Att-7-Award Approval Request.pdf

Award Approval Request For Solicitation Number HSHQWA-10-R-00001

This award approval request shall be completed only if an Offeror has represented under Homeland Security Acquisition Regulation (HSAR) clause 3052.209-76,Prohibition on Federal Protective Service guard services contracts with business concerns owned, controlled, or operated by an individual convicted of a felony, that it IS a business concern owned, controlled or operated by an individual convicted of a felony.

1. Name and Address of the business concern submitting the proposal.

2. Basis for Award Request (Please check applicable basis and provide a detailed explanation)

a. Subject felony is not a serious felony as defined by (HSAR) 48 CFR 3009.171-5.

b. Individual does not/ or no longer owns, controls or operates the business concern

c. Commission of a serious felony no longer calls into question the individual or business concern’s integrity or business ethics and that an award would be consistent with the mission of FPS.

3. Name and Date of Birth of Individual Convicted of a felony

4. A full description of which roles or interests indicate that the individual owns, controls, or operates, or may own, control or operate the business concern.

5. Date Sentenced:

6. Statute/Charge:

7. Docket/Case Number

8. Court/Jurisdiction:

9. The nature and circumstances surrounding the conviction

10. Protective measures taken by the individual to or business concern to reduce or eliminate the risk of further misconduct:

11. Actions the individual has taken to accept responsibility and make restitution for past misconduct resulting in the felony conviction:

Privacy Notice. The collection of this information is authorized by the Federal Protective Service Guard Contracting Reform Act of 2008 (Pub.L 110-356) and Department of Homeland Security (DHS) implementing regulations at Homeland Security Acquisition Regulation (HSAR) 48 CFR 3009.171. This information is being collected to determine whether an individual that owns, controls, or operates the business concern submitting this offer has been convicted of a felony that would disqualify the offeror from receiving an award. This information will be used by and disclosed to DHS personnel and contractors or other agents who require this information to determine whether an award request should be approved or denied. Additionally, DHS may share this personal information with the U.S. Justice Department and other Federal and State agencies for collection, enforcement, investigatory, or litigation purposes, or as otherwise authorized.

Submission of this information by the individual is voluntary, however, failure to provide it may result in denial of an award to the offeror. Individuals who wish to correct inaccurate information in or to remove their information from an offer that has been submitted should contact the business concern submitting the offer and request correction. Should individuals seek to correct inaccurate information or remove their information from an offer that has been submitted in response to a solicitation for FPS guard services prior to contract award, an authorized representative of the business concern submitting the offer must contact the contracting officer of record and request that the firm’s offer be formally withdrawn or submit a correction to the award request.

After contract award, it is recommended that an authorized representative of the business concern that submitted the inaccurate or erroneous information contact the contracting officer of record. The contracting officer will handle such requests on a case by case basis.

I have read the above privacy notice and authorize DHS/FPS to use the information contained within this award approval request for the purposes stated within the Privacy Notice.

(Signature of the individual convicted of a felony) Date (Print Name and Title)

I hereby deny this award approval request:

Karl H. Johnson Date:

Contracting Officer Signature

I hereby recommend approval of this award request:

I hereby deny this award approval request:

Kathleen R. Sewell Date:

Chief, West Consolidated Contracting Group

I hereby approve this award request to permit award of a contract for Federal Protective Service guard services to a business concern owned, controlled, or operated by an individual convicted of a felony.

Soraya Correa Date:

Head of Contracting Activity