N0040619Q0144.pdf

SEE ADDENDUM

(No Collect Calls)

N0040619Q0144 22-Mar-2019

b. TELEPHONE NUMBER

360-476-4832

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 05 Apr 2019

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

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

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

N004069. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JULIO A. HERNANDEZ

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

(TYPE OR PRINT)

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

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

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

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

N4425519RCWN055

ARE NOT ATTACHED

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

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

NAVSUP FLC PUGET SOUND

467 W STREET, 2ND FLR

ATTN: JULIO HERNANDEZ

BREMERTON WA 98314

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

476-4656FAX:

TEL: 360-476-4832

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$7,500,000

NAICS:

811310

OFFER DATED

29. AWARD OF CONTRACT: REF.

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

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

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

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF51

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

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

REPRESENTATIVE

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

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

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

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

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

N0040619Q0144

Section SF 30 - BLOCK 14 CONTINUATION PAGE

POC INFORMATION

*** THIS SOLICITATION FOR MUST BE COMPLETED AND RETURNED IN FULL TO BE

CONSIDERED RESPONSIVE****

****CONTACT CONTRACTING OFFICIAL AT EMAIL:

E-MAIL: JULIO.A.HERNANDEZ@NAVY.MIL

FAX: 360-476-4656

MUST PROVIDE:

YOUR CAGE CODE NUMBER: _______________________________

YOUR E-MAIL ADDRESS: ________________________________________

YOUR PHONE NUMBER: _________________________________________

YOUR FAX NUMBER: __________________________________________

Is material or service being offered exactly as specified? Yes___ No____

Delivery date offered, if different than specified: __________

Name of Manufacturer_______________________________

Country of Origin___________________________________

SIZE OF MANUFACTURE: LARGE OR SMALL (PLEASE CIRCLE)

PAYMENT INFORMATION WILL BE ENTERED IN ANY RESULTING AWARD BY GOVERNMENT

WIDE AREA WORK FLOW SYSTEM, WAWF

INSPECTION LEVEL:

QA 4 7 DAYS INSPECTION

STATEMENT OF WORK

PERFORMANCE WORK STATEMENT

REQUISITION: N4425519RCWN055

SHIP/ACTIVITY: COMMANDER NAVY REGION NORTHWEST

TITLE: MAINTENANCE FOR COOLING WATER CHEMICAL TREATMENT, FOR THE AIR

COMPRESSOR AND DIESEL GENERATOR (FOR THE STEAM PLANT)

IN SUPPORT OF COMMANDER NAVY REGION NORTHWEST, NAVY BASE KITSAP, BREMERTON WA,

PROVIDE ON-SITE MAINTENANCE FOR COOLING WATER CHEMICALS FOR AIR COMPRESSORS

mailto:JULIO.A.HERNANDEZ@NAVY.MIL

AND DIESEL GENERATORS. THE CHEMICALS ARE USED TO PROTECT SYSTEMS FROM THE FOUR

KEY PROBLEMS SUFFERED BY COOLING SYSTEMS NAMELY: SCALE, CORROSION, BIOFOULING,

AND SUSPENDED SOLIDS. THESE CHEMICALS HELP IMPROVE SYSTEM EFFICIENCY AND

MAINTAIN SAFE WORKING CONDITIONS WITHIN THE COOLING SYSTEM ITSELF. THE COOLING

WATER CHEMICALS SHALL INHIBIT SCALE AND CORROSION WITH THE USE OF MOLYBDATES,

SILICATES, ALL ORGANICS AND PHOSPHONATES, ETC. UNDER NO CONDITIONS MAY THE

CHEMICALS CAUSE AN OATMEAL-LIKE MATERIAL TO BE FORMED IN THE COOLING TOWERS.

THIS CAN RESULT IN SIGNIFICANT OPERATING FAILURES AND COST TO THE GOVERNMENT.

THE PERIOD OF PERFORMANCE FOR THIS SERVICE SHALL BE A BASE YEAR WITH OPTION YEARS.

