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AFFIDAVIT OF INDIVIDUAL SURETY

(See instructions on reverse)

STATE OF

COUNTY OF

SS.

I, the undersigned, being duly sworn, depose and say that I am: (1) the surety to the attached bond(s); (2) a citizen of the United States; and of full age and legally competent. I also depose and say that, concerning any stocks or bonds included in the assets listed below, that there are no restrictions on the resale of these securities pursuant to the registration provisions of Section 5 of the Securities Act of 1933. I recognize that statements contained herein concern a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious or fraudulent statement may render the maker subject to prosecution under Title 18, United States Code Sections 1001 and 494. This affidavit is made to induce the United States of America to accept me as surety on the attached bond.

1. NAME (First, Middle, Last) (Type or Print) 2. HOME ADDRESS (Number, Street, City, State, ZIP Code)

3. TYPE AND DURATION OF OCCUPATION 4. NAME AND ADDRESS OF EMPLOYER (If Self-employed, so State)

5. NAME AND ADDRESS OF INDIVIDUAL SURETY BROKER USED

(Number, Street, City, State, ZIP Code)

6. TELEPHONE NUMBER

HOME -

BUSINESS -

7. THE FOLLOWING IS A TRUE REPRESENTATION OF THE ASSETS I HAVE PLEDGED TO THE UNITED STATES IN SUPPORT OF THE ATTACHED BOND:

(a) Real estate (Include a legal description, street address and other identifying description; the market value; attach supporting certified documents including recorded lien; evidence of title and the current tax assessment of the property. For market value approach, also provide a current appraisal.)

(b) Assets other than real estate (describe the assets, the details of the escrow account, and attach certified evidence thereof).

8. IDENTIFY ALL MORTGAGES, LIENS, JUDGEMENTS, OR ANY OTHER ENCUMBRANCES INVOLVING SUBJECT ASSETS INCLUDING REAL ESTATE TAXES DUE AND

PAYABLE.

9. IDENTIFY ALL BONDS, INCLUDING BID GUARANTEES, FOR WHICH THE SUBJECT ASSETS HAVE BEEN PLEDGED WITHIN 3 YEARS PRIOR TO THE DATE OF

EXECUTION OF THIS AFFIDAVIT.

DOCUMENTATION OF THE PLEDGED ASSET MUST BE ATTACHED.

10. SIGNATURE 11. BOND AND CONTRACT TO WHICH THIS AFFIDAVIT RELATES (Where Appropriate)

12. SUBSCRIBED AND SWORN TO BEFORE ME AS FOLLOWS:

a. DATE OATH ADMINISTERED

MONTH DAY YEAR

b. CITY AND STATE (Or other jurisdiction)

Official Sealc. NAME AND TITLE OF OFFICIAL ADMINISTERING OATH

(Type or print)

d. SIGNATURE e. MY COMMISSION

EXPIRES

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is not usable

STANDARD FORM 28 (REV. 6/2003)

Prescribed by GSA-FAR (48 CFR) 53.228(e)

Public reporting burden for this collection of information is estimated to average 0.4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Regulatory Secretariat (VPR), Office of Acquisition Policy, GSA, Washington, DC 20405.

OMB Number: 9000-0001 Expiration Date: 11/30/2014

INSTRUCTIONS

1. Individual sureties on bonds executed in connection with Government contracts must complete and submit this form with the bond. (See 48 CFR 28.203, 53.228(e).) The surety must have the completed form notarized.

2. No corporation, partnership, or other unincorporated association or firm, as such, is acceptable as an individual surety. Likewise, members of a partnership are not acceptable as sureties on bonds that a partnership or an association, or any co-partner or member thereof, is the principal obligor. However, stockholders of corporate principals are acceptable provided (a) their qualifications are independent of their stockholdings or financial interest therein, and (b) that the fact is expressed in the affidavit of justification. An individual surety will not include any financial interest in assets connected with the principal on the bond that this affidavit supports.

3. United States citizenship is a requirement for individual sureties for contracts and bonds when the contract is awarded in the United States. However, when the Contracting Officer is located in an outlying area or a foreign country, the individual surety is only required to be a permanent resident of the area or country in which the contracting officer is located.

4. All signatures of the affidavit submitted must be originals. Affidavits bearing reproduced signatures are not acceptable. An authorized person must sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of a firm, partnership, or joint venture, or an officer of the corporation involved.

STANDARD FORM 28 (REV. 6/2003) BACK

AFFIDAVIT OF INDIVIDUAL SURETY

(See instructions on reverse)

STATE OF

COUNTY OF

SS.

I, the undersigned, being duly sworn, depose and say that I am: (1) the surety to the attached bond(s); (2) a citizen of the United States; and of full age and legally competent. I also depose and say that, concerning any stocks or bonds included in the assets listed below, that there are no restrictions on the resale of these securities pursuant to the registration provisions of Section 5 of the Securities Act of 1933. I recognize that statements contained herein concern a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious or fraudulent statement may render the maker subject to prosecution under Title 18, United States Code Sections 1001 and 494. This affidavit is made to induce the United States of America to accept me as surety on the attached bond.

1. NAME (First, Middle, Last) (Type or Print)

2. HOME ADDRESS (Number, Street, City, State, ZIP Code)

3. TYPE AND DURATION OF OCCUPATION

4. NAME AND ADDRESS OF EMPLOYER (If Self-employed, so State)

5. NAME AND ADDRESS OF INDIVIDUAL SURETY BROKER USED

(Number, Street, City, State, ZIP Code)

6. TELEPHONE NUMBER

HOME -

BUSINESS -

7. THE FOLLOWING IS A TRUE REPRESENTATION OF THE ASSETS I HAVE PLEDGED TO THE UNITED STATES IN SUPPORT OF THE ATTACHED BOND:

(a) Real estate (Include a legal description, street address and other identifying description; the market value; attach supporting certified documents including recorded lien; evidence of title and the current tax assessment of the property. For market value approach, also provide a current appraisal.)

