Atch 5 - AFRICOM Business Compliance Checklist Coversheet.docx

Source Selection Information – See FAR 2.101 and 3.104 (When filled-in, this Document becomes CUI//SP-SSEL)

HTC71126RE119 AFRICOM DPACS

Attachment 5

Business Compliance Checklist Coversheet Offeror Name:

Complete all requirements listed below and check the corresponding boxes (☐) to confirm compliance. Submission of this checklist as the cover sheet for your Business Compliance submission is mandatory.

I. BUSINESS COMPLIANCE SUBMISSION REQUIREMENTS

A. SOLICITATION & CONTRACT DOCUMENTATION

☐ SF 1449 - Complete all required blocks (12, 17a, 30a-c) ☐ CAGE Code - Include in Block 17a ☐ Authorized Signature - SF 1449 signed by company representative ☐ SAM Registration - Verify active status at submission time ☐ Atch 4 - DD 254 – Fill-in box 7, box 8 if applicable

B. PAYMENT & REMITTANCE INFORMATION

☐ Address Verification - Check Block 17b if remittance differs from business address ☐ Remittance Details - Provide complete address (if different from business) ☐ SAM Alignment - Confirm remittance address matches SAM.gov registration

C. SOLICITATION AMENDMENTS

☐ SF 30 Amendment Acknowledgment- Return one signed copy of each amendment received D. COMPANY IDENTIFICATION - Prime Contractor Information and Principal Subcontractor(s) Information (if applicable):

☐ Complete Attachment 9 ☐ Company/Division name and street address ☐ Company POC authorized to negotiate on behalf of company ☐ Unique Entity Identifier (UEI) ☐ CAGE code

F. ELIGIBILITY REQUIREMENTS

☐ Attachment 10 - Complete Basic Eligibility form ☐ Air Carrier Certification- Provide FAA/CAA Operations Specification (OpSpecs) or foreign equivalent for services offered ☐ DoD CARB Status- Submit DoD Commercial Air Transportation Quality and Safety Review Program documentation of approval into program

G. REPRESENTATIONS & CERTIFICATIONS

☐ SAM.gov Submission - Submit representations and certifications online at sam.gov Alternative Submission – Submit filled-in representations and certifications included in the solicitation that are not available on sam.gov (check as applies):

☐ FAR 52.204-24 - Telecommunication and Video Surveillance Services Representation (Nov 2021) ☐ FAR 52.209-7 - Information Regarding Responsibility Matters (Oct 2018) ☐ FAR 52.212-3 - Offeror Representations & Certifications (DEVIATION 2025-O0003/O0004) (Mar 2025) ☐ FAR 52.229-11 - Tax on Foreign Procurements Representation (Jun 2020) ☐ IRS Form W-14 - Submit if representing as "foreign person" ☐ DFARS 252.204-7017 - Covered Defense Telecommunications Equipment Prohibition (May 2021)

H. CYBERSECURITY COMPLIANCE

☐ NIST SP 800-171 Assessment - Current DoD assessment (≤3 years) with scores in SPRS ☐ Basic Assessment - Complete and uploaded to SPRS module in PIEE ☐ CMMC Level 2 (Self) - Complete and uploaded to SPRS module in PIEE

II. PROPOSAL SUBMISSION CERTIFICATION

I certify that all items checked above have been completed and are included in this proposal submission. This proposal constitutes an offer that may be accepted by the Government and acknowledges our agreement to all contract terms, conditions, and Performance Work Statement (PWS) requirements.

Company Name: _________________________________ Authorized Representative: _________________________________ Title: _________________________________ CAGE Code: ____________ UEI: _________________________________

Signature: ________________________________ Date: _____________

PLEASE NOTE

Failure to complete all required items in this checklist may result in your proposal being deemed not acceptable in accordance with RFP FAR 52.212-2(d)(1). Proposals found non-compliant will be excluded from further evaluation or award consideration.