Attachment 4 - RFP Information and General Compliance Worksheet 1 Dec 2022.xlsx
XLSX spreadsheet 18 KB Posted
- Attached to
- Klaipeda, Klaipedos Smelte Terminal, Lithuania S&RTS Federal contract opportunity
- Solicitation number
- HTC711-23-R-R003
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Sheet1 SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104 (When Filled-in, this Document becomes CUI//SP-SSEL)
| ATTACHMENT 4: RFP Information and General Compliance Worksheet |
| REQUEST FOR PROPOSAL: HTC71123RR003 |
| Stevedoring & Related Terminal Services (S&RTS) Klaipeda, Klaipedos Smelte Terminal (KST), Lithuania |
| Period of Performance: 15 February 2023 through 14 February 2028 |
| Government Points of Contact: |
| Emily Fishbein, Contracting Officer |
USTRANSCOM/TCAQ-R
508 Scott Drive, Bldg. 1900W Scott AFB, IL 62225 emily.j.fishbein.civ@mail.mil Connor Breyer, Contract Specialist
USTRANSCOM/TCAQ-R
508 Scott Drive, Bldg. 1900W Scott AFB, IL 62225 connor.n.breyer.civ@mail.mil
| GENERAL INFORMATION - Complete the requested information below. | |||
| COMPANY NAME: | |||
| COMPANY ADDRESS: | |||
| COMPANY TELEPHONE NUMBER: | |||
| COMPANY EMAIL ADDRESS: | |||
| BUSINESS SIZE (NAICS 488320): | |||
| CAGE CODE: | |||
| SAM NUMBER: | |||
| TAX IDENTIFICATION NUMBER: | |||
| IBAN/SWIFT CODE: | |||
| REMITTANCE ADDRESS: (Only if remittance address is different, such address must be registered in the System for Award Management (SAM) database, If not mark as N/A) | |||
| PRIMARY POC: To include title and contact information | |||
| (Person/s with authority to make decision and negotiate with respect to the | |||
| proposal and who can obligate your company contractually.) | |||
| ALTERNATE POC: To include title and contact information | |||
| (Person/s with authority to make decision and negotiate with respect to the | |||
| proposal and who can obligate your company contractually.) | |||
| PROMPT PAYMENT DISCOUNT: (If applicable, If not mark as N/A) | |||
| DATE/TIME OF SUBMISSION: | |||
| PROPOSAL VALIDITY DATE: (180 calendar days, at minimum) | |||
| CONTRACT DOCUMENTATION | |||
| GENERAL: | ACTION ITEMS | COMPLETED | COMMENTS |
| Active in SAM (Offeror must be registered as Active in SAM by proposal due date) | |||
| NAICS in SAM contains 488320 | |||
| REPRESENTATIONS AND CERTIFICATIONS (REPS & CERTS): **Please Complete in RFP if not in SAM.gov** | ACTION ITEMS | COMPLETED | COMMENTS |
| FAR 52.204-24, Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Nov 2021). NOTE: FAR 52.204-24 only needs to be completed if FAR 52.204-26 is not completed in SAM.gov, or if the quoter represents it “will” provide or “does” use covered telecommunications equipment. | |||
| FAR 52.209-7, Information Regarding Responsibility Matters (Oct 2018) | |||
| FAR 52.212-3, Offeror Representations and Certifications—Commercial Products and Commercial Services (May 2022), with Alternate I. NOTE: A small business joint venture offeror must submit, with its offer, the representation required in paragraph (c) of FAR solicitation provision 52.212-3, Offeror Representations and Certifications-Commercial Products and Commercial Services, and paragraph (c) of FAR solicitation provision 52.219-1, Small Business Program Representations, in accordance with 52.204-8(d) and 52.212-3(b) for the following categories: (A) Small business; (B) Service-disabled veteran-owned small business; (C) Women-owned small business (WOSB) under the WOSB Program; (D) Economically disadvantaged women-owned small business under the WOSB Program; or (E) Historically underutilized business zone small business. | |||
| FAR 52.229-11, Tax On Certain Foreign Procurements Notice & Representation (Jun 2020) NOTE: Offerors representing as a "foreign person" must also submit an IRS Form W-14. | |||
| DFARS 252.204-7017, Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services—Representation (May 2021). NOTE: DFARS 252.204-7017 only needs to be completed if DFARS 252.204-7016 is not completed in SAM.gov, or if the quoter represents it “does” provide covered defense telecommunications equipment or services in DFARS 252.204-7016. | |||
| DFARS 252.229-7001, Tax Relief (Apr 2020) | |||
| DFARS 252.247-7022, Representation of Extent of Transportation by Sea (Jun 2019) | |||
| ANCILLARY DOCUMENTATION | |||
| CONTINUATION OF | ACTION ITEMS | COMPLETED | COMMENTS |
| ESSENTIAL CONTRACTOR | |||
| SERVICES PLAN: | |||
| Attachment 3, Contractor Plan for Essential Contractor Services, completed and submitted. | |||
| TECHNICAL WORKSHEET | |||
| ACTION ITEMS | COMPLETED | COMMENTS | |
| Attachment 5, Technical Worksheet, completed and submitted. | |||
| Technical Worksheet did not exceed the page requirement - 15 pages. | |||
| PRICE PROPOSAL, SCHEDULE OF RATES (SOR) | |||
| ACTION ITEMS | COMPLETED | COMMENTS | |
| Attachment 2, Schedule of Rates, completed and submitted on the correct SOR. (If the SOR was Amended, it must be on the last Amended SOR.) | |||
| Unit prices were free of formulas. | |||
| Unit prices were only two decimal places. | |||
| All unit prices were completed for each quantity. | |||
| ACKNOWLEDGMENTS | |||
| SF1449: | ACTION ITEMS | COMPLETED | COMMENTS |
| Completed SF 1449 Block 12 (should be completed even if no discount is offered) | |||
| Completed SF 1449 Block 17a | |||
| Completed SF 1449 Block 30a | |||
| Completed SF 1449 Block 30b | |||
| Completed SF 1449 Block 30c | |||
| Returned signed and dated on the SF 1449 (In doing so, offeror accedes to the contract terms and conditions as written in the RFQ, with attachments) | |||
| Completed SF 1449 Block 17b (Only if remittance address is different, such address must be registered in the System for Award Management (SAM) database. | |||
| SF30: | ACTION ITEMS | COMPLETED | COMMENTS |
| Completed SF 30 Block 8 on each SF 30 | |||
| Completed SF 30 Block 15a on each SF 30 | |||
| Completed SF 30 Block 15b on each SF 30 |
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