THE CONTRACTOR SHALL SUPPLY THE COOLING TOWERS AT BUILDINGS 818, 818A, 900, & 923

WITH THE FOLLOWING PRODUCTS AS NEEDED IN 55 GALLON OR 30 GALLON CONTAINERS. ALL

COOLING TOWER CHEMICALS TO BE SUPPLIED AND USED FOR THIS CONTRACT SHALL NOT

CONTAIN ANY HEAVY METALS SUCH AS COPPER, NICKEL, ZINC, CHROMIUM, OR LEAD. TESTING

AND CONTROL OF BIOFOULING, TO INCLUDE BUT NOT LIMITED TO LEGIONELLA BACTERIA TO

BE PERFORMED.

CHEMICALS:

1) CHEMICALS PROVIDED IN PAST BY CHEMTREAT:

a. INHIBITOR, POTASSIUM HYDROXIDE, CL-1469,20%: CORROSIVE, HAZARD CLASS 8

b. MICROBIOCIDE, 5-CHLORO-2-METHYL-4-ISOTHIAZOLIN-3-ONE AND 2-METHYL-4-

ISOTHIAZOLIN-3-ONE, CL-2150: HAZARD CLASS 8

c. MICROBIOCIDE, GLUTARALDEHYDYE, CL-2112: HAZARD CLASS 8

d. INHIBITOR, SODIUM NITRITE AND SODIUM TETRABORATE (ANHYDROIUS

PENTAHYDRATE), BL-180: HAZARD CLASS 8

2) CHEMICALS PROVIDED IN PAST BY NALCO:

a. DRUMS, SODIUM HYDROXIDE, 1%-5%, ST70, HAZARD CLASS 8

b. DRUMS, PHOSPHORIC ACID (1-5%) AND SULPHURIC ACID (1-5%) AND AROMATIC

AMINE (1-5%), 3DT289, CORROSIVE, HAZARD CLASS 8

c. DRUMS, GLUTERALDEHYDE, 30-60%, H-550, CORROSIVE, HAZARD CLASS 8

d. DRUMS, GLUTERALDEHYDE, 45%, 7338, CORROSIVE, HAZARD CLASS 8

THE CONTRACTOR IS REQUIRED TO PROVIDE THE FOLLOWING SERVICES:

PROVIDE BI-WEEKLY ON-SITE WATER CHEMISTRY EVALUATIONS OF ALL COOLING

TOWER SYSTEMS.

PROVIDE MONTHLY TECHNICAL RECOMMENDATIONS BASED ON MONTHLY CHEMISTRY

EVALUATIONS.

CALIBRATE AND PERFORM MAINTENANCE WORK ON ALL COOLING TOWER

CONDUCTIVITY BLEED AND CHEMICAL FEED CONTROLLERS. CALIBRATIONS ARE

CONDUCTED ON AN AS-NEEDED BASIS.

PROVIDE CHEMICAL FEED/MONITORING CONTROL SYSTEMS AND PERFORM

PROGRAMMING OF COOLING TOWER CONTROLLER(S).

CONTROLLER(S) FOR ALL COOLING TOWERS SHALL HAVE THE FOLLOWING

CAPABILITIES:

o ABILITY TO DIRECTLY MONITOR AND CONTROL BOTH THE ADDITION OF THE

CORROSION INHIBITOR, THE PRIMARY OXIDIZING BIOCIDE AND THE SECONDARY

BIOCIDE. IT MUST ALSO BE ABLE TO MEASURE THE ACTIVE POLYMER IN THE

SYSTEM.

o ABILITY TO MONITOR AND CONTROL CONDUCTIVITY (BLEED).

o EQUIPPED WITH AN AUTOMATIC SYSTEM THAT DETECTS AND REACTS TO

BIOLOGICAL ACTIVITY REAL TIME TO BASE FEED AND CONTROL STRATEGIES ON

BOTH PLANKTONIC AND SESSILE BACTERIA LEVELS. THE FEED STRATEGIES MUST

ALLOW FOR MANUAL, SLUG-BASED OR TIMER FEED OPTIONS. THIS SHALL

INCLUDE PRE-BLEED AND LOCKOUT CAPABILITY.

