HSCG87-08-Q-643361.doc

REQUEST FOR QUOTATION (RFQ) HSCG87-08-Q-643361

UNITED STATES COAST GUARD

CIVIL ENGINEERING UNIT - JUNEAU

REQUEST FOR QUOTATIONS

PORTABLE STEAM TRAILERS

KODIAK, ALASKA

HSCG87-08-Q-643361

TO ACCESS THE STANDARD FORM (SF 1449), DOUBLE CLICK ON ABOVE ICON. AFTER OBTAINING THE SF 1449, CLOSE THE DOCUMENT AND CONTINUE SCROLLING DOWN FROM THIS POINT TO OBTAIN THE REMAINDER OF THE SOLICITATION.

YOU MUST RETURN IN HARD COPY ONE (1) COMPLETE COPY OF THE SF 1449, OFFEROR REPRESENTATIONS AND CERTIFICATIONS (PAGES 11-21 of 25) AND ALL OTHER INFORMATION REQUIRED BY THE SOLICITATION. PLEASE MAIL OR FAX YOUR QUOTE TO THE ADDRESS/FACSIMILE NUMBER LISTED IN BLOCK 9 OF SF1449. SENDER IS RESPONSIBLE FOR FAXED INFORMATION. DO NOT CALL TO INQUIRE IF YOUR QUOTE HAS BEEN RECEIVED AS THIS INFORMATION WILL NOT BE RELEASED.

NOTICE TO VENDORS

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DESCRIPTION/SPECIFICATION/WORKSTATEMENT

PART 1 - GENERAL

1.1. Provide all labor, equipment, materials, transportation, incidentals, supervision and follow-up service visits to supply two fully compliant Portable Steam Boiler Plants delivered to USCG Integrated Support Command Kodiak, Kodiak, AK 99619.

1.2. The Coast Guard is seeking quotes from qualified and experienced manufacturers or assemblers and suppliers of portable steam boiler plants. Past performance will be an evaluation factor (see EVALUATION, on page 10).

PART 2 - MATERIALS

2.1 BOILER PACKAGE

2.1.1 General:

The portable boiler steam plants shall be complete and fully operable van trailer mounted steam systems. Each steam plant shall include a Scotch Marine type steam boiler and associated controls and instrumentation, a feedwater tank system, fuel tank for the boiler and, bottom blow down system, all necessary piping and wiring, insulation, and connections to steam, and makeup water. The two portable steam plants shall be identical, composed of parts of the same manufacture, e.g. boilers, feedwater equipment, etc.

2.1.2 Boilers:

Shall be a 50 hp, steam output 1725 PPH, heating surface (minimum) 250 sq ft, three or four pass oil fired Scotch Marine type dry back refractory lined rear door fire tube steam boiler. The boilers shall be constructed and stamped per the requirements of ASME Boiler and Pressure Vessel Code Section 1, Rules for Construction of Power Boilers for 150 psig MAWP. The boilers shall be designed to have an operating pressure of 50 psig. The boilers shall have a steady state efficiency of at least 84% when fired at the maximum and minimum rated capacities, which are provided and allowed by the controls. The boilers shall comply with local, state and federal emission regulations. Boiler furnaces shall comply with combustion control safety devices conforming to ASME CSD-1, UL and Factory Mutual (FM) requirements. Burners of the rotary type are not acceptable. Programming controls shall be of the automatic recycling type and shall incorporate means for automatic self-checking of the circuit at the beginning of each start-up cycle. Include a repetitive self-checking circuit to check components at intervals not to exceed the flame failure response time specified in the referenced combustion controls requirements during the entire period of burner operation. Combustion controls shall be modulating-positioning type with a manual switch to allow the operator quickly gets the unit up to operating pressure. Boiler shall be automatic start. Boilers shall operate on 208/120/3/60 voltage. A remote emergency shutoff switch, contained in an emergency break glass box and located on the outside of the van, shall be included.

