N4215816TN009_COMBINED__RENTAL.doc

This is a COMBINED SYNOPSIS/SOLICITATION for commercial items prepared in accordance with the information in FAR Subpart 12.6, using Simplified Acquisition Procedures under the test program for commercial items found at FAR 13.5, as supplemented with the additional information included in this notice. This announcement constitutes the only solicitation; a written solicitation will not be issued. PAPER COPIES OF THIS SOLICITATION WILL NOT BE AVAILABLE. This combined synopsis/solicitation SHALL be posted on both FEDBIZOPPS and NECO (https://www.neco.navy.mil/).

The RFQ number is N4215816TN009. This solicitation documents and incorporates provisions and clauses in effect through FAC 2005-89 and DFARS Publication Notice 20160802. It is the responsibility of the contractor to be familiar with the applicable clauses and provisions. The clauses may be accessed in full text at these addresses:

https://www.acquisition.gov/far/ and http://www.acq.osd.mil/dpap/dars/dfarspgi/current/index.html. The NAICS code is 532490 and the Small Business Standard is $32.5 Million. This is a competitive, 100% total small business (SB) set-aside action. The Small Business Office concurs with the set-aside decision.

The NAVSUP Fleet Logistics Center – Norfolk requests responses from qualified sources capable of providing:

Line Item – 0001: Rental of (2) two 60 ton chillers 8,000 CFM

(IAW STATEMENT OF WORK AND TECHNICAL CAPABILITIES FOUND WITHIN THE SOLICITATION).

****NOTE: Freight-in and Freight-out will remain separate from the monthly rental rates per line item.

Line Item – 0002: Freight-in and Freight-out

Bid’s must contain rates daily, weekly, monthly (equals 30 days) and the total amount of bid otherwise they will not be considered Contractor must provide manufacture specification when they submit bid (See Specifications under Technical Capabilities Item #1) Technical Capabilities must be answered and initialed and submitted with bid

STATEMENT OF WORK

Scope:

Title: 60 Ton Chiller Unit-RENTAL

Self-contained, 150 GPM (minimum).

Location of work:

Inside NNSY waterfront CIA (Controlled Industrial Area)

Reference:

Federal Specification RR-C-271D.

Hazardous Energy Control (HEC) procedures as identified in NAVSEA’s Occupational Safety, Health, and Environment Corporate Manual (OSHECM) Chapter 250 (latest revision)

OSHA requirements for hazardous energy control IAW 29 CFR 1915.89

NAVFAC-P-307 Standards Lifting and Rigging.

FAR 22.102-1 (a) entitled“Safety”

MARKINGS:

The equipment shall be marked in a prominent location with vendor Point Of Contact information, including name and phone number.

The equipment shall be marked in a prominent location with the gross weight. Marking shall be upper case letters of a contrasting color, with a minimum height of 1”. Marking shall include the units (i.e. “pounds”, “long tons”, etc.).

Period of Performance

Shall be during the period of August 25th, 2016 thru April 24, 2017

Contractor Requirements:

Deliver and retrieve the 60 TON Chiller Unit to Norfolk Naval Shipyard, Portsmouth Virginia, inside the Controlled Industrial Area.

Delivery crew security clearance request is required for shipment offload within the Controlled Industrial Area at NNSY. Contractor shall arrange the Security clearance request with NNSY POC.

Connect the accessory equipment that is not integral to the 60 TON Chiller Unit.

Provide commercial operating instruction manuals and training for Government operators at least once for the 60 TON Chiller Unit and any other major components of the system.

Provide 24 hour a day, seven-day a week on-call repair service during the rental period. The vendor will be responsible for initiating repairs on-site, at Norfolk Naval Shipyard, within 8 hours of verbal or written notification that the equipment has malfunctioned. The contractor will replace the malfunctioning component, at no additional cost to the Government, if the system cannot be returned to service within 8 hours of being notified of the original malfunction.

Contractor personnel shall notify the Temporary Service Zone Manager (TSZM) Duane L. Look Jr. (757)-396-5895, for authorization prior to any work or maintenance on rental unit.

Lost items by Government personnel and equipment damaged beyond normal wear and tear Contractor must submit a claim separate from rental. This is to be submitted within 30 days of the end of the rental period. NNSY POC to verify claim prior to submitting.

Vendor to contact NNSY TSZM 3 days prior to the end of rental period to confirm pickup date.

Preparation For Delivery:

The 60 TON Chiller Unit must be preserved and packaged per the manufacturer's commercial practice. Packing shall be in a manner that will insure acceptance by a common carrier and safe delivery at the destination. The shipping container and method of packing must comply with the Uniform Freight Classification Rules or other carrier regulation as applicable to the mode of transportation.

Government Responsibility:

Provide operators for equipment.

Monitor Equipment.

Equipment movements.

Provide point of contact for delivery, escort and 1-3 day notification to contractor for rental pickup. (TSZM) Points Of Contact:

Technical POC:

Invoice Certifying POC:

Safety Requirements:

"Per FAR 22.102-1(a) entitled "Safety", Contractors are hereby informed that their employees or representatives present on property under Norfolk Naval Shipyard cognizance must follow Federal and State OSHA requirements OSHE OSHECM Chapter Hazardous Energy Control (HEC) requirements or safety requirements for site specific location of the contract.

a.

Contractors and Non-NNSY Government Agencies (NNGAs) are hereby informed that their employees or representatives present on property under Norfolk Naval Shipyard (NNSY) cognizance must adhere to Federal OSHA requirements for hazardous energy control IAW 29 CFR 1915.89 and must follow Hazardous Energy Control (HEC) procedures as identified in NAVSEA’s Occupational Safety, Health, and Environment Corporate Manual (OSHECM) Chapter 250 (latest revision), when performing work under NNSY contract. All HEC work to be performed by Contractors and NNGAs requires that NNSY Technical Points of Contact (TPOCs) and/or Contracting Officer’s Representatives (CORs) be notified of the HEC scope of work prior to starting work. Any changes or deviations in the initial scope of HEC work requires the NNSY TPOCs and/or CORs be informed of the change/deviation. Appendix 250.B-1 through B-3 of OSHECM Chapter 250 for multiple employer work identifies when Contractors and NNGAs are required to assign their Lockout/Tags-Plus Coordinator (LOTC) to coordinate HEC work with the cognizant NNSY LOTC. HEC locks shall be provided by the contractor or NNGA for their employees use. The HEC locks shall have red bodies with name labels or name tags affixed, identifying who installed the HEC lock(s) and a point of contact telephone number. HEC lock name labels and tags must be made of materials that will hold up to the environment to which they are exposed. HEC tags used for Tags-Plus HEC work shall be provided by the cognizant NNSY LOTC to the contractor or NNGA for their use if machinery, equipment, or systems (MES) cannot be locked out. OSHECM Chapter 250 Tags-Plus procedures will be strictly followed.

b.

Contractors and NNGAs may obtain electronic copies of OSHECM Chapter 250 (latest revision) and access the OSHA 1915.89 web site by using the following link to NNSY’s public access web site: http://www.navsea.navy.mil/shipyards/norfolk/default.aspx Names and contact information for NNSY LOTCs and/or the Building Monitor will be provided by NNSY TPOC and/or CORs set forth elsewhere in this award document.

PICKUP/REMOVAL OF RENTAL UNITS:

Unless otherwise notified by NAVSUP FLCN Contracting, Norfolk Naval Shipyard Maritime Industrial Division, Code 533, rental/lease unit(s) shall be picked-up (removed) by Contractor on the morning after expiration of the established contract period of performance. In the event that this date occurs on a Saturday, Sunday, or a recognized Federal Holiday, the contractor may make the appropriate arrangements to pick-up the equipment on the first working day following the expiration of the contract at no additional cost to the Government.

If any difficulty is experienced in picking-up (removing) unit(s), the Contractor MUST immediately request the Contracting Officer's direction by contacting Carol Easter, Code 412 via telephone 757-396-9689 AND providing notification of same via email to carol.easter@navy.mil A Contractor's failure to follow the above instructions regarding pick-up/removal of rental units will relieve the Government of any liability for further charges for the equipment.

Additional Information

The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for the rental of two (2 two 60 ton water chiller units via a secure data collection site. The contractor is required to completely fill in all required data fields using the following web address https://doncmra.nmci.navy.mil.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk, linked at https://doncmra.nmci.navy.mil.

Contract POC On Any Problems Concerning The Order, Please Contact Purchasing Agent, Carol Easter, Code 412, NAVSEA, Norfolk Naval Shipyard Maritime Industrial Branch, Hampton Roads Division, Contracting Department, Bldg. 1500, 2nd Floor, Portsmouth, VA 23709-5000, Telephone: (757) 396-9689.

IMPORTANT INFORMATION:

MARKINGS:

In addition to any other marking requirements found herein, the Contractor shall ensure that all equipment supplied under this contract shall bear the following information:

1. Contractor’s Name and Point of Contact information (name, tele# etc)

2. Government Contract Number; Contracting Officer’s information (name, tele# etc)

3. Vessel Name/Code

The above information should be prominently displayed in a manner that will withstand weather conditions under which this equipment may be exposed.

If any difficulty is experienced in picking-up (removing) unit(s), the Contractor MUST immediately request the Contracting Officer’s direction by contacting Carol Easter, Code 412, via telephone (757) 396-9689AND providing notification of same via email to Carol.easter@navy.mil AND angela.goldsmith@navy.mil.

A Contractor’s failure to follow the above instructions regarding pick-up/removal of rental units will relieve the Government of any liability for further charges for the equipment.

The following FAR provision and clauses are applicable to this procurement:

52.204-7 System for Award Management (July 2013)

52.212-1 Instructions to Offerors - Commercial Items;

52.212-3 and its ALT I, Offeror Representations and Certifications - Commercial Items;

52.212-4 Contract Terms and Conditions - Commercial Items;

Use with its ALT I, when a time and materials contract is anticipated;

52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders – Commercial Items including 52.204-13 SAM Maintenance (July 2013)

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards (July 2013)

52.204-19 Incorporation by Reference of Representations and Certifications (DEC 2014)

52.209-2 Prohibition on Contracting with Inverted Domestic Corporations--Representation (Dec 2014)

52.209-6 Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (August 2013) 52.209-10 Prohibition on Contracting with Inverted Domestic Corporations

52.211-15 Defense Priority And Allocation Requirements

52.211-17 Delivery of Excess Quantities 52.219-6 Notice of Total Small Business Set-Aside (Nov 2011)

52.219-28 Post Award Small Business Program Rerepresentation (July 2013)

52.222-3 Convict Labor (June 2003)

52.222-19 Child Labor—Cooperation with Authorities and Remedies 52.222-21 Prohibition of Segregated Facilities

52.222-26 Equal Opportunity 52.222-36 Affirmative Action for Workers with Disabilities

52.222-50 Combating Trafficking in Persons

52.223-2 Affirmative Procurement of Biobased Products Under Service and Construction Contracts (Sept 2013)

52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving 52.225-13 Restriction on Foreign Purchases (June 2008) 52.225-25 Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran--Reps and Certs (Dec 2012)

52.232-33 Payment by Electronic Funds Transfer – SAM (July 2013)

52.232-39 Unenforceability of Unauthorized Obligations (June 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) 52.237-2 Protection of Government Buildings, Equipment, and Vegetation (APR 1984)

52.247-34 F.O.B. Destination

Quoters shall include a completed copy of 52.212-3 and its ALT I with quotes. All clauses shall be incorporated by reference in the order. Additional contract terms and conditions applicable to this procurement are:

252.203-7000 Requirements Relating To Compensation of Former DoD Officials (Sept 2011) 252.203-7005 Representation Relating to Compensation of Former DoD Officials (Nov 2011)

252.204-7003 Control of Government Personnel Work Product (April 1992)

252.204-7004 System for Award Management (May 2013)

Alt A

252.204-7012 Safeguarding of Unclassified Controlled Technical Information (Nov 2013) 252.204-7015 Disclosure of Information To Litigation Support Contractors (Feb 2014) 252.223-7006 Prohibition on Storage, Treatment, and Disposal of Toxic or Hazardous Materials (Sept 2014) 252.223-7008 Prohibition of Hexavalent Chromium (May 2011)

252.232-7003 Electronic Submission of Payment Requests And Receiving Reports (Mar 2008) 252.232-7010 Levies On Contract Payments

252.237-7010 Prohibition on Interrogation of Detainees by Contractor Personnel (Nov 2010) 252.244-7000 Subcontracts for Commercial Items (June 2013) 252.247-7023 Transportation of Supplies by Sea (April 2014)

CLAUSES INCORPORATED BY FULL TEXT

52.212-1 INSTRUCTIONS TO OFFERORS –COMMERCIAL ITEMS (FEB 2012) ADDENDUM

Quotations shall be emailed Carol Easter (E-mail: carol.easter@navy.mil)

Questions relating to this notice shall be submitted in writing via the above e-mail address.

Quotations will consist of the following documents submitted together in Adobe Acrobat .pdf format:

1. Completed FAR 52.212-3 representations and certifications unless otherwise completed in SAM;

2. Completed technical certification that each item being quoted meets all of the required specifications;

3. Price for each line item being quoted in accordance with the Schedule

Quoters may propose on one/some/all of the items identified.

Unless specifically stated otherwise, submission of a quote means the quoter agrees to partial contract award.

The completion and submission of the above items will constitute a quote and will be considered the vendor’s unconditional assent to the terms and conditions of this solicitation and any attachments and/or exhibits.

Failure to provide all of these documents by the required date and time may preclude a quotation from award consideration at the discretion of the Government.

Quotations are valid for 30 days.

52.212-2 EVALUATION - COMMERCIAL ITEMS (JAN 1999) ADDENDUM

The Government intends to award to the lowest priced technically acceptable and deliverable quote for each item.

Technical acceptability will be determined by reviewing the technical certifications submitted for each item quoted.

Technically acceptable items meet all of the specifications.

Technically unacceptable items do not meet all of the specifications.

If an item is technically unacceptable, the quote for that item will no longer be considered for award.

The quoted prices (including option and FAR 52.217-8 OPTION TO EXTEND SERVICES) of all technically acceptable items will be evaluated and the contracting officer shall assume, for the purpose of making multiple awards, that $500 would be the administrative cost to the Government for issuing and administering each contract awarded under this Request for Quotations.

Individual awards shall be for the items or combinations of items that result in the lowest aggregate cost to the Government, including the assumed administrative costs.

52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within any period prior to contract expiration.

(End of clause)

52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(s):

FAR Clauses: http://acquisition.gov/far/ DFARS Clauses: http://www.acq.osd.mil/dpap/dars/dfars/

(End of clause)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2013) ALTERNATE I (APR 2011)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via http://www.acquisition.gov. If an offeror has not completed the annual representations and certifications electronically at the System for Award Management (SAM) website, the offeror shall complete only paragraphs (b) through (i) of this provision.

(a) Definitions. As used in this provision:

"Emerging small business" means a small business concern whose size is no greater than 50 percent of the numerical size standard for the NAICS code designated.

"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.

Inverted domestic corporation, as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the United States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code at 26 U.S.C. 7874.

“Manufactured end product” means any end product in Federal Supply Classes (FSC) 1000-9999, except—

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

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

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

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

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

(8) FSC 9610, Ores;

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

(10) FSC 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.

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 small business concern" means a small business concern—

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

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

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

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

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

(Offeror to identify the applicable paragraphs at (c) through (n) 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 on ORCA.]

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

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

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(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, for general statistical purposes, 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 to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

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

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

(ii) It [ ___ ballot] is, [ ___ ballot] 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 [ ___ ballot] is, [ ___ ballot] 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 [ ___ ballot] is, [ ___ ballot] 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) Small Business Size for the Small Business Competitiveness Demonstration Program and for the Targeted Industry Categories under the Small Business Competitiveness Demonstration Program. (Complete only if the offeror has represented itself to be a small business concern under the size standards for this solicitation.)

(i) (Complete only for solicitations indicated in an addendum as being set-aside for emerging small businesses in one of the designated industry groups (DIGs).) The offeror represents as part of its offer that it ( ) is, ( ) is not an emerging small business.

(ii) (Complete only for solicitations indicated in an addendum as being for one of the targeted industry categories (TICs) or designated industry groups (DIGs).) Offeror represents as follows:

(A) Offeror's number of employees for the past 12 months (check the Employees column if size standard stated in the solicitation is expressed in terms of number of employees); or

(B) Offeror's average annual gross revenue for the last 3 fiscal years (check the Average Annual Gross Number of Revenues column if size standard stated in the solicitation is expressed in terms of annual receipts).

(Check one of the following):

Average Annual

Number of Employees Gross Revenues

___ 50 or fewer ___ $1 million or less

___ 51 - 100 ___ $1,000,001 - $2 million

___ 101 - 250 ___ $2,000,001 - $3.5 million

___ 251 - 500 ___ $3,500,001 - $5 million

___ 501 - 750 ___ $5,000,001 - $10 million

___ 751 - 1,000 ___ $10,000,001 - $17 million

___ Over 1,000 ___ Over $17 million

(11) (Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns or FAR 52.219-25, Small Disadvantaged Business Participation Program-Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.)

(i) General. The offeror represents that either--

(A) It ( ___ ) is, ( ___ ) is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the SAM Dynamic Small Business Search Database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); or

(B) It ( ___ ) has, ( ___ )( has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

(ii) Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(9)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. (The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ___ .)

(12) Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) or (c)(10) 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, U.S. Trust Territory of the Pacific Islands (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) Certifications and representations required to implement provisions of Executive Order 11246—

(1) Previous Contracts and Compliance. The offeror represents that--

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

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

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

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

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

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $100,000.) 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 Act--Balance of Payments Program Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act--Balance of Payments Program--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 Act--Supplies.”

(2) Foreign End Products:

(List as necessary)

(3) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(g)(1) Buy American Act -- Free Trade Agreements -- Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American Act -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)

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 Act-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 Act--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:

[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 Act—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:

(iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25.

(2) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(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 Act—Free Trade Agreements—Israeli Trade Act”:

Canadian End Products:

Line Item No.:

[List as necessary]

(3) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(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 Act--Free Trade Agreements--Israeli Trade Act'':

Canadian or Israeli End Products:

(4) Buy American Act--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 Act--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:

(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:

(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 Act. 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; and

(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) [ ___ ballot] Have, [ ___ ballot] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is 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. Sec. 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. Sec. 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to 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. Sec. 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). (The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).)

(1) Listed End Product

(2) Certification. (If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.)

( ___ )(i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

( ___ ) (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that is has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) ( ___ )In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) ( ___ ) Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) (The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.)

( ___ ) (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror ( ___ ) does ( ___ ) does not certify that—

(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees…