M00263-21-Q-1020 MCRD PISC Ice.pdf

SEE ADDENDUM

(No Collect Calls)

M0026321Q1020 28-Apr-2021

b. TELEPHONE NUMBER

843-228-2157

8. OFFER DUE DATE/LOCAL TIME

02:00 PM 14 May 2021

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

M002639. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

PHILIP PICKENS

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

M3200121SUVXVX3

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

REGIONAL CONTRACTING OFFICE

ATTN: SSGT PHILIP PICKENS P.O. BOX 5069

PARRIS ISLAND SC 29905

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE M00263 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

MCRD PARRIS ISLAND

MANNIE SMART

BLDG 500A

ALASKA ST.

PARRIS ISLAND SC 29905

TEL: 843-228-2632 FAX:

(843) 228-2163FAX:

TEL: (843) 228- 2157

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

NAICS:

312113

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF50

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

M0026321Q1020

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1,500,000 Pound Ice and Freezer rental

FFP

Ice Delivery to (3) locations with rental of (2) Outdoor Walk-in Freezer units capable of storing up to 7,000lbs (ea) of ice for the duration of this contract in accordance with the PWS

FOB: Destination

MILSTRIP: M3200121SUVXVX3

PURCHASE REQUEST NUMBER: M3200121SUVXVX3

PSC CD: 8960

NET AMT

CLIN MINIMUM/MAXIMUM QUANTITY AND CLIN VALUE

The minimum quantity(s) and CLIN value(s) for all orders issued against the CLIN(s) on this contract shall not be less than the minimum quantity(s) and CLIN value(s) stated in the following table. The maximum quantity(s) and CLIN value(s) for all orders issued against the CLIN(s) on this contract shall not exceed the maximum quantity(s) and CLIN value(s) stated in the following table.

CLIN

MINIMUM

QUANTITY

MINIMUM

AMOUNT

MAXIMUM

QUANTITY

MAXIMUM

AMOUNT

0001 10,000.00 1,500,000.00

CLIN DELIVERY/TASK ORDER MINIMUM/MAXIMUM QUANTITY AND CLIN ORDER VALUE

The minimum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not be less than the minimum quantity and order value stated in the following table. The maximum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not exceed the maximum quantity and order value stated in the following table.

CLIN

MINIMUM

QUANTITY

MINIMUM

AMOUNT

MAXIMUM

QUANTITY

MAXIMUM

AMOUNT

0001 10000.00

30,000.00

Section C - Descriptions and Specifications

PERFORMANCE WORK STATEMENT

1. GENERAL: This requirement is for ice delivery and freezer rental at Marine Corps Recruit Depot, Parris

Island (MCRDPI), South Carolina. The contractor will provide freezer rentals to two designated locations and weekly ice delivery to three designated locations at MCRDPI.

1.1 SCOPE OF WORK: The contractor will provide freezer rentals at (2) locations that are capable of storing up to 7,000 lbs of ice and weekly ice delivery at (3) designated locations from 20 May 2021 to 19 May 2026.

1.2 PERIOD OF PERFORMANCE: The period of performance shall be for (5) Year Ordering Period from

20 May 2021 to 19 May 2026.

2. REQUIREMENTS

2.1 Freezer Rental

2.1.1 Contractor will provide (2) outside freezer units capable of storing 7,000 lbs of ice at locations 3b

& 3c as identified in paragraph 3. The contractor may provide no more than seven (7) freezers (1,000 lbs each) per location to accomplish this task (3b (AS-26) and 3c (Event 6)). (See enclosure 1 for locations)

2.1.2 The contractor shall be responsible for all maintenance requirements without any additional cost to the government.

2.1.3 All maintenance requests shall be completed or equipment replaced within 36 hours from notification to include weekends and holidays.

