FA812120R0015_01.pdf

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1447 (REV. 8/2016)

PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.214(d)

23. ACCOUNTING AND APPROPRIATION DATA

SEE SCHEDULE

24. TOTAL AWARD AMOUNT (For Government Use Only)

TELEPHONE NUMBER

UNIQUE ENTITY

IDENTIFIER

CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

NO COLLECT CALLS

4. SOLICITATION NUMBER

FA8121-20-R-0015

X

6.SOLICITATION ISSUE DATE

8. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

HUBZONE SMALL

BUSINESS EDWOSB

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS NAICS: 336412

8(A) SIZE STANDARD: 1,000

DATE SIGNED

28. UNITED STATES OF AMERICA (Signature of Contracting Officer)

26. AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION NUMBER

SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS OR CHANGES WHICH

ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

FMS REQUIREMENT

Subject to the terms and conditions stated herein, the Contractor agrees to hold its offered prices firm for 120 days.

USAF & FMS requirements

CRITICAL SAFETY ITEM

Estimated contract value of Basic and Option periods if all options are exercised is:

Basic - Year 1: $TBD (DD MMM YYYY - DD MMM YYYY) Option I - Year 2: $TBD (DD MMM YYYY - DD MMM YYYY) Option II - Year 3: $TBD (DD MMM YYYY - DD MMM YYYY) Option III - Year 4: $TBD (DD MMM YYYY - DD MMM YYYY) Option IV - Year 5: $TBD (DD MMM YYYY - DD MMM YYYY)

EST TOTAL............... $TBD

22.

AMOUNT

16. AUTHORITY FOR USING OTHER THAN 10 USC 2304 41 USC 253

FULL AND OPEN COMPETITION (c) ( ) (c) ( )

DATE SIGNED

27. SIGNATURE OF OFFEROR/CONTRACTOR

20.

UNIT

21.

UNIT PRICE

19.

QUANTITY

13. CONTRACTOR OFFEROR CODE FACILITY CODE

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT WITHIN * ___ CALENDAR DAYS (60 CALENDAR DAYS UNLESS OFFEROR

INSERTS A DIFFERENT PERIOD) FROM THE DATE SET FORTH IN BLOCK 9 ABOVE, THE CONTRACTOR AGREES TO HOLD

ITS OFFERED PRICES FIRM FOR THE ITEMS SOLICITED HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO

THE TERMS AND CONDITIONS STATED HEREIN. *120

RATING

DO: A1

3. AWARD/EFFECTIVE DATE

FA8121

2. CONTRACT NUMBER

X

17.

ITEM NUMBER

12. ADMINISTERED BY CODE

Total

SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK: 14 EFT:T

SCD:B

NAME AND TITLE OF SIGNER (Type or Print) NAME OF CONTRACTING OFFICER

5. SOLICITATION TYPE

SEALED BIDS NEGOTIATED

(IFB) (RFP)

15. PROMPT PAYMENT DISCOUNT

25. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SETFORTH OR OTHERWISE

IDENTIFIED ABOVE AND ON ANY CONTINUATION SHEETS SUBJECT

THE TERMS AND CONDITIONS SPECIFIED HEREIN.

10. ITEMS TO BE PURCHASED (Brief Description)

SUPPLIES SERVICES Aircraft Engine and Engine Parts Manufacturing

9. (Agency Use)

10-JUL-2020 3:00PM

18.

SCHEDULE OF SUPPLIES/SERVICES

14. PAYMENT WILL BE MADE BY CODE

(SEE ESP CLAUSE 252.232-7003.)

X

7. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, AFSC PZAAA

3001 STAFF DR STE 1AF1 98C

TINKER AFB OK 73145-3303

BUYER: Dawn Purtle/AFSC/PZAAA dawn.purtle.3@us.af.mil Phone: (405) 734- 8487

X

1. THIS CONTRACT IS A RATED ORDER UNDER DPAS

(15 CFR 700)SOLICITATION/CONTRACT

BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27.

J

STANDARD FORM 1447 (REV. 8/2016) BACK

NO RESPONSE FOR REASONS CHECKED

TYPE OR PRINT NAME AND TITLE OF SIGNER

SIGNATURENAME AND ADDRESS OF FIRM (Include Zip Code)

WE DO NOT DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF

ITEMS INVOLVED

WE DO

OTHER (Specify)

UNABLE TO IDENTIFY THE ITEM(S)

CANNOT COMPLY WITH SPECIFICATIONS CANNOT MEET DELIVERY REQUIREMENT

DO NOT REGULARILY MANUFACTURE OR SELL THE TYPE OF ITEMS

INVOLVED

DATE AND LOCAL TIME 10 JUL 2020 3:00 PM

SOLICITATION NUMBER FA812120R0015

FROM: AFFIX

STAMP

HERE

TO:

ATTN: Dawn Purtle/AFSC/PZAAA

DEPARTMENT OF THE AIR FORCE, AFSC PZAAA

3001 STAFF DR STE 1AF1 98C

TINKER AFB OK 73145-3303

FA8121-20-R-0015

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

This will be a one year basic with four one-year options requirements contract.

Period: From: To:

Basic - Year 1 TBD TBD

Option I -Year 2 TBD TBD

Option II - Year 3 TBD TBD

Option III - Year 4 TBD TBD

Option IV - Year 5 TBD TBD

Please populate the following line items with your proposed prices and return the solicitation to the issuing office via email no later than 6 Jul 20 @ 3:00 PM (CST).

Clause 52.216-21 will be filled in with a date at time of award. The date will be one year from the last exercised option's periof of performance.

Cluase 252.216-7006 will be filled in before award with the effective date of the contract.

Note: "IUID Required: NO" is on the following line items BUT it is required if the unit price is $5,000 or more IAW clause 252.211-7003 Item Unique Identification and Valuation. Any resultant contract with a line item unit price $5,000 or more will have "IUID Required: Yes".

There is a Best Estimated Quantity (BEQ) listed on the CLINs. Propose a per unit price and place an estimated total dollar amount under the 'Amount' under each CLIN.

Notice to Offeror(s)/Supplier(s): Funds are not presently available for this effort. No award will be made under this solicitation until funds are available. The Government reserves the right to cancel this solicitation, either before or after the closing date. In the event the Government cancels this solicitation, the Government has no obligation to reimburse an offeror for any costs.

In accordance with FAR 16.503(c) Government Property Furnished for Repair (GFP) - When a requirements contract is used to acquire work (e.g., repair, modification, or overhaul) on existing items of Government property, the contracting officer shall specify in the Schedule that failure of the Government to furnish such items in the amounts or quantities described in the Schedule as "estimated" or "maximum" will not entitle the contractor to any equitable adjustment in price under the Government Property clause of the contract.

This is an Overhaul requirement. No Government Furnished Material shall be provided. Contractor Furnished Material (CFM) is required for all repairs described herein.

Repair shall be performed IAW the manufacturer's overhaul manual and the attached Performance Work Statement (PWS).

The Government reserves the right to adjust the Latest Cost Amount as reflected in this document either upward or downward at any time prior to and after contract award. Should the requirement for adjustment occur after award of the contract, the ACO/PCO will issue a unilateral modification to reflect the current Latest Cost Amount. The adjustment is not subject to negotiation.

Upon receipt of an order, the Contractor shall furnish all plant, labor and equipment and technical expertise to perform repair/overhaul services described herein. In addition, the Contractor shall furnish those materials and parts contemplated in any attachments as may be futher defined herein. All such items as may be set forth on order issued by the Government here under shall be overhauled and prepared for storage and shipped to the Government as a completely serviceable item.

Condemnations shall be replaced and will not be counted as production. Cost of condemnations will be included in unit prices.

Accelerated delivery is desirable and acceptable.

Fast Transportation is ONLY authorized IF the Contracting Officer, by written authorization through the ACO, authorizes Fast Transportation. Fast Transportation is not applicable for FMS orders.

USAF - Overhaul of F-100 3rd Stage Turbine Sealing Ring

BASIC - YEAR 1

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Estimated Total Price

55 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

ISO 9001-2008 2008

Buy American Act/Balance of Payments Program IUID Required: No Latest Cost Amount: $1,933.86

USAF - Overhaul of F-100 3rd Stage Turbine Sealing Ring

BASIC - YEAR 1

Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

6 EA *30 Calendar Days

Proposed Delivery

6 EA

Delivery is 6 each per month starting 30 days after receipt of order and will continue at that rate till contract is complete.

Early delivery is acceptable.

FMS - Overhaul of F-100 3rd Stage Turbine Sealing Ring

BASIC - YEAR 1

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Estimated Total Price

2 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301930361 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

FMS - Overhaul of F-100 3rd Stage Turbine Sealing Ring

BASIC - YEAR 1

Required Delivery

1 EA *30 Calendar Days

Proposed Delivery

1 EA

Delivery is 1 each per month starting 30 days after receipt of order and will continue at that rate till

USAF - Over & Above

BASIC - YEAR 1

Item No.

Firm Fixed Price Quantity U/I Not to Exceed Price

1 LO

Over & Above - USAF The Over and Above (O&A) items set forth below are not included in the scope and prices of the basic work items detailed under the Attachments outlined at Section J. In accordance with DFARS 252.217-7028 "Over and Above Work" and "Additional Over and Above Work Procedures", any work/performance required by this CLIN shall be accomplished only when directed and authorized by the Administrative Contracting Officer (ACO) or Procurement Contracting Officer (PCO), in conjunction with the necessary Defense Contract Management Agency (DCMA) consultation.

Associated Document(s) Line Item(s)

FD20301900621 0002

Buy American Act/Balance of Payments Program

USAF/FMS - Data & Repots

BASIC - YEAR 1

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Associated Document(s) Line Item(s)

FD20301900621 0003

FD20301930361 0002

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION I - YEAR 2

Item No.

Firm Fixed Price Quantity U/I Unit Price Estimated Total Price

55 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

6 EA *30 Calendar Days

Proposed Delivery

6 EA

Delivery is 6 each per month starting 30 days after receipt of order and will continue at that rate till

FMS - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION I - YEAR 2

Item No.

Firm Fixed Price

FMS - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION I - YEAR 2

Best Estimated Qty

U/I Unit Price Estimated Total Price

2 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

FD20301930361 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

1 EA *30 Calendar Days

Proposed Delivery

1 EA

Delivery is 1 each per month starting 30 days after receipt of order and will continue at that rate till

OPTION I - YEAR 2

Item No.

Quantity U/I Not to Exceed Price

USAF - Over & Above

OPTION I - YEAR 2

1 LO

Over & Above - USAF The Over and Above (O&A) items set forth below are not included in the scope and prices of the basic work items detailed under the Attachments outlined at Section J. In accordance with DFARS 252.217-7028 "Over and Above Work" and "Additional Over and Above Work Procedures", any work/performance required by this CLIN shall be accomplished only when directed andauthorized by the Administrative Contracting Officer (ACO) or Procurement Contracting Officer (PCO), in conjunction with the necessary Defense Contract Management Agency (DCMA) consultation.

Associated Document(s) Line Item(s)

FD20301900621 0002

Buy American Act/Balance of Payments Program

USAF/FMS - Data & Repots

OPTION I - YEAR 2

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Associated Document(s) Line Item(s)

FD20301900621 0003

FD20301930361 0002

Buy American Act/Balance of Payments Program

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION II - YEAR 3

Item No.

Firm Fixed Price Quantity U/I Unit Price Estimated Total Price

55 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION II - YEAR 3

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

6 EA *30 Calendar Days

Proposed Delivery

6 EA

Delivery is 6 each per month starting 30 days after receipt of order and will continue at that rate till

Item No.

Firm Fixed Price Quantity U/I Unit Price Estimated Total Price

2 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301930361 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

FMS - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION II - YEAR 3

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

1 EA *30 Calendar Days

Proposed Delivery

1 EA

Delivery is 1 each per month starting 30 days after receipt of order and will continue at that rate till

Item No.

Firm Fixed Price Quantity U/I Not to Exceed Price

1 LO

Over & Above - USAF The Over and Above (O&A) items set forth below are not included in the scope and prices of the basic work items detailed under the Attachments outlined at Section J. In accordance with DFARS 252.217-7028 "Over and Above Work" and "Additional Over and Above Work Procedures", any work/performance required by this CLIN shall be accomplished only when directed and authorized by the Administrative Contracting Officer (ACO) or Procurement Contracting Officer (PCO), in conjunction with the necessary Defense Contract Management Agency (DCMA) consultation.

Associated Document(s) Line Item(s)

FD20301900621 0002

Buy American Act/Balance of Payments Program

USAF/FMS - Data & Repots

OPTION II - YEAR 3

Item No.

Not Separately Priced Quantity U/I Amount 1 LO Not Separately Priced

Associated Document(s) Line Item(s)

FD20301900621 0003

FD20301930361 0002

USAF/FMS - Data & Repots

OPTION II - YEAR 3

Buy American Act/Balance of Payments Program

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION III - YEAR 4

Item No.

Firm Fixed Price Quantity U/I Unit Price Estimated Total Price

55 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

6 EA *30 Calendar Days

Proposed Delivery

6 EA

Delivery is 6 each per month starting 30 days after receipt of order and will continue at that rate till

FMS - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION III - YEAR 4

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Estimated Total Price

2 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301930361 0002

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

1 EA *30 Calendar Days

Proposed Delivery

1 EA

Delivery is 1 each per month starting 30 days after receipt of order and will continue at that rate till

OPTION III - YEAR 4

Item No.

USAF - Over & Above

OPTION III - YEAR 4

Quantity U/I Not to Exceed Price

1 LO

Over & Above - USAF The Over and Above (O&A) items set forth below are not included in the scope and prices of the basic work items detailed under the Attachments outlined at Section J. In accordance with DFARS 252.217-7028 "Over and Above Work" and "Additional Over and Above Work Procedures", any work/performance required by this CLIN shall be accomplished only when directed and authorized by the Administrative Contracting Officer (ACO) or Procurement Contracting Officer (PCO), in conjunction with the necessary Defense Contract Management Agency (DCMA) consultation.

