J-0200000-11 Contractor Self Performance Cert.pdf

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Attachment J-0200000-11

Contractors Self Performance Certification & Notification of Subcontracting Form

From:

To: Kara Holwick NAVFACSYSCOM Mid-Atlantic, Contracting

Subj: Solicitation/Contract No. N40085-22-R-2547

1. In accordance with the provisions of FAR Clause 52.219-14, Limitations on Subcontracting, the Contracting Officer is hereby notified that ________________________(Company) intends to subcontract the following portion(s) of the requirements of this contract:

SUBCONTRACTOR INFORMATION TYPE OF WORK TO BE

SUBCONTRACTED

PERCENT (%) OF

TOTAL CONTRACT

VALUE

NAME:

ADDRESS:

CAGE/DUNS:

PRIMARY NAICS:

COMPANY SIZE:

POC:

PHONE:

EMAIL:

NAME:

ADDRESS:

CAGE/DUNS:

PRIMARY NAICS:

COMPANY SIZE:

POC:

PHONE:

EMAIL:

* * Table may be expanded as needed.

2. Furthermore, in accordance with the provisions of FAR 52.219-14, Limitations on Subcontracting (Nov 2011), by submission of an offer and execution of this contract, ________________________(Company) agrees that in performance of this contract, in the case of a contract for –

(a) Services (except construction) - it will not pay more than 50 percent of the amount paid by the Government for contract performance to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count toward the 50 percent subcontract amount that cannot be exceeded;

(b) Supplies (other than procurement from a non-manufacturer of such supplies), it will not pay more than 50 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count toward the 50 percent subcontract amount that cannot be exceeded;

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(c) General construction, it will not pay more than 85 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count toward the 85 percent subcontract amount that cannot be exceeded

3. Additionally, __________________________(Company) certifies that they will self-perform the following work –

Description of Work Percentage of the Total Contract Value

* * Table may be expanded as needed.

Note: Percentages of subcontracted work plus self-performed work should equal 100%.

4. No changes in subcontractors are allowed without prior written approval of the Contracting Officer and the SBA. The contractor shall notify the Contracting Officer and its SBA servicing center a minimum of 10 business days prior to any needed change. The contractor shall not proceed with any requested change in advance of written approval from the Contracting Officer and the SBA.

CONTRACTOR:

SIGNATURE NAME AND TITLE DATE

CONTRACTING OFFICER APPROVAL:

SIGNATURE NAME AND TITLE DATE

SBA APPROVAL:

SIGNATURE NAME AND TITLE DATE