o ABILITY TO MONITOR AND CONTROL THE COOLING WATER’S PH, AND ORP.

o INCLUDE IN-LINE MILD STEEL AND COPPER CORROSION PROBES, AND BE

CAPABLE OF SENDING THOSE READINGS TO THE CONTROLLER FOR

INSTANTANEOUS CORROSION RATE MEASUREMENTS.

o CAPABLE OF MEASURING TURBIDITY.

o ABILITY FOR REMOTE MONITORING AND CONTROL, EITHER THROUGH A PHONE

LINE, OR A WEB BASED SYSTEM. IT MUST ALSO BE ABLE TO SEND ALARMS VIA

PHONES, TEXTS AND/OR EMAILS.

o THE CONTROLLER MUST BE EQUIPPED WITH A DATA MANAGEMENT PROGRAM, CAPABLE OF STORING MEASURED VALUES FOR A ONE YEAR PERIOD, AND BE

ABLE TO GENERATE GRAPHS AND REPORTS ON ANY OR ALL OF THE VARIABLES.

o ADDITIONAL MEASUREMENT CAPABILITIES SHALL INCLUDE TEMPERATURE, CELL FOULING, RELAY STATUS, AND PULSE COUNTER WITH WATER METER.

o CAPABLE OF CALCULATING THE FOLLOWING PARAMETERS: HOLDING TIME

INDEX, SYSTEM VOLUME, BLOWDOWN RATE, HEAT REJECTION, MAKEUP WATER

RATE, RECIRCULATION RATE, PUMP DUTY, AND PRODUCT USAGE.

o ADDITIONAL TWO (2) 4/20 MA INPUT RELAYS AND EIGHT (8) ADDITIONAL OUTPUT

RELAYS.

PROVIDE CHEMICAL TRANSFERS VIA DRUM PUMP TO THE PERMANENT ON-LINE

CONTAINERS; PERFORM INVENTORY MONITORING AND EQUIPMENT INSPECTIONS.

PROVIDE BI-WEEKLY COOLING TOWER WATER INSPECTION REPORT AND, ON A

QUARTERLY BASIS A FORMAL WATER ANALYSIS OF ALL CRITICAL COOLING WATER

APPLICATIONS TO B/900 KEY PERSONNEL. THE REPORTS SHALL INCLUDE DATA

RELATING TO WATER USAGE, CHEMICAL USAGE, CHEMICAL INVENTORY, PH, ORP,

CORROSION, FOULING AND BIOLOGICAL STATUS.

INSURE THAT DISCHARGE FROM ALL OPEN AND CLOSED HVAC WATER SYSTEMS INTO

THE BASE SEWER SYSTEM WILL BE WITHIN THE ACCEPTABLE LIMITS OF ANY AGENCY

OR ANY GOVERNING BODY HAVING JURISDICTION.

CONTRACTORS ARE RESPONSIBLE FOR COMPLIANCE WITH ALL CONTRACTUAL

REQUIREMENTS INCLUDING COMPLIANCE WITH ALL FEDERAL, STATE AND LOCAL

ENVIRONMENTAL REQUIREMENTS.

