Quotations_15T4276.pdf

REQUEST FORQl,JOTATIONS

(THIS IS NOT AN ORDER)

THISRFQ [ ]IS [)(]ISNOTASMALLBUSINESSSET-ASIDE

PAGE OF PAGES

I

f. REQUESf NO. 2. DATE ISSUED I 3. REQUISITION/PURCHASE REQUESfNO.

4. CERT. FORNAT. DEF. RATING

28-11/Bv-2015

NSV\CDD

UNDER BDSA REG. 2

AND/OR DMS REG. 1

6. DELIVERBY (Date)

ATTN: RITANEVIMAN/CODE026

DORITHANE\1\MAN@NAVY.MIL

17632 DAHLGREN ROAD SUITE 157

DAHLGREN VA22485

SEE SCHEDULE

. CB..IVERY

~--------------------------------------------------~[X] FOB

5b. FOR INFORMATION CALL: (Name and Telephone no) (No collect calls)

OORITHA J. NE\M\116.N

DESfiNATION

] OTHER

(See Schedule)

8. TO: NAME AND ADDRESS, INCLUDING ZIP CODE DESfiNATION (Consignee and address, including ZIP Code)

I I

6220TISDALE ROAD STE 159

DAHLGREN VA22448-5114

TEL: 54().653-1784 FAX:

10. PLEASE FURNISH QUOTATIONS TO THE ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS:

(Date) 11-Jun-2015

IMPORTANT. This is a request fur iufunnation, and quotations furnished are not ofiers. Ifyou are una!>le to quote, please so indicate on this furmand return it to the address in Block Sa. This request does not connit the Government to pay any costs incurred in the preparation of the submission of this contract fur supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representatio'l

Request fur Quotations must be COflllle!ed by the quoter.

SEE SCHEDULE

AMOUNT

(f)

12. DISCOUNT FOR PROMPT PAYMENT I a. 10 CALENDAR DAYS b. 20 CALENDARDAYS I c. 30 CALENDAR DAYS

13. NAME AND ADDRESS OF QUOTER (Street, City, County, State, and ZIP Code)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

15. DATE OF

QUOTATION

16. "NAME AND TITLE OF SIGNER (Type or print) 1ELEPHONENO.

(Include area code)

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA FAR (48CFR) 53.215-1(a)

Section B - Supplies or Services and Prices

ITEM NO SUPPLIES/SERVICES QUANTITY

0001 18

PART# DUNET-30-4948-01

FFP

UNIT

Each

DuraNET 4948 Ruggedized Cisco 4948E Switch, 48+4 Ports FOB: Destination

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT

Each 0002 7

OPTION PART# DUNET-30-4948-01

FFP

DuraNET 4948 Ruggedized Cisco 4948E Switch, 48+4 Ports FOB: Destination

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT

Each 0003 2

OPTION PART# DUNET-30-4948-01

FFP

DuraNET 4948 Ruggedized Cisco 4948E Switch, 48+4 Ports FOB: Destination

•• N00178-15-T-4276

Page2 of42

UNIT PRICE AMOUNT

NETAMT

UNIT PRICE AMOUNT

NETAMT

UNIT PRICE AMOUNT

NETAMT

ITEM NO SUPPLIES/SERVICES QUANTITY

0004 4

OPTION PART# DUNET-30-4948-01

FFP

UNIT

Each

DuraNET 4948 Ruggedized Cisco 4948E Switch, 48+4 Ports FOB: Destination

ITEM NO SUPPLIES/SERVICES QUANTITY

0005 6

OPTION PART# DUNET-30-4948-01

FFP

UNIT

Each

DuraNET 4948 Ruggedized Cisco 4948E Switch, 48+4 Ports FOB: Destination '

N00178-15-T-4276

Page 3 of42

UNIT PRICE AMOUNT

NETAMT

UNIT PRICE AMOUNT

NETAMT

Section E - Inspection and Acceptance

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY

0001 Destination . Government 0002 Destination Government 0003 Destination Government 0004 Destination Government 0005 Destination Government

