N0018918QZ034_Starrag_maintenance.docx
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N0018918QZ034
Section SF 1449 - CONTINUATION SHEET
| ITEM NO |
| SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 2 |
| Visit |
Technical Services
FFP
Maintenance FOB: Destination
BRAND NAME/SOLE SOURCE: SS
MILSTRIP: N4215818RC80185
PURCHASE REQUEST NUMBER: N4215818RC80185
PROJECT: Starrag SU16 SU17
NET AMT
| ITEM NO |
| SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 2 |
| Each |
ODC
FFP
Travel plus ODC FOB: Destination
BRAND NAME/SOLE SOURCE: SS
MILSTRIP: N4215818RC80185
PURCHASE REQUEST NUMBER: N4215818RC80185
NET AMT
| ITEM NO |
| SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 3 |
| Visit |
| OPTION |
| Technical Services |
FFP
Maintenance, POP 01 OCT 2018 through 30 SEP 2019 FOB: Destination
BRAND NAME/SOLE SOURCE: SS
MILSTRIP: N4215818RC80185
NET AMT
| ITEM NO |
| SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 3 |
| Each |
| OPTION |
| ODC |
FFP
Travel plus ODC FOB: Destination
BRAND NAME/SOLE SOURCE: SS
MILSTRIP: N4215818RC80185
NET AMT
STATEMENT OF WORK
Performance Work Statement Naval Foundry and Propeller Center (NFPC) Preventative Maintenance Program of Profiling Machine SU16 & SU17
1. Scope:
The Naval Foundry and Propeller Center (NFPC) requires outside vendor support to provide triannual (every four months) on-site preventative evaluation/assessment and minor maintenance services on the electrical, electronic, and mechanical systems on two (2) each Starrag-Heckert CNC High Speed Profiling machines. In addition to the on-site support, NFPC will require consultation services with remote (off-site) Original Equipment Manufacturer (OEM) technicians, and system engineers to provide assistance in troubleshooting machine malfunctions while recommending remedies to correct the problem(s).
2. Period of Performance:
The period of performance associated with this Performance Work Statement (PWS) shall be for one (1) nine (9) month base period, and one (1) twelve (12) month option year to be exercised at the option of the Government.
3. Place of Performance:
Naval Foundry & Propeller Center 1701 Kitty Hawk Avenue, 546 Building Philadelphia, PA 19112
4. Description of Services:
NFPC requires on-site vendor support for preventative evaluation/assessment and minor corrective maintenance services to improve productivity of the precision high-speed machining centers, SU16/SU17. The preventative/corrective maintenance coverage will include an inspection of both machines to determine the overall reliability and integrity of the mechanical, electrical, and electronic systems. Services will be in conjunction with NFPC’s maintenance, facility’s engineering personnel, programmers, and machinists. The Virginia Project Office and Maintenance Department shall pre-determine and communicate the expected scope of work with the vendor prior to their visit. Subsequently, the vendor shall provide the following preventative and minor corrective maintenance coverage in the following areas:
| a. Oil Filters |
| b. Axis Drives |
| c. Ram/Head(s) Interface and Alignment Checks |
| d. Head(s) spindle interface |
| e. Head Changer |
| f. Tool Changer |
| g. Blum Laser Tool Setter |
| h. Geometry Checks |
| i. Coolant System |
| j. Chilled Water System |
| k. Hydraulic System |
| l. Pneumatic System |
| m. Tool/Head Clamping System |
| n. Electronic Systems connected to machine functions |
| o. Continued instruction on Siemens Step 7 & NC/PLC Programming |
4.1 Site Visits: Services will comprise of visits predicated upon the availability of machines in accordance with the Virginia Project Office and machining schedules. Vendor shall provide one (1) each certifiably trained Electronic Maintenance Technician III and one (1) each Machinery Maintenance Mechanic proficient in their respective trades per visit. The duration of the each visit will consist of ten (10) work days and two (2) travel days. The two (2) Technicians shall arrive in Philadelphia on a designated Monday, report to NFPC on Tuesday, work for five (5) consecutive days (Tuesday thru Saturday), Sunday is scheduled off. Work schedule will resume on Monday for an additional five (5) consecutive days.
Security Requirements
| 5.1 | Clearance Level: At a minimum, all contractor personnel must be able to pass a local background check. An inability to pass the required background check as specified in the task Order will be cause for dismissal of ineligible employee. For security reasons, NFPC personnel will be assigned to escort the vendor throughout the entire visit. |
| 5.2 | Visit Request: The Contractor shall provide visit requests and clearances for contractor personnel performing work on this contract and resulting Task Orders. The Contractor must check the Contractor Verification System within three (3) days prior to start of job for contractor employee’s clearance verification. Cleared contractor employees may report to NNSY/NFPC Security / Pass Office Building 712 to pick up appropriate color NAVSEA badge within 90 days of clearance but within five (5) days prior to arrival. The Contractor shall comply with all current badging and security procedures required to gain access to any Government site listed in this Performance Work Statement (PWS). |
| 5.2.1 | CVS. Contractors/subcontractors shall submit Visit Request using the NNSY version of the Contractor Verification System Excel Spreadsheet (CVS). The NNSY CVS spreadsheet may be obtained at https://www.cnic.navy.mil/regions/cnrma/om/contractor_verification_system.html under the link titled “NNSY Visitor and Contractor CAC Form.” The Contractor must complete all cells in the Visit, Visitor and Sponsor Information columns for each employee. The sheet should be saved and submitted electronically via encrypted e-mail to m_cnic_cnrma_cvs@navy.mil (NNSY SMO Code: 001816) and Cc: NNSY TL COR up to ninety (90) days but no later than ten (10) business days prior to entering the installation. |
| 5.3 | Badging: Contractor employees shall require an individual NAVSEA identification badge, and may require additional badges i.e., CAC, to gain access to job sites. One day shipyard access badges do not meet proper badging requirements. In no case will a One Day badge be considered sufficient to meet the badging requirement. |
| 5.3.1 | Lack of proper identification badge(s) shall result in denial of access to the Naval Installation, resulting in a delay at the Contractor's expense. |
| 5.3.2 | Contractor personnel are authorized to retain temporary badges until the badge expiration date or termination of employment. Upon badge expiration date, termination of employment, or completion of contract, the Contractor is required to immediately notify the Contracting Officer’s Security Officer and return all badges. |
| 5.3.3 | Badges must be displayed on the outermost garment above the waist at all times. The only exception would be while the contractor personnel are engaged in work which could cause a safety hazard if the badge were worn while performing the work. |
| 5.3.4 | Lost or misplaced badges shall be reported immediately to the Contracting Officer’s Security Officer, or to the NNSY Security & Pass Office. |
| 5.3.5 | All additional badging or access requirements will be identified on a case-by-case basis. |
| 5.4 | Parking: Contractor personnel are not authorized to drive or park personal vehicles on installation. However, contracted personnel may park in satellite parking lots located outside the facility perimeter fence. |
| 5.5 | Cell phones: Cell phones equipped with cameras are PROHIBITED inside any building within the Controlled Access Area (CAA). Violators will be disciplined under NNSY Camera Cell Phone Policy which could include handcuff of person and/or confiscation of cellphone with camera or any recording device. Any individual found with a functioning camera phone with unauthorized photos will have their phones permanently confiscated. Findings may be referred to NCIS. The government will not be responsible for replacing the device. |
Government Technical Point of Contact (TPOC):
Government Technical Point of Contact shall be provided at time of award.
Machines to be preventatively and correctively maintained:
SU-16 - FOGS800153
SU-17 - FOGS800500
8. Statement of current condition of NFPC’s High Speed Milling Machines equipment: “AS IS” at time of award.
| 9. | Warranty: All preventative and minor corrective maintenance shall be warranted against defects in workmanship for a minimum of three months. Where the vendor is notified of such defects, the vendor shall make all repairs necessary to correct defects at its sole expense. All replacement parts shall be warranted against defects for the period of the parts standard manufacturer’s warranty. |
| 10. | Qualification Standards for Technicians performing maintenance: The two technicians, dispatched to perform preventative and minor corrective maintenance will be at a minimum, certifiably trained tradesman in their respective fields; Electronics Maintenance Technician III and Machinery Maintenance Mechanic. |
11. Deliverables: Vendor shall provide timely written report(s) identifying machine, serial number, repair services performed, and recommended repairs ensuring reliability to NFPC’s TPOC.
12. Operating Hours: NFPC’s normal hours of operation are Sunday thru Saturday, 7:30am – 4:00 pm.
13. Straight Time/Overtime Schedules: Straight time work shall be conducted utilizing eight (8) hours shifts during normal operating hours; 7:30 am – 4:00 pm, Monday through Friday, excluding Federal Holidays. Weekly (Monday thru Friday) overtime will be conducted between 4:00 - 6:00 PM daily. Weekend over time work shall be conducted utilizing eight (8) hour shifts during normal weekend operating hours, 7:30AM – 4:00 PM, Saturday and Sunday.
14. REPORTING LABOR:
5237.102-90 Enterprise-wide Contractor Manpower Reporting Application (ECMRA)
The contractor shall report contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the SU-16 and SU-17 Milling Machines via a secure data collection site. Contracted services excluded from reporting are based on Product Service Codes (PSCs).
The excluded PSCs are:
(1) W, Lease/Rental of Equipment;
(2) X, Lease/Rental of Facilities;
(3) Y, Construction of Structures and Facilities;
(4) D, Automatic Data Processing and Telecommunications, IT and Telecom- Telecommunications Transmission (D304) and Internet (D322) ONLY;
(5) S, Utilities ONLY;
(6) V, Freight and Shipping ONLY.
The contractor is required to completely fill in all required data fields using the following web address https://doncmra.nmci.navy.mil.
Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year.
Contractors may direct questions to the help desk, linked at https://doncmra.nmci.navy.mil.
INSPECTION AND ACCEPTANCE TERMS
Supplies/services will be inspected/accepted at:
| CLIN |
| INSPECT AT |
| INSPECT BY |
| ACCEPT AT |
| ACCEPT BY |
| 0001 |
| Destination |
| Government |
| Destination |
| Government |
| 0002 |
| Destination |
| Government |
| Destination |
| Government |
| 1001 |
| Destination |
| Government |
| Destination |
| Government |
| 1002 |
| Destination |
| Government |
| Destination |
| Government |
DELIVERY INFORMATION
| CLIN |
| DELIVERY DATE |
| QUANTITY |
| SHIP TO ADDRESS |
| DODAAC / CAGE |
| 0001 |
| POP 01-MAR-2018 TO |
30-SEP-2018
| N/A |
| NAVAL FOUNDRY AND PROPELLER CENTER |
TOM NEHER 215-897-2258
NORFOLK NAVAL SHIPYARD DETACHMENT
1701 KITTY HAWK AVE BLDG 20A GATE #3
PHILADELPHIA PA 19112-5087
215-897-2258 FOB: Destination N42158
| 0002 |
| POP 01-MAR-2018 TO |
30-SEP-2018
| N/A |
| (SAME AS PREVIOUS LOCATION) |
N42158
| 1001 |
| POP 01-OCT-2018 TO |
30-SEP-2019
| N/A |
| (SAME AS PREVIOUS LOCATION) |
N42158
| 1002 |
| POP 01-OCT-2018 TO |
30-SEP-2019
| N/A |
| (SAME AS PREVIOUS LOCATION) |
N42158
CLAUSES INCORPORATED BY REFERENCE
| 52.204-2 |
| Security Requirements |
| AUG 1996 |
| 52.204-7 |
| System for Award Management |
| OCT 2016 |
| 52.204-19 |
| Incorporation by Reference of Representations and Certifications. |
| DEC 2014 |
| 52.209-11 |
| Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under and Federal Law |
| FEB 2016 |
| 52.212-1 |
| Instructions to Offerors--Commercial Items |
| JAN 2017 |
| 52.212-4 |
| Contract Terms and Conditions--Commercial Items |
| JAN 2017 |
| 52.215-8 |
| Order of Precedence--Uniform Contract Format |
| OCT 1997 |
| 52.222-52 |
| Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Certification |
| MAY 2014 |
| 52.232-18 |
| Availability Of Funds |
| APR 1984 |
| 252.203-7000 |
| Requirements Relating to Compensation of Former DoD Officials |
| SEP 2011 |
| 252.203-7002 |
| Requirement to Inform Employees of Whistleblower Rights |
| SEP 2013 |
| 252.204-7004 Alt A |
| System for Award Management Alternate A |
| FEB 2014 |
| 252.204-7009 |
| Limitations on the Use or Disclosure of Third-Party Contractor Reported Cyber Incident Information |
| OCT 2016 |
| 252.204-7012 |
| Safeguarding Covered Defense Information and Cyber Incident Reporting |
| OCT 2016 |
CLAUSES INCORPORATED BY FULL TEXT
NECO
52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2017) 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 located at https://www.sam.gov/portal . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) 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 (u) 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:
| LINE ITEM NO. |
| COUNTRY OF ORIGIN |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
[List as necessary]
(3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.
(g)
(1) Buy American -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)
(i) 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:
| LINE ITEM NO. |
| COUNTRY OF ORIGIN |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(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:
| LINE ITEM NO. |
| COUNTRY OF ORIGIN |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(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:
| Line Item No.: |
| Country of Origin: |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 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:
| Line Item No.: |
| Country of Origin: |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(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
| Line Item No.: |
| Country of Origin: |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(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 $3,500 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
| Listed End Product: |
| Listed Countries of Origin: |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
| ___ |
(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 equipment as described in FAR 22.1003-4(c)(1). 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 22.1003-4(d)(1). The offeror [ ___ ] does [ ___ ] does not certify that—
(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 of less 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)(1) or (k)(2) of this 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)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.
(l) 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 (l)(3) through (l)(5) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 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 Government (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;
[ ___ ] 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 parent.
[ ___ ] Offeror is not owned or controlled by a common parent:
[ ___ ] Name and TIN of common parent:
Name ___
TIN ___
(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 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4.
(2) Representation. The Offeror represents that--
(i) It [ ___ ] is, [ ___ ] is not an inverted domestic corporation; and
(ii) It [ ___ ] is, [ ___ ] is not a subsidiary of an inverted domestic corporation.
(o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran.
(1) The offeror shall email questions concerning sensitive technology to the Department of State at CISADA106@state.gov.
(2) Representation and Certification. 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—
(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 $3,500 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/t11sdn.pdf).
(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…
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