2.2 Ice Delivery

2.2.1 DELIVERY ORDERS. The Government shall submit Delivery Orders utilizing the Standard

Form (SF) 1449 Solicitation/Contract/Order for Commercial Items, issued by the Regional Contacting Office

(RCO). No work shall be allowed to start without a signed Delivery Order. The contractor shall be required to prepare to commence work on each Delivery Order within 12 business hours after issuance of the Delivery

Order, unless the Delivery Order specifies differently. Point of contact and telephone information shall be identified for each delivery order by the RCO

2.2.1.1 The Contractor shall maintain the capability to deliver weekly no less than 1,000 lbs and no more than 7,000lbs at each designated location. During HOTSOP April - October the estimated weekly requirement is 6,000-21,000 lbs of ice. During COLDSOP November - March the estimated weekly requirement is 0-6,000 lbs

2.2.2 DELIVERY TICKETS. The Contractor shall furnish the authorized Government Representative with a copy of the Delivery Ticket at the time of delivery. Each delivery ticket shall reflect the Order Number, Contract Number, Item Number, Description of Supplies/Services and the Quantities Received. The authorized

Government Representative is responsible for Inspection and Acceptance for all items orders, prior to certifying items received in Wide Area WorkFlow (WAWF)

2.2.3 The contractor will be required to off load the ice and place it inside the freezers at all three delivery locations

2.2.4 Ice shall be delivered in plastic bags no smaller than 10 lbs and no larger than 40 lbs. Bags used for packaging must be made with odor-free 100% virgin Linear low-density polyethylene (LLDPE) resins, which meet all U.S. Food and Drug Administration (FDA) & United States Department of Agriculture (USDA) requirements for food contact

2.2.5 Ice labels on packaged ice shall meet the FDA Food Labeling requirements. The labels must list the name and place of business of the manufacturer, packer, or distributor of the ice. The labels must also list the net quantity of contents of the product. Because ice is a single ingredient food, packaged ice does not need listing of ingredients. In addition, ice does not require a nutrition facts label, unless the package has a nutrient content claim (such as low in sodium). Ice labeled as being from a specific source, such as spring water or artesian well water, must be truthfully labeled and not misleading; in other words, it must really be from that source. The source water must meet all the requirements for such types of source water, as described in the

FDA Regulations

2.2.5.1 CERTIFICATION. The Contractor shall confirm in writing, that they meet or exceed the minimum sanitary requirements for manufacture, storage, and transport of ice as follows and in accordance with the Current Good Manufacturing Practice in Manufacturing, Packing, or Holding Human Food (Code of Federal Regulation Title 21, Chapter 1, Part 110). Certification shall be provided to the Contracting

Officer within 30 days after contract award

2.2.6 The government’s initial order will be for 10,000 lbs. The government may issue additional task orders up to an additional 1,500,000 lbs during the performance of this contract

2.2.7 The government and the contractor will keep copies of delivery receipts and a delivery order tracking list. The delivery order tracking list will at a minimum contain: date of delivery, location delivered

(there are three locations), quantity delivered, printed name of government representative present at delivery, signature of government representative, total ice delivered to date, and running total of ice remaining on contract. (See Enclosure 2)

2.2.8 BASE ACCESS. Shall be coordinated with the designated Government Representative. All personnel employed by the contractor, or any representative of the contractor entering MCRD, Parris Island, SC, shall abide by all the regulations of the installation, which may be in effect during the contract period. The

Government reserves the right to restrict access to the installation under the contract of any contractor employee, or prospective contractor employee, who is identified as potential threat to the health, safety, security, general well-being, or operational mission of the installation and its population

2.2.9 INSPECTION OF CONTRACTOR FACILITIES. The Government reserves the right to conduct an inspection of contract facilities prior to awarding a contract or at any time during the contracted period. The

Contracting Officer may be accompanied by a representative from the offices of the Staff Judge Advocate, Inspector General, Preventive Medicine, and Crime Prevention, Safety and Fire Departments and/or other personnel deemed appropriate by the Contracting Officer. Such inspection will be performed to ascertain that the Contractor’s manufacturing facility meets the standards established in the Army Regulation 40-657, NAVSUP 4355.4H and MCO P10110.31H Veterinary/Medical Food Safety, Quality Assurance, and Laboratory

Services. Failure to pass the inspection shall be cause for suspension and/or termination of the contract

3. Delivery Locations and Distance:

3a. Ice Station #1: Building 699 Shanghai St, Parris Island, SC (Distance from main gate, 2.1 miles)

3b. Ice Station #2: AS-26, 77 Chamber Dr (Distance from main gate, 3.5 miles)

3c. Ice Station #3: Event 6, Building 42 Pusan Rd, Parris Island, SC (Distance from main gate - 2.8 miles)

Enclosure (1) – Delivery Locations

3a. Ice Station #1: Building 699 Shanghai St, Parris Island, SC (Distance to AS-26, 2.7 miles)

3b. Ice Station #2: AS-26, 77 Chamber Dr (Distance to Event 6, 2.6 miles)

3c. Ice Station #3: Event 6, Building 42 Pusan Rd, Parris Island, SC (Distance to Event 2.8 miles)

Enclosure (2) – Template Ice Delivery Tracking List. (Available in Excel)

Delivery Order # RTR

PAGE

FIELD

EVENT

Delivery Date

Gov. Rep.

Printed Name

Gov. Rep.

Signature total delivered

Ice Station #3

Freezer and Ice Ice Station #2

Freezer and Ice

Ice Station #1

Ice Only

Ice On

Total Ice Available 1500000.00

Ice purchased 0.00 lbs Ice Remaining Balance 1500000.00 lbs

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

Section F - Deliveries or Performance

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 5 yrs. ADC 1,500,000 MCRD PARRIS ISLAND

MANNIE SMART

BLDG 500A

ALASKA ST.

PARRIS ISLAND SC 29905

843-228-2632

FOB: Destination

M00263

Section G - Contract Administration Data

BASE ACCESS

BASE ACCESS

CONTRACTOR ACCESS TO MCRD PARRIS ISLAND, SOUTH CAROLINA

A. INTRODUCTION

The Commanding General (CG), MCRD/ERR PI grants the privilege to gain access to the Depot, conditionally, to those individuals or organizations that meet the minimum qualifications and conform to regulations. CG, MCRD/ERR PI retains the responsibility to suspend or revoke access privileges if necessitated by and action deemed contrary to maintaining good order and discipline aboard this installation. In order to gain access to Marine Corps Recruit Depot, Parris Island (MCRDPI), SC, non-Federal Government and non-DoD issued ID cardholders require identity proofing and vetting to determine fitness and eligibility for access.

All contractor personnel, to include delivery personnel, who perform work on Marine Corps Recruit Depot Parris Island, SC (MCRDPI) for the cited contract must adhere to the Defense Biometric Identification System (DBIDS) process to gain access MCRDPI provided in paragraphs B and C. Individuals operating a vehicle aboard our military installations are required to have a valid, U.S. Driver’s License, registration, and insurance. If an individual has a foreign driver’s license, said individual must also provide a valid Passport. The contractor shall understand and comply with Depot Order 5512.12A Access Control Regulations.

Marine Corps Installations across the region are transitioning to a new government-owned access control system called Defense Biometric Identification System (DBIDS). This new and enhanced system replaces RAPIDGate and MCESS for contractors and other non-DoD-affiliated personnel requiring installation access. DBIDS is already installed at more than 320 sites with over 5 million registered personnel and unlike previous systems, this one is a free service.

In order to reduce wait time when exchanging your RAPIDGate/MCESS credential, it is highly recommended each applicant pre-register at https://dbids-global.dmdc.mil/enroll#!/.

B. DBIDS ACCESS

DBIDS credentials is now being issued as of October 1, 2018. If you currently hold a valid Common Access Card (CAC), dependent ID card, reserve ID card, or retiree ID card, issued by the Defense Enrollment Eligibility Reporting System (DEERS), no further action is required.

You will be automatically enrolled in DBIDS when your ID card is initially scanned at the gate.

Expect a one-time delay of 3-6 seconds as the DBIDS system initially registers your information.

CURRENT CONTRACTORS

- DBIDS credentials will be valid for the duration of your contract, not to exceed five years;

however, re-vetting of individuals’ information will occur each year.

- RAPIDGate/MCESS credentials are still being accepted at Parris Island Depot. An exact termination of RAPIDGate is 31 December 2018.

https://dbids-global.dmdc.mil/enroll#!/

NEW CONTRACTORS

The contractor shall submit a written request on company letterhead to the Contracting Office listing the following: contract number, location of work site, start and stop dates, and names of employees and subcontractor employees needing access to the base. The format for the letter will be provided by the Contracting Office. In addition to the aforementioned letter, the contractor must also submit a contractor information sheet on each employee. A template for the letter and contractor informational sheet template will be provided upon contract award. The Contracting Office will endorse the request and forward to the Depot Security Manager Office for processing. This information must be provided to the assigned Contract Specialist and/or Contracting Officer for the contract at least two (2) weeks prior to start of the contracts period of performance.

Contractors must do the following in order to obtain a base access card:

- Submit Contractor Application Form and cover sheet to the Contracting Office

- The Contracting Office will send the form to G3 Security

- Once cleared (weekly list sent out), pre-register at DBIDS o Google DBIDS (1st link) o https://dbids-global.dmdc.mil/enroll#!/

- Take QR code to PMO for badge

- If cleared with the Air Station, an application still needs to be submitted to Security at

Parris Island but we will reciprocate off of their cleared/not cleared for base access.

- New contractors requiring access for over 60 days will receive a credential valid for up to one year.

- New contractors requiring access for less than 60 days will receive a temporary paper pass.

Pending means that there were issues that our office needs to review to determine if the individual will or will not be denied base access.

If you have questions regarding the exchange of a current RAPIDGate/MCESS credential for DBIDS or you are a new contractor seeking enrollment into DBIDS, please contact the Security Office at 843-228-4174.

C. Contractor’s Responsibility A criminal background check conducted by the MCRDPI Security Manager’s Office shall be required for all contractor personnel who make frequent visits to or perform work on the MCRDPI cited in the Contract, prior to the start date of the contract. Contractors are required to review any proposed employee prior to submitting their names for the background check. Depot access will be denied if it is determined that the personnel requesting access are within one of the following categories:

1. On the National Terrorist Watch List.

2. Illegally present in the United States.

3. The subject to any outstanding warrant or criminal summons.

4. Has knowingly submitted an employment questionnaire with false or fraudulent information.

5. Has been issued a debarment order and is currently banned from any military installation.

6. A prisoner on work-release program or currently on felony probation/parole.

7. A registered sex offender.

8. Membership within the previous 10 years in any organization that advocated the overthrow of the U.S. Government or affiliated with any active gang.

https://dbids-global.dmdc.mil/enroll

9. Is pending any felony charges.

10. Has been convicted of a felony within the last ten (10) years.

11. Has multiple (three or more) misdemeanor criminal offenses to include, but not limited to:

a. Drug Offenses

b. Offenses of violence

c. Weapons offenses including those where the weapon was used as either the means of the violence or threat of violence

d. Larceny/theft

12. Any reason the Installation Commander deems reasonable for good order and discipline.

No physical badge will be issued. If a contractor’s proposed employees requiring access meet the required criminal background check, upon entry, each contractor employee must present a valid form of identification (Driver’s License). At the front gate, the Provost Marshall’s Office will screen each contractor employee against MCRDPI Security Manager’s Office listing of approved contractor employees. The operator of the motor vehicle must also provide valid registration and current insurance.

D. ADDITIONAL BASE ACCESS GUIDANCE

1. All vehicles are subject to search

2. No Illegal Drugs

3. Firearms are prohibited

4. Fireworks are prohibited

5. Strictly obey speed limits

6. No Cell Phone use while driving

7. DO NOT enter any training, unauthorized, or restricted areas.

8. Military Police Contact Information

i. Emergency Dial – 911

ii. Non-Emergency Dial – 843.228.3444

Contractor’s Letterhead Here

(Date)

From: (Position, Company Name, Phone, Email, and Address)

To: Assistant Chief of Staff, Operations and Training (G-3)

Via: (Requesting Commercial/Contract Employer)

Subj: DEPOT ACCESS REQUEST IN LEIU OF RAPIDGATE; IN CASE OF CONTRACT #

Ref: (a) MARADMIN

Encl: (1) Information Sheet

1. In accordance with the references, it is requested that the following personnel, listed on the enclosure(s), be granted access to MCRD/ERR Parris

Island in support of Contract #___________________________.

2. The term of this contract is considered valid _____________until

_____________ and will require access aboard MCRD/ERR Parris Island during

(hours and days of the week). Personnel aboard the installation working in union with this contract will /will not additionally be required access to any “Restricted Area”.

3. Personnel identified in the enclosures have been advised, understand, and expressly consent to a background investigation conducted by representatives of the U.S. Marine Corps using the personal information provided herein.

4. Personnel understand they will initially be issued one 30 day temporary pass and thereafter will only be able to obtain temporary passes for up to 4 days at a time.