ACCEPT AT

Destination Destination Destination Destination Destination

NOO 178-15-T -4276

Page 4 of42

ACCEPT BY

Government Government Government Government Government

Section F - Deliveries or Performance

DELIVERY INFORMATION

CLIN DELIVERYDATE QUANTITY

0001 31-AUG-2015 18

0002 30-0CT-2015 7

0003 31-DEC-2015 2

0004 29-FEB-2016 4

0005 29-APR-2016 6

CLAUSES INCORPORATED BY REFERENCE

52.247-34 F.O.B. Destination

CLAUSES IN CORPORA TED BY FULL TEXT

Ddl-F20 RECEIVING HOURS OF OPERATION

.e N00178-15-T-4276

Page 5 of42

SHIP TO ADDRESS VIC

NAVAL SURFACE WARFARE CENTER N00178

6220 TISDALE ROAD STE 159

DAHLGREN VA 22448-5114

540-653-1784 FOB: Destination

(SAME AS PREVIOUS LOCATION)

FOB: Destination

(SAME AS PREVIOUS LOCATION)

FOB: Destination

(SAME AS PREVIOUS LOCATION)

FOB: Destination

(SAME AS PREVIOUS LOCATION)

FOB: Destination

NOV 1991

N00178

N00178

N00178

N00178

All deliveries to the Receiving Officer, Dahlgren Division, Naval Surface Warfare Center, Dahlgren, VA shall be made Monday through Friday from 7:00a.m. to 2:30p.m., local time. Deliveries will not be accepted after 2:30 p.m. No deliveries will be made on government holidays.

Ddl-F40 CONTRACTOR NOTICE REGARDING LATE DELIVERY

In the event the contractor anticipates or encounters difficulty in complying with the contract delivery schedule or date, he/she shall immediately notifY, in writing, the Contracting Officer and the cognizant Contract Administration Services Office, if assigned. The notice shall give the pertinent details; however such notice shall not be construed e e N00178-15-T-4276

Page 6 of42

"as a waiver by the Government of any contract delivery schedule, or of any rights or remedies provided by law or under this contract.

NOO 178-15-T -4276

Section G - Contract Administration Data

CLAUSES IN CORPORA TED BY REFERENCE

52.232-18 252.204-000 1 252.232-7003

A vail ability Of Funds Line Item Spec~fic: Single Funding Electronic Submission of Payment Requests and Receiving Reports

CLAUSES IN CORPORA TED BY FULL TEXT

APR 1984

SEP 2009

JUN 2012

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(a) Defmitions. As used in this clause~-

Page 7 of42

Department of Defense Activity Address Code (DoDAAC) is a six position code that uniquely identifies a unit, activity, or organization.

Document type means the type of payment request or receiving report available for creation in Wide Area WorkFlow

(WAWF).

Local processing office (LPO) is the 0ffice responsible for payment certification when payment certification is done external to the entitlement system.

(b) Electronic invoicing. The W A WF system is the method to electronically process vendor payment requests and receiving reports, as authorized by DFARS 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WA WF access. To access WA WF,the Contractor shall--

( 1) Have a designated electronic business point of contact in the System for Award Management Registration at https://www.acquisition.gov; and

(2) Be registered to use WA WF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this Web site.

(d) W A WF training. The Contractor should follow the training instructions of the W A WF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WA WF. Both can be accessed by selecting the "Web Based Training" link on the WA WF home page at https:/ /wawf. eb.mil/.

(e) W A WF methods of document submission. Document submissions may be via Web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WA WF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in W A WF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

INVOICE AND RECEIVING REPO~T COMBO (FFP SUPPLY)

Page 8 of42

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WA WF, as specified by the contracting officer.

INSPECTION LOCATION: DESTINATION

ACCEPTANCE LOCATION: DESTINATION

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in W A WF when creating payment requests and receiving reports in the system.

