation Policy: Contractor will be given at least 48 hour notice, if the shoot is cancelled by the Government. Contractor will be reimbursed for air fare and/or other validated costs. If contractor cancels, then the Government is not responsible for any costs and the Contractor shall rectify the cancellation by notifying the Government of its plan of action.

DELIVERABLES: Contractor shall provide the following deliverables after each shoot:

a) One SxS Card. Contractor shall provide the SxS card with the shot footage to the COR after each shoot.

CONTRACTOR QUALIFICATIONS/REQUIREMENTS: Qualified professional 2-person video camera crew with a minimum of 5-years of professional experience in video shooting and video lighting professional productions. Video crew must be experienced in shooting documentary style productions on location as well as interview settings in a variety of environments. Camera person must have proven experience in multiple fixed and hand held shooting platforms (Steadicam, dollies, jibs, etc.). Audio person must have proven experience in recording high quality audio through the use of a variety of microphones. A minimum of 3 professional performance reviews from clients is requested. Established production knowledge of the Department of Defense; familiarity with the base realignment and closure process;

compatible land use issues; Defense industry adjustment and economic development is preferred along with previous OEA production experience.

REQUIREMENTS: Contractor is required to have the following equipment for each shoot to capture footage:

a) Camera Equipment: Sony PMW-F3L or F5 Super 35mm full-high-definition compact camcorder.

b) Camera Accessories: Standard lens, zoom lens, wide-angle lens; HD monitor; Filter and Matte Box kit; Tripod and support gear batteries.

c) Monitor: 17” HDSDI monitor with sunshade / 8" HD SDI monitor with sunshade.

d) Lighting: 200 watt battery/AC HMI Interview light kit; Light kit with 8 instruments:

Kino Diva light, Arri 1K with chimera, Arri 650 with chimera, 650 Fresnel, 300 Fresnel, 2 - 150 watt Fresnel, Leko light with pattern; Duvative black fabric.

e) Audio: Three to Four Channel Mixer; Two wireless Mics; Shotgun mic with boom and quality wind zeppelin Lav mics Standard cables.

The work shall be executed in a careful and professional manner, compliance with copyright laws and regulations. If the contractor has equipment problems it will be the contractor’s responsibility to take care of the issue with NO CHARGE TO OEA.

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TRAVEL: Travel will originate from the Washington, DC Metropolitan area only, but video shoot locations can be anywhere within the United States. Video crew will depart from the same airport and same flight (unless flight is sold out) as OEA project manager. Travel is estimated to include all scheduled locations within the United States. Total travel shall not exceed $5000.00.

The Contractor shall be reimbursed for actual allowable, allocable, and reasonable travel costs incurred during performance of this effort in accordance with the FAR 31.205-46 “Travel costs.”

and the Joint Travel Regulations, Volume 2, which applies to DoD civilian employees and others traveling at DoD expense. Requests for approval of costs in excess of maximum per diem rates in accordance with the procedures contained in FAR 31.205-46(a)(3) must be submitted to the COR and the Contracting Officer for final approval prior to commencement of travel.

Video crew will fly in economy class and will pay for two bags per person. Flights originating from the Washington, DC area will be reimbursed. Any video crew member working in another State will have to pay out of pocket to fly to the departure airport to fly with the OEA project manager. The Government will pay for equipment baggage. The Government (OEA project manager) will rent required vehicle for travel location transportation.

GOVERNMENT FURNISHED PROPERTY: The Government will provide the SxS cards for the contractor’s use in capturing data.

INSPECTION AND ACCEPTANCE:

Supplies/services indicated in CLINS 0001 and 0002, shall be inspected/accepted by the OEA Project Manager is responsible for all inspection and acceptance of work performed under contract upon award.

ADDENDUM TO FAR 52.212-1

Provision at 52.212-1, Instructions to Quoters—Commercial, applies to this acquisition. Note below that an addenda to the provision 52.212-1(b) has been incorporated to solicitation HQ003414T0200.

Quotes shall be submitted to Tashona Beale at tashona.n.beale.civ@mail.mil by Thursday, September 18, 2014 at 8:00 am (EST). Quoters shall submit their quotes electronically only.

All responses to solicitation HQ003414T0200 identify the Quoter’s agreement with all terms, conditions, and provisions included in this solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

a. Text – Text shall be at least single-spaced, on 8½ x 11 inch paper, with a minimum one-inch margin all around. Pages shall be numbered consecutively. Pages submitted in excess of the page limitations stated throughout this document will be removed and not evaluated.