(b) Assets other than real estate (describe the assets, the details of the escrow account, and attach certified evidence thereof).

8. IDENTIFY ALL MORTGAGES, LIENS, JUDGEMENTS, OR ANY OTHER ENCUMBRANCES INVOLVING SUBJECT ASSETS INCLUDING REAL ESTATE TAXES DUE AND PAYABLE.

9. IDENTIFY ALL BONDS, INCLUDING BID GUARANTEES, FOR WHICH THE SUBJECT ASSETS HAVE BEEN PLEDGED WITHIN 3 YEARS PRIOR TO THE DATE OF EXECUTION OF THIS AFFIDAVIT.

DOCUMENTATION OF THE PLEDGED ASSET MUST BE ATTACHED.

10. SIGNATURE

11. BOND AND CONTRACT TO WHICH THIS AFFIDAVIT RELATES (Where Appropriate)

12. SUBSCRIBED AND SWORN TO BEFORE ME AS FOLLOWS:

a. DATE OATH ADMINISTERED

MONTH

DAY

YEAR

b. CITY AND STATE (Or other jurisdiction)

Official Seal

c. NAME AND TITLE OF OFFICIAL ADMINISTERING OATH (Type or print)

d. SIGNATURE

e. MY COMMISSION EXPIRES

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is not usable

STANDARD FORM 28 (REV. 6/2003) Prescribed by GSA-FAR (48 CFR) 53.228(e)

Public reporting burden for this collection of information is estimated to average 0.4 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Regulatory Secretariat (VPR), Office of Acquisition Policy, GSA, Washington, DC 20405.

OMB Number: 9000-0001

Expiration Date: 11/30/2014

INSTRUCTIONS

1. Individual sureties on bonds executed in connection with Government contracts must complete and submit this form with the bond. (See 48 CFR 28.203, 53.228(e).) The surety must have the completed form notarized.

2. No corporation, partnership, or other unincorporated association or firm, as such, is acceptable as an individual surety. Likewise, members of a partnership are not acceptable as sureties on bonds that a partnership or an association, or any co-partner or member thereof, is the principal obligor. However, stockholders of corporate principals are acceptable provided (a) their qualifications are independent of their stockholdings or financial interest therein, and (b) that the fact is expressed in the affidavit of justification. An individual surety will not include any financial interest in assets connected with the principal on the bond that this affidavit supports.

3. United States citizenship is a requirement for individual sureties for contracts and bonds when the contract is awarded in the United States. However, when the Contracting Officer is located in an outlying area or a foreign country, the individual surety is only required to be a permanent resident of the area or country in which the contracting officer is located.

4. All signatures of the affidavit submitted must be originals. Affidavits bearing reproduced signatures are not acceptable. An authorized person must sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of a firm, partnership, or joint venture, or an officer of the corporation involved.

STANDARD FORM 28 (REV. 6/2003) BACK

8.2.1.3144.1.471865.466429

STATE OF:

COUNTY OF:

SS.:

1. NAME (First, Middle, Last) (Type or Print):

2. HOME ADDRESS (Number, Street, City, State, ZIP Code) :

3. TYPE AND DURATION OF OCCUPATION:

4. NAME AND ADDRESS OF EMPLOYER (If Self-employed, so State) :

5. NAME AND ADDRESS OF INDIVIDUAL SURETY BROKER USED (Number, Street, City, State, ZIP Code):

6. HOME TELEPHONE NUMBER:

6. BUSINESS TELEPHONE NUMBER:

7. THE FOLLOWING IS A TRUE REPRESENTATION OF THE ASSETS I HAVE PLEDGED TO THE UNITED STATES IN SUPPORT OF THE ATTACHED BOND:

(a) Real estate (Include a legal description, street address and other identifying description; the market value; attach supporting certified documents including recorded lien; evidence of title and the current tax assessment of the property. For market value approach, also provide a current appraisal.):

(b) Assets other than real estate (describe the assets, the details of the escrow account, and attach certified evidence thereof).:

8. IDENTIFY ALL MORTGAGES, LIENS, JUDGEMENTS, OR ANY OTHER ENCUMBRANCES INVOLVING SUBJECT ASSETS INCLUDING REAL ESTATE TAXES DUE AND PAYABLE.:

9 Identify All Bonds Including Bid Guarantees For Which the Subject Assets Have Been Pledged Within 3 Years Prior to the Date of Execution of This Affidavit:

11. BOND AND CONTRACT TO WHICH THIS AFFIDAVIT RELATES (Where Appropriate) :

12. b. CITY AND STATE (Or other jurisdiction):

12. c. NAME AND TITLE OF OFFICIAL ADMINISTERING OATH (Type or print):

10. DIGITAL SIGNATURE:

10. SIGNATURE. This is a protected field.:

12. d. SIGNATURE. This is a protected field.:

12. d. DIGITAL SIGNATURE:

e. MY COMMISSION EXPIRES. DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

12. a. DATE OATH ADMINISTERED. Enter 2 digit month, 2 digit day and 4 digit year.:

Section J Attachment 14

REQUIRED FORMAT FOR IREVOCABLE LETTER OF CREDIT

(As stated in FAR 52.228-14 and prescribed in FAR 28.204-4)

(Issuing Financial Institution’s Letterhead or Name and Address)

Issue Date __________________, 20_____

IRREVOCABLE LETTER OF CREDIT NO. _____________________

Account party’s name __________________________________________________

Account party’s address __________________________________________________

For Solicitation No. __________________________________________________

TO: (U.S. Government Agency) (U.S. Government Agency’s address)

1. We hereby establish this irrevocable and transferable Letter of Credit in your favor for one or more drawings up to United States $___________________. This Letter of Credit is payable at (issuing financial institution’s and, if any, confirming financial institution’s) office at (issuing financial institution’s address and, if any, confirming financial institution’s address) and expires with our close of business on ________________, Or any automatically extended expiration date.