Routing Data Table!!<

Field Name in WA WF

Pay Official DoDAAC Issue By DoDAAC Admin DoDAAC Inspect By DoDAAC Ship To Code Ship From Code Mark For Code Service Approver (DoDAAC) Service Acceptor (DoDAAC) Accept at Other DoDAAC LPODoDAAC DCAA Auditor DoDAAC Other DoDAAC(s)

Data to be entered in W A WF

PROVIDED AT TIME OF AWARD

N00178 N00178 N!A N00178 N/A N/A N/A

WA

N/A N/A

NIA

N/A

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and sub line item descriptions ofthe work performed or supplies delivered, unit · price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

( 5) W A WF email notifications. The Contractor shall enter the email address identified below in the ''Send Additional Email Notifications" field of WA WF once a document is submitted in the system.

TO BE PROVIDED AT TIME OF A WARD

(g) W A WF point of contact. ( 1) The Contractor may obtain clarification regarding invoicing in W A WF from the following contracting activity's W A WF point of contact.

DLGR_NSWC_WAWF_Admin®navy.mil

(2) For technical W A WF help, contact the W A WF helpdesk at 866-618-5988.

(End of clause)

Page 9 of42

HQ G-2-0009 SUPPLEMENTAL INSTRUCTIONS REGARDING ELECTRONIC INVOICING (NAVSEA) (SEP 2012) .

(a) The Contractor agrees to segregate costs incurred under this contract/task order (TO), as applicable, at the lowest level of perfonnance, either at the technical instruction (TI), sub line item number (SLIN), or contract line item number (CLIN) level, rather than on a total contract/TO basis, and to submit invoices reflecting costs incurred at that level. Supporting documentation in Wide Area Workflow (W A WF) for invoices shall include summaries of work charged during the period covered as well as overall cumulative summaries by individual labor categories, rate~, and hours (both straight time and overtime) invoiced; as well as, a cost breakdown of other direct costs (ODCs), materials, and travel, by TI, SLIN, or CLIN level. For other than finn fixed price subcontractors, subcontractors are also required to provide labor categories, rates, and hours (both straight time and overtime) invoiced; as well as, a cost breakdown ofODCs, materials, and travel invoiced. Supporting documentation may be encrypted before submission to the prime contractor for W A WF invoice submittal. Subcontractors may email encryption code infonnation directly to the Contracting Officer (CO) and Contracting Officer Representative (COR).

Should the ~ubcontractor lack encryption capability, the subcontractor may also email detailed supporting cost infonnation directly to the CO and CQR; or other method as agreed to by the CO.

(b) Contractors submitting payment requests and receiving reports to W A WF using either Electronic Data Interchange (EDI) or Secure File Transfer Protocol (SFTP) shall separately send an email notification to the COR and CO on the same date they submit the invoice in WA WF. No payments shall be due if the contractor does not provide the COR and CO email notification as required herein.

Section I - Contract Clauses

CLAUSES IN CORPORA TED BY REFERENCE

52.204-7 52.204-13 52.204-16 52.204-17 52.204-18 52.204-19

52.209-2

52.211-6 52.212-4 52.225-25

52.232-39 52.232-40

52.233-1 52.244-6 252.203-7000

252.203-7002 252.203-7005

System for Award Management Systeni for Award Management Maintenance Commercial anq Government Entity Code Reporting Ownership or Control of Offeror Commercial and Government Entity Code Maintenance Incorporation by Reference of Representations and Certifications.

Prohibition on Contracting with Inverted Domestic Corporations--Representation Brand Name or Equal Contract Terms and Conditions--Commercial Items Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-- Representation and Certifications.

Unenforceability of Unauthorized Obligations Providing Accelerated Payments to Small Business Subcontractors Disputes Subcontracts for Commercial Items Requirements Relating to Compensation of Former DoD Officials Requirement to Inform Employees of Whistle blower Rights Representation Relating to Compensation of Former DoD Officials

252.204-7000 Disclosure Of Information 252.204-7003 Control Of Government Personnel Work Product 252.204-7004 AltA System for Award Management Alternate A 252.204-7012 Safeguarding ofUnclassified Controlled Technical