APPROXIMATE CHEMICAL USAGE PER YEAR:

CHEMTREAT CHEMICALS:

8 EACH 55 GALLON BARRELS OF CL-1469

10 EACH 30 GALLON BARRELS OF CL-2150

10 EACH 30 GALLON BARRELS OF CL-2112

2 EACH 5 GALLON PAILS OF BL-180 @ 45 LBS/PAIL

NALCO CHEMICALS:

6.5 EACH 55 GALLON BARRELS OF 3DT289

1.5 EACH 55 GALLON BARRELS OF H-550

6.5 EACH 55 GALLON BARRELS OF ST-70

COOLING TOWER INFORMATION

FOUR (4) EACH COOLING TOWERS ASSOCIATED WITH AIR COMPRESSORS, B/818.

o BALTIMORE AIRCOIL SERIES 3000

TWO (2) EACH COOLING TOWERS ASSOCIATED WITH AIR COMPRESSORS, B/818A

o EVAPCO MODEL ATWB 12-6L12-Z W/ PULSE-PURE WATER TREATMENT SYSTEM

FIVE (5) EACH COOLING TOWERS ASSOCIATED WITH EMERGENCY DIESEL

GENERATORS, B/900.

o MARLEY MODEL 8805, SERIES NC

THREE (3) EACH COOLING TOWERS ASSOCIATED WITH AIR COMPRESSORS, B/900.

o BALTIMORE AIRCOIL SERIES 3000

THREE (3) EACH COOLING TOWERS ASSOCIATED WITH AIR COMPRESSORS, B/923.

o BALTIMORE AIRCOIL SERIES 3000

REQUIRED FIELD WORK

- MONTHLY FIELD SERVICE CALLS TO CHECK ON THE WATER CHEMISTRY AT THESE

BUILDINGS

- CHEMICAL FEED SYSTEM MONITORING

- CHEMICAL TRANSFERS TO EXISTING FEED TANKS

- CORROSION COUPON ANALYSES AND MICROBIOLOGICAL MONITORING

- SERVICE REPORTS TO BE GENERATED AND FORWARDED TO ALL PERTINENT BASE

PERSONNEL

CONTRACTORS ARE RESPONSIBLE FOR COMPLIANCE WITH ALL CONTRACTUAL REQUIREMENTS

INCLUDING COMPLIANCE WITH ALL APPLICABLE FEDERAL, STATE AND LOCAL

ENVIRONMENTAL REQUIREMENTS. PLEASE SEE ATTACHMENT 3 FOR ENVIRONMENTAL AND

SAFETY REQUIREMENTS FOR THE BREMERTON NAVAL COMPLEX.

TECHNICAL CUSTOMER POC

ANTHONY BERNETT- PUBLIC WORKS DEPARTMENT

ANTHONY.BERNETT@NAVY.MIL

360-476-5232 mailto:anthony.bernett@navy.mil

THE FOLLOWING NAVSUP LOCAL TEXT IS HEREBY MADE PART OF THE STATEMENT OF

WORK/PERFORMANCE WORK STATEMENT.

NAVSUP FLCPS may utilize contractor support through the AbilityOne Program, as needed, to perform contract closeout functions for this acquisition. Information, including business sensitive/confidential or proprietary data, that the offeror provides to the Government or information already in the possession of the Government may be viewed and utilized by the AbilityOne Program support contractor personnel during the course of its contract performance.

The information that may be made available to the support contractor may include, for example, pricing and technical proposals, historical contract, pricing and performance information, Commercial Asset Visibility (CAV) reporting information and similar data/information.

By submission of a proposal in response to this solicitation, the offeror and its subcontractors consent to a release of their business sensitive/confidential or proprietary data to the Government's AbilityOne Program support contractor personnel in order to perform close out services. Prior to the release of any such information to the support contractor, the support contractor will have in place with the Government a Non-Disclosure/Non-Use Agreement in accordance with the terms of the AbilityOne Program support contract.

Offerors may execute their own Non-Disclosure Agreement with the AbilityOne Program (AbilityOne contact information available from the contracting point of contact). The support contractor must provide copies of the executed agreements to the Contracting Officer and the Contracting Officer's Representative (COR) for the support contract; and the offeror/contractor for this acquisition must provide copies of the executed Agreement to the

Contracting Officer for this acquisition. If the offeror/contractor seeks such a Non-Disclosure Agreement with the

AbilityOne Program support contractor, the Agreement must be executed no later than the date of final delivery under the resulting NAVSUP FLCPS contract.

