M67861-16-T-0002_amendment_01.doc

Section SF 1449 - CONTINUATION SHEET

Event Space

FFP

Please see attached Statement of Work for extended description

FOB: Destination

MILSTRIP: M2014316RC00002

PURCHASE REQUEST NUMBER: M2014316RC00002

NET AMT

STATEMENT OF WORK

PERFORMANCE WORK STATEMENT

MUSTER VENUE

1. Scope. This is a non-personal service for conference facilities, and other services to be provided to United States Marine Corps, also referred to herein as ("the Government"). The Marine Individual Ready Reserve Muster will be held on 9 January 2016 in the vicinity of Fort Worth, Texas. The actual location will be within 20 miles of the center of Fort Worth (ZIP Code 76102).

1.1. The anticipated attendance is approximately 1,400 Marine Individual Ready Reserve attendees divided in to two sessions. The morning session will begin at approximately 0700 and the afternoon session will begin at approximately 1200. Attendees are mostly Marine enlisted members from E-3 through E-5 from in and around the Fort Worth, TX area. All of the attendees are members of the Marine Individual Ready Reserve.

2. General Requirements. The Government will require nine meeting rooms on 9 January 2016 and one space on 8 January 2016. For internet connectivity, the government will require either wireless access or 2 LAN connections.

2.1. Main meeting room. The main meeting room will be required on 9 January 2016. The main meeting room should be approximately 8,000 square feet with at least a 12 foot ceiling height clearance (to accommodate screen height), chairs will be set up in theater style to accommodate up to 700 attendees per session (two sessions per day) without obstructions such as pillars or posts. The main meeting space will also require a small stage in the front of the theater seating flanked by projection screens. The venue shall provide one small stage, two (one minimum) 10 x 12 screens and usage of house sound and audiovisual equipment. Total chairs for room is 700. The venue will allow access to this room the night prior to the event in order to allow the government to set up equipment.

2.2. Muster partner room. One administrative room or common area, approximately 5,000 square feet, with 70 six-foot (minimum) tables with linen and skirting, with two chairs at each table. Total tables for Muster Partners is 70, total chairs is 140. The muster partner room will be required for 9 January 2016.

2.3. PDHRA registration room. One administrative room, approximately 3,000 square feet with at least a 12 foot ceiling height (for HIPAA requirements related to health screening). The 12 foot ceiling is a requirement. The pipe and drape used to create semiprivate space requires a ceiling height of 12 feet. Front of room shall be set up with ten 6-foot tables with linen and skirting in “U” shape. Two chairs per table shall be provided (20 table chairs). There shall be theater-style seating for 70 at the rear of the room. Total chairs for room is 90. The government must have access to this room the night prior to the event on 8 January 2016 and will need access the morning of at 0545 on 9 January 2016.

2.4. PDHRA counseling room. One administrative room, approximately 3,000 square feet set up with six 48” round tables with linen and skirting with 4 chairs at each table on left and six 48” round tables with linen and skirting with 4 chairs at each table on right. The second room should be in close proximity to the PDHRA registration room. Total chairs required: 48. The government must have access to this room the night prior on 8 January 2016 and will need access the morning of at 0545 on 9 January 2016.

2.5. MHA counseling room. One administrative room, approximately 3,000 square feet, set up with 25 6-foot tables around the perimeter, each with two chairs. Total chairs required: 50. The government must have access to this room the night prior on 8 January 2016 and will need access the morning of at 0545 on 9 January 2016.

2.6. Tiering room. One administrative room, approximately 2,500 square feet, set up with seven six-foot table with four chairs, and two 48” round tables, each with two chairs. This room shall also have theater-style seating for 20. Total chairs required: 52. Total tables required: 7 six foot and two round. The government must have access to this room the night prior on 8 January 2016 and will need access the morning of at 0545 on 9 January 2016.

2.7. Breakout room / COC. One conference/boardroom with at least 30 chairs and conference table for 9 January 2016.

2.8. VA Room. One administrative room, approximately 1,500 square feet, set up with ten six-foot tables with two chairs for a total of 20 chairs. Tables set up around the room with two chairs at each table and four cocktail rounds.

2.9. Classroom. Once administrative room, approximately 1,500 square feet, set up with eleven six-foot tables with four chairs a piece in a classroom style setting. Total tables required: 11 and total chairs required: 41. Room is needed for 8 January 2016.

2.10. Signage. Government owned signage shall be permitted in public areas of venue. Government will take full responsibility for posting and removing all signage. All signage will be placed on government owned easels.