Information 252.204-7015 252.225-700 I

252.225-7048 252.232-70 I 0 252.239-7017 252.239-7018 252.243-7001 252.246-7007

252.24 7-7023

Disclosure of Information to Litigation Support Contractors Buy American And Balance Of Payments Program-- Basic (Nov 2014) Export-Controlled Items Levies on Contract Payments Notice of Supply Chain Risk Supply Chain Risk Pricing Of Contract Modifications Contractor Counterfeit Electronic Part Detection and A voidance System Transportation of Supplies by Sea

CLAUSES INCORPORATED BY FULL TEXT

JUL2013

JUL2013

NOV 2014

NOV 2014

NOV 2014

DEC2014

DEC2014

AUG 1999

DEC 2014

DEC2012

JUN 2013

DEC 2013

MAY2014

APR2015

SEP 2011

SEP 2013

NOV 2011

AUG2013

APR 1992

FEB 2014

NOV2013

FEB 2014

NOV 2014

JUN 2013

DEC2006

NOV2013

NOV2013

DEC 1991

MAY2014

APR2014

N00178-15-T-4276

Page 10 of42

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (MAR 2015)

The Offeror shall complete only paragr&ph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for A ward Management (SAM) Web site accessed

Page 11 of42 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) Defmitions. 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 aneil 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-

(I) 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 tije age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties1.

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 defmitions of6 U.S.C. 395(c).

Manufactured end product means anyend 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.

e • N00178-15-T-4276

Page 12 of42

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 fmished 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 defmed in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-17 4 ). Restricted business operations do not include business operations that the person (as that term is defmed in Section 2 of the Sudan Accountability and Divestment Act of2007) conducting the business can demonstrate--

(I) 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 fi:om the requirement to be conducted under such authorization; ·

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

(4) Consist of providing ~oods 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--

(I) 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 oflran; 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--

(I) Means a small business concern--

(i) Not less than 51 percent ofwhich 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 defmed in 38 U.S. C. 101(2), with a disability that is service connected, as defmed in 38 U.S. C. 101(.16).

Page 13 of42

"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 defmed at 13 CFR 124.105) by--

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

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions seHorth 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 (l)(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; Qr

(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 defmed 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 busiqess 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 electronically on the SAM website.

(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

'I"J.'"''""·'

- e

Page 14 of42 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 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 only1 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 ORCA.]

(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)( I) 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) ofthis 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 ifthe 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 defmed 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)( I) of this provision.) The offeror represents that it ( _ ) is, ( _ ) is not a women owned small business concern.

Note to paragraphs (c)(8) and (9): 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) lt [ _ ] 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--

Page 15 of42

(i) It [ _ ] is, [ _ ] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circum~tances 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 ofthe 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:

( 1 0) HUB Zone 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 HU8Zone small business concern listed, on the date of this representation, on the List of Qualified HUB Zone 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)(lO)(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 ofthis 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.

4',,.i.J., . N00178-15-T-4276

(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 ofth!;) 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.)

(l) The offeror certifies that each end product, except those listed in paragraph (t)(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 defmed 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 ofF AR Part 25.

(g)(l) 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)(l)(iii) of this provision, is a domestic end product arid that for oth\lr 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 defmed 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 defmed in the clause ofthis 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:

Page 17 .of 42

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(l)(ii) of this provision) as defined in the clause ofthis 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 quality 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 defmition of"domestic end product."

Other Foreign End Products:

[List a:; necessary]

(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)(l)(ii) for paragraph (g)(l)(ii) of the basic provision:

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

Canadian End Products:

[List as necessary] ri.",.

e - N00178-15-T-4276

Page 18 of42

(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)(l )(ii) for paragraph (g)(I)(ii) of the basic provision:

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

Canadian or Israeli End Products:

[List as necessary]

(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)( I )(ii) for paragraph {g)( I )(ii) ofthe basic provision:

(g)(l)(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 ofthis 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:

[List as necessary]

(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 p!,'oduct, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.

made or designated country end product, as defmed 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:

N00178-15-T -4276

Page 19 of42

[List as necessary]

(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 ofU.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 ofU.S.-made or designated country end products unless the Contracting Officer determines that there are no qffers 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 ifthe contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the. best of its knowledge and belief, ·

(1) The offeror and/or any of its principals ( _ ) 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 ofthese offenses enumerated in paragraph (h)(2) ofthis 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 fmally determined. The liability is finally determined if it has been assessed. A liability is not fmally 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 deterp1ined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in makiQg 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.