Contractor Unclassified Access to Federally Controlled Facilities, Sensitive Information, Information

Technology (IT) Systems or Protected Health Information

Executive Order 13467, Reforming Processes Related to Suitability for Government Employee, Fitness for

Contractor Employees and Eligibility for Access to Classified National Security Information, Homeland

Security Presidential Directive (HSPD)-12, requires government agencies to develop and implement Federal security standards for Federal employees and contractors. The 5 CFR 32 Part 157 in concert with DoD Manual

1000.13, Vol 1, implements the Federal Standards.

APPLICABILITY

This text applies to all DoD sponsored individuals who require CAC eligibility (or login and P/W if acceptable per contract) for: Physical access to DoD facilities or non-DoD facilities on behalf of DoD; Logical access to information systems (whether on site or remotely); or remote access to DoD networks that use only the CAC logon for user authentication, or access to sensitive and protected information. This applies to the Office of the

Secretary of Defense, the Military Departments, the Office of the Chairman of the Joint Chiefs of Staff and the

Joint Staff, the Combatant Commands, the Office of the Inspector General of the DoD, the Defense Agencies, the DoD Field Activities and all other organizational entities within the DoD (hereinafter referred to collectively as the "DoD Components").

Each contractor employee providing services at a Navy Command under this contract is required to obtain a

Department of Defense Common Access Card (DoD CAC). Additionally, depending on the level of computer/network access, the contract employee will require a successful investigation as detailed below.

ACCESS TO FEDERAL FACILITIES

Per HSPD-12 and implementing guidance, all contractor employees working at a federally controlled base, facility or activity under this clause will require a DoD CAC. When access to a base, facility or activity is required contractor employees shall in-process with the Command’s Security Manager upon arrival to the Command and shall out-process prior to their departure at the completion of the individual’s performance under the contract.

START-UP PERIOD

All contractor resource onboarding documents must be submitted via the prime contractor. The prime contractor shall make all necessary preparations to assume full responsibility for productive performance of the performance start date.

Definition of “productive”:

a. Visit Authorization Request (VAR)

b. Contractor Information Sheet (CIS)

c. Completed EQIP (Electronic Investigation)

d. All contractor resource(s) must have an active JPAS profile.

e. Common Access Card (CAC)

Note (1): Invoicing by the contractor will begin as of the commencement of the performance period of services and no reimbrusement will be paid by the government for efforts expended during the start-up period.

Note (2): Foreign Nationals are not allowed acces sot the functional/system side of Enterprise Resource Planning

(ERP).

ACCESS TO DOD INFORMATION TECHNOLOGY ( IT) SYSTEMS

In accordance with (IAW) Secretary of the Navy (SECNAV) M-5510.30, contractor employees who require access to DoN or DoD networks are categorized as IT-I, IT-II, or IT-III. The IT-II level, defined in detail in SECNAV M-

5510.30, includes positions which require access to sensitive information. Sensitive information includes information protected under the Privacy Act, to include Protected Health Information (PHI). All contractor employees under this contract who require access to Privacy Act protected information are therefore categorized no lower than IT-II. IT Levels are determined by the requiring activity’s Command Information System Security

Manager (ISSM)/Information Assurance Manager (IAM).

Contractor employees requiring privileged or IT-I level access, (when specified by the terms of the contract) require a Single Scope Background Investigation (SSBI) or T5 or T5R equivalent investigation , which is a higher level investigation than the National Agency Check with Law and Credit (NACLC)/T3/T3R described below. Due to the privileged system access, an investigation suitable for High Risk national security positions is required. Individuals who have access to system control, monitoring, or administration functions (e.g. system administrator, database administrator) require training and certification to Information Assurance Technical Level 1, and must be trained and certified on the Operating System or Computing Environment they are required to maintain.