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b. Font Size – Print shall be of minimum 12 point font size spacing. Bolding, underlining, and italics may be used to identify topic demarcations or points of emphasis. Graphic presentations, including tables, while not subject to the same font size and spacing requirements, shall have spacing and text that is easily readable.

c. Cover sheets – The cover sheet shall include the solicitation number, date of submittal, acknowledgement of any amendments, the Quoter’s name, address, Taxpayer ID number, CAGE code, and the Quoter’s POC name, phone, and email. The cover sheet shall not count against any page limitation.

Volume I

Factor 1 Past Performance (2 page limit per summary)

(a) Relevant Project Summaries. The Quoter shall identify up to three (3) recent (within the last two years) and most relevant projects performed (completed or ongoing) of similar service/support efforts, complexity, dollar value, contract type, and other comparable attributes to the requirements within solicitation HQ003414T0200. If the Vendor has less than three relevant projects, the Vendor shall submit as many projects as it has.

(b) The Quoter shall initiate the Past Performance Questionnaires for each of the projects used above. The Quoter shall complete blocks 1 through 7 on the form. The Quoter shall request that the company or customer representative most knowledgeable of the project complete blocks 8 through 10 on the form and that they submit the Past Performance Questionnaires directly to the WHS/AD POC identified on the form no later than the quote due date. Vendors are responsible for ensuring that the telephone numbers provided for the owner’s representative indicated on each Relevant Project Summary are accurate and that the representative is aware that the WHS/AD may be contacting them regarding the questionnaire and the Quoters’ past performance. Quoters are also reminded that it is their responsibility to ensure the Questionnaires are properly received by the due date of the quote. Past Performance Questionnaires that are submitted late may not be considered.

Volume II Factor 2 - Price (No page limitation) Quoters shall provide a firm-fixed-price quote for the specified period of performance. The Vendor’s price quote shall identify the number of hours and hourly rates for each labor category, and any equipment required to perform the SOW.

52.212-2 EVALUATION--COMMERCIAL ITEMS (JAN 1999)

(a) The Government will award a contract resulting from this solicitation to the responsible quoter whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered.

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This acquisition will utilize the best value trade-off methodology to make an integrated assessment for a best value award decision. The evaluation factors are past performance and price. Past performance is significantly more important than price. The Government intends to make an award without revisions. Award will be made to the responsible quoter whose quotation provides the best value to the Government.

Factor 1. Past Performance

The relevancy and quality of each past performance reference and assign an overall confidence rating to the body of past performance information reviewed:

Relevancy: Relevancy is a measure of the extent of similarity between the instant requirement in terms of scope (types of tasks), magnitude (dollar value), and complexity. Past performance with established production knowledge of the Department of Defense; familiarity with the base realignment and closure process;

compatible land use issues; Defense industry adjustment and economic development and/or previous OEA production experience will be considered more favorable to the Government.

Quality: The quality of past performance is determined by how well the quoter satisfied their customer’s needs in terms of schedule, performance requirements, resource management, and general customer satisfaction. The quality of an offeror’s past will be evaluated for each past performance questionaire or other source of information that may be consulted.

The Government reserves the right to evaluate past performance other than those submitted by the quoter. Quoters with no relevant past performance will not be rated favorably or unfavorably but will receive a nuetral rating.

Past Performance Questionnaire Adjectival Rating

i. Outstanding: Performance meets contractual requirements and exceeds many to the

Customer's benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

ii. Excellent: Performance meets contractual requirements and exceeds some to the customer's benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

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iii. Acceptable: Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

iv. Marginal: Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified or taken satisfactory corrective action.

v. Unacceptable: Performance does not meet most contractual requirements and recovery did not occur or is not likely to occur in a timely manner. The element being assessed contains a serious problem(s) for which the contractor's corrective action appears or was ineffective.

vi. Not Observed: Does not apply to the acquisition.

Past Performance Composite Adjectival Ratings

i. High: A combination of relevant prime and subcontractor past performance references that provides the Government with a high level of confidence of successful contract performance. The Government must have two or more ratings of exceptional, good, or satisfactory to support a high rating.

ii. Moderate: A combination of relevant prime and subcontractor past performance references that provides the Government with a moderate level of confidence of successful contract performance.

iii. Low: A combination of relevant prime and subcontractor past performance references that provides the Government with a low level of confidence of successful contract performance or prime contractor marginal OUSD(I) reference.

iv. Neutral: The quoter has no record of past performance or for whom information on past performance is not available. The quoter is not evaluated either favorably or unfavorably on past performance.

Factor 2. Price

Price: The price will be evaluated to determine if it is reasonable. Quoter shall provide pricing for CLINs 0001-0002 contained herein.

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DEFINITIONS AND ACRONYMS

DEFINITIONS:

CONTRACTOR. The term as used in this contract refers to the prime.

CONTRACTING OFFICER. A person with authority to enter into, administer, or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S.

Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations.

This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

ACRONYMS:

ACOR Alternate Contracting Officer's Representative AR Army Regulation CFR Code of Federal Regulations CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer Representative COTR Contracting Officer's Technical Representative

THE FOLLOWING CLAUSES SHALL APPLY TO THIS SOLICITATION:

FAR 52.252-2 Clauses Incorporated by Reference.

CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://farsite.hill.af.mil/ http://www.acquisition.gov/far/

(End of clause)

FAR 52.211-6 Brand Name or Equal, (Aug 1999) FAR 52.212-4 Contract Terms and Conditions-Commercial Items FAR 52.253-1 Computer Generated Forms.

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DFARS 222.17 Combating Trafficking in Persons.

DFARS 252.211-7003 Item Identification and Validation, DFARS 252.225-7002 Qualifying Country Sources as Subcontractors DFARS 252.232-7003 Electronic Submission of Payment Requests DFARS 252.247-7023 (Alt III) Transportation of Supplies by Sea.

Local Clause 8852.204-7400 MANDATORY CONTRACTOR MANPOWER

REPORTING (FEB 2013)

The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address: http://www.ecmra.mil/ <http://www.ecmra.mil/>.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year, beginning with 2013. Contractors may direct technical questions to the help desk at: http://www.ecmra.mil <http://www.ecmra.mil>.

[Reference: DPAP memorandum of 28 November 2012, “Enterprise-wide Contractor Manpower Reporting Application.”]

(End of provision)

252.209-7993 REPRESENTATION BY CORPORATIONS REGARDING AN UNPAID

DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY

FEDERAL LAW—FISCAL YEAR 2014 APPROPRIATIONS (DEVIATION 2014-

OO0009) (FEB 2014)

(a) In accordance with sections 8113 and 8114 of the Department of Defense Appropriations Act, 2014, and sections 414 and 415 of the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2014 (Public Law 113-76, Divisions C and J), none of the funds made available by those divisions (including Military Construction funds) may be used to enter into a contract with any corporation that—

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless the agency has considered suspension or debarment of the corporation and made a determination that this further action is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless the http://www.ecmra.mil/ http://www.ecmra.mil/ http://www.ecmra.mil/ http://www.ecmra.mil/

pg. 10 agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Quoter represents that—

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability,

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

52.212-3 -- Offeror Representations and Certifications -- Commercial Items.

Offeror Representations and Certifications -- Commercial Items (May 2014)

An offeror shall complete only paragraphs (b) of this provision if the offeror has completed the annual representations and certificates electronically via http://www.acquisition.gov . If an offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) website, the offeror shall complete only paragraphs (c) through (o) of this provision.

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

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“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.

http://www.acquisition.gov/

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“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—

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(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.

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(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 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 its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

“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 the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127),” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States.

(b)

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(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 SAMwebsite.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation 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 (o) 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 electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract is to 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.

https://www.acquisition.gov/

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(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)(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 for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: _________.] Each WOSB concern eligible under the WOSB Program 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, 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)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses 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

pg. 16 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) [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 SAM 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)(10)(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: ________________.]

pg. 17

(11) 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 changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and

(ii) It [_] is, [_] is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(11)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture:

__________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) 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 to the Equal Opportunity clause of this solicitation; 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 parts 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 $150,000.) 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

pg. 18 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 Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American – 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—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 -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)

pg. 19

(i) 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, Panamanian, 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--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, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”:

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

(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—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:

pg. 20

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

(2) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. 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—Free Trade Agreements—Israeli Trade Act”:

Canadian End Products:

Line Item No.:

[List as necessary]

(3) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II.

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--Free Trade Agreements--Israeli Trade Act'':

Canadian or Israeli End Products:

Line Item No.: Country of Origin:

pg. 21

(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III.

If Alternate III to the clause at 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 Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”:

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

(5) 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)(5)(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.

pg. 22

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 statute. 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;

(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) [_] Have, [_] 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.

pg. 23

(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 payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples.

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appear rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals Contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability.

This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C.

§362 (the Bankruptcy Code).

pg. 24

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(1) Listed End Product

Listed End Product: Listed Countries of Origin:

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

[_] (i) The…