N32253-21-Q-0034 - Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

N3225321Q0034 04-May-2021

b. TELEPHONE NUMBER

808-473-8000 X-5370

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 11 May 2021

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 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.

N322539. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

MONICA NAPOLEON

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

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

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

SEE SCHEDULE

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

PEARL HARBOR NAVAL SHIPYARD & IMF

ATTN: MONICA NAPOLEON

667 SAFEGUARD STREET., STE 100, C410

JBPHH HI 96860-5035

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 N32553 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

PEARL HARBOR NAVAL SHIPYARD & IMF

MIKE WATTERS

PEARL HARBOR NSY & IMF

RECEIVING DEPT.

667 SAFEGUARD STREET, BLDG 167

JBPHH HI 96860-5033

TEL: 808-473-8000 X4960 FAX: 808-471-1133

FAX:

TEL: 808-473-8000 EXT 5370 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

NAICS:

334412

X

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)

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.

N3225321Q0034

Section SF 30 - BLOCK 14 CONTINUATION PAGE

IMPORTANT INFORMATION

Solicitation POC:

MONICA NAPOLEON; TEL: 808-473-8000 X-5370; E-MAIL: monica.l.napoleon@navy.mil

THE DOD AND NAVY REQUIRE PAPERLESS DISTRIBUTION OF PURCHASE ORDERS,

CONTRACTS, AND MODIFICATIONS. PLEASE PROVIDE YOUR E-MAIL ADDRESS:

The Contractor shall be registered in the SAM database prior to submitting an invoice and through final payment of any contract, basic agreement, basic ordering agreement, or blanket purchasing agreement resulting from this solicitation.

The SAM registration shall be for the same name and address identified on the contract, with its associated CAGE code and DUNS or DUNS+4.

Contractors may obtain information on registration and annual confirmation requirements via the SAM accessed through https://www.acquisition.gov or by calling 866-606-8220, or 334-206-7828 for international calls.

SINGLE AWARD – The Government intends to award a single contract resulting from this solicitation.

Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specified otherwise in the offer.

**** THE FOLLOWING INFORMATION MUST BE PROVIDED OR YOUR QUOTE MAY NOT BE

ACCEPTED. PLEASE EMAIL ME FOR QUESTIONS. ****

Material is required to be delivered within 30 DAYS OR BEST DELIVERY after receipt of order (ARO).

If the required delivery cannot be met, an alternate delivery schedule may be considered. Provide your best delivery schedule:

___ FOB Destination; Shipping Method: _________________

Estimated delivery time ________________ days/weeks/months (circle one).

__Y / N__ Product(s) is/are made in USA or DFARS compliant?

***IF QUOTING FOR “EQUAL OR SUBSTITUTE” BRAND OR PRODUCT, PLEASE PROVIDE COPY

OF LITERATURE/SPECIFICATIONS, MAKE/MODEL OF ITEMS BEING OFFERED***

Business size (check one, in accordance with Federal Government Standards) CAGE CODE: __________ Small ____ Large ____Women-Owned____ Disadvantaged _____ Other_____ Prompt Payment Terms_______% _______Days NET ______ If on GSA Contract: [ ] GSA Contract #____________________Expiration Date: ______

METHOD OF PAYMENT IS WIDE AREA WORK FLOW (WAWF)

DFAR Clause 252.232-7003 (MAR 2008) ELECTRONIC SUBMISSION OF PAYMENT REQUEST AND RECEIVING REPORTS is applicable to this solicitation. Please note that the WAWF (Wide Area Work Flow) will be used as the method of payment for supplies and/or services procured under this solicitation. Information regarding WAWF is available on the internet at https://wawf.eb.mil. If you are not able to accept payment by WAWF please provide the reason(s) below:

https://www.acquisition.gov/ https://wawf.eb.mil/

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

CLIN

Number

2 Each

CIRCUIT CARD ASSEMBLY

FFP

CIRCUIT CARD ASSEMBLY: 3.000" NOM O/A WIDTH X 6.000" NOM O/A

LENGTH, CB-68LPR I/O CONNECTOR BLOCK, P/N 777145-02

FOB: Destination

MILSTRIP: N322530303V007

MFR PART NR: 777145-02

PURCHASE REQUEST NUMBER: N322530303V007

PROJECT: NY3

PSC CD: 5998

NET AMT

CABLE ASEMBLY

FFP

CABLE ASSEMBLY, SPECIAL PURPOSE, ELECTRICAL: SHC68-68-EPM

SHIELDED CABLE, 68-D-TYPE TO 68 VHDCI OFFSET, 1 M, P/N 192061-01.

FOB: Destination

MILSTRIP: N322530303V008

MFR PART NR: 192061-01

PURCHASE REQUEST NUMBER: N322530303V008

PSC CD: 5995

CABLE ASSEMBLY POWE

FFP

CABLE ASSEMBLY: TYPE SH100-100-FLEX, 1 M, P/N 185095-01

FOB: Destination

MILSTRIP: N322530303V009

MFR PART NR: 185095-01

PURCHASE REQUEST NUMBER: N322530303V009

PSC CD: 6145

COUPLER,DIGITAL DATA

FFP

CONNECTOR BLOCK: CONNECTOR BLOCK, SCB-100 NOISE REJECTING,

SHIELDED I/O, NATIONAL INSTRUMENTS P/N 776990-01.

FOB: Destination

MILSTRIP: N322530303V010

MFR PART NR: 776990-01

PURCHASE REQUEST NUMBER: N322530303V010

PSC CD: 6150

CABLE ASSEMBLY,POWE

FFP

CABLE ASSEMBLY: TYPE SH100-100-FLEX, 1 M, P/N 185095-01

FOB: Destination

MILSTRIP: N322530303V011

MFR PART NR: 185095-01

PURCHASE REQUEST NUMBER: N322530303V011

COUPLER,DIGITAL DATA

FFP

CONNECTOR BLOCK: CONNECTOR BLOCK, SCB-100 NOISE REJECTING,

SHIELDED I/O, NATIONAL INSTRUMENTS P/N 776990-01

FOB: Destination

MILSTRIP: N322530303V012

MFR PART NR: 776990-01

PURCHASE REQUEST NUMBER: N322530303V012

NI REMOTE CONTROLLER

FFP

NI REMOTE CONTROLLER: CONTROLLER; REMOTE; PXIE-8301

THUNDERBOLT 3 REMOTE CONTROLLER; 2-PORT; NATIONAL

INSTRUMENTS P/N 785679-01.

FOB: Destination

MILSTRIP: N322530303V013

MFR PART NR: 785679-01

PURCHASE REQUEST NUMBER: N322530303V013

NI THUNDERBOLT CABLE

FFP

NI THUNDERBOLT CABLE: CABLE, THUNDERBOLT 3 TYPE-C CABLE,

PASSIVE 20 GBPS, 3A, 2M; NATIONAL INSTRUMENTS P/N 785608-02.

FOB: Destination

MILSTRIP: N322530303V014

MFR PART NR: 785608-02

PURCHASE REQUEST NUMBER: N322530303V014

NI DAQ MODULE

FFP

NI DAQ MODULE: PXI-6281, M SERIES DAQ, (16 ANALOG INPUTS, 24

DIGITAL I/O, 2 ANALOG OUTPUTS); NATIONAL INSTRUMENTS P/N

779121-01.

FOB: Destination

MILSTRIP: N322530303V015

MFR PART NR: 779121-01

PURCHASE REQUEST NUMBER: N322530303V015

NI CABLE

FFP

NI CABLE: CABLE, SHC68-68-EPM SHIELDED CABLE, 68-D-TYPE TO 68

VHDCI OFFSET, 2 M; NATIONAL INSTRUMENTS P/N 192061-02

FOB: Destination

MILSTRIP: N322530303V016

MFR PART NR: 192061-02

PURCHASE REQUEST NUMBER: N322530303V016

NI DI-DO MODULE

FFP

NI DI-DO MODULE: MODULE, PXI-6528 INDUSTRIAL, 24 DI, 24 DO, CH-

CH ISOLATED DIO; NI-DAQ; NATIONAL INSTRUMENTS P/N 778543-01.

FOB: Destination

MILSTRIP: N322530303V017

MFR PART NR: 778543-01

PURCHASE REQUEST NUMBER: N322530303V017

NI CABLE ASSY

FFP

NI CABLE ASSY: CABLE ASSY, TYPE SH100-100-FLEX, 2 M; NATIONAL

INSTRUMENTS P/N 185095-02.

FOB: Destination

MILSTRIP: N322530303V018

MFR PART NR: 185095-02

PURCHASE REQUEST NUMBER: N322530303V018

8 Each

NI DMM MODULE

FFP

NI DMM MODULE, MODULE, PXIE-4080 HIGH-PERFORMANCE 6 1/2

DIGIT DMM AND 300 V DIGITIZER; NATIONAL INSTRUMENTS P/N

783129-01.

FOB: Destination

MILSTRIP: N322530303V019

MFR PART NR: 783129-01

PURCHASE REQUEST NUMBER: N322530303V019

3 Each

NI PXI EXPRESS

FFP

NI PXIE EXPRESS: 8381, X8 GEN 2 MXI-EXPRESS FOR PXI EXPRESS

INTERFACE; NATIONAL INSTRUMENTS P/N 782362-01.

FOB: Destination

MILSTRIP: N322530303V020

MFR PART NR: 782362-01

PURCHASE REQUEST NUMBER: N322530303V020

NI MXI-EXPRESS CABLE

FFP

NI MXI-EXPRESS CABLE, MXI EXPRESS CABLE, GEN 2 X8, FIBER OPTIC,

100M (GEN 2X4SPEED); NATIONAL INSTRUMENTS P/N 783329-100.

FOB: Destination

MILSTRIP: N322530303V021

MFR PART NR: 783329-100

PURCHASE REQUEST NUMBER: N322530303V021

FFP

NI MXI-EXPRESS CABLE, MXI EXPRESS CABLE, GEN 2 X8, FIBER OPTIC,

30M (GEN 2X4SPEED); NATIONAL INSTRUMENTS P/N 783329-30.

FOB: Destination

MILSTRIP: N322530303V022

MFR PART NR: 783329-30

PURCHASE REQUEST NUMBER: N322530303V022

NI CONNECTOR BLOCK

FFP

NI CONNECTOR BLOCK: CONNECTOR BLOCK, SCB-100 NOISE

REJECTING, SHIELDED I/O; NATIONAL INSTRUMENTS P/N 776990-01.

FOB: Destination

MILSTRIP: N322530303V023

MFR PART NR: 776990-01

PURCHASE REQUEST NUMBER: N322530303V023

CHASSIS: PXIE-1078, 9-SLOT 3U PXI EXPRES

FFP

CHASSIS: PXIE-1078, 9-SLOT 3U PXI EXPRESS; NATIONAL

INSTRUMENTS P/N 781622-01.

FOB: Destination

MILSTRIP: N322530303V024

MFR PART NR: 781622-01

PURCHASE REQUEST NUMBER: N322530303V024

NI CHASSIS KIT

FFP

NI CHASSIS KIT, CHASSIS KIT, PXI-103X AND PXIE-107X SIDE HANDLE

AND RUBBER FEET KIT; NATIONAL INSTRUMENTS P/N 781482-01.

FOB: Destination

MILSTRIP: N322530303V025

MFR PART NR: 781482-01

PURCHASE REQUEST NUMBER: N322530303V025

NI PXI CARRYING CASE

FFP

PXI CARRYING CASE; NATIONAL INSTRUMENTS P/N 780398-01.

FOB: Destination

MILSTRIP: N322530303V026

MFR PART NR: 780398-01

PURCHASE REQUEST NUMBER: N322530303V026

4 Each

NI PXI SLOT BLOCKER

FFP

NI PXI SLOT BLOCKER, NI PXI SLOT BLOCKER, SET OF 5; NATIONAL

INSTRUMENTS P/N 199198-01.

FOB: Destination

MILSTRIP: N322530303V027

MFR PART NR: 199198-01

PURCHASE REQUEST NUMBER: N322530303V027

NI PXI CONTROLLER

FFP

CONTROLLER, PXIE-8821RT, LABVIEW RT WITH EXTENDED TEMP AND

24/7 OPERATION, 80GB (OR GREATER) GB SOLID STATE DRIVE (779175-

07); NATIONAL INSTRUMENTS P/N 785158-33 .

FOB: Destination

MILSTRIP: N322530303V028

MFR PART NR: 785158-33

PURCHASE REQUEST NUMBER: N322530303V028

SOLID STATE DRIVE

FFP

80GB (OR GREATER) GB SOLID STATE DRIVE, EXTENDED TEMP AND

24/7 OPERATION, CONTROLLER OPTION, FOR USE WITH PXIE-8821 RT

CONTROLLER; NATIONAL INSTRUMENTS P/N 779175-07.

FOB: Destination

MILSTRIP: N322530303V029

MFR PART NR: 779175-07

PURCHASE REQUEST NUMBER: N322530303V029

FFP

NI DI-DO MODULE: MODULE, PXI-6528 INDUSTRIAL, 24 DI, 24 DO, CH-

CH ISOLATED DIO; NI-DAQ; NATIONAL INSTRUMENTS P/N 778543-01.

FOB: Destination

MILSTRIP: N322530303V030

MFR PART NR: 778543-01

PURCHASE REQUEST NUMBER: N322530303V030

FFP

NI CABLE ASSY: CABLE ASSY, TYPE SH100-100-FLEX, 2 M; NATIONAL

INSTRUMENTS P/N 185095-02.

FOB: Destination

MILSTRIP: N322530303V031

MFR PART NR: 185095-02

PURCHASE REQUEST NUMBER: N322530303V031

3 Each

NI INTERFACE

FFP

INTERFACE: NI PXIE—8384, X8 GEN 2 MXI-EXPRESS DAISYCHAIN

INTERFACE; NATIONAL INSTRUMENTS P/N 782363-01.

FOB: Destination

MILSTRIP: N322530303V032

MFR PART NR: 782363-01

PURCHASE REQUEST NUMBER: N322530303V032

FFP

INTERFACE: PXI-8433/4, 2000V ISOLATED RS422/485, 4 PORT SERIAL

INTERFACE; NATIONAL INSTRUMENTS P/N 779539-01.

FOB: Destination

MILSTRIP: N322530303V033

MFR PART NR: 779539-01

PURCHASE REQUEST NUMBER: N322530303V033

FFP

NI CONNECTOR BLOCK: CONNECTOR BLOCK, SCB-100 NOISE

REJECTING, SHIELDED I/O; NATIONAL INSTRUMENTS P/N 776990-01.

FOB: Destination

MILSTRIP: N322530303V034

MFR PART NR: 776990-01

PURCHASE REQUEST NUMBER: N322530303V034

FFP

NI CHASSIS KIT, CHASSIS KIT, PXI-103X AND PXIE-107X SIDE HANDLE

AND RUBBER FEET KIT; NATIONAL INSTRUMENTS P/N 781482-01.

FOB: Destination

MILSTRIP: N322530303V035

MFR PART NR: 781482-01

PURCHASE REQUEST NUMBER: N322530303V035

FFP

PXI CARRYING CASE; NATIONAL INSTRUMENTS P/N 780398-01.

FOB: Destination

MILSTRIP: N322530303V036

MFR PART NR: 780398-01

PURCHASE REQUEST NUMBER: N322530303V036

4 Each

FFP

NI PXI SLOT BLOCKER, NI PXI SLOT BLOCKER, SET OF 5; NATIONAL

INSTRUMENTS P/N 199198-01.

FOB: Destination

MILSTRIP: N322530303V037

MFR PART NR: 199198-01

PURCHASE REQUEST NUMBER: N322530303V037

FFP

NI MXI-EXPRESS CABLE, MXI EXPRESS CABLE, GEN 2 X8, FIBER OPTIC,

100M (GEN 2X4SPEED); NATIONAL INSTRUMENTS P/N 783329-100.

FOB: Destination

MILSTRIP: N322530303V038

MFR PART NR: 783329-100

PURCHASE REQUEST NUMBER: N322530303V038

NI CHASSIS

FFP

CHASSIS: PXIE-1078, 9-SLOT 3U PXI EXPRESS; NATIONAL

INSTRUMENTS P/N 781622-01.

FOB: Destination

MILSTRIP: N322530303V039

MFR PART NR: 781622-01

PURCHASE REQUEST NUMBER: N322530303V039

NI SOFTWARE, LABVIEW

FFP

SOFTWARE, LABVIEW PROFESSIONAL DEVELOPMENT SYSTEM,

WINDOWS, ALL LANGUAGES, INCLUDE 1 YEAR SSP INTERFACE: PXI-

8433/4, 2000V ISOLATED RS422/485, 4 PORT SERIAL INTERFACE;

NATIONAL INSTRUMENTS P/N 776678-35.

FOB: Destination

MILSTRIP: N322530303V040

MFR PART NR: 776678-35

PURCHASE REQUEST NUMBER: N322530303V040

PSC CD: 7G21

NI SOFTWARE, LABVIEW

FFP

SOFTWARE: LABVIEW REAL-TIME MODULE. INCLUDE 1 YEAR SSP;

NATIONAL INSTRUMENTS P/N 777844-035.

FOB: Destination

MILSTRIP: N322530303V041

MFR PART NR: 777844-35

PURCHASE REQUEST NUMBER: N322530303V041

PSC CD: 5963

1 Each

NI PXI CONTROLLER

FFP

CONTROLLER, PXIE-8821RT, LABVIEW RT WITH EXTENDED TEMP AND

24/7 OPERATION, 80GB (OR GREATER) GB SOLID STATE DRIVE (779175-

07); NATIONAL INSTRUMENTS P/N 785158-33 .

FOB: Destination

MILSTRIP: N322530303V042

MFR PART NR: 785158-33

PURCHASE REQUEST NUMBER: N322530303V042

NI CHASSIS

FFP

CHASSIS: PXIE-1078, 9-SLOT 3U PXI EXPRESS; NATIONAL

INSTRUMENTS P/N 781622-01.

FOB: Destination

MILSTRIP: N322530303V043

MFR PART NR: 781622-01

PURCHASE REQUEST NUMBER: N322530303V043

FFP

NI CHASSIS KIT, CHASSIS KIT, PXI-103X AND PXIE-107X SIDE HANDLE

AND RUBBER FEET KIT; NATIONAL INSTRUMENTS P/N 781482-01.

FOB: Destination

MILSTRIP: N322530303V044

MFR PART NR: 781482-01

PURCHASE REQUEST NUMBER: N322530303V044

FFP

PXI CARRYING CASE; NATIONAL INSTRUMENTS P/N 780398-01.

FOB: Destination

MILSTRIP: N322530303V045

MFR PART NR: 780398-01

PURCHASE REQUEST NUMBER: N322530303V045

FFP

NI PXI SLOT BLOCKER, NI PXI SLOT BLOCKER, SET OF 5; NATIONAL

INSTRUMENTS P/N 199198-01.

FOB: Destination

MILSTRIP: N322530303V046

MFR PART NR: 199198-01

PURCHASE REQUEST NUMBER: N322530303V046

SOLID STATE DRIVE

FFP

80GB (OR GREATER) GB SOLID STATE DRIVE, EXTENDED TEMP AND

24/7 OPERATION, CONTROLLER OPTION, FOR USE WITH PXIE-8821 RT

CONTROLLER; NATIONAL INSTRUMENTS P/N 779175-07.

FOB: Destination

MILSTRIP: N322530303V047

MFR PART NR: 779175-07

PURCHASE REQUEST NUMBER: N322530303V047

FFP

NI CONNECTOR BLOCK: CONNECTOR BLOCK, SCB-100 NOISE

REJECTING, SHIELDED I/O; NATIONAL INSTRUMENTS P/N 776990-01.

FOB: Destination

MILSTRIP: N322530303V048

MFR PART NR: 776990-01

PURCHASE REQUEST NUMBER: N322530303V048

NI CABLE

FFP

NI CABLE: CABLE, SHC68-68-EPM SHIELDED CABLE, 68-D-TYPE TO 68

VHDCI OFFSET, 2 M; NATIONAL INSTRUMENTS P/N 192061-02

FOB: Destination

MILSTRIP: N322530303V049

MFR PART NR: 192061-02

PURCHASE REQUEST NUMBER: N322530303V049

FFP

NI DI-DO MODULE: MODULE, PXI-6528 INDUSTRIAL, 24 DI, 24 DO, CH-

CH ISOLATED DIO; NI-DAQ; NATIONAL INSTRUMENTS P/N 778543-01.

FOB: Destination

MILSTRIP: N322530303V050

MFR PART NR: 778543-01

PURCHASE REQUEST NUMBER: N322530303V050

FFP

NI CABLE ASSY: CABLE ASSY, TYPE SH100-100-FLEX, 2 M; NATIONAL

INSTRUMENTS P/N 185095-02.

FOB: Destination

MILSTRIP: N322530303V051

MFR PART NR: 185095-02

PURCHASE REQUEST NUMBER: N322530303V051

NI DMM MODULE

FFP

NI DMM MODULE, MODULE, PXIE-4080 HIGH-PERFORMANCE 6 1/2

DIGIT DMM AND 300 V DIGITIZER; NATIONAL INSTRUMENTS P/N

783129-01.

FOB: Destination

MILSTRIP: N322530303V052

MFR PART NR: 783129-01

PURCHASE REQUEST NUMBER: N322530303V052

FFP

INTERFACE: PXI-8433/4, 2000V ISOLATED RS422/485, 4 PORT SERIAL

INTERFACE; NATIONAL INSTRUMENTS P/N 779539-01.

FOB: Destination

MILSTRIP: N322530303V053

MFR PART NR: 779539-01

PURCHASE REQUEST NUMBER: N322530303V053

NI DAQ MODULE

FFP

NI DAQ MODULE: PXI-6281, M SERIES DAQ, (16 ANALOG INPUTS, 24

DIGITAL I/O, 2 ANALOG OUTPUTS); P/N 779121-01.

FOB: Destination

MILSTRIP: N322530303V054

MFR PART NR: 779121-01

PURCHASE REQUEST NUMBER: N322530303V054

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

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 14-JUN-2021 2 PEARL HARBOR NAVAL SHIPYARD &

IMF

MIKE WATTERS

PEARL HARBOR NSY & IMF

RECEIVING DEPT.

667 SAFEGUARD STREET, BLDG 167

JBPHH HI 96860-5033

808-473-8000 X4960 FOB: Destination

N32553

0002 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0003 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0004 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0005 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0006 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0007 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0008 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0009 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0010 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0011 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0012 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0013 14-JUN-2021 8 (SAME AS PREVIOUS LOCATION)

0014 14-JUN-2021 3 (SAME AS PREVIOUS LOCATION)

0015 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0016 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0017 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0018 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0019 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0020 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0021 14-JUN-2021 4 (SAME AS PREVIOUS LOCATION)

0022 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0023 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0024 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0025 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0026 14-JUN-2021 3 (SAME AS PREVIOUS LOCATION)

0027 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0028 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0029 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0030 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0031 14-JUN-2021 4 (SAME AS PREVIOUS LOCATION)

0032 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0033 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0034 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0035 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0036 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0037 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0038 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0039 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0040 14-JUN-2021 2 (SAME AS PREVIOUS LOCATION)

0041 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0042 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0043 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0044 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0045 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0046 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0047 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

0048 14-JUN-2021 1 (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.203-19 Prohibition on Requiring Certain Internal Confidentiality

Agreements or Statements

JAN 2017

52.204-7 System for Award Management OCT 2018 52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

JUN 2020

52.204-13 System for Award Management Maintenance OCT 2018 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 52.204-17 Ownership or Control of Offeror AUG 2020 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.204-20 Predecessor of Offeror AUG 2020 52.204-22 Alternative Line Item Proposal JAN 2017 52.204-23 Prohibition on Contracting for Hardware, Software, and

Services Developed or Provided by Kaspersky Lab and Other Covered Entities.

JUL 2018

52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment.

AUG 2020

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

AUG 2020

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment

JUN 2020

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law

FEB 2016

52.212-1 Instructions to Offerors--Commercial Items JUN 2020 52.212-2 Evaluation - Commercial Items OCT 2014 52.212-4 Contract Terms and Conditions--Commercial Items OCT 2018 52.212-5 Contract Terms and Conditions Required to Implement

Statutes or Executive Orders--Commercial Items

JUN 2020

52.219-6 (Dev) Notice of Total Small Business Set-Aside (DEVIATION 2020-O0008).

NOV 2020

52.219-33 Nonmanufacturer Rule MAR 2020 52.222-3 Convict Labor JUN 2003 52.222-19 Child Labor -- Cooperation with Authorities and Remedies JAN 2020 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity SEP 2016 52.222-36 Equal Opportunity for Workers with Disabilities JUN 2020 52.222-50 Combating Trafficking in Persons OCT 2020 52.223-18 Encouraging Contractor Policies To Ban Text Messaging

While Driving

JUN 2020

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.225-25 Prohibition on Contracting with Entities Engaging in Certain

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

JUN 2020

52.232-33 Payment by Electronic Funds Transfer--System for Award Management

OCT 2018

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-3 Protest After Award AUG 1996 52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.243-1 Changes--Fixed Price AUG 1987 52.246-2 Inspection Of Supplies--Fixed Price AUG 1996 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7009 Limitations on the Use or Disclosure of Third-Party Contractor Reported Cyber Incident Information

OCT 2016

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting

DEC 2019

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

MAY 2016

252.213-7000 Notice to Prospective Suppliers on Use of Supplier Performance Risk System in Past Performance Evaluations

SEP 2019

252.215-7013 Supplies and Services Provided by Nontraditional Defense Contractors.

JAN 2018

252.225-7001 Buy American And Balance Of Payments Program-- Basic DEC 2017 252.225-7012 Preference For Certain Domestic Commodities DEC 2017 252.225-7031 Secondary Arab Boycott Of Israel JUN 2005 252.225-7048 Export-Controlled Items JUN 2013 252.231-7000 Supplemental Cost Principles DEC 1991 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006 252.247-7023 Transportation of Supplies by Sea FEB 2019

CLAUSES INCORPORATED BY FULL TEXT

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (DEC

2019)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(c) Representation. The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(End of provision) https://www.sam.gov/

ADDENDUM TO FAR 52.212-2

ADDENDUM TO FAR 52.212-2

1. The evaluation factors are:

a. Basis for Contract Award This will be a Lowest Price Technically Acceptable (LPTA) evaluation conducted in accordance with (IAW) Federal Acquisition Regulation (FAR)13 Simplified Acquisition Procedures, as supplemented by the Defense Federal Acquisition Regulation Supplement (DFARS), and Navy Marine Corps Acquisition Regulation Supplement (NMCARS). These regulations are available electronically at the Air Force (AF) FARSite, http://farsite.hill.af.mil . A contract may be awarded to the contractor who is deemed responsible in accordance with the FAR part 9.1, as supplemented, whose quote conforms to the solicitation’s requirements (to include all stated terms, conditions, representations, certifications, and all other information required by Addendum to FAR 52.212-1 of this solicitation) and is judged, based on the evaluation factors, to represent the lowest price technically acceptable quote.

b. Solicitation Requirements, Terms and Conditions Contractors are required to meet all solicitation requirements, such as terms and conditions, representations and certifications, and technical requirements, in addition to those identified as factors. Failure to comply with the terms and conditions of the solicitation may result in the contractor being ineligible for award. Contractors must clearly identify any exception to the solicitation terms and conditions and must provide complete supporting rationale. The Government reserves the right to determine any such exceptions unacceptable.

TABLE 1- TECHNICAL RATINGS

RATING DESCRIPTION

Acceptable Quote meets the requirement in the solicitation and PWS.

Unacceptable Quote does not meet the requirements in the solicitation and PWS.

CLAUSES INCORPORATED BY FULL TEXT

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (JUN 2020)

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 (v) of this provision.

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

“Covered telecommunications equipment or services” has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

“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 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 http://www.sam.gov/ 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(s) applicable to the NAICS code(s) 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 (v) 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”:

Fre…