Access to sensitive IT systems is contingent upon a favorably adjudicated background investigation. When access to IT systems is required for performance of the contractor employee’s duties, such employees shall in-process with the Navy Command’s CSM and ISSM/IAM upon arrival to the Navy command and shall out-process prior to their departure at the completion of the individual’s performance under the contract. Completion and approval of a

System Authorization Access Request Navy (SAAR-N) form is required for all individuals accessing Navy

Information Technology resources. The decision to authorize access to a government IT system/network is inherently governmental. The contractor supervisor is not authorized to sign the SAAR-N; therefore, the government employee with knowledge of the system/network access required or the COR shall sign the SAAR-N as the “supervisor”.

The SAAR-N shall be forwarded to the Command’s Security Manager at least 30 days prior to the individual’s start date. Failure to provide the required documentation at least 30 days prior to the individual’s start date may result in delaying the individual’s start date.

When required to maintain access to required IT systems or networks, the contractor shall ensure that all employees requiring access complete annual Cyber Awareness training, and maintain a current requisite background investigation. The Contractor’s Security Representative shall contact the Command Security Manager for guidance when reinvestigations are required.

INTERIM ACCESS

The Command's Security Manager may authorize issuance of a DoD CAC and interim access to a DoN or DoD unclassified computer/network upon a favorable review of the investigative questionnaire and advance favorable fingerprint results. When the results of the investigation are received and a favorable determination is not made, the contractor employee working on the contract under interim access will be denied access to the computer network and this denial will not relieve the contractor of his/her responsibility to perform.

DENIAL OR TERMINATION OF ACCESS

The potential consequences of any requirement under this clause including denial or termination of physical or system access in no way relieves the contractor from the requirement to execute performance under the contract within the timeframes specified in the contract. Contractors shall plan ahead in processing their employees and subcontractor employees. The contractor shall insert this clause in all subcontracts when the subcontractor is permitted to have unclassified access to a federally controlled facility, federally-controlled information system/network and/or to government information, meaning information not authorized for public release.

CONTRACTOR’S SECURITY REPRESENTATIVE

The contractor shall designate an employee to serve as the Contractor’s Security Representative. Within three work days after contract award, the contractor shall provide to the requiring activity’s Security Manager and the

Contracting Officer, in writing, the name, title, address and phone number for the Contractor’s Security

Representative. The Contractor’s Security Representative shall be the primary point of contact on any security matter. The Contractor’s Security Representative shall not be replaced or removed without prior notice to the

Contracting Officer and Command Security Manager.

BACKGROUND INVESTIGATION REQUIREMENTS AND SECURITY APPROVAL PROCESS FOR

CONTRACTORS ASSIGNED TO NATIONAL SECURITY POSITIONS OR PERFORMING SENSITIVE

DUTIES

Navy security policy requires that all positions be given a sensitivity value based on level of risk factors to ensure appropriate protective measures are applied. Contractor employees under this contract are recognized as Non-

Critical Sensitive [ADP/IT-II] positions when the contract scope of work require physical access to a federally controlled base, facility or activity and/or requiring access to a DoD computer/network, to perform unclassified sensitive duties. This designation is also applied to contractor employees who access Privacy Act and Protected

Health Information (PHI), provide support associated with fiduciary duties, or perform duties that have been identified as National Security Positions. At a minimum, each contractor employee must be a US citizen and have a favorably completed NACLC or T3 or T3R equivalent investigation to obtain a favorable determination for assignment to a non-critical sensitive or IT-II position. The investigation consists of a standard NAC and a FBI fingerprint check plus law enforcement checks and credit check. Each contractor employee filling a non-critical sensitive or IT-II position is required to complete:

SF-86 Questionnaire for National Security Positions (or equivalent OPM investigative product)

Two FD-258 Applicant Fingerprint Cards (or an electronic fingerprint submission)

Original Signed Release Statements

Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date. Background investigations shall be reinitiated as required to ensure investigations remain current (not older than 10 years) throughout the contract performance period. The

Contractor’s Security Representative shall contact the Command Security Manager for guidance when reinvestigations are required.

Regardless of their duties or IT access requirements ALL contractor employees shall in-process with the CSM upon arrival to the command and shall out-process prior to their departure at the completion of the individual’s performance under the contract. Employees requiring IT access shall also check-in and check-out with the Navy

Command’s ISSM/IAM. Completion and approval of a System Authorization Access Request Navy (SAAR-N) form is required for all individuals accessing Navy Information Technology resources. The SAAR-N shall be forwarded to the Navy Command’s Security Manager at least 30 days prior to the individual’s start date. Failure to provide the required documentation at least 30 days prior to the individual’s start date shall result in delaying the individual’s start date.

The contractor shall ensure that each contract employee requiring access to IT systems or networks complete annual

Cyber Awareness training, and maintain a current requisite background investigation. Contractor employees shall accurately complete the required investigative forms prior to submission to the Command Security Manager. The

Command’s Security Manager will review the submitted documentation for completeness prior to submitting it to the Office of Personnel Management (OPM); Potential suitability or security issues identified may render the contractor employee ineligible for the assignment. An unfavorable determination is final (subject to SF-86 appeal procedures) and such a determination does not relieve the contractor from meeting any contractual obligation under the contract. The Command’s Security Manager will forward the required forms to OPM for processing. Once the investigation is complete, the results will be forwarded by OPM to the DoD Central Adjudication Facility (CAF) for a determination.

If the contractor employee already possesses a current favorably adjudicated investigation, the contractor shall submit a Visit Authorization Request (VAR) via the Joint Personnel Adjudication System (JPAS) or a hard copy

VAR directly from the contractor’s Security Representative. Although the contractor will take JPAS “Owning” role over the contractor employee, the Navy command will take JPAS "Servicing" role over the contractor employee during the hiring process and for the duration of assignment under that contract. The contractor shall include the IT

Position Category per SECNAV M-5510.30 for each employee designated on a VAR. The VAR requires annual renewal for the duration of the employee’s performance under the contract.

BACKGROUND INVESTIGATION REQUIREMENTS AND SECURITY APPROVAL PROCESS FOR

CONTRACTORS ASSIGNED TO OR PERFORMING NON-SENSITIVE DUTIES

Contractor employee whose work is unclassified and non-sensitive (e.g., performing certain duties such as lawn maintenance, vendor services, etc. ...) and who require physical access to publicly accessible areas to perform those duties shall meet the following minimum requirements:

Must be either a US citizen or a US permanent resident with a minimum of 3 years of legal residency in the

United States (as required by The Deputy Secretary of Defense DTM 08-006 or its subsequent DoD instruction) and

Must have a favorably completed National Agency Check with Written Inquiries (NACI) or T1 investigation equivalent including a FBI fingerprint check prior to installation access.

To be considered for a favorable trustworthiness determination, the Contractor’s Security Representative must submit for all employees each of the following:

SF-85 Questionnaire for Non-Sensitive Positions

Two FD-258 Applicant Fingerprint Cards (or an electronic fingerprint submission)

Original Signed Release Statements

The contractor shall ensure each individual employee has a current favorably completed National Agency Check with Written Inquiries (NACI) or T1 equivalent investigation, or ensure successful FBI fingerprint results have been gained and investigation has been processed with OPM

Failure to provide the required documentation at least 30 days prior to the individual’s start date may result in delaying the individual’s start date.

* Consult with your CSM and ISSM/IAM for local policy when IT-III (non-sensitive) access is required for non-US citizens outside the United States.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Months

COOLING WATER CHEMICALS - 12 MONTHS

FFP

IN ACCORDANCE WITH STATEMENT OF WORK

PROVIDE A PER DRUM PRICE BREAKDOWN FOR PRICE JUSTIFICATION

PURPOSES.

PRDUCT DESCRIPTIONS QTY/YR PRICE

FOB: Destination

MILSTRIP: N4425519RCWN055

PURCHASE REQUEST NUMBER: N4425519RCWN055

SIGNAL CODE: A

PSC CD: J044

NET AMT

0002 12 Months

COOLING WATER MAINTENANCE

FFP

SERVICE TO BE PROVIDED IN ACCORDANCE WITH STATEMENT OF

WORK

0003 1 Group

CHEMICAL FEED-MONITORING CONTROL SYSTEM

FFP

1001 1 Months

OPTION COOLING WATER CHEMICALS - 12 MONTHS

FFP

IN ACCORDANCE WITH STATEMENT OF WORK

PROVIDE A PER DRUM PRICE BREAKDOWN FOR PRICE JUSTIFICATION

PURPOSES.

PRDUCT DESCRIPTIONS QTY/YR PRICE

1002 12 Months

OPTION COOLING WATER MAINTENANCE

FFP

1003 1 Group

OPTION CHEMICAL FEED-MONITORING CONTROL SYSTEM

FFP

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

0003 Destination Government Destination Government

1001 Destination Government Destination Government

1002 Destination Government Destination Government

1003 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 19-MAY-2019 TO

18-MAY-2020

N/A N/A

0002 POP 19-MAY-2019 TO

0003 POP 19-MAY-2019 TO

1001 POP 19-MAY-2020 TO

18-MAY-2021

1002 POP 19-MAY-2020 TO

1003 POP 19-MAY-2020 TO

CLAUSES INCORPORATED BY REFERENCE

52.204-2 Security Requirements AUG 1996

52.204-7 System for Award Management OCT 2018

52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011

52.204-13 System for Award Management Maintenance OCT 2018

52.204-16 Commercial and Government Entity Code Reporting JUL 2016

52.204-18 Commercial and Government Entity Code Maintenance JUL 2016

52.209-2 Prohibition on Contracting with Inverted Domestic

Corporations--Representation

NOV 2015

52.212-1 Instructions to Offerors--Commercial Items OCT 2018

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

52.223-3 Hazardous Material Identification And Material Safety Data JAN 1997

52.223-5 Alt I Pollution Prevention and Right-to-Know Information (May

2011) Alternate I

MAY 2011

52.223-5 Alt II Pollution Prevention and Right-to-Know Information (May

2011) Alt II

MAY 2011

52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran-- Representation and Certifications.

AUG 2018

52.232-18 Availability Of Funds APR 1984

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

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

252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7003 Control Of Government Personnel Work Product APR 1992

252.204-7005 Oral Attestation of Security Responsibilities NOV 2001

252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

OCT 2016

252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

252.225-7036 Alt I Buy American--Free Trade Agreements--Balance of

Payments Program--Alternate I (Dec 2017)

DEC 2017

252.225-7048 Export-Controlled Items JUN 2013

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006

252.243-7001 Pricing Of Contract Modifications DEC 1991

252.244-7000 Subcontracts for Commercial Items JUN 2013

252.246-7003 Notification of Potential Safety Issues JUN 2013

252.247-7023 Transportation of Supplies by Sea FEB 2019

CLAUSES INCORPORATED BY FULL TEXT

52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016)

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

Commercial and Government Entity (CAGE) code means—

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics

Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity;

or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA

Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

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.

(b) 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 to paragraph (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture.

(c) If the Offeror indicates ``has'' in paragraph (b) of this provision, enter the following information:

Immediate owner CAGE code:

Immediate owner legal name: ___

(Do not use a ``doing business as'' name)

Is the immediate owner owned or controlled by another entity?:

[ ___ ] Yes or [ ___ ] No.

(d) If the Offeror indicates ``yes'' in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest-level owner CAGE code:

Highest-level owner legal name:

(Do not use a ``doing business as'' name)

(End of provision)

52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations

Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that--

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered suspension or debarment of the corporation and made a determination that suspension or debarment is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless an agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that--

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (OCT 2018)

ALTERNATE I (OCT 2014)

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

https://www.sam.gov/

(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 in SAM.

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

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

[Offeror to identify the applicable paragraphs at (c) through (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.

http://www.sam.gov/

(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,…