Associated Document(s) Line Item(s)

FD20301900621 0002

Buy American Act/Balance of Payments Program

USAF/FMS - Data & Repots

OPTION III - YEAR 4

Item No.

Not Separately Priced Quantity U/I Amount 1 LO Not Separately Priced

Associated Document(s) Line Item(s)

FD20301900621 0003

FD20301930361 0002

Buy American Act/Balance of Payments Program

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION IV - YEAR 5

Item No.

Firm Fixed Price Quantity U/I Unit Price Estimated Total Price

53 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301900621 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

USAF - Overhaul of F100 3rd Stage Turbine Sealing Ring

OPTION IV - YEAR 5

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

6 EA *30 Calendar Days

Proposed Delivery

6 EA

Delivery is 6 each per month starting 30 days after receipt of order and will continue at that rate till

OPTION IV - YEAR 5

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Estimated Total Price

2 EA

GROUP STOCK NO P/N CAGE

Group 001 Input 2840-01-450-9977 NZ 4083239-01

GROUP STOCK NO P/N CAGE

Group 001 Output 2840-01-450-9977 NZ 4083239-01

NSN: 2840-01-450-9977 NZ

3rd stage turbine sealing ring Waspaloy Associated Document(s) Line Item(s)

FD20301930361 0001

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

IUID Required: No Latest Cost Amount: $1,933.86 Type / Ship To PACRN Mark For

PAA

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

1 EA *30 Calendar Days

Proposed Delivery

1 EA

Delivery is 1 each per month starting 30 days after receipt of order and will continue at that rate till

Item No.

Firm Fixed Price Quantity U/I Not to Exceed Price

1 LO

Over & Above - USAF The Over and Above (O&A) items set forth below are not included in the scope and prices of the basic work items detailed under the Attachments outlined at Section J. In accordance with DFARS 252.217-7028 "Over and Above Work" and "Additional Over and Above Work Procedures", any work/performance required by this CLIN shall be accomplished only when directed and authorized by the Administrative Contracting Officer (ACO) or Procurement Contracting Officer (PCO), in conjunction with the necessary Defense Contract Management Agency (DCMA) consultation.

Associated Document(s) Line Item(s)

FD20301900621 0002

Buy American Act/Balance of Payments Program

USAF/FMS - Data & Repots

OPTION IV - YEAR 5

Item No.

Not Separately Priced Quantity U/I Amount 1 LO Not Separately Priced

USAF/FMS - Data & Repots

OPTION IV - YEAR 5

Associated Document(s) Line Item(s)

FD20301900621 0003

FD20301930361 0002

Buy American Act/Balance of Payments Program

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A TBD

TO BE DETERMINED 00000-0000

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

PART I - THE SCHEDULE

SECTION E

INSPECTION AND ACCEPTANCE

52.246-4 INSPECTION OF SERVICES--FIXED-PRICE (AUG 1996)

(IAW FAR 46.304)

52.246-11 HIGHER-LEVEL CONTRACT QUALITY REQUIREMENT (DEC 2014)

(IAW FAR 46.311, DFARS 246.202-4(1))

(a) The Contractor shall comply with the higher-level quality standard(s) listed below. [If more than one standard is listed, the offeror shall indicate its selection by checking the appropriate block.]*

Title Number Date Tailoring *See Individual Line Item Schedule

(Applicable only if specified in the individual order/call issued hereunder)

52.246-16 RESPONSIBILITY FOR SUPPLIES (APR 1984)

(IAW FAR 46.316)

(Applicable to the furnishing of supplies, services involving the furnishing of supplies, or research and development, when a fixed-price contract is contemplated and the contract amount is expected to exceed the simplified acquisition threshold)

INSPECTION AND ACCEPTANCE (SEP 1999)

(IAW FAR 46.401(b), FAR 46.503) (Applicable to all orders issued hereunder)

Government Contract Quality Assurance Inspection and Acceptance will be at (Final):

[CONTRACTOR FILL-IN]

Item No(s): See schedule for items with the following code(s) listed below :

Inspection Code and Address:

PART I - THE SCHEDULE

SECTION F

DELIVERIES OR PERFORMANCE

52.242-15 STOP-WORK ORDER (AUG 1989)

(IAW FAR 42.1305(b)(1)) (Applicable for supplies, services, or research and development)

52.247-29 F.O.B. ORIGIN (FEB 2006)

(IAW FAR 47.303-1(c))

52.247-30 F.O.B. ORIGIN, CONTRACTOR'S FACILITY (FEB 2006)

(IAW FAR 47.303-2(c))

52.247-55 F.O.B. POINT FOR DELIVERY OF GOVERNMENT-FURNISHED PROPERTY

(JUN 2003)

(IAW FAR 47.305-12(a)(2))

PART I - THE SCHEDULE

SECTION G

CONTRACT ADMINISTRATION DATA

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (DEC 2018)

(IAW DFARS 232.7004(b), PGI 232.7004(b)(1), DFARS 212.301(f)(liii))

(f) WAWF payment instructions. The Contractor must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

(Contracting Officer: Insert applicable document type(s).

Note: If a “Combo” document type is identified but not supportable by the Contractor’s business systems, an “Invoice” (stand-alone) and “Receiving Report” (stand-alone) document type may be used instead.)

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.

(Contracting Officer: Insert inspection and acceptance locations or “Not applicable.”)

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table* Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC Issue By DoDAAC Admin DoDAAC Inspect By DoDAAC Ship To Code

Ship From Code Mark For Code Service Approver (DoDAAC) Service Acceptor (DoDAAC) Accept at Other DoDAAC LPO DoDAAC DCAA Auditor DoDAAC Other DoDAAC(s) (*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g.

timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the e-mail address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

(Contracting Officer: Insert applicable email addresses or “Not applicable.”)

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity’s WAWF point of contact.

(Contracting Officer: Insert applicable information or “Not applicable.”)

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

(Applicable when 252.232-7003 is used and neither 232.7003(b) nor (c) apply)

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA TO BE CITED ON EACH INDIVIDUAL ORDER $0.00

ACRN TOTAL $ 0.00

ACTIVITY ADDRESS CODE/ROUTING IDENTIFIER CODE (RIC) (MAR 2010)

(IAW AFI 24-230, DoD 4000.25-6M) The Contractor shall use Activity Address Code (EZ/EY/EJ/ED/EB/EP) ____________, when receiving, taking custody, issuing, or shipping DoD assets. Contractor will use Routing Identifier Code (RIC) ____ for accessing Government Data Systems.

*Activity Address Code **RIC City State

(The above Clause/Provision has been modified.)

PART II - CONTRACT CLAUSES

SECTION I

CONTRACT CLAUSES

252.201-7000 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 1991)

(IAW DFARS 201.602-70)

(Applicable to all orders issued hereunder)

5352.201-9101 OMBUDSMAN (JUN 2016)

(IAW AFFARS 5301.9103)

(c) If resolution cannot be made by the contracting officer, the interested party may contact the ombudsman, AFSC/PZC at 405 736 -3273 , FAX 000 000 -0000 , email . Concerns, issues, disagreements, and recommendations that cannot be resolved at the Center/MAJCOM/DRU/SMC ombudsman level, may be brought by the interested party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330-1060, phone number (571) 256-2395, facsimile number (571) 256-2431.

(Applicable to all solicitations and contracts)

52.202-1 DEFINITIONS (NOV 2013)

(IAW FAR 2.201)

52.203-3 GRATUITIES (APR 1984)

(IAW FAR 3.202)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

(IAW FAR 3.404)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT (SEP 2006)

(IAW FAR 3.503-2)

52.203-7 ANTI-KICKBACK PROCEDURES (MAY 2014)

(IAW FAR 3.502-3)

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS

(OCT 2010)

(IAW FAR 3.808(b))

(Applicable over $150,000)

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND REQUIREMENT TO

INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS (APR 2014)

(IAW FAR 3.908-9)

52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY

AGREEMENTS OR STATEMENTS (JAN 2017)

(IAW FAR 3.909-3 (b))

(Applicable in all solicitations and resultant contracts other than personal services contracts with individuals)

252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS

(SEP 2011)

(IAW DFARS 203.171-4(a), DFARS 212.301(f)(ii))

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT

AWARDS (OCT 2018)

(IAW FAR 4.1403(a))

(Applicable over $30,000, unless not required to be reported in FPDS)

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)

(IAW FAR 4.1105(b)) (Applicable to solicitations that contain the provision at 52.204-7, and resulting contracts)

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (JUL 2016)

(IAW FAR 4.1804(c), FAR 12.301(d)) (Applicable when there is a requirement to be registered in SAM or to have a DUNS Number)

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS

(DEC 2014)

(IAW FAR 4.1202(b))

52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS

(JUN 2016)

(IAW FAR 4.1903)

(Applicable to all solicitations and contracts, except COTs, when a contractor’s system may contain Federal contract information)

52.204-23 PROHIBITION ON CONTRACTING FOR HARDWARE, SOFTWARE, AND SERVICES

DEVELOPED OR PROVIDED BY KASPERSKY LAB AND OTHER COVERED

ENTITIES (JUL 2018)

(IAW FAR 4.2004)

(Applicable on all contracts and solicitations.)

52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (AUG 2019)

(IAW 4.2105(b))

252.204-7003 CONTROL OF GOVERNMENT PERSONNEL WORK PRODUCT (APR 1992)

(IAW DFARS 204.404-70(b))

252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT

REPORTING (DEC 2019)

(IAW DFARS 204.7304(c))

(Applicable to all solicitations and contracts, including commercial except when solely for commercial-off-the-shelf items)

252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION

SUPPORT (MAY 2016)

(IAW DFARS 204.7403(b), DFARS 212.301(f)(i)(F))

(Applicable to solicitations and contracts that involve litigation support services when 252.204-7014 is not included)

252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE

TELECOMMUNICATIONS EQUIPMENT OR SERVICES (DEC 2019)

(IAW DFARS 204.2105(c))

(Applicable to all soliciations.)

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH

CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT

(OCT 2015)

(IAW FAR 9.409)

(Applicable when exceeding $35,000)

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (OCT 2018)

(IAW FAR 9.104-7(c))

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS

(NOV 2015)

(IAW FAR 9.108-5(b))

(Applicable to all solicitations and contracts for the acquisition of products and services (including construction) unless waived

IAW FAR 9.108-4)

252.209-7004 SUBCONTRACTING WITH FIRMS THAT ARE OWNED OR CONTROLLED BY THE

GOVERNMENT OF A COUNTRY THAT IS A STATE SPONSOR OF TERRORISM

(MAY 2019)

(IAW DFARS 209.409)

(Applicable to solicitations and contracts with a value of $150,000 or more)

252.209-7010 CRITICAL SAFETY ITEMS (AUG 2011)

(IAW DFARS 209.270-5)

(b) Identification of critical safety items. One or more of the items being procured under this contract is an aviation or ship critical safety item. The following items have been designated aviation critical safety items or ship critical safety items by the designated design control activity:

Line Item Description

0001 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

0002 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

1001 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

1002 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

2001 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

2002 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

3001 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

3002 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

4001 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

4002 0001 NSN: 2840-01-450-9977NZ P/N: 4083239-01

(Applicable to solicitations and contracts when the acquisition includes one or more items designated by the design control activity as critical safety items)

52.211-15 DEFENSE PRIORITY AND ALLOCATION REQUIREMENTS (APR 2008)

(IAW FAR 11.604(b)) This is a rated order certified for national defense , emergency preparedness, and energy program use, and the Contractor shall follow all the requirements of the Defense Priorities and Allocations System regulation (15 CFR 700).

(Applicable to all rated orders)

252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION (MAR 2016)

(IAW DFARS 211.274-6(a)(1), DFARS 212.301(f)(xii))

(a) Definitions. As used in this clause—

“DoD recognized unique identification equivalent” means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at http://www.acq.osd.mil/dpap/pdi/uid/iuid/equivalents.html .

“Unique item identifier type” means a designator to indicate which method of uniquely identifying a part has been used. The current list of accepted unique item identifier types is maintained at http://www.acq.osd.mil/dpap/pdi/uid/uii_types.html .

(c) Unique item identifier.

(1) The Contractor shall provide a unique item identifier for the following:

(i) Delivered items for which the Government’s unit acquisition cost is $5,000 or more, except for the following line items:

Contract Line, Subline, or Item Description

Exhibit Line Item Number See Schedule as Applicable

(ii) Items for which the Government’s unit acquisition cost is less than $5,000 that are identified in the Schedule or the following table:

Contract Line, Subline, or Exhibit Line Item Number

Item Description

*Items less than $5000, which require UID, will be specifically identified in the schedule.

See Schedule as Applicable

(iii) Subassemblies, components, and parts embedded within delivered items, items with warranty requirements, DoD serially managed reparables and DoD serially managed nonreparables as specified in Attachment Number _____( or See Schedule as Applicable).

(iv) Any item of special tooling or special test equipment as defined in FAR 2.101 that have been designated for preservation and storage for a Major Defense Acquisition Program as specified in Attachment Number _____( or See Schedule as Applicable).

(v) Any item not included in paragraphs (c)(1)(i), (ii), (iii), or (iv) of this clause for which the contractor creates and marks a unique item identifier for traceability.

(f) The Contractor shall submit the information required by paragraphs (d) and (e) of this clause as follows:

(1) End items shall be reported using the receiving report capability in Wide Area WorkFlow (WAWF) in accordance with the clause at 252.232-7003. If WAWF is not required by this contract, and the contractor is not using WAWF, follow the procedures at http://dodprocurementtoolbox.com/site/uidregistry/ .

(2) Embedded items shall be reported by one of the following methods—

(i) Use of the embedded items capability in WAWF;

(ii) Direct data submission to the IUID Registry following the procedures and formats at http://dodprocurementtoolbox.com/site/uidregistry/; or

(iii) Via WAWF as a deliverable attachment for exhibit line item number ______, Unique Item Identifier Report for Embedded Items, Contract Data Requirements List, DD Form 1423.

252.211-7007 REPORTING OF GOVERNMENT-FURNISHED PROPERTY (AUG 2012)

(IAW DFARS 211.274-6(b), DFARS 212.301(f)(iv))

52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT (OCT 1997)

(IAW FAR 15.209(h), AFFARS 53.15.209(h)) (Applicable when using uniform contract format that is not commercial or for construction)

52.215-23 LIMITATIONS ON PASS-THROUGH CHARGES (OCT 2009)

(IAW FAR 15.408(n)(2))

52.216-19 ORDER LIMITATIONS (OCT 1995)

(IAW FAR 16.506(b))

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than quantity of 1, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor--

(1) Any order for a single item in excess of quantity of 55;

(2) Any order for a combination of items in excess of quantity of 283; or

(3) A series of orders from the same ordering office within 30 days that together call for quantities exceeding the limitation in subparagraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 30 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

52.216-21 REQUIREMENTS (OCT 1995)

(IAW FAR 16.506(d)(1))

(f) the Contractor shall not be required to make any deliveries under this contract after

52.216-24 LIMITATION OF GOVERNMENT LIABILITY (APR 1984)

(IAW FAR 16.603-4(b)(2), DFARS 217.7406)

(a) In performing this contract, the Contractor is not authorized to make expenditures or incur obligations exceeding $ dollars.

(b) The maximum amount for which the Government shall be liable if this contract is terminated is $ dollars.

252.216-7006 ORDERING (SEP 2019)

(IAW DFARS 216.506(a))

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the contract schedule. Such orders may be issued from .

(Applicable to solicitations and contracts when a definite-quantity contract, a requirements contract, or an indefinite-quantity contract is contemplated)

52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

(IAW FAR 17.208(f)) 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 30 days at the current unit price.

52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(IAW FAR 17.208(g))

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 days provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 30 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 5 years

252.217-7028 OVER AND ABOVE WORK (DEC 1991)

(IAW DFARS 217.7702)

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (MAR 2020)

(IAW FAR 19.309(c))

(h) If the Contractor does not have representations and certifications in SAM, or does not have a representation in SAM for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

(1) The Contractor represents that it [ ] is, [ ] is not a small business concern under NAICS Code ________ assigned to contract number _______________.

(2) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002.

(3) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not a women-owned small business concern.

(4) Women-owned small business (WOSB) concern eligible under the WOSB Program.

[Complete only if the Contractor represented itself as a women-owned small business concern in paragraph (h)(3) of this clause.] The Contractor 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 is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(4)(i) of this clause is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture.

[The Contractor 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.

(5) Economically disadvantaged women-owned small business (EDWOSB) concern.

[Complete only if the Contractor represented itself as a women-owned small business concern eligible under the WOSB Program in (h)(4) of this clause.] The Contractor represents that—

(i) It [ ] is, [ ] is not an EDWOSB 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 (h)(5)(i) of this clause is accurate for each EDWOSB concern participating in the joint venture.

[The Contractor 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.

(6) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not a veteran-owned small business concern.

(7) [Complete only if the Contractor represented itself as a veteran-owned small business concern in paragraph (h)(6) of this clause.] The Contractor represents that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern.

(8) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents 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 (h)(8)(i) of this clause is accurate for each HUBZone small business concern participating in the HUBZone joint venture.

[The Contractor 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.

[Contractor to sign and date and insert authorized signer’s name and title.]

(Applicable in solicitations and contracts exceeding the micro-purchase threshold when the contract will be performed in the United States or its outlying areas)

52.222-1 NOTICE TO THE GOVERNMENT OF LABOR DISPUTES (FEB 1997)

(IAW FAR 22.103-5(a), AFFARS 5322.101-1)

52.222-3 CONVICT LABOR (JUN 2003)

(IAW FAR 22.202)

(Applicable when performance is in the U.S., Puerto Rico, Northern Mariana Islands, American Samoa, Guam, or the U.S. Virgin Islands, unless subject to the Walsh-Healey Public Contracts Act, purchase is from Federal Prisons Industries, Inc., or purchase is from any State prison of finished supplies that may be secured in the open market/existing stocks, as distinguished from supplies requiring special fabrication, and exceeds the micro-purchase threshold)

52.222-21 PROHIBITION OF SEGREGATED FACILITIES (APR 2015)

(IAW FAR 22.810(a)(1)) (Applicable when exceeding $10,000, except those exempted by FAR 22.807 (b) which includes those for work to be performed outside the U.S. by employees who were not recruited within the U.S.)