2. We hereby undertake to honor your or the transferee’s sight draft (s) drawn on the issuing or, if any, the confirming financial institution, for all or any part of this credit if presented with this Letter of Credit and confirmation, if any, at the office specified in paragraph 1 of this Letter of Credit on or before the expiration date or any automatically extended expiration date.

3. (This paragraph is omitted if used as a bid guarantee, and subsequent paragraphs are renumbered.) It is a condition of this Letter of Credit that it is deemed to be automatically extended without amendment for one year from the expiration date hereof, or any future expiration date, unless at least sixty (60) days prior to any such expiration date, we notify you or the transferee by registered mail, or other receipted means of delivery, that we elect not to consider this Letter of Credit renewed for any such additional period. At the time we notify you, we also agree to notify the account party (and confirming financial institution, if any) by the same means of delivery.

4. This Letter of Credit is transferable. Transfers and assignments of proceeds are to be effected without charge to either the beneficiary or the transferree/assignee of proceeds. Such transfer or assignment shall be only at the written direction of the Government (the beneficiary) in a form satisfactory to the issuing financial institution and the confirming financial institution, if any.

5. This Letter of Credit is subject to the Uniform Customs and Practice (UCP) for Documentary Credits, 1993 Revision, International Chamber of Commerce Publication No. 500, and to the extent not inconsistent therewith, to the laws of ________________ (state of confirming financial institution, if any, otherwise state of issuing financial institution).

6. If this confirmation expires during an interruption of business of this financial institution as described in Article 17 of the UCP, the financial institution specifically agrees to effect payment if this credit is drawn against within 30 days after the resumption of our business.

Sincerely, (Confirming financial institution)

Section J Attachment 15

REQUIRED FORMAT FOR FINANCIAL INSTITUTION TO CONFIRM AN

IREVOCABLE LETTER OF CREDIT

(As stated in FAR 28-14 and prescribed in FAR 28.204-4)

__________________, 20_____

Our Letter of Credit Advice Number _____________________

Beneficiary: _________________________________________ (U.S. Government agency)

Issuing Financial Institution __________________________________________________

Issuing Financial Institution’s Letter of Credit No.: ________________________________

Gentlemen:

1. We hereby confirm the above indicated Letter of Credit, the original of which is attached, issued by _______________________________ (name of issuing financial institution) for drawings of up to United States dollars _________________/U.S. $___________________ and expiring with our close of business on _________________ (the expiration date), or any automatically extended expiration date.

2. Draft(s) drawn under the Letter of Credit and this Confirmation are payable at our office located at

3. We hereby undertake to honor sight draft(s) drawn under and presented with the Letter of Credit and this Confirmation at our offices as specified herein.

4. (This paragraph is omitted if used as a bid guarantee, and subsequent paragraphs are renumbered.) It is a condition of this confirmation that it be deemed automatically extended without amendment for one year from the expiration date hereof, or any automatically extended expiration date, unless:

(a) At least sixty (60) days prior to any such expiration date, we shall notify the Contracting Officer, or the transferee and the issuing financial institution, by registered mail or other receipted means of delivery, that we elect not to consider this confirmation extended for any such additional period; or

(b) The issuing financial institution shall have exercised its right to notify you or the transferee, the account party, and ourselves, of its election not to extend the expiration date of the Letter of Credit.

5. This confirmation is subject to the Uniform Customs and Practice (UCP) for Documentary Credits, 1993 Revision, International Chamber of Commerce Publication No. 500, and to the extent not inconsistent therewith, to the laws of ________________ (state of confirming financial institution).

6. If this confirmation expires during an interruption of business of this financial institution as described in Article 17 of the UCP, we specifically agree to effect payment if this credit is drawn against within 30 days after the resumption of our business.

Sincerely, (Confirming financial institution)

Attachment 17

DEPARTMENT OF HOMELAND SECURITY

SMALL, SMALL DISADVANTAGED, WOMEN-OWNED SMALL, HUBZone SMALL, VETERAN-OWNED

SMALL BUSINESS, & SERVICE DISABLED VETERAN OWNED

SMALL BUSINESS CONCERNS SUBCONTRACTING PLAN OUTLINE

Solicitation HSFLBP-14-R-00001

The following outline meets the minimum requirements of Public Law 95-507 and the Federal Acquisition Regulation (FAR) Subparts 19.7. It is intended to be a guideline. It is not intended to replace any existing corporate plan which is more extensive. If assistance is needed to locate small business sources, please contact the Operational Small Business Specialist. Please note that the

Department of Homeland Security Organizational Elements have subcontracting goals of 45% for small business, 5% for small disadvantaged business, 5% for women-owned small business, 3% for HUBZONE small business, and 3% for Service

Disabled Veteran-Owned small business concerns for fiscal year 2014. For this procurement, the Department of Homeland Security expects all proposed subcontracting plans to be expressed as percentages of the total available subcontracting dollars.

Identification Data:

Company Name:__________________________________________________

Address:_______________________________________________________

Date Prepared:_____________Solicitation Number:________________

Item/Service:__________________________________________________

Place of Performance:__________________________________________

1. TYPE OF PLAN: (Check only one).

_ INDIVIDUAL PLAN: In this type of plan all elements are developed specifically for this contract and are applicable for the full term of this contract.