5. Personnel identified in the enclosures have been advised and understand that while working aboard the installation they are subject to and will:

a. Abide by all local, State and Federal Laws and Regulations governing conduct, registration, licensing and traffic flow.

b. Proceed directly to their work area to begin work and depart directly off the Depot once their work day has ended.

c. Not travel into Military Housing areas unless directed to do so by the scope of the contract and with direct authorization from a supervisor/foreman.

6. Any questions regarding this matter should be directed to (Contractor

Rep), (Company Name), at extension (phone number).

(Contractor Company Authorizing

Signature)

ENDORSEMENT

From: (Commercial/Contracting Agency)

To: AC/S, Operations and Training (G-3)

Attn: Security Manager

Subj: ACCESS REQUEST

1. Forwarded Approved; recommend issuance of Temporary Pass.

Print

Signature

DEPOT CONTRACTOR INFORMATION SHEET

COMPANY REQUIRED INFORMATION

Contractor:

Contract # and Contract Expiration Date:

Subcontractor:

Subcontractor Expiration Date:

Company Point of Contact

(Name/Email/Phone #):

EMPLOYEE INFORMATION

U.S. Citizen: Yes No

(Circle One)

SSN: Alien Registration #: Expires:

PERSON INFORMATION

Last Name:

First Name: Middle Name: Sr., Jr., III etc:

Driver’s License Number: Driver’s License State: Driver’s License Country:

Date of Birth: (YYYYMMDD) City of Birth: State of Birth: Country of Birth:

APPEARANCE INFORMATION (Physical Description)

Weight:

Height: Race: Gender: Hispanic? (Y/N) Hair Color: Eye Color:

LOCATION INFORMATION

Contractor: Base Duty Location:

Work Phone:

Home Phone: Cell Phone:

Employer

(Subcontractor Company Name):

Employee Start Date:

Full Home Address:

(including zip code)

Full Mailing Address (If Different):

(including zip code)

Privacy Act Statement: Information requested above, including the Social Security Number, is collected under the authority provided by Title 5 US Code Sec. 301 and Title 44 US Code Sec. 3101. This information is being solicited in order to allow representatives of the U.S. Marine Corps to make a determination regarding access to

Marine Corps Recruit Depot, Parris Island. Disclosure of this information is voluntary, however, failing to provide the information requested above may result in a denial of access to the military facility. Routine use of the information provided shall include, without limitation, all those functions necessary to comply with civil/military administrative and regulatory actions.

Employee’s Signature: ______________________________________________________ Date:

I certify that the above named employee is in our employment and requires access until the indicated expiration date.

Supervisor Signature: ______________________________________________________ Date:

Requires After Hours Access: YES / NO Requires Access to Depot Housing Areas: YES / NO

DEPOT SECURITY MANAGERS OFFICE USE ONLY

Check CLEOC:

Run NCIC Date/Time:

Decision by Security Manager:

CLEOC Narr Added Date/Time:

ENCLOSURE (2)

FOR OFFICIAL USE ONLY

Section I - Contract Clauses

CLAUSES INCORPORATED BY REFERENCE

52.203-3 Gratuities APR 1984

52.203-13 Contractor Code of Business Ethics and Conduct JUN 2020

52.203-17 Contractor Employee Whistleblower Rights and Requirement

To Inform Employees of Whistleblower Rights

JUN 2020

52.204-2 Security Requirements MAR 2021

52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011

52.204-13 System for Award Management Maintenance OCT 2018

52.204-18 Commercial and Government Entity Code Maintenance AUG 2020

52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.204-24 Representation Regarding Certain Telecommunications and

Video Surveillance Services or Equipment.

OCT 2020

52.212-1 Instructions to Offerors--Commercial Items JUN 2020

52.212-4 Contract Terms and Conditions--Commercial Items OCT 2018

52.224-1 Privacy Act Notification APR 1984

52.224-2 Privacy Act APR 1984

52.232-17 Interest MAY 2014

52.232-23 Assignment Of Claims MAY 2014

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-1 Disputes MAY 2014

52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.242-13 Bankruptcy JUL 1995

52.247-34 F.O.B. Destination NOV 1991

52.253-1 Computer Generated Forms JAN 1991

252.201-7000 Contracting Officer's Representative DEC 1991

252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7003 Control Of Government Personnel Work Product APR 1992

252.225-7001 Buy American And Balance Of Payments Program-- Basic DEC 2017

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2017

252.225-7012 Preference For Certain Domestic Commodities DEC 2017

252.227-7000 Non-estoppel OCT 1966

252.232-7010 Levies on Contract Payments DEC 2006

252.247-7007 Liability and Insurance DEC 1991

252.247-7023 Transportation of Supplies by Sea FEB 2019

CLAUSES INCORPORATED BY FULL TEXT

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (FEB 2021)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

(a) Definitions. As used in this provision --

“Covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“Economically disadvantaged women-owned small business (EDWOSB) Concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

"Forced or indentured child labor" means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation” means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except--

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

https://www.sam.gov/

“Place of manufacture” means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.

“Reasonable inquiry” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain

Telecommunications and Video Surveillance Services or Equipment.

“Restricted business operations” means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate--

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

“Sensitive technology”--

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically--

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act

(50 U.S.C. 1702(b)(3)).

“Service-disabled veteran-owned small business concern”--

(1) Means a small business concern--

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

"Small business concern"--

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13

CFR part 121 and size standards in this solicitation.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

“Small disadvantaged business concern”, consistent with 13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that--

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by--

(i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

“Subsidiary” means an entity in which more than 50 percent of the entity is owned--

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term

“successor” does not include new offices/divisions of the same company or a company that only changes its name.

The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

“Veteran-owned small business concern” means a small business concern--

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

"Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

“Women-owned small business concern” means a small business concern--

(1) That is at least 51 percent owned by one or more women or, in the case of any publicly owned business, at least

51 percent of its stock is owned by one or more women; or

(2) Whose management and daily business operations are controlled by one or more women.

“Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)”, means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the

United States.

(b) (1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM.

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror

Representations and Certifications--Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __.

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United

States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a small business concern.

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. (Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.) The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ___ ) is, ( ___ ) is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ___ ) is, ( ___ ) is not a women-owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that--http://www.sam.gov/

(i) It [ ___ ] is, [ ___ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB

Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___ .] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that--

(i) It [ ___ ] is, [ ___ ] is not an EDWOSB concern, has provided all the required documents to the WOSB

Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___ -.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(8) Women-owned business concern (other than small business concern). (Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ( ___ ) is, a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:

(10) HUBZone small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents, as part of its offer, that--

(i) It [ ___ ] is, [ ___ ] is not a HUBZone small business concern listed, on the date of this representation, on the

List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It [ ___ ] is, [ ___ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: ___ .] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) Certifications and representations required to implement provisions of Executive Order 11246--

(1) Previous Contracts and Compliance. The offeror represents that--

(i) It ( ___ ) has, ( ___ ) has not, participated in a previous contract or subcontract subject either to the Equal

Opportunity clause of this solicitation, the and

(ii) It ( ___ ) has, ( ___ ) has not, filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that--

(i) It ( ___ ) has developed and has on file, ( ___ ) has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR

Subparts 60-1 and 60-2), or

(ii) It ( ___ ) has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of

Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB

Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy

American --Supplies, is included in this solicitation.)

(1) (i) The Offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product.

(ii) The Offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products.

(iii) The terms "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Supplies."

(2) Foreign End Products:

Line item No. Country of origin

[List as necessary]

(3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(g)(1) Buy American--Free Trade Agreements--Israeli Trade Act Certificate. (Applies only if the clause at FAR

52.225-3, Buy American--Free Trade Agreements--Israeli Trade Act, is included in this solicitation.)

(i) (A) The Offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (iii) of this provision, is a domestic end product.

(B) The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product,"

"Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American--Free

Trade Agreements--Israeli Trade Act."

(ii) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than

Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--Israeli Trade Act."

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian

End Products) or Israeli End Products:

(iii) The Offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American--Free Trade Agreements--

Israeli Trade Act." The Offeror shall list as other foreign end products those end products manufactured in the

United States that do not qualify as domestic end products.

Other Foreign End Products:

(iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(2) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph

(g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American -Free Trade Agreements-Israeli Trade Act":

Canadian End Products:

Line item No.

(3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph

(g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Canadian or Israeli End Products:

Line item No. Country of origin

(4) Buy American--Free Trade Agreements--Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American --Free Trade Agreements--Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or

Peruvian End Products) or Israeli End Products:

(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled "Trade Agreements".

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products:

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.