Provide water level control with modulation of feedwater control, ASME safety valve, primary low water cutoff, auxiliary low water cutoff with manual reset, operating pressure control, high limit pressure control with manual reset, modulating fuel-air controller.

When the boiler hinged doors are opened, all tubes, tubesheets and furnace surfaces shall be exposed for ease of inspection and maintenance. The rear door shall be refractory lined and have an air-cooled observation port. Tubes shall be cleanable and removable from either front or back.

2.1.3 Burner:

Oil burner shall be forced draft integral with hinged front boiler, cast aluminum blower fan, blower motor, and modulating air damper/linkage/cams, air flow switches, fuel trains, and control panel. Modulating fire with proven low fire start. Oil burner shall be of the low-pressure air atomizing type for #1 and #2 fuel oil. Burner shall have a propane pilot, pressure regulator and shut off cock. Oil train shall consist of retractable nozzle with flexible hoses, gages, manifold block, air purge valve, fuel oil controller with ten point characterized cam assembly, dual oil solenoids, temperature switch, air compressor assembly and oil pump assembly. Oil pump shall be factory mounted, piped and wired. Minimum oil turn down ratio shall be 4:1.

2.1.4 Boiler Instrumentation:

In addition to the instruments required by the boiler specifications referenced above, provide the following instruments and locate where recommended by instrument manufacturer:

a. A flue gas temperature gage.

b. A draft gage, conforming to ASME B40.1.

2.1.5 Boiler Plant Controls and Instruments:

Provide the following plant controls and instruments:

a. Gas Analyzer: Provide a flue gas analyzer, Orsat type conforming to FS A-A-50504 or an electronic analyzer that provides equivalent results. Analyzer shall determine CO2, CO, and O2 in the flue gas and shall be complete with chemicals and accessories for use in such determinations.

b. Volumetric fuel flow meter.

c. Steam pressure gage in the main steam header for indicating atomizing steam pressure and a pressure gage for indicating feedwater pressure with gages conforming to ASME B40.1.

d. Potentiometer with manual-auto switch on boiler control panel in addition to automatic firing rate controller.

2.1.6 Boiler Control and Instrument Cabinet:

Provide boiler control and instrument cabinet. Shall be UL listed NEMA 1 enclosures with key lock. Mount steam flow recorder on or adjacent to control panel. The boiler shall have annunciator lights for load demand, fuel on, low water, and flame failure. Design control panel so that all indicating and recording devices and manually operated switches shall be flush mounted in a gasketed removable top front panel with indicating and recording devices at eye-level. Design to facilitate maintenance. Access to panel enclosure shall be through gasketed double piano-hinged doors. Doors shall be reinforced to prevent sagging. Include a full width fluorescent lighting canopy also. Prime coat complete control panel and lighting canopy and finished in baked enamel. Identify flush-mounted devices on panel with engraved lamicore nameplates.

2.1.7 Control Panel Electrical and Piping:

Control panel shall be factory wired in accordance with NFPA-70. Wire shall be thermoplastic Type THW, THWN, XHHW, or UL approved. For intended use, color and number coded, and run in plastic ducts to numbered terminal blocks. Control circuits shall be separately fused with properly rated cartridge type fuses. Power leads to and from magnetic starters and contactors shall terminate at terminal blocks so that field wiring is necessary only from terminal blocks to external equipment. Control leads to and from external control devices shall terminate at separate terminal blocks from power leads. Steam and draft operated devices shall be factory piped to permanently affixed external connections. The boiler operating switch shall be dust tight sealed snap-action type. The precision switches shall have cadmium, silver or platinum contacts, wiping action type, rated at 10 amperes.

2.1.8 Integrated Boiler Control and Management System:

Boiler shall be factory equipped with a boiler control system combining a digital burner management system for flame safety, and a programmable logic controller for boiler modulation and operator interface functions. The factory pre-configured boiler control system shall integrate the burner management functions and the PLC based modulation and operator interface functions.

Major Functions provided by the Boiler Control System shall include:

· Automatic sequencing of the boiler through standby, pre-purge, pilot flame establishing period, main flame establishing period, run, flame proving and lockout and post-purge.

· Full modulation control of fuel and air.

· Utilize solid state controls and sensors to provide various control functions, such as:

· Modulation control (PID type),

· Thermal shock protection,

· High and Low limit alarms and shutdowns.

· Human machine interface with a graphical display to include:

· Manual control of the boiler firing rate to increment and decrement the firing rate,

· Display indication of burner management controller status and diagnostics,

· Display of system alarms and faults.

· System shall keep a record of history of alarms and faults and display them on demand.

· Display recommendations for troubleshooting of fault conditions,

· On screen water level indication and alarm(s).

· Stack Flue Gas, Combustion Air and Shell (water) temperature indication

· Boiler efficiency calculation

· Alarms shall be both visual and audible.

Provide all safety features required by ASME CSD-1.

Noise levels outside the van shall be minimized so as not to disturb nearby housing occupants.

2.1.9 Boiler Breeching:

Boiler breeching shall meet the requirements of NFPA 211. Provide suitable cleanouts with doors that will permit cleaning the entire breeching without dismantling. Structural materials shall comply with the applicable sections of AISC 335.

Cleanout doors: Construct of gage steel not less than that of the breeching. Provide a non-asbestos gasket between cleanout doors and frames. Plug type cleanouts are not acceptable.

2.1.10 Stacks:

Stacks shall be constructed per the requirements of NFPA-31 and NFPA 211 and shall be steel of welded construction and of proper sizes to adequately serve the boiler. Provide rain caps.

2.1.11 Steam Manifold and Steam Pressure Reducing Station:

Provide a steam manifold with all necessary valves and components that will supply both high-pressure steam (at the boiler's operating pressure) and 12 to 15 psig low-pressure steam. The low-pressure steam supply will have a PRV and all necessary valves and components. Steam connection points shall be 3" flange connection.

2.2 BLOWDOWN EQUIPMENT

Pipe the blowdown pipe 1 ½” as a boiler drain pipe through floor or wall with 3 valves, two quick-acting, and one slow-acting.

2.3 FEEDWATER EQUIPMENT

2.3.1 General:

Provide a packaged atmospheric feedwater system complete with pumps, tank, trim, and vent, and control panel sized for 50 HP boiler operating at 50 psig that can operate in the following:

100% Make-up Water (no condensate return) The system shall pre-heat the feedwater to approximately 200 degrees F.

2.3.2 Boiler Feed Pumps:

Provide duplex turbine type feed pumps. Pumps shall have cast iron casings and shall be bronze fitted. Impellers shall be bronze. Provide pressure relief protection for pumps operating in or at deadhead condition. Packed stuffing boxes or mechanical seals suitable for the design conditions shall be provided. The capacity of each pump shall not be less than 150% of maximum total boiler capacity. Pump suction side shall include gate valve and strainer. Pumps shall have inlet and outlet pressure gages.

UL listed, NEMA 1 control panel containing individual motor starters and fuse protection with individual oil-tight pump run lights.

2.4 ELECTRIC MOTORS

Motors, which are not an integral part of a packaged boiler, shall be rated for high efficiency service. Motors, which are an integral part of the packaged boiler system, shall be the highest efficiency available by the manufacturer of the packaged boiler.

2.5 Enclosure:

Sound attenuated enclosure. If exposed to weather provide a weather resistant enclosure.

2.6 Utility Power Connection:

Provide a means to use outside utility or outside generator power.

2.7 FUEL TANKS

2.7.1 Propane System:

a. General: Conform to NFPA 58 and NFPA 37. Provide all valves, piping, regulator, and appurtenances required to make this system fully functional in supplying fuel to the boiler pilot flame subsystem.

b. Propane Tanks: Provide a 10 gallon propane tank to supply the boiler pilot light. If possible mount the propane tank on the outside of the boiler plant van trailer.

2.7.2 Fuel Oil System:

a. General: Conform to the requirements of NFPA 30 and NFPA 37. Provide all valves, vents, piping, regulator, transfer pump, filters, safety valves and appurtenances required to make this system fully functional in supplying fuel to the boiler and.

b. Fuel Oil Tank: Provide a 60 gallon double wall steel fuel tank. Provide tank with level gage and makeup control valve. Include connections for inlet, outlet, overflow, vent, drain, level controller, and high and low level alarm switches. Primary tank, its outer steel tank, interstitial insulation, and exterior fiberglass coating shall be completely constructed in the manufacturer's factory.

(1) Primary Tank and Outer Steel Tank: Listed under UL 142. Shall be incompliance with NFPA 30. Warranted for minimum of 20 years by manufacturer.

(2) Interstitial Insulation: Insulation is bounded by primary and outer steel tanks. Shall encase and protect the primary tank. Shall provide a two hour fire rating.

(3) Level Alarm Switches: Provide tank top mounted or external float cage, single-pole, single-throw type designed for use on fuel oil tanks. Arrange high level alarm switches to close on rise of liquid level, and low level alarm switches to close on fall of liquid level. Contacts suitable for starting battery.

(4) Tank Gages: Provide tank gage. Gage shall be buoyant force type, with dial indicator not less than 4 inches in sized and arranged for side mounting. Gage calibrated to read from empty to full with intermediate points of ¼, ½ and ¾.

(5) Spill and Overfill Protection: Provide an UL listed 7 gallon spill/overfill container manufactured as an integral part of the primary tank, surrounding the fill tub and protected by the two hour fire rating of the encasement. Container shall have a stick port and normally closed valve to release spilled fluid into the primary tank.

(6) Overspill Protection: Provide audible and visible high level alarm.

(7) Anti-spill Valves: Where product piping extends below the top of the primary tank, piping shall include shutoff valve and a normally closed safety valve; Safety valve shall be an approved anti-siphon valve or an electric solenoid valve.

(8) Manifolding Fuel Tanks: Provide a manifold and connection point with necessary valves and components so that an additional fuel oil tank can be connected to the system from outside of the trailer.

2.8 TRAILER

2.8.1 General:

Shall provide a new freestanding 17' inside trailer. The trailer shall be constructed of corrosion resistant material to withstand the salt air environment on Kodiak Island. The trailer shall include diamond plate flooring, overhead lights, maintenance and tool electrical outlets throughout, rear and side access doors, stairs, and electric unit space heater. The unit space heater shall be 240/3/60, intended to keep the trailer a minimum of 45F year round in Kodiak, and shall be designed to run from an exterior source of power 208/120/3/60 (not Genset).

2.8.2 Noise:

The trailer shall have acoustical insulation to minimize noise levels exterior to the trailer. The proposal shall provide a detailed technical description how this will be accomplished (not to exceed 80 dpA at high firing rate).

2.8.3 Flexible Hose Connection:

Two forty foot sections of 1 ½” inch flexible steam hose shall be provided for connections between the Portable Steam Plant and the emergency connection. Hose and connections shall be rated for the design operating pressure. Ends of hose shall be 1 1/2-inch NPT. The hoses shall be stored on a reel attached to the trailer.

2.8.4 Utility Connections:

a. Water: Provide a 40-foot hose for connection to a potable water supply. The hose shall be provided. This hose shall be stowed on a reel in the trailer. Provide hose connections.

2.9 SERVICE & PARTS MANUALS

2.9.1 General:

Shall provide three (3) copies of service and parts manual. Manuals shall include cut-away views of all equipment, schematics including fuel trains, instructions for maintenance and inspections, a comprehensive preventive maintenance schedule, troubleshooting procedures, and a complete list of parts for all equipment installed.

PART 3 - INSTALLATIONS

3.1 General:

All the above equipment shall be installed/secured in the van trailer, to provide a fully functioning portable steam plant. Equipment shall be installed in a modular fashion with the various modules on skids so that whole modules can selectively be removed and replaced using forklifts via the trailer end and side access doors without moving the other modules. Sufficient room shall be provided in the van so that the plant operating personnel can perform their functions and light maintenance work with the access doors closed. The system shall be designed for ease of operation.

PART 4 - START UP AND TESTING

4.1 General:

After the Portable Steam Plant is completed the unit shall be shop-tested.

4.2 Startup:

Start up shall include equipment inspection, setting combustion and emissions, and checking all operating and safety circuits including fuel, flame safeguard, LWCO, ALWCO, air flow and limit circuits. Start up shall include balancing.

4.3 Testing:

Testing shall include written reports on boiler firing rate, turndown, efficiency, motor amperage, O2, CO, NOX levels, flue gas temperature, ambient temperature, and all control settings. This shall include hydro testing of the boiler, steam line and feedwater piping. Boil-out will be done. Each piece of equipment shall be tested for proper operation. Then the system shall be tested, to include setting combustion throughout the firing range.

PART 5 - FIELD SERVICE IN KODIAK, AK

5.1 General:

Shall field inspect delivered steam plants, make repairs if necessary, and provide two four hour on-site training sessions for operation of Portable Steam Plant to include, actual startup, operation, maintenance, troubleshooting, and shutdown.

5.2 Follow-up Visit:

Shall provide a one (1) day follow-up visit to Kodiak 30 to 60 days after delivery to ensure that Portable Steam Plant is fully operational and contract compliant.

PART 6 - INVOICING REQUIREMENTS

6.1 Invoices shall be submitted for payment to the designated billing office identified below:

Original plus one copy to:

Contracting Officer (ko)

Civil Engineering Unit, Juneau

P. O. Box 21747

Juneau, Alaska 99802-1747

6.2 Prior to submission of invoice, contractor is required to review billing statements with designated inspector or Contracting Officer Representative to establish advance agreement on invoicing amounts.

6.3 Invoices must identify contractor’s tax identification number.

PART 7 - CONTRACT ADMINISTRATION

7.1 This contract will be administered by the Contracting Officer located at U.S. Coast Guard Civil Engineering Unit, P. O. Box 21747, Juneau, Alaska 99802-1747, telephone number 907-463-2418. All matters related to the performance of this contract shall be coordinated through the Contracting Officer.

7.2 All correspondence, unless otherwise specified, shall be directed to the address shown in 5.1. DUE TO INCREASED SECURITY CONCERNS, ALL CORRESPONDENCE MUST INCLUDE THE SENDER’S RETURN ADDRESS.

TIME OF DELIVERY (FAR 52.211-8) (JUNE 1997)

(a) The Government requires delivery to be made according to the following schedule:

Required Delivery Schedule

Delivery to Air Station Kodiak, Alaska

The Government will evaluate equally, as regards time of delivery, offers that propose delivery of each quantity within the applicable delivery period specified above. Offers that propose delivery that will not clearly fall within the applicable required delivery period specified above, will be considered nonresponsive and rejected. The Government reserves the right to award under either the required delivery schedule or the proposed delivery schedule, when an offeror offers an earlier delivery schedule than required above. If the offeror proposes no other delivery schedule, the required delivery schedule above will apply.

Offeror's Proposed Delivery Schedule

(b) Attention is directed to the Contract Award provision of the solicitation that provides that a written award or acceptance of offer mailed, or otherwise furnished to the successful offeror, results in a binding contract. The Government will mail or otherwise furnish to the offeror an award or notice of award not later than the day award is dated. Therefore, the offeror should compute the time available for performance beginning with the actual date of award, rather than the date the written notice of award is received from the Contracting Officer through the ordinary mails. However, the Government will evaluate an offer that proposes delivery based on the Contractor's date of receipt of the contract or notice of award by adding (1) five calendar days for delivery of the award through the ordinary mails, or (2) one working day if the solicitation states that the contract or notice of award will be transmitted electronically. (The term "working day" excludes weekends and U.S. Federal holidays.) If, as so computed, the offered delivery date is later than the required delivery date, the offer will be considered nonresponsive and rejected.

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

(a) Quotes are considered to be for informational purposes and are not “offers” that can be accepted to create a binding contract. The Government may reject any or all quotes without obligation. Quote information will not be released. If a contract is awarded, only the vendor information and awarded price will be made public.

(b) The Government may FORMDROPDOWN a contract resulting from this solicitation to the responsible FORMDROPDOWN whose FORMDROPDOWN conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors will be used to evaluate FORMDROPDOWN

(1) PRICE AND PRICE-RELATED FACTORS

(2) TECHNICAL FEATURES AND CHARACTERISTICS OF THE PRODUCT OFFERED (Quoter is required to submit product literature with quote for the item offered to meet the Government requirements)

(3) PAST PERFORMANCE OF THE VENDOR IN MANUFACTURING/ ASSEMBLING AND SUPPLYING PORTABLE BOILER STEAM PLANTS in terms of quality of product offered, adherence to delivery schedules and terms, customer service and effectiveness of management.

Technical Features/Past Performance when combined are approximately equal in importance to Price & price related factors. Technical Features and Past Performance are approximately equal in importance.

OFFEROR REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL ITEMS (FAR 52.212-3) (MAY 2008) ALTERNATE I (APR 2002), ALTERNATE II (OCT 2000)

An offeror shall complete only paragraph (l) 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 (k) 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.

"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.

"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 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 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.

(b) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to a central contractor registration database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (b)(3) through (b)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS).

(2) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN.

(3) Taxpayer Identification Number (TIN).

FORMCHECKBOX

TIN: _____________________.

FORMCHECKBOX

TIN has been applied for.

FORMCHECKBOX

TIN is not required because:

FORMCHECKBOX

Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

FORMCHECKBOX

Offeror is an agency or instrumentality of a foreign government;

FORMCHECKBOX

Offeror is an agency or instrumentality of the Federal Government.

(4) Type of organization.

FORMCHECKBOX

Sole proprietorship;

FORMCHECKBOX

Partnership;

FORMCHECKBOX

Corporate entity (not tax-exempt);

FORMCHECKBOX

Corporate entity (tax-exempt);

FORMCHECKBOX

Government entity (Federal, State, or local);

FORMCHECKBOX

Foreign government;

FORMCHECKBOX

International organization per 26 CFR 1.60494;

FORMCHECKBOX

Other _________________________.

(5) Common parent.

FORMCHECKBOX

Offeror is not owned or controlled by a common parent;

FORMCHECKBOX

Name and TIN of common parent:

Name ___________________.

TIN _____________________.

(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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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):

(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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX has, FORMCHECKBOX 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) FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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 FORMCHECKBOX is, FORMCHECKBOX 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.

(d) Representations required to implement provisions of Executive Order 11246-

(1) Previous contracts and compliance. The offeror represents that-

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

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

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

(i) It FORMCHECKBOX has developed and has on file, FORMCHECKBOX 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 FORMCHECKBOX 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 Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act-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 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. The terms “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American Act—Supplies.”

(2) Foreign End Products:

[List as necessary]

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

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

(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 the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian or Moroccan end product,” “component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade Agreement Country,” “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 or Moroccan 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 or Moroccan 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) of 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.

Other Foreign End Products:

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

(2) Buy American Act--Free Trade Agreements--Israeli Trade Act Certificate, Alternate I. 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.

(3) Buy American Act--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 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-

(1) The offeror and/or any of its principals FORMCHECKBOX are, FORMCHECKBOX are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; and

(2) FORMCHECKBOX

Have, FORMCHECKBOX 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 offerors; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property; and

(3) FORMCHECKBOX

are, FORMCHECKBOX are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses.

(4) FORMCHECKBOX

Have, FORMCHECKBOX 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 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 appeal 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).

(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 products.

(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.]

FORMCHECKBOX

(i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

FORMCHECKBOX

(ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) FORMCHECKBOX

In the United States. (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) FORMCHECKBOX

Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.]

FORMCHECKBOX

(1) Maintenance, calibration, or repair…