Cable_TV_RFQ_Final.docx

FEDERAL BUREAU OF INVESTIGATION

FINANCE DIVISION | PROCUREMENT SECTION

May 24, 2017

RE: Request for Quote (RFQ) 5476 for Cable Television and Internet Services

The FBI Procurement Section is issuing this RFQ to solicit for the purpose of entering into a contract to provide commercial internet and television services for three sites located in Virginia The period of performance for this contract will be a 12 month (one year) base period with four (4) renewable 12 month option periods.

Contractors interested in competing for this effort may participate by submitting quotes in accordance with the procedures set forth in this RFQ.

Site Visit: TBD, Names to be submitted by: 5/30/2017 11:00 am EST/EDT Questions To the Contracting Officer Are Due: 6/9/2017 11:00 am EST/EDT

Quotes Must Be Submitted No Later Than: 6/16/2017 11:00 am EST/EDT

The contractor shall provide commercial internet and television services at three (3) operation and administrative locations in Virginia.

The purpose of this RFQ is to award a contract for internet and cable services for three (3) locations.

2.2 SCOPE OF WORK

The Contractor shall provide all personnel, equipment, facilities, tools, materials, supervision, and other items and services necessary to provide internet and cable services for three (3) locations in Virginia as defined in this SOW.

2.2.1 Site Visit

Site visit attendance is highly encouraged. The site visit will be scheduled based on the response received from this RFQ. The location of the site visit will be Deployment Facility – 1 Maj Preddy Dr., Sandston, VA. This will be the only site that is visited, of the three sites, as it is the only one that requires that connectivity/infrastructure lines from the street to the facility be installed. Only two (2) individuals of any one company may attend the site visit. All interested parties need to ensure they provide a list of personnel who plan to attend the site visit to the CO via e-mail (Nancy.beck@ic.fbi.gov) no later than May 30, 2017 at 11:00 AM EST. Required information: full name of individual, date of birth, social security number for each person and the make model and license plate of the vehicle they will be driving.

2.2.2 Services and Programming

This SOW is for internet and cable television services includes all services required by the Federal Communications Commission (FCC) and any other federal laws or regulations. The contractor shall provide at a minimum, the following:

Cable Services shall include these broad categories of programming:

· 24-hour News and Weather Programming

· Public Broadcast Services

· Major and Local Network Programming – Virginia, Washington DC

· See attachment for detailed requirements

Internet Services shall include:

· Commercial internet services

· See attachment for detailed requirements

2.2.3 Program Guide

The contractor shall provide a channel guide upon any change in programming.

2.2.4 Monthly Report

The contractor shall provide a monthly report of all downtime, upon request by the contracting officer or technical point of contact (TPOC).

2.2.5 Repair Requirements

The TPOC, upon notification of outages from the customer for television or internet services, will contract the contractor, who shall initiate a log for the purposes of tracking customer outages. The contractor shall submit this log to the TPOC monthly, upon request. The contractor has one business day from the time of notification to respond to outages. If the outage is not repaired within two (2) days date shall be established and reported to the TPOC.

2.2.6 Remote Controls

The contractor shall provide one remote control per cable box/receiver.

2.2.7 Cable Box

The contractor shall provide a total of 26 cable box receivers with HDTV capability. Cable boxes shall be installed at the requested location based upon the following:

2.2.8 Internet Needs

Commercial internet services for operational locations. This provides connectivity for mission-critical networks enclaves that require commercial internet, as well as provides the platform for network/system updates for critical communications gear.

2.2.9 Contractor Provided Equipment

The contractor will be reimbursed for lost, stolen, or damaged equipment beyond fair wear and tear. The contract must submit a claim for this reimbursement. Additionally, the contractor will replace any equipment that is found faulty or not working as needed in accordance with the contract.

2.2.10 Government Provided Equipment

No Government furnished property will be provided for this requirement.

2.2.11 Construction and Installation Approval

The contractor shall not undertake any construction or installation of equipment or facilities without the prior written consent of the CO.

2.2.11.1 Prior to obtaining such approval, the contractor shall submit to the CO for review any drawings, plans and other relevant supporting data. This includes, but is not limited to one set of the drawings showing cable routings, typical service entrances, antennae sites and/or towers, technical center location, and other related constructions details.

2.2.11.2 At completion of any construction, installation or maintenance resulting in changes of cable routings, wirings or other significant changes in facilities and equipment, the contractor shall provide appropriate document changes to the CO.

2.2.11.3 Notwithstanding any approval granted, the Government at any time may direct the contractor to remove, relocate, or modify any equipment or facilities, including above ground and underground cable. The contractor shall be entitled to an equitable adjustment.

2.2.12 Safety Concerns.

The contractor is solely responsible for compliance with OSHA standards for the protection of their employees. The government is not responsible for ensuring theat Contractors comply with “personal” safety requirements that do not present the potential to damage Government resources.

2.3 DELIVERABLES

The following are the contractual deliverables.

2.4 TERM OF CONTRACT

It is the intention of the government that this contract for cable television and internet services be for one (1), twelve (12) month base period with four (4) twelve month renewable option periods. The maximum period of performance is a period of five (5) years, contingent upon each option year being exercised, the availability of funding and the need of the Government.