Page 20 of42

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. Sec. 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 fmal tax liability until the taxpayer has exercised all judicial appeal 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. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to furt4er 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 fmal tax liability. Should the taxpayer seek tax court review, this will not be a fmal 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. Sec. 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 bankru,ptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 1I 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 Requ~ring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(I) Listed end products.

(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)(l) 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)( I) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or

Page 21 of42 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.

0) 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.

G) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition ofmanufactur.ed 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)(l) or (k)(2) applies.]

[ _ ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(l). The

/offeror ( _ ) does ( _ ) does not certify that-

·(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental

, purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR

22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

[ _ ] (2) Certain services as described in FAR 22.1 003-4( d)(l ). The offeror ( _ ) does ( _ ) does not certify that-

Page 22 of42

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices

(see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average ofless than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the. contract period if the contract period is less than a month) servicing the

Government contract; and

(iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers.

(3) If paragraph (k)(l) or (k)(2) ofthis clause applies-

(i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Labor Standards wage determination to the solicitation, the offeror shall notify the

Contracting Officer as soon as possible; and

(ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(l) or (k)(2) of this clause or to contactthe Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(I) Taxpayer Identification Number (TIN) (26 U.S. C. 6109, 31 U.S. C. 7701 ). (Not applicable if the offeror is required to provide this information to the SAM database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (1)(3) through (1)(5) of this provision to comply with debt collection requirements of31 U.S.C. 7701(c) and 3325(d), reporting requirements of26 U.S.C. 6041;

6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS).

(2) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Govel1lllient (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN.

(3) Taxpayer Identification Number (TIN).

( _ ) TIN: --------------------.

( _ ) TIN has been applied for.

( _ ) TIN is not required because:

( ) Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

( _ ) Offeror is an agency or instrumentality of a foreign government;

,e e

( _ ) Offeror is an agency or instrumentality of the Federal Government.

(4) Type of organization.

( _ ) Sole proprietorship;

( _ ) Partnership;

( _ ) Corporate entity (not tax-exempt);

( _ ) Corporate entity (tax-exempt);

( _ ) Government entity (Federal, State, or local);

( _ ) Foreign government;

( _ ) International organization per 26 CFR 1.6049-4;

( _ ) Other----------.

(5) Common p~ent.

( _ ) Offeror is not owned or controlled by a common parent;

( _ ) Name and TIN of common parent:

Name

TIN-

Page 23 of42

(m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan.

(n) Prohibition on Contracting with Inverted Domestic Corporations-

(1) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.l08-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4.

(2) Representation. By submission of its offer, the offeror represents that--

(i) It is not an inverted domestic corporation; and

(ii) It is not a subsidiary of an inverted domestic corporation.

( o) Prohibition on contracting with entities engaging in certain activities or transaction·s relating to Iran.

(1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA 1 06@state.gov.

(2) Representation and certifications. Unless a waiver is granted or an exception applies as provided in paragraph (o)(3) of this provision, by submission of its offer, the offeror--

NOOI78-15-T-4276

Page 24 of42

(i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran;

(ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and

(iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not knowingly engage in any transaction that exceeds $3,000 with Iran's Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in property of which are blocked pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701 et seq.) (see OFAC's Specially Designated Nationals and Blocked Persons List at http://www.treasury.gov/ofac/downloads/tllsdn.pdt).

(3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if-

(i) This solicitation includes a trade agreements certification (e.g., 52.212-3(g) or a comparable agency provision);

and

(ii) The offeror has certified that all the offered products to be supplied are designated country end products.

(p) Ownership or Control of Offeror. (Applies in all solicitations when there is a requirement to be registered in SAM or a requirement to have a DUNS Number in the solicitation.

(1) The Offeror represents that it [ _. ] has or [ _ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond…