Amd_0005_Conformed.pdf

MILITARY SEALIFT COMMAND NORFOLK

471 EAST C STREET, BLDG SP-47 NAVAL STATI

NORFOLK VA 23511

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE ADDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

(No Collect Calls)

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

X

CODE

N32205-16-T-4013 09-Dec-2015

b. TELEPHONE NUMBER

757-443-5948

8. OFFER DUE DATE/LOCAL TIME

10:00 AM 19 Jan 2016

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescribed by GSA

FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA X ARE

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

22. UNIT 23. UNIT PRICE 24. AMOUNT21. QUANTITY

CODE 10. THIS ACQUISITION IS

UNRESTRICTED

FAX: NAICS:

TEL:

CODE 18a. PAYMENT WILL BE MADE BYOFFEROR

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TEL.

N32205

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

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

15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

MARK P. DRALUCK

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

1 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

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES

SEE SCHEDULE

333618

TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS

SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

SB

HUBZONE SB

SET ASIDE: % FOR

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

TEL: EMAIL:

0 COPIES

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

.OFFER DATED YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 29. AWARD OF CONTRACT: REFERENCE

8(A)

SVC-DISABLED VET-OWNED SB

EMERGING SB

X

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

SEE SCHEDULE

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY 22. UNIT 24. AMOUNT

PAGE 2 OF

23. UNIT PRICE

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 3/2005) BACK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

N32205-16-T-4013

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 8 Each

00235040351 ROLLER PIN

FFP

00235040351 ROLLER PIN. Price shall include shipping and WPM Compliance FOB: Destination

NET AMT

0002 20 Each T360948 Cylinder Head Blocking Pieces

FFP

T360948 Cylinder Head Blocking Pieces. Price shall include shipping and WPM Compliance

0003 20 Each

E41802243 2910014698061 NOZZLE ASSEMBLY,

FFP

E41802243 2910014698061 NOZZLE ASSEMBLY, SEMT. Price shall include shipping and WPM Compliance

0004 20 Each T433392 5310015530509 Washer

FFP

T433392 5310015530509 Washer. Price shall include shipping and WPM

0005 20 Each T319807 5360012833535 Nozzle, Spring

FFP

T319807 5360012833535 Nozzle, Spring. Price shall include shipping and

0006 20 Each T12615305-2 Body, Injector

FFP

T12615305-2 Body, Injector. Price shall include shipping and WPM

0007 Each T017737 Valve, Exhaust

FFP

T017737 Valve, Exhaust. Price shall include shipping and WPM

0008 20 Each OT23504.040.1 Pin, Roll 4x40

FFP

OT23504.040.1 Pin, Roll 4x40. Price shall include shipping and WPM

0009 20 Each OT23510.014.1 Pin, Roll 10x14

FFP

OT23510.014.1 Pin, Roll 10x14. Price shall include shipping and WPM

0010 4 Each OT65255.70.63 O-Ring

FFP

OT65255.70.63 O-Ring. Price shall include shipping and WPM

0011 2 Each T99570584102-0001 Paste, Molykote G-N

FFP

T99570584102-0001 Paste, Molykote G-N. Price shall include shipping and WPM Compliance

0012 20 Each

OT65130.38.40 RING, JOINT

FFP

OT65130.38.40 RING, JOINT. Price shall include shipping and WPM

0013 20 Each T601700 5365015133029 Shim

FFP

T601700 5365015133029 Shim. Price shall include shipping and WPM

0014 20 Each ON23508.035.1 Pin, Roll

FFP

ON23508.035.1 Pin, Roll. Price shall include shipping and WPM

0015 Each T212336 2815012810834 Valve, Inlet

FFP

T212336 2815012810834 Valve, Inlet. Price shall include shipping and

0016 34 Each T319472 2815014147938 Seat, Valve Insert

FFP

T319472 2815014147938 Seat, Valve Insert. Price shall include shipping and WPM Compliance