_ MASTER PLAN: In this type of plan, goals are developed for this contract; all other elements are standard. The master plan must be approved every three (3) years. Once incorporated into a contract with specific goals, it is valid for the life of the contract.

COMMERCIAL PLAN: This type of plan is used when the contractor sells products and services customarily used for non-government purposes. Plan/goals are negotiated with the initial agency on a company-wide basis rather than for individual contracts. The plan is effective only during year approved. The contractor must provide a copy of the initial agency approval, AND MUST SUBMIT AN

ANNUAL SF 295 TO DHS WITH A BREAKOUT OF SUBCONTRACTING PRORATED

FOR DHS (WITH An Organizational Element BREAKDOWN, IF POSSIBLE).

2. GOALS:

FAR 19.704(a)(1) requires separate dollar and percentage goals for using small business concerns, small disadvantaged business concerns, women-owned small business, HUBZone small business concerns, veteran-owned small business, and service disabled veteran-owned small business concerns as subcontractors for the base year and each option year. (Please note that the goals for, small disadvantaged business, women-owned small business, HUBZONE small business, veteran-owned small business, and service disabled veteran-owned small business concerns are sub-sets of the small business goal).

A. Estimated dollar value of all planned subcontracting, i.e., to all types of business concerns under this contract is:

FY FY FY FY FY

BASE 1ST OPTION 2ND OPTION 3RD OPTION 4TH OPTION**

B. Estimated dollar value* and percentage of planned subcontracting to small business concerns is:

(*This figure includes the amount in C., D., E., F., and G. below.)

C. Estimated dollar value and percentage of planned subcontracting to small disadvantaged business concerns is:

D. Estimated dollar value and percentage of planned subcontracting to small women-owned business concerns is:

E. Estimated dollar value and percentage of planned subcontracting to small

HUBZone business concerns is:

F. Estimated dollar value and percentage of planned subcontracting to veteran-owned small business concerns is:

G. Estimated dollar value and percentage of planned subcontracting to service disabled veteran-owned small business concerns is:

**IF ANY CONTRACT HAS MORE THAN FOUR OPTIONS, PLEASE ATTACH ADDITIONAL SHEETS

SHOWING DOLLAR AMOUNTS AND PERCENTAGES.

H. Supplies and/or services to be subcontracted under this contract, business size (i.e., SB, SDB, WOB, HUBZone, VOSB, SDVOSB, and LB), and the estimated dollar expenditure, are: (Check all that apply).

SUPPLY/ COMPANY BUSINESS DOLLAR

SERVICE NAME SIZE AMOUNT

(IF KNOWN) (SB, SDB, WOB, HUBZone

VOSB, SDVOSB, LB)

(Attach additional sheets if necessary.)

I. Explain the methods used to develop the subcontracting goals for small, small disadvantaged, women-owned small business, HUBZone small business, business concerns. Explain how the product and service areas to be subcontracted were established, how the areas to be subcontracted to small, small disadvantaged, women-owned small, HUBZone small business, businesses were determined, and how the capabilities of small, small disadvantaged, women-owned small, HUBZone small, veteran-owned, and service disabled veteran-owned small businesses were determined.

Identify all source lists used in the determination process.

J. Indirect and overhead costs ______ HAVE BEEN

______ HAVE NOT BEEN

included in the dollar and percentage subcontracting goals stated above.

(Check one.)

K. If indirect and overhead costs HAVE BEEN included, explain the method used to determine the proportionate share of such costs to be allocated as subcontracts to small, small disadvantaged, women-owned small, HUBZone small, veteran-owned, and service disabled veteran-owned small business concerns.

3. PLAN ADMINISTRATOR:

FAR 19.704(a)(7) requires information about the company employee who will administer the subcontracting program. Please provide the name, title, address, phone number, position within the corporate structure and the duties of that employee.

Name:

Title:

Address:

Telephone:

Fax:

E-mail Address:

Position:

Duties: Does the individual named above perform the following? (If NO is checked, please indicate who in the company performs those duties, or indicate why the duties are not performed in your company).

A. Developing and promoting company/division policy statements that demonstrate the company's/division's support for awarding contracts and subcontracts to small, small disadvantaged, women-owned small, HUBZone small, veteran-owned, and service disabled veteran-owned small business concerns.

__________YES __________NO

B. Developing and maintaining bidders' lists of small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns from all possible sources.

C. Ensuring periodic rotation of potential subcontractors on bidders' lists.

D. Assuring that small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small businesses are included on the bidders' list for every subcontract solicitation for products and services they are capable of providing.

E. Ensuring that subcontract procurement "packages" are designed to permit the maximum possible participation of small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small businesses.

F. Reviewing subcontract solicitations to remove statements, clauses, etc., which might tend to restrict or prohibit small, small disadvantaged, disabled veteran-owned small business participation.

G. Ensuring that the subcontract bid proposal review board documents its reasons for not selecting any low bids submitted by small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns.

H. Overseeing the establishment and maintenance of contract and subcontract award records.

I. Attending or arranging for the attendance of company counselors at

Business Opportunity Workshops, Minority Business Enterprise Seminars, Trade Fairs, etc.

J. Directly or indirectly counseling small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns on subcontracting opportunities and how to prepare responsive bids to the company.

K. Providing notice to subcontractors concerning penalties for misrepresentations of business status as small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, or service disabled veteran-owned small business for the purpose of obtaining a subcontract that is to be included as part or all of a goal contained in the contractor's subcontracting plan.

L. Conducting or arranging training for purchasing personnel regarding the intent and impact of Public Law 95-907 on purchasing procedures.