2.11. Network access. Internet access is required in main meeting room and administration rooms. Wireless internet preferred. If not available, at least two LAN connections are required. In the case of a LAN connection, the government will supply necessary routers and cabling for terminal connections. Whatever the connection method, up to forty computers will be expected to use the network.

2.12. Shipping/Receiving. Venue shall receive and store a minimum of 20 Pelican cases no larger than 36” X 20” X 20”, each weighing up to 200lbs during the week prior to the muster.

3. Registration Space

3.1. Space is required for five 6-foot tables with linen and skirting for the greeting/sign-in counters near entry to conference spaces and five cocktail rounds. Each table shall have 3 chairs (15 chairs). Also required is a 10 foot x 40 foot area near registration counters for computer registration, which requires ten 6 ft tables with linen and skirting. Each table shall have 2 chairs (20 chairs). Total chairs required: 35. Total 6-foot tables: 15 and 5 cocktail rounds. The government will require access to this room the night prior and will need access the morning of 9 January 2016 at 0545

3.2. Internet access is required at or near computer registration. Minimum of one LAN line or twenty wireless high-speed Internet access codes.

4. Audio/Visual

4.1. Venue shall indemnify the government for damage to any equipment provided.

4.2. Venue shall provide all audio/visual labor charges (personnel/setup) within the total service charges.

4.3. Venue shall provide standard lectern/microphone in general session meeting room included in the total package price.

4.4. Audio/visual support within main meeting room:

Projection Screens – two 10’ x 12’

All necessary cabling, power cords, data video cables

Projection screen skirting

Projectors – two at 5700 Lumens (minimum)

Linen and skirting for projection table

Wireless handheld microphone (one handheld microphone at podium, one handheld microphone on stand in front of room)

Podium with light and microphone holder

Adjustable microphone stand

Audio mixer, 4 channel

Audio patch into house sound

5. Other Requirements.

5.1. Parking will be required for all attendees, to include IRR Marines, administrative staff, and muster partners on the date of 9 January 2016. A total of 1,400 spaces will be needed for the day. Approximately 700 spaces will be utilized in the morning session. Approximately 700 spaces will be utilized for the afternoon session for a total of 1,400 spaces throughout the day. Parking must be at no expense to the IRR Marines. If there is a cost attached to parking, it must be included in contract with the government.

5.2. Members attending the training in the classroom set up on 8 January 2016 will be paying individually for their parking; parking for Thursday, 8 January 2016 shall not be included in the contract with the Government.

5.3. All rooms shall be accessible the night prior to the venue for set up of equipment and accessible the morning of the event no later than 0545.

5.4. Traffic of the event. All spaces should be located on the same floor of the venue. The preferred set-up is included in the enclosed diagrams. The government prefers spaces 2.3 through 2.6 be located in the same space such as a ballroom, but other layouts will be considered. IRR Marines will be required to attend stations throughout the venue and the government can only retain the IRR Marines for four hours. These requirements make the traffic flow in the venue important for time management.

6. Business Center.

6.1. Business center shall be available for muster staff participants with access to a copy machine. Staff will need to make approximately 250 copies on the day of the event. The cost of copies shall be included in the total cost of the event.

7. Labor/Services.

7.1. Venue shall set up and take down all material provided by the venue. All gear brought by the Government will be set up and taken down by the Government.

7.2. Venue shall provide one audio/visual and/or internet system technician for the duration of the muster on 9 January 2016.

7.3. Venue shall provide audio/visual service charges (personnel/set up) within the total service charges.

All A/V charges will be quoted on a firm-fixed price basis.

Milestones

Completion Date

9 Jan 2016

9 Jan 2016

2 x display screens (10’ x 12’), 2 x 5700 lumens projectors, cabling, power cords, data video cables, projection screen skirting, 2 wireless handheld microphones, podium, audio mixer.

9 Jan 2016

ADDENDUM TO FAR 52.212-1

INSTRUCTIONS TO OFFERORS

This is a Competitive solicitation under FAR Part 12 for a firm-fixed price contract for the purchase of conference space. See Statement of Work for detailed description.

[QUOTATIONS may be submitted via email only to irving.romero@usmc.mil and cc:shelley.mentzos@usmc.mil

- All responsible sources may submit a quotation which, if received in a timely manner, shall be considered by the agency.

- Award will be made to the lowest-priced technically acceptable (LPTA) offer.

- The Government will accept Open Market or GSA offers only.

- The Government will consider competitive bids only.

- This solicitation will be awarded on an all-or-none basis.

- Method of Invoicing/Payment: Wide Area Workflow (WAWF) DFARS 252.232-7006 WAWF Instructions.