0017 20 Each T99361354601 Adhesive, Permabond 910

FFP

T99361354601 Adhesive, Permabond 910. Price shall include shipping and

0018 20 Each OT23512.030.1 Pin, Roll

FFP

OT23512.030.1 Pin, Roll. Price shall include shipping and WPM

0019 20 Each ON06018.10.05 Plug, Male Threaded

FFP

ON06018.10.05 Plug, Male Threaded. Price shall include shipping and

0020 40 Each ON65118.24.40 Gasket, Round Copper

FFP

ON65118.24.40 Gasket, Round Copper. Price shall include shipping and

0021 60 Each ON65145.55.40 Gasket

FFP

ON65145.55.40 Gasket. Price shall include shipping and WPM

0022 20 Each 04030900007 fuel pump overhaul kit

FFP

04030900007 fuel pump overhaul kit. Price shall include shipping and

0023 Each 04003000023 long stud

FFP

04003000023 long stud. Price shall include shipping and WPM

0024 Each 54003001100 short stud

FFP

54003001100 short stud. Price shall include shipping and WPM

0025 Each 04003000024 Top nut long

FFP

04003000024 Top nut long. Price shall include shipping and WPM

0026 Each 54003001200 Top nut short

FFP

54003001200 Top nut short. Price shall include shipping and WPM

0027 Each 54003001300 Bottom nut

FFP

54003001300 Bottom nut. Price shall include shipping and WPM

0028 12 Each 04001800100 bearing shell set

FFP

04001800100 bearing shell set. Price shall include shipping and WPM

0029 24 Each 00652557063 o ring

FFP

00652557063 o ring. Price shall include shipping and WPM Compliance

0030 60 Each 00652395368 o ring

FFP

00652395368 o ring. Price shall include shipping and WPM Compliance

0031 48 Each 00652717069 o ring

FFP

00652717069 o ring. Price shall include shipping and WPM Compliance

0032 2 Each 54471910200 bearing shell set

FFP

54471910200 bearing shell set. Price shall include shipping and WPM

0033 2 Each 99602326301 Rubber ring

FFP

99602326301 Rubber ring. Price shall include shipping and WPM

0034 4 Each 04071800100 Flange (set)

FFP

04071800100 Flange (set). Price shall include shipping and WPM

0035 80 Each 00652295368 O ring

FFP

00652295368 O ring. Price shall include shipping and WPM Compliance

0036 44 Each 04496000100 bearing shells (set)

FFP

04496000100 bearing shells (set). Price shall include shipping and WPM

0037 4 Each 99500604533 roller bearing

FFP

99500604533 roller bearing. Price shall include shipping and WPM

0038 2 Each 03059012900 spring

FFP

03059012900 spring. Price shall include shipping and WPM Compliance

0039 2 Each 54059010200 plate

FFP

54059010200 plate. Price shall include shipping and WPM Compliance

0040 2 Each 04059002500 bush pin

FFP

04059002500 bush pin. Price shall include shipping and WPM Compliance

0041 4 Each 0020010006 bush pin

FFP

0020010006 bush pin. Price shall include shipping and WPM Compliance

0042 2 Each 03059004500 spring

FFP

03059004500 spring. Price shall include shipping and WPM Compliance

0043 2 Each 03059004400 spring

FFP

03059004400 spring. Price shall include shipping and WPM Compliance

0044 2 Each 00652112663 o ring

FFP

00652112663 o ring. Price shall include shipping and WPM Compliance

0045 2 Each 00653123363 o ring

FFP

00653123363 o ring. Price shall include shipping and WPM Compliance

0046 2 Each 03059004700 piston

FFP

03059004700 piston. Price shall include shipping and WPM Compliance

0047 2 Each 03059001500 bush pin

FFP

03059001500 bush pin. Price shall include shipping and WPM Compliance

0048 2 Each 04025000200 disk

FFP

04025000200 disk. Price shall include shipping and WPM Compliance

0049 2 Each 99602402201 joint

FFP

99602402201 joint. Price shall include shipping and WPM Compliance

0050 2 Each 99602420801 joint

FFP

99602420801 joint. Price shall include shipping and WPM Compliance

0051 2 Each 00115270008 nut

FFP

00115270008 nut. Price shall include shipping and WPM Compliance

0052 2 Each 99605104501 joint

FFP

99605104501 joint. Price shall include shipping and WPM Compliance

0053 2 Each 04465800200 sleeve

FFP

04465800200 sleeve. Price shall include shipping and WPM Compliance

0054 4 Each 00652747063 o ring

FFP

00652747063 o ring. Price shall include shipping and WPM Compliance

0055 2 Each 04065000900 screw

FFP

04065000900 screw. Price shall include shipping and WPM Compliance

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 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government 0011 Destination Government Destination Government 0012 Destination Government Destination Government 0013 Destination Government Destination Government 0014 Destination Government Destination Government 0015 Destination Government Destination Government 0016 Destination Government Destination Government 0017 Destination Government Destination Government 0018 Destination Government Destination Government 0019 Destination Government Destination Government 0020 Destination Government Destination Government 0021 Destination Government Destination Government 0022 Destination Government Destination Government 0023 Destination Government Destination Government 0024 Destination Government Destination Government 0025 Destination Government Destination Government 0026 Destination Government Destination Government 0027 Destination Government Destination Government

0028 Destination Government Destination Government 0029 Destination Government Destination Government 0030 Destination Government Destination Government 0031 Destination Government Destination Government 0032 Destination Government Destination Government 0033 Destination Government Destination Government 0034 Destination Government Destination Government 0035 Destination Government Destination Government 0036 Destination Government Destination Government 0037 Destination Government Destination Government 0038 Destination Government Destination Government 0039 Destination Government Destination Government 0040 Destination Government Destination Government 0041 Destination Government Destination Government 0042 Destination Government Destination Government 0043 Destination Government Destination Government 0044 Destination Government Destination Government 0045 Destination Government Destination Government 0046 Destination Government Destination Government 0047 Destination Government Destination Government 0048 Destination Government Destination Government 0049 Destination Government Destination Government 0050 Destination Government Destination Government 0051 Destination Government Destination Government 0052 Destination Government Destination Government 0053 Destination Government Destination Government 0054 Destination Government Destination Government 0055 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 01-MAY-2016 8 N/A

0002 01-MAY-2016 20 N/A

0003 01-MAY-2016 20 N/A

0004 01-MAY-2016 20 N/A

0005 01-MAY-2016 20 N/A

0006 01-JUN-2016 20 N/A

0007 01-APR-2016 0 N/A

0008 01-MAY-2016 20 N/A

0009 01-MAY-2016 20 N/A

0010 01-MAY-2016 4 N/A

0011 01-MAY-2016 2 N/A

0012 01-MAY-2016 20 N/A

0013 01-MAY-2016 20 N/A

0014 01-MAY-2016 20 N/A

0015 01-APR-2016 0 N/A

0016 01-MAY-2016 34 N/A

0017 01-MAY-2016 20 N/A

0018 01-MAY-2016 20 N/A

0019 01-MAY-2016 20 N/A

0020 01-MAY-2016 40 N/A

0021 01-MAY-2016 60 N/A

0022 01-JUN-2016 20 N/A

0023 01-APR-2016 0 N/A

0024 01-APR-2016 0 N/A

0025 01-APR-2016 0 N/A

0026 01-APR-2016 0 N/A

0027 01-APR-2016 0 N/A

0028 01-MAY-2016 12 N/A

0029 01-MAY-2016 24 N/A

0030 01-MAY-2016 60 N/A

0031 01-MAY-2016 48 N/A

0032 01-MAY-2016 2 N/A

0033 01-MAY-2016 2 N/A

0034 01-MAY-2016 4 N/A

0035 01-MAY-2016 80 N/A

0036 01-MAY-2016 44 N/A

0037 01-MAY-2016 4 N/A

0038 01-MAY-2016 2 N/A

0039 01-JUN-2016 2 N/A

0040 01-MAY-2016 2 N/A

0041 01-MAY-2016 4 N/A

0042 01-MAY-2016 2 N/A

0043 01-MAY-2016 2 N/A

0044 01-MAY-2016 2 N/A

0045 01-MAY-2016 2 N/A

0046 01-MAY-2016 2 N/A

0047 01-MAY-2016 2 N/A

0048 01-JUN-2016 2 N/A

0049 01-MAY-2016 2 N/A

0050 01-MAY-2016 2 N/A

0051 01-JUN-2016 2 N/A

0052 01-MAY-2016 2 N/A

0053 01-MAY-2016 2 N/A

0054 01-MAY-2016 4 N/A

0055 01-MAY-2016 2 N/A

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions NOV 2013 52.203-3 Gratuities APR 1984 52.203-11 Certification And Disclosure Regarding Payments To

Influence Certain Federal Transactions

SEP 2007

52.203-12 Limitation On Payments To Influence Certain Federal Transactions

OCT 2010

52.203-17 Contractor Employee Whistleblower Rights and Requirement To Inform Employees of Whistleblower Rights

APR 2014

52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper

MAY 2011

52.204-7 System for Award Management JUL 2013 52.204-13 System for Award Management Maintenance JUL 2013 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.207-4 Economic Purchase Quantity-Supplies AUG 1987 52.209-7 Information Regarding Responsibility Matters JUL 2013 52.212-1 Instructions to Offerors--Commercial Items OCT 2015 52.212-4 Contract Terms and Conditions--Commercial Items MAY 2015 52.223-18 Encouraging Contractor Policies To Ban Text Messaging

While Driving

AUG 2011

52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-- Representation and Certifications.

OCT 2015

52.227-1 Authorization and Consent DEC 2007 52.227-2 Notice And Assistance Regarding Patent And Copyright

Infringement

DEC 2007

52.232-17 Interest MAY 2014 52.232-23 Assignment Of Claims MAY 2014 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-1 Disputes MAY 2014 52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.242-13 Bankruptcy JUL 1995 52.246-2 Inspection Of Supplies--Fixed Price AUG 1996 52.246-16 Responsibility For Supplies APR 1984 52.247-34 F.O.B. Destination NOV 1991 52.247-64 Preference for Privately Owned U.S. - Flag Commercial

Vessels

FEB 2006

52.253-1 Computer Generated Forms JAN 1991 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

252.203-7996 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements—Representation.

NOV 2015

252.203-7997 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements

NOV 2015

252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7004 Alt A System for Award Management Alternate A FEB 2014 252.204-7006 Billing Instructions OCT 2005 252.204-7008 (Dev) Compliance with Safeguarding Covered Defense Information

Controls

OCT 2015

252.204-7012 (Dev) Safeguarding Covered Defense Information and Cyber Incident Reporting

OCT 2015

252.205-7000 Provision Of Information To Cooperative Agreement Holders DEC 1991

252.209-7004 Subcontracting With Firms That Are Owned or Controlled By The Government of a Country that is a State Sponsor of Terrorism

OCT 2015

252.223-7008 Prohibition of Hexavalent Chromium JUN 2013 252.225-7001 Buy American And Balance Of Payments Program-- Basic

(Nov 2014)

NOV 2014

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2012 252.225-7008 Restriction on Acquisition of Specialty Metals MAR 2013 252.225-7012 Preference For Certain Domestic Commodities FEB 2013 252.225-7016 Restriction On Acquisition Of Ball and Roller Bearings JUN 2011 252.225-7031 Secondary Arab Boycott Of Israel JUN 2005 252.225-7048 Export-Controlled Items JUN 2013 252.225-7050 Disclosure of Ownership or Control by the Government of a

Country that is a State Sponsor of Terrorism

DEC 2014

252.226-7001 Utilization of Indian Organizations and Indian-Owned Economic Enterprises, and Native Hawaiian Small Business Concerns

SEP 2004

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991 252.243-7002 Requests for Equitable Adjustment DEC 2012 252.246-7000 Material Inspection And Receiving Report MAR 2008 252.246-7003 Notification of Potential Safety Issues JUN 2013 252.247-7023 Transportation of Supplies by Sea APR 2014

CLAUSES INCORPORATED BY FULL TEXT

52.204-5 WOMEN-OWNED BUSINESS (OTHER THAN SMALL BUSINESS) (OCT 2014)

(a) Definition. Women-owned business concern, as used in this provision, means a concern that is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

(b) Representation. [Complete only if the offeror is a women-owned business concern and has not represented itself as a small business concern in paragraph (c)(1) of FAR 52.219-1, Small Business Program Representations, of this solicitation.] The offeror represents that it ( ___ ) is a women-owned business concern.

(End of provision)

52.212-1 (ADDENDUM) ADDITIONAL INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS

In addition to the quote submission requirements stated in FAR provision 52.212-1, quoters shall provide the following, as part of the quote submisison package, no later than the time and date for quote submission stated in the SF 1449 block 8:

1. Signed and completed SF 1449

2. Company information including name, address, DUNS number, CAGE code, and TAX ID.

3. Price related information: Completed Price Abstract to include unit pricing and total CLIN pricing.

4. A description including part number and title for each item listed in the solicitation to allow the

Government to verify that the quotes parts match the requirements listed in the requirements schedule.

5. Verification of compliance with FAR and DFARS Part 25 terms and conditions. Includes submission of the place of manufacture for each part in the requirements schedule.

6. Completed DFARS Provisions 252.209-7991

7. The Contract states various delivery dates. The vendor shall indicate if these dates can be met or if different ones are requested:___________________________________________.

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

Award will be made in accordance with the Federal Acquisition Regulation (FAR) Subpart 13.5 to a single quoter who is deemed responsible in accordance with, whose quote offers a technically acceptable solution, who has acceptable past performance, conforms to the solicitation requirements, and whose quote, judged by an overall assessment of the evaluation criteria and other considerations specified in this solicitation, represents the lowest price. To be considered a technically acceptable solution, the quoted parts shall meet the solicitation requirements including required parts, delivery dates, and terms and conditions stated in the draft contract. A past performance evaluation will be conducted in accordance with FAR 13.106-2(b)(3). The Government intends to utilize the Governmentwide Past Performance Information Retrieval System (PPIRS) for the past performance evaluation as a basis for anticipating successful/unsuccessful performance on this required effort. To be considered acceptable for past performance, a search of the PPIRS shall reveal no negative past performance information for the recent and relevant records or in the event that there are no recent and/or relevant PPIRS records, the quoter’s past performance record shall be considered “unknown.” In the context of acceptable or unacceptable, “unknown” past performance shall be considered “acceptable.” To be considered recent, the effort must have been completed within the previous three (3) years from date of this draft award notice. To be considered relevant the record should be similar in terms of scope, complexity, and magnitude. At the quoter’s discretion, additional past performance may be submitted with the quote as a supplement to PPIRS. If furnished, this submission will be evaluated in accordance with the procedures described above. The Government will evaluate quoted pricing for reasonableness utilizing techniques described in FAR 13.106-3.

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

ALTERNATE I (OCT 2014)

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

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

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

“Forced or indentured child labor” means all work or service—

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

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

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

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

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

395(c).

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

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

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

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

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

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

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

(8) PSC 9610, Ores;

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

(10) PSC 9630, Additive Metal Materials.

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

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

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

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

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

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

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

(6) Have been voluntarily suspended.

Sensitive technology—

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

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

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

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

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

(1) Means a small business concern—

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

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

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

“Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

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

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

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

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

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

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

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

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

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

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

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

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

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

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

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

(b)

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

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation and certifications currently posted electronically at FAR 52.212- 3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ___ . [Offeror to identify the applicable paragraphs at (c) through (p) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer. Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on

SAM.]

(c) Offerors must complete the following representations when the resulting contract is to be performed in the United States or its outlying areas. Check all that apply.

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

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

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

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

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

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

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

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

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___ .] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

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

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

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

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

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

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

(i) It [ ___ ] is, [ ___ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and

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

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

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

___ Black American.

___ Hispanic American.

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

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

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

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

(d) Representations required to implement provisions of Executive Order 11246 --

(1) Previous contracts and compliance. The offeror represents that --

(i) It [ ___ ] has, [ ___ ] has not, participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

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

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

(i) It [ ___ ] has developed and has on file, [ ___ ] has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or

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

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American – Supplies, is included in this solicitation.)

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

(2) Foreign End Products:

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

[List as necessary]

(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

[List as necessary]

(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:

[List as necessary]

(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:

[List as necessary]

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

(i) The offeror certifies that each end 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:

[List as necessary]

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers 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…