M. Developing and maintaining an incentive program for buyers which support the subcontracting program.

N. Monitoring the company's performance and making any adjustments necessary to achieve the subcontract plan goals.

O. Preparing and submitting timely reports.

P. Coordinating the company's activities during compliance reviews by

Federal agencies.

4. EQUITABLE OPPORTUNITY

FAR 19.704(a)(8) requires a description of the efforts your company will make to ensure that small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns will have an equitable opportunity to compete for subcontracts.

(Check all that apply.)

A. Outreach efforts to obtain sources:

Contacting minority and small business trade associations

Contacting business development organizations

Attending small and minority business procurement conferences and trade fairs

Finding sources from the Small Business Administration's

Procurement Network (CCR/ProNet)

B. Internal efforts to guide and encourage purchasing personnel:

Presenting workshops, seminars and training programs

Establishing, maintaining and using small, small disadvantaged, disabled veteran-owned small business source lists, guides and other data for soliciting subcontracts

Monitoring activities to evaluate compliance with the subcontracting plan

C. Additional efforts: (Please describe.)

5. CLAUSE INCLUSION AND FLOW DOWN

FAR 19.704(a)(9) requires that your company include FAR 52.219-8, "Utilization of Small Business Concerns", in all subcontracts that offer further subcontracting opportunities. Your company must require all subcontractors, except small business concerns, that receive subcontracts in excess of

$500,000 ($1,000,000 for construction) to adopt and comply with a plan similar to the plan required by FAR 52.219-9, "Small Business Subcontracting Plan."

Your company agrees that the clause will be included and that the plans will be reviewed against the minimum requirements for such plans. The acceptability of percentage goals for small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns must be determined on a case-by-case basis depending on the supplies and services involved, the availability of potential small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business subcontractors and prior experience. Once the plans are negotiated, approved, and implemented, the plans must be monitored through the submission of periodic reports, including

Standard Form (SF) 294 and SF 295 reports.

6. REPORTING AND COOPERATION

FAR 19.704(a)(10) requires that your company (1) cooperate in any studies or surveys as may be required, (2) submit periodic reports which show compliance with the subcontracting plan; (3) submit Standard Form (SF) 294, "Subcontracting Report for Individual Contracts," and SF 295, "Summary

Subcontract Report," in accordance with the instructions on the forms; and (4) ensure that subcontractors agree to submit SF 294 and SF 295. The cognizant

Contracting Officer of the DHS Organizational Element(OE) must receive the report(s) within 30 days after the close of each calendar period. That is:

Calendar Period Report Due Date Due Send Report To

10/01--03/31 SF 294 04/30 OE Contracting

Officer

04/01--09/30 SF 294 10/30 OE Contracting

10/01--09/30 SF 295 10/30 OE Contracting

NOTE: A copy of the 295 report must also be sent to the Director, Office of Small Business Development, Department of Homeland Security. The address is as follows:

Department of Homeland Security

Attn: Director, Office of Small Business Development

245 Murray Drive, Bldg. 410

(Attn: OSDBU/Kyle B. Groome/Rm. 3514)

Washington, DC 20528

7. RECORDKEEPING

FAR 19.704(a)(11) requires a list of the types of records your company will maintain to demonstrate the procedures adopted to comply with the requirements and goals in the subcontracting plan. (Check all that apply.) (If NO is checked, please indicate why these types of records are not maintained).

A. Small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concern source lists, guides, and other data identifying such vendors.

B. Organizations contacted for small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business sources.

C. On a contract-by-contract basis, records on all subcontract solicitations over $100,000 which indicate for each solicitation (1) whether small business concerns were solicited, and if not, why not;

(2)whether small disadvantaged business concerns were solicited, and if not, why not; (3) whether women-owned small business concerns were solicited, and if not, why not; (4)whether HUBZone small business concerns were solicited, and if not, why not; (5) whether veteran-owned small business concerns were solicited, and if not, why not; (6) whether service disabled veteran-owned small businesses were solicited, and if not, why not; and (7) reasons for the failure of solicited small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns to receive the subcontract award.

D. Records to support other outreach efforts, e.g., contacts with minority and small business trade associations, attendance at small and minority business procurement conference and trade fairs.

E. Records to support internal activities to (1) guide and encourage purchasing personnel, e.g., workshops, seminars, training programs, incentive awards; and (2) monitor activities to evaluate compliance.

F. On a contract-by-contract basis, records to support subcontract award data including the name, address and business size and ownership status

(SDB, WOB, HUBZone, VOSB, SDVOSB, etc.) of each subcontractor. (This item is not required for company or division-wide commercial plans.)

G. Other records to support your compliance with the subcontracting plan:

(Please describe)

8. TIMELY PAYMENTS TO SUBCONTRACTORS

FAR 19.702 requires your company to establish and use procedures to ensure the timely payment of amounts due pursuant to the terms of your subcontracts with small business concerns, small disadvantaged business concerns, women-owned small business concerns, HUBZone small business concerns, veteran-owned small business concerns, and service disabled veteran-owned small business concerns.

Your company has established and uses such procedures:

YES NO

9. DESCRIPTION OF GOOD FAITH EFFORT

Maximum practicable utilization of small, small disadvantaged women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business concerns as subcontractors in Government contracts is a matter of national interest with both social and economic benefits. When a contractor fails to make a good faith effort to comply with a subcontracting plan, these objectives are not achieved, and 15 U.S.C. 637(d)(4)(F) directs that liquidated damages shall be paid by the contractor. In order to demonstrate your compliance with a good faith effort to achieve the small, small disadvantaged, women-owned small, HUBZone small, veteran-owned small, and service disabled veteran-owned small business subcontracting goals, outline the steps your company plans to take. These steps will be negotiated with the contracting officer prior to approval of the plan.