52.222-26 EQUAL OPPORTUNITY (SEP 2016)

(IAW FAR 22.810(e))

52.222-35 EQUAL OPPORTUNITY FOR VETERANS (OCT 2015)

(IAW FAR 22.1310(a)(1), DFARS 222.1310(a)(1)) (Applicable when the expected value is $150,000 or more except when work is performed outside the United States by employees recruited outside the United States or the Director, Office of Federal Contract Compliance Programs, has waived, in accordance with 22.1305(b), all of the terms of the clause)

52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES (JUL 2014)

(IAW FAR 22.1408(a)) (Applicable over $15,000 except when performance of work and recruitment of workers will occur outside the United States, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and Wake Island, or the agency head has waived, in accordance with 22.1403(a) or 22.1403(b) all the terms of the clause)

52.222-37 EMPLOYMENT REPORTS ON VETERANS (FEB 2016)

(IAW FAR 22.1310(b)) (Applicable when the expected value is $150,000 or more and workers were recruited within the United States)

52.222-40 NOTIFICATION OF EMPLOYEE RIGHTS UNDER THE NATIONAL LABOR

RELATIONS ACT (DEC 2010)

(IAW FAR 22.1605)

52.222-41 SERVICE CONTRACT LABOR STANDARDS (AUG 2018)

(IAW FAR 22.1006(a)) (Applicable to services over $2,500)

52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 2014)

(IAW FAR 22.1006(b)) This Statement is for Information Only:

It is not a Wage Determination

Employee Class Monetary Wage Fringe Benefits

(Applicable to service items over $2,500)

52.222-44 FAIR LABOR STANDARDS ACT AND SERVICE CONTRACT LABOR

STANDARDS--PRICE ADJUSTMENT (MAY 2014)

(IAW FAR 22.1006(c)(2))

(Applicable over $100,000, fixed price, time-and-materials, or labor-hour service and FAR 52.222-41 applies)

52.222-50 COMBATING TRAFFICKING IN PERSONS (JAN 2019)

(IAW FAR 22.1705(a)(1))

52.222-55 MINIMUM WAGES UNDER EXECUTIVE ORDER 13658 (DEC 2015)

(IAW FAR 22.1906)

(Applicable to solicitations and contracts that include FAR 52.222-6 or 52.222-41, where work is to be performed, in whole or in part, in the United States)

52.222-62 PAID SICK LEAVE (EXECUTIVE ORDER 13706) (JAN 2017)

(IAW FAR 22.2110)

(Applicable to contracts that include Service Contract Labor Standards where work is performed, in whole or part, in the United States)

52.223-6 DRUG-FREE WORKPLACE (MAY 2001)

(IAW FAR 23.505)

(Applicable when the simplified acquisition threshold is exceeded except if performance is entirely outside the U.S. and its outlying areas)

52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING WHILE

DRIVING (AUG 2011)

(IAW FAR 23.1105)

52.223-20 AEROSOLS (JUN 2016)

(IAW FAR 23.804(a)(3)) (Applicable to solicitations and contracts not delivered or performed outside the U.S. or it’s outlying areas, for products that may contain high global warming potential hydrofluorocarbons or involve maintenance or repair of electronic or mechanical devices)

252.223-7008 PROHIBITION OF HEXAVALENT CHROMIUM (JUN 2013)

(IAW DFARS 223.7306, DFARS 212.301(f)(xxi))

52.224-3 PRIVACY TRAINING (JAN 2017)

(IAW FAR 24.302(a)) (Applicable to all solicitations and contracts where contractor employees will have access to a system of records or personally identifiable information)

52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES (JUN 2008)

(IAW FAR 25.1103(a)) (Applicable to supplies or services involving the furnishing of supplies unless an exception applies)

252.225-7001 BUY AMERICAN AND BALANCE OF PAYMENTS PROGRAM--BASIC (DEC 2017)

(IAW DFARS 225.1101(2)(i) and (2)(ii)) (Applicable except when an exception to the Buy American statute or Balance of Payments Program is known to apply, or if using the clause at 252.225-7021, Trade Agreements; or 252.225-7036, Buy American —Free Trade Agreements—Balance of Payments Program)

252.225-7002 QUALIFYING COUNTRY SOURCES AS SUBCONTRACTORS (DEC 2017)

(IAW DFARS 225.1101(3))

(Applicable if one of the following clauses are included: DFARS 252.225-7001, 252.225-7021 or 252.225-7036)

252.225-7012 PREFERENCE FOR CERTAIN DOMESTIC…