SF-1449_to_HSBP1013R0033.docx.pdf

12. DISCOUNT TERMS

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS

6. SOLICITATION

ISSUE DATE

3. AWARD/EFF. DATE 5. SOLICITATION NUMBER2. CONTRACT NO. 4. ORDER NUMBER

a. NAME b. TELEPHONE NUMBER (No collect calls)7. FOR SOLICITATION

INFORMATION CALL:

SET ASIDE : % FOR:

SMALL BUSINESS

NAICS:

SIZE STANDARD:

HUBZONE SMALL

BUSINESS

11. DELIVERY FOR FOB

DESTINATION UNLESS

BLOCK IS MARKED

SEE SCHEDULE

13b. RATING

14. METHOD OF SOLICITATION

IFB RFPRFQ

15. DELIVER TO CODE 16. ADMINISTERED BY CODEDELIVERY DATE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE

TELEPHONE NO.

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS

BLOCK BELOW IS CHECKED.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS

IN OFFER.

8(A)

00/00/0000 HSBP1013R0033

Sharron White 202-344-3889 12/10/2013 1:00 PM, EDT

DHS - Customs & Border Protection

Department of Homeland Security

1300 Pennsylvania Ave, NW

Procurement Directorate - NP 1310

Washington DC 20229

621111

See Attached Delivery Schedule

03/03/2015 DHS - Customs & Border Protection Department of Homeland Security 1300 Pennsylvania Ave, NW Procurement Directorate - NP 1310 Washington DC 20229

DHS - Customs & Border Protection National Finance Center

PO Box 68908 Indianapolis IN 46268

PAGE OF PAGES1. REQUISITION NUMBERSOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12,17,23,24, & 30 0020071756 1 3

ORDER UNDER DPAS (15 CFR 700)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

UNRESTRICTED OR

13a. THIS CONTRACT IS A RATED

10/28/2013

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

24.

AMOUNT

22.

UNIT

23.

UNIT PRICE

SEE ADDENDUM

WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE

UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL BUSINESS

(EDWOSB)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

31c. DATE SIGNED

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED.

ADDENDA

ADDENDA

ARE ARE NOT ATTACHED.

ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND

RETURN

AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR

OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

29. AWARD OF CONTRACT: REF.

YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING

ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO

ITEMS:

OFFER DATED

30A. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE

SIGNED

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

STANDARD FORM 1449 (REV. 5/2011)

Prescribed by GSA - FAR (48 CFR) 53.212

$0.00

Susan Hargett-Evans

COPIES TO ISSUING OFFICE. CONTRACTOR

10 Pre-employment and Employee Med Services 1.000 AU

2 3

CONTRACT NO.: REQUISITION NUMBER AWARD/EFF. DATE

PAGE OF PAGES

ADDITIONAL INFORMATION:

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

32a. QUANTITY IN COLUMN 21 HAS BEEN

ACCEPTED AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVT. REPRESENTATIVE 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

FINALPARTIAL

36. PAYMENT 37. CHECK NUMBER

COMPLETE PARTIAL FINAL

39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41c. DATE 42b. RECEIVED AT (Location)

STANDARD FORM 1449 (REV. 5/2011) BACK

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

0020071756 00/00/0000

See attached documents:

Statement of Work

Attachment 1 - Medical Guidelines for CBP and ICE Weapon Carrying Positions Attachment 2 - Candidate Medical Examination and History Report Attachment 3 - Employee Medical Examination and History Report Attachment 4A - Border Patrol Agent Standards Attachment 4B - Customs and Border Protection Standards Attachment 4C - Agricultural Specialist Standards Attachment 4D - Aircraft Mechanic Standards Attachment 4E - Automotive Mechanic Standards Attachment 4F - Aviation Enforcement Agent Standards Attachment 4G - Aviation Maintenance Inspection Position Description Attachment 4H - Aviation Maintenance Officer Position Description Attachment 4I - Supervisory Aviation Maintenance Officer Attachment 4J - Criminal Investigator Standards Attachment 4K - Engineering Equipment Operator Physical Requirements Attachment 4L - Heavy Mobile Equipment Mechanic Standards and Physical Requirements Attachment 4M - Laborer Standards and Physical Requirements Attachment 4N - Maintenance Mechanic Standards and Physical Requirements Attachment 4O - Maintenance Worker Standards and Position Description Attachment 4P - Marine Interdiction Agent Position Description and Task List Attachment 4Q - Materials Handler Standards and Physical Requirements Attachment 4R - Motor Vehicle Operator Standards and Physical Requirments Attachment 4S - Range Officer Position Description Attachment 4T - Supervisory Air Interdiction Position Description Attachment 4U - Tools and Parts Attendant Standards and Physical Requirements Attachment 4V - Welder Physical Requirements Attachment 4W - Seized Property Specialist Attachment 4X - Investigative Program Specialist Attachment 5 - Candidate Medical Examination Rating Sheet Attachment 6 - Employee Medical Examination Rating Sheet Attachment 7 - Employee CDL Exam Request Form Attachment 8 - Employee CDL Exam Form Attachment 9 - Non-Psych Medical Consultation Attachment 10 - Non-Psych Level I Consultation Medical Qualification Template Attachment 11 - Non-Psych Consultation Medical Qualification Template Attachment 12 - Non-Psych Specialist Consultation Medical Qualification Template Attachment 13 - Non-Psych Consultation Return to Academy Template

3 3

CONTRACT NO.: REQUISITION NUMBER AWARD/EFF. DATE

PAGE OF PAGES

ADDITIONAL INFORMATION:

STANDARD FORM 1449 (REV. 5/2011) BACK

0020071756 00/00/0000

Attachment 14 - Specimen collection locations CBP map Attachment 15 - DHS Handbook for Safeguarding Sensitive Personally Identifiable Information Attachment 16 - Psychiatric Consultation Template Attachment 17 - DHS Sensitive Systems Handbook Attachment 18 - CBP Information Systems Security Policies and Procedures Attachment 19 - Med&DT export to ctr Attachment 20 - Med&DT import to ctr Attachment 21 - Sub-contracting Plan Attachment 22 - Pricing Table Attachment 23 - Pricing Worksheet Attachment 24 - Past Performance Survey Attachment 25 - Copy of Employee Count by State Attachment 26 - Candidate Historical Volume Attachment 27 - DHS Form 11000-6 Attachment 28 - 4300 ITSS