10. SIGNATURES REQUIRED

This subcontracting plan was SUBMITTED by:

Signature:

Typed Name:

Date:

This subcontracting plan was REVIEWED by:

Title: Contracting Officer

Title: Small Business Specialist

Title: Small Business Administration PCR

This subcontracting plan was ACCEPTED by:

Title: Contracting Officer

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 18

FOR OFFICIAL USE ONLY

RFP HSFLBP-14-R-00001

ATTACHMENT 18 to RFP

Experience and Past Performance “FACTS Sheet”

(TO BE COMPLETED BY OFFEROR)

Request the offeror complete a separate FACTS Sheet for each relevant contract. See Section L of this RFP for detailed instructions and limits on completion of FACTS Sheets. Offeror is requested to provide frank, concise comments regarding experience and past performance on the program identified in B.

below.

Experience Section

A. OFFEROR: (Including: (1) Name (Company/Division), (2) Address: (3) CAGE Code)

B. PROGRAM TITLE and CONTRACT NUMBER:

C. NAME OF CONTRACTING ACTIVITY OR CUSTOMER:

D. CONTRACT TYPE(S) – PLEASE LIST ALL THAT APPLY (firm fixed price, time & materials, etc.)

E. CONTRACT $ VALUE:

1. Original contract $ value and current $ value:

2. Estimated value at completion and primary causes of changes:

3. If Award Fee Contract, what percentages of the fee have been awarded in each of last 3 years?:

F. BRIEF DESCRIPTION OF EFFORT AS: _____ PRIME ___ SUBCONTRACTOR

1. As a part of this narrative description, highlight portions considered most relevant to the current acquisition; addressing how and to what extent the proposed effort relates to the program identified in B. above. Completion of the relevancy grid as identified in paragraph N. below will supplement the data provided in response to this paragraph.

2. This paragraph shall also include details to support the offeror’s record for on time delivery, technical quality and cost control for this effort identified in paragraph B. above.

PLEASE NOTE: The Government is not bound by the offeror’s opinion of relevancy. The Government will perform an independent assessment of relevancy of the data provided or obtained.

F. PERIOD OF PERFORMANCE:

1. Original schedule and current schedule:

2. Estimate at completion:

3. How many times changed and primary causes of changes:

H. PRIMARY POINTS OF CONTACT: (The offeror is responsible for exerting its best efforts to ensure that current information is provided for all individuals.)

Name and Title Phone Number Email

1. Procuring Contracting Officer

2. Program Manager

3. Administrative Contracting Officer

4. Other (Please Specify)

I. Specify, by name, key individual(s) who will participate in the proposed effort under this acquisition who also participated in the program identified in B. above, and indicate their contract role. Describe how participation of these key personnel contributed to the success of the previous effort and how this indicates probability of success on the proposed effort.

J. Use this space to address any aspect about this program considered unique. Describe quality awards or certifications that indicate the offeror possesses a high-quality process for developing and producing the product/service required.

K. Complete the following regarding relevancy of the effort identified in paragraph B. to the proposed effort.

Category Fill-in for the Proposed

Effort Fill-in for the Effort

Identified in para. B above

1. Nature of Business Area(s) Involved

Construction

2. Required Levels of Technology

Biocontainment, Process Piping and Process Control, Medium Voltage, Laboratory HVAC and Controls, Modular Construction

3. Materials and Production Processes

Mechanical, Electrical, Concrete and Coatings

4. Performance Location Plum Island Animal Disease Center, Orient Point, NY

5. Contract Type(s) FFP

6. Quantities produced, # repaired or other quantitative data

ECC $25 - 35 Million

7. Program Complexity

Waste Water Thermal Decontamination System

8. Program Phase FFP w/Schedule of Values, EVM

9. Extent of subcontractor involvement

10. Other

Past Performance Section

L. Summarize contract issues relative to the number and severity of quality deficiencies recorded/contract discrepancy reports issued, cure notices, show cause letters, termination for default or cause, disputes, claims, latent defects; and, corrective actions taken for the contract listed in paragraph B. above.

M. Additionally, for those efforts where the offeror is cognizant of unfavorable and/or marginal past performance ratings/reports previously assessed by customers or clients, but feel that significant progress has been made but not yet credited or formally documented, provide the program name, contract number, customer location and a narrative explaining "fixes" made to date, or any other information regarding the unfavorable/marginal assessment. This narrative portion is limited to one (1) additional page beyond the FACTS sheet required page limitation. It is not presumed that the offeror's performance has been perfect.

Rather, the proposal should contain evidence of the offeror's ability to isolate the root causes of problems and should describe programs or actions taken to resolve those causes. Demonstrated corrective actions (not just planned or promised), and the overall work record will be considered. Problems not addressed by the offeror, but found by the Government during the evaluation of the information in this volume, will be assumed to still exist. Note: In the case of Contractor Performance Assessment Report System (CPARS), if your input has already been provided and the rationale/ circumstances have not changed, DO NOT repeat them here.

N. Was this contract effort (as identified in paragraph B. above) submitted as a past performance source of data for a previous FLETC procurement. Yes No . If yes, identify the buyer and/or contracting officer, their phone number and office symbol and solicitation number of the procurement for which this effort was submitted.

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 19

ATTACHMENT 19 TO RFP

PAST PERFORMANCE QUESTIONNAIRE

TITLE: CONSTRUCTION OF A REPLACEMENT WASTE WATER THERMAL

DECONTAMINATION SYSTEM (WWTDS)

AT THE PLUM ISLAND ANIMAL DISEASE CENTER

(This questionnaire, when filled in, shall be treated as Source Selection Information in accordance with FAR 3.104-3 and shall not be disclosed to anyone outside the Government Source Selection Team)

Contractor__________________________ Contract Number: _______________ Prime? Sub? FFP? YES NO – If no, specify:

Contract Value (Original): $_______________________ ___________________________________

(Current) $_______________________ If Award Fee Contract, What % of the fee has been awarded in each of the last 3 years?

Contract Start & Completion:____________________ ____________________________________

If contractor is behind schedule, list primary causes: ________________________________________

Program Description: (Description of Project Scope of Work)

PLEASE FILL IN THE FOLLOWING RESPONDENT INFORMATION:

NAME: __________________________________ Role relative to contract:

ADDRESS: __________________________________ _________________________________

__________________________________ (ACO, Inspector, Contract Administrator, Project Engineer, Buyer, Quality Assurance Evaluator, Other-explain)

FAX No: ._____________________________ E-Mail Address: ________________________________

CHECK THE BOX RELATING TO THE APPROPRIATE RATING FOR EACH AREA BELOW:

NA=Not Applicable, U=Unsatisfactory, M=Marginal, S=Satisfactory, A=Above Average, O=Outstanding

For any rating of “Unsatisfactory” or “Marginal”, please provide (1) Rationale for rating, (2) Indication of contractor problem notification, and (3) Contractor’s corrective action, as applicable, in “Additional Remarks”.

PAST PERFORMANCE INFORMATION:

1. Quality/acceptability of services delivered

2. Completion of work according to schedule

3. Responsiveness to unscheduled/emergency requirements

4. Performance of all technical requirements

5. Responsiveness to contract changes/modifications

6. Timeliness of proposal submissions/other reports

7. Sufficiency of material and personnel to accomplish tasks

8. Performance of contract requirements within agreed prices

9. Competent/responsible/effective on-site managers

10. Overall Program Management

11. Attitude (customer relations)

12. Effectiveness in managing subcontractors

13. Adequately prices contract changes/modifications

14. Contractor’s overall performance

N/A U M S A O

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 19

15. Have there been any contract modifications or disputes/claims relative to the contract?

If “yes”, please explain in “Additional Remarks”. Yes: ____ No:____

16. Has action been initiated to cancel or terminate contract for default?

If yes, please explain in “Additional Remarks”. Yes: ___ No:_____

17. Given a choice, would you use this contractor again? Yes: ____ No_____

Do you know anyone else who can tell us about this contractor’s performance? (Please list Name, Phone No. and

Email

Name: ________________________________Phone: _______________Email: ________________

Additional Remarks: (Use separate sheets as necessary) PLEASE PROVIDE COMMENTS

Respondent Signature Date

Typed or Printed Name

Please return questionnaire to: Erin.Riffey@fletc.dhs.gov and Edel.Brooks-Wilcox@fletc.dhs.gov .

mailto:Erin.Riffey@fletc.dhs.gov

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 20

ATTACHMENT 20 to RFP

Transmittal Letter for Government Sources to Accompany Past Performance Questionnaire

[TO BE COMPLETED BY OFFEROR]

MEMORANDUM FOR: [OFFEROR’S POC]

FROM: [OFFEROR’S ADDRESS AND POINT OF CONTACT]

SUBJECT: Past Performance Questionnaire for Contract(s) .

1. We are currently responding to the Department of Homeland Security, Federal Law Enforcement Training

Center (FLETC), Request for Proposal (RFP) HSFLBP-14-R-00001, for the procurement to Construct the

Replacement Waste Water Thermal Decontamination System at the Plum Island Animal Disease Center, off of

Orient Point, NY. This RFP specifically requires that we, as an offeror, do the following:

The offeror shall send out -- and track the completion of -- the Past Performance Questionnaire to each of the offeror’s Points of Contact (POCs). The responsibility to send out and track the completion of the Past Performance Questionnaires rests solely with the offeror - i.e., it shall not be delegated to any subcontractors, teaming contractors, and/or joint venture partners. The offeror shall exert its best efforts to ensure that at least two POCs, per relevant contract, submit a completed Past Performance

Questionnaire directly to the Government not later than [OFFEROR FILL-IN RFP CLOSING

DATE]. Each of the offeror’s POCs shall email their completed Past Performance Questionnaire directly to:

Erin.Riffey@fletc.dhs.gov AND Edel.Brooks-Wilcox@fletc.dhs.gov

2. We have identified subject contract(s) as relevant to this acquisition and you as our POC. As such, please take a few moments of your time to fill out the attached questionnaire and send it directly back to FLETC. Please make comments under “Additional Remarks”. The information contained in the completed Past Performance

Questionnaires are considered sensitive and cannot be released to us, the offeror. If you have any questions about the acquisition or the attached questionnaire, your questions must be directed back to the Government’s points of contact identified above. Thank you for your timely assistance.

1 ATCH [OFFEROR’S POINT OF CONTACT]

Past Performance Questionnaire

[Client Authorization Letter(s), if applicable] mailto:Erin.Riffey@fletc.dhs.gov mailto:Edel.Brooks-Wilcox@fletc.dhs.gov

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 21

ATTACHMENT 21 to RFP

NOTE TO OFFERORS: This procurement could be similar to commercial supplies/services. Therefore, to assist the Government’s Performance Evaluation Team in assessing your past performance on relevant commercial contracts, the following letter must be sent to your points of contact (POCs) for those commercial efforts that you identify to us in your past performance volume. Should you propose to use teaming contractors and/or Joint Venture partners, you must obtain a similar client authorization letter from each entity. HOWEVER, it is your sole responsibility, as the offeror, to then send out these authorization letters, with the performance questionnaires, to your own POCs and to those of your teaming contractors or Joint Venture partners and include a copy in your past performance volume.

SOURCE SELECTION INFORMATION – See FAR 2.101 and FAR 3.104

PROCUREMENT SENSITIVE – FOR OFFICIAL USE ONLY

Client Authorization Letter

(TO BE ACCOMPLISHED BY OFFEROR)

Dear (Client):

We are currently responding to the Department of Homeland Security, Federal Law Enforcement Training

Center (FLETC), Request for Proposal (RFP) HSFLBP-14-R-00001 for the procurement to Construct the

Replacement Waste Water Thermal Decontamination System for the Plum Island Animal Disease Center off of Orient Point, NY.

As you know, an offeror’s past performance has become an element of increased emphasis in acquisitions.

They are requesting that clients of companies who submit proposals in response to the RFP be contacted, and that their participation in the validation process be requested. We, therefore, respectfully request and hereby authorize you to complete the attached Questionnaire with regards to work we have performed for you, and forward by email directly to the Government Point(s) of Contact at the following addresses:

Erin.Riffey@fletc.dhs.gov and Edel.Brooks-Wilcox@fletc.dhs.gov

Reference: RFP: HSFLBP-14-R-00001

We have identified Mr./Ms. (Name) of your organization as the point of contact based on their knowledge concerning our work. Your cooperation in this matter is appreciated. Any questions may be directed to:

[NAME, PHONE NUMBER, EMAIL FOR THE OFFEROR’S POINT OF CONTACT]

[OFFEROR'S POINT OF CONTACT]

mailto:Edel.Brooks-Wilcox@fletc.dhs.gov

SOURCE SELECTION INFORMATION – SEE FAR 3.104 Attachment 22

ATTACHMENT 22 to RFP

Past Performance Questionnaire Tracking Record

[TO BE ACCOMPLISHED BY OFFEROR]

OFFEROR’S REFERENCES COMPANY/AGENCY NAME:

REFERENCE ADDRESS:

REFERENCE CONTRACT NUMBER/PROGRAM NAME:

Date Of

Action

Type Of Action (E.G., Sent

Questionnaire, Follow-Up Call)

Person Contacted/

Phone #

Position Of

Person Contacted

Offeror Contact Status Of Questionnaire

REQUEST FOR AUTHORIZATION OF

ADDITIONAL CLASSIFICATION AND RATE

INSTRUCTIONS: THE CONTRACTOR SHALL COMPLETE ITEMS 3 THROUGH 16, KEEP A PENDING COPY, AND SUBMIT THE REQUEST, IN

QUADRUPLICATE, TO THE CONTRACTING OFFICER.

1. TO:

ADMINISTRATOR, Employment Standards Administration

WAGE AND HOUR DIVISION

U.S. DEPARTMENT OF LABOR

WASHINGTON, D.C. 20210

2. FROM: (REPORTING OFFICE)

3. CONTRACTOR 4. DATE OF REQUEST

5. CONTRACT NUMBER 6. DATE BID OPENED (SEALED

BIDDING)

7. DATE OF AWARD 8. DATE CONTRACT WORK

STARTED

9. DATE OPTION EXERCISED (If

APPLICABLE) (SCA ONLY)

10. SUBCONTRACTOR (IF ANY)

11. PROJECT AND DESCRIPTION OF WORK (ATTACH ADDITIONAL SHEET IF NEEDED)

12. LOCATION (CITY, COUNTY AND STATE)

13. IN ORDER TO COMPLETE THE WORK PROVIDED FOR UNDER THE ABOVE CONTRACT, IT IS NECESSARY TO ESTABLISH THE FOLLOWING RATE(S) FOR THE INDICATED CLASSIFICATION(S) NOT INCLUDED IN THE DEPARTMENT OF LABOR DETERMINATION

NUMBER: DATED:

a. LIST IN ORDER: PROPOSED CLASSIFICATION TITLE(S); JOB DESCRIPTION(S); DUTIES;

AND RATIONALE FOR PROPOSED CLASSIFICATIONS (SCA ONLY) b. WAGE RATE(S)

c. FRINGE BENEFITS

PAYMENTS

(Use reverse or attach additional sheets, if necessary)

14. SIGNATURE AND TITLE OF SUBCONTRACTOR REPRESENTATIVE

(IF ANY)

15. SIGNATURE AND TITLE OF PRIME CONTRACTOR REPRESENTATIVE

16. SIGNATURE OF EMPLOYEE OR REPRESENTATIVE TITLE CHECK APPROPRIATE BOX-REFERENCING BLOCK 13.

AGREE DISAGREE

TO BE COMPLETED BY CONTRACTING OFFICER (CHECK AS APPROPRIATE - SEE FAR 22.1019 (SCA) OR FAR 22.406-3 (DBA)) THE INTERESTED PARTIES AGREE AND THE CONTRACTING OFFICER RECOMMENDS APPROVAL BY THE WAGE AND HOUR DIVISION. AVAILABLE

INFORMATION AND RECOMMENDATIONS ARE ATTACHED.

THE INTERESTED PARTIES CANNOT AGREE ON THE PROPOSED CLASSIFICATION AND WAGE RATE. A DETERMINATION OF THE QUESTION BY THE WAGE AND HOUR DIVISION IS THEREFORE REQUESTED. AVAILABLE INFORMATION AND RECOMMENDATIONS ARE ATTACHED.

(Send copies 1, 2, and 3 to Department of Labor)

SIGNATURE OF CONTRACTING OFFICER OR

REPRESENTATIVE

STANDARD FORM 1444 (REV. 12-2001)

Prescribed by GSA-FAR (48 CFR) 53.222(f)

TITLE AND COMMERCIAL TELEPHONE NO. DATE SUBMITTED

CHECK APPROPRIATE BOX

SERVICE CONTRACT

CONSTRUCTION CONTRACT

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS USABLE

Public reporting burden for this collection of…