- Any direct customer contact by Bidders is not authorized during the solicitation phase or your bid may be at risk of being eliminated from consideration for this solicitation.

- NO PHONE CALLS will be accepted regarding this solicitation. ALL QUESTIONS shall be sent in writing via email to irving.romero@usmc.mil and cc: shelley.mentzos@usmc.mil.

TO BE CONSIDERED RESPONSIVE TO THIS SOLICITATION, bidders shall provide all the following:

- CAGE code

- DUNS number

- Address

- Point of contact

- Delivery lead time after receipt of order for supplies and period of performance for services if different than listed in the solicitation document. List by line item if the delivery lead time differs from one line item to another. This shall be visible on the face of the quote and not incorporated as a link or other attachment.

- Prompt payment/discount terms (if offered). This will not be used to evaluate offers.

- Contract number and expiration date shall be included if bidding under a GSA, SEWP or other contract. This shall be listed per line item unless the contract vehicle is applicable to all line items.

-Bidders shall include all hotel costs and fees that may apply including hotel cancellation fees on the face of the quote for pre-award consideration. For potential bidders outside the continental United States (OCONUS), the U.S. Army Public Health Command may request permission to conduct a Food and Water Risk Assessment (FWRA) to provide mitigation strategies to reduce the potential of foodborne illness among U.S. forces. The result of this assessment will be used to assist the Government in determining technical acceptability of food establishments being considered to provide food and water in support of military operations and exercises OCONUS. Bidders not willing to authorize this assessment will be excluded from consideration from this solicitation.

Contracting Officer’s Representative (COR): The COR/technical point of contact (TPOC) for this contract is TBD and can be reached via email at TBD. The COR is not authorized to make any changes to this contract. Only a warranted Contracting Officer (CO) is authorized to make changes to this contract. In the event the contractor effects any change at the direction of any person other than the Contracting Officer, the change will be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase incurred as a result thereof.

Contractor Support

The contractor shall designate a single point of contact with complete authority to make decisions on all technical matters connected with this purchase. That individual will be the single point of contact with whom the Contracting Officer’s Representative may interact for all support requests outlined in the Statement of Work (SOW) or Performance Work Statement (PWS) included in this solicitation. The SOW or PWS takes precedence if this paragraph conflicts with any language in the SOW or PWS.

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

09-JAN-2016

LAUREN YAW

2000 OPELOUSAS AVENUE

NEW ORLEANS LA 70146

5046977169

FOB: Destination M20143

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

Lowest-Priced Technically Acceptable

BASIS OF AWARD - Lowest Price Technically Acceptable - Offers will be ranked lowest to highest according to price. The lowest price offer will be forwarded to the requiring activity for technical evaluation (offer will be deemed either technically acceptable or technically unacceptable). If the lowest price offer is found technically acceptable and its price is determined fair and reasonable by the Contracting Officer, evaluation will be deemed complete and award will be made based on the lowest price offer. If the lowest price offer is determined technically unacceptable, the next lowest price offer will be sent for technical evaluation and price analysis. This process is repeated in order of price until an offer is deemed technically acceptable and price is determined fair and reasonable. The actual evaluation template is incorporated into this solicitation for reference. The actual evaluation template is incorporated into this solicitation for reference.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (MAR 2015) ALTERNATE I (OCT 2014)

The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site accessed through http://www.acquisition.gov . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

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

“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.

“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.

“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” 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.

“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.

“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 its stock 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 the stock of which is owned by one or more women; and

(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 posted on the SAMwebsite.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation 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 applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ___ . [Offeror to identify the applicable paragraphs at (c) through (p) 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 is to 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.

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

(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—

(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.

(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.

(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.)

[The offeror shall check the category in which its ownership falls]:

___ Black American.

___ Hispanic American.

___ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).

___ Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).

___ Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal).

___ Individual/concern, other than one of the preceding.

(d) 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 to the Equal Opportunity clause of this solicitation; 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 parts 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) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item,” “component,” “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:

[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) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms “Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,” “commercially available off-the-shelf (COTS) item,” “component,” “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) or 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, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.”

Other Foreign End Products:

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

(2) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. 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.:

[List as necessary]

(3) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II. 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:

(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 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. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals--

(1) [ ___ ] Are, [ ___ ] are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) [ ___ ] Have, [ ___ ] have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property; and

(3) [ ___ ] Are, [ ___ ] are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) [ ___ ] Have, [ ___ ] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples.

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. §6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appear rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals Contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. §362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(1) Listed End Product

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

[ ___ ] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

[ ___ ] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) [ ___ ] In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) [ ___ ] Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.]

(1) [ ___ ] Maintenance, calibration, or repair of certain…