Base Period: Date of award 2017 – xxxx xx, 2018 Option Period 1: xxxx xx, 2018 - xxxx xx, 2019 Option Period 2: xxxx xx, 2019 - xxxx xx, 2020 Option Period 3: xxxx xx, 2020 - xxxx xx, 2021 Option Period 4: xxxx xx, 2021 - xxxx xx, 2022

2.4.1 PLACE OF PERFORMANCE

The places of performance shall be:

Gateway – 18300 Quantico Gateway Drive, Triangle, VA.

Deployment Facility – 1 Maj Preddy Dr., Sandston, VA Operational Support Facility – 15015 Farm Creek Drive, Woodbridge, VA

2.4.2 CONTRACTOR PHASE-IN

During the Phase-in Period, the incoming contractor shall accomplish, as practicable, tasks required to ensure a smooth transition, to include:

* Become thoroughly familiar with work requirements

* Complete personnel requirements including the hiring or personnel to assure satisfactory performance beginning on the operational performance start date

* Obtain security checks and vehicle passes – if necessary

* The contractor shall be allowed access to government facilities to familiarize supervisors, key personnel and staff with existing equipment, work scheduling and procedures. The TPOC will arrange the access to ensure interference does not occur.

* The incoming contractor shall cooperate with the incumbent contractor to the extent necessary to permit an orderly transition of service provider without service degradation.

2.4.3 CONTRACTOR PHASE-OUT

In the event a follow-on contract is awarded to other than the incumbent, the incumbent contractor shall cooperate with the incoming contractor to the extent necessary to permit an orderly transition of service provider without service degradation.

2.5 SERVICES AND PRICES/COSTS

The following abbreviations are used in this price schedule:

CLIN - Contract Line Item Number FFP – Firm Fixed Price NTE – Not to Exceed

The contractor shall provide FFP monthly pricing and identify the percentage discounted from list price; if any, or what the government discount is, this applies to the hourly rate prices for labor deemed necessary to accomplish the requirements of the SOW. Prices will be evaluated based upon the unit pricing quoted for the base and option periods.

2.5.1 Pricing

The prices to the Government shall be lower than, or as low as those charged to the Contractor’s most favored customer (MFC) for comparable quantities under similar terms and conditions in addition to any discounts for prompt payment.

2.5.2 CLINS

Pricing shall be provided in the contractor’s normal pricing format, the following information is required at a minimum.

BASE YEAR

OPTION YEAR ONE

OPTION YEAR TWO

OPTION YEAR THREE

OPTION YEAR FOUR

TOTAL FOR BASE AND ALL OPTION YEARS:

2.5.3 Invoicing

All invoices shall be submitted electronically to CENTRAL_INVOICES@IC.FBI.GOV. Note that there is an underscore (_) between CENTRAL and INVOICES.

Invoices will be handled in accordance with the Prompt Payment Act and Far Clause 52.232-25. Contractors shall assign an identification number to each invoice.

The contractor shall certify with a signed and dated statement that the invoice is correct and proper for payment. Small Business status shall be self-certified on each invoice.

Vendors must be registered in SAM, effective July 29, 2012 to receive government contracts. The FBI uses a financial system that has a direct interface with SAM. Please ensure that your company’s SAM information is updated and accurate. This includes TIN, EFT, DUNS, addresses and contact information. The EFT banking information on file in SAM will be what the FBI uses to process payment to your organization.

2.5.4 Proper Invoice

A proper invoice shall include the following information:

· Name and address of the Contractor

· Invoice date and invoice number. (The Contractor should date invoices as close as possible to the date of mailing or transmission.)

· Contract number, Task Order number, contract line item number and, if applicable, an order number

· Description, quantity, unit of measure, unit price and extended price of the items delivered

· Shipping number and date of shipment including the bill of lading number and weight of shipment if shipped Government bill of lading

· Terms of any discount for prompt payment offered

· Name and address of official to whom payment is to be sent

· Name, title, and phone number of person to notify in event of defective invoice

· Electronic Funds Transfer (ETF) banking information

· Taxpayer Identification Number (TIN)

· Small Business contractors shall self-certify on each invoice their small business status.

The Contractor shall include this information on each and every invoice when invoicing for full or partial supplies/services delivered/performed. If an invoice does not contain the above information, the Bureau reserves the right to reject the invoice(s) as IMPROPER and notify the Contractor within seven (7) calendar days after receipt of the invoice at the designated billing office pursuant. (Resubmission of a PROPER invoice(s) will be required).

Payment will be made by the FBI’s Commercial Payment Unit in accordance with the Prompt Payment Act, FAR clause 52.232-25 (OCT 2003) upon the COR’s (or designee) certification of receipt of services and the CO final authorization for payment.

2.6 SECURITY AND ACCESS REQUIREMENTS

2.6.1 Security – General

1, The performance of tasks described in this SOW are unclassified.

2. The contractor will have access to

3. For the purposes of this Project, all personnel access security matters shall be coordinated with the FBI's designated TPOC.

4. Access to FBI facilities or property shall be granted only when such access is clearly consistent with the mission and responsibilities of the FBI. If, for any reason, a contractor or subcontractor employee is denied access to any FBI facility or property, the FBI will not disclose to the Contractor the reason for denial; nor will the FBI be liable for any expense in the replacement of the individual or any costs incurred by the Contractor as a result of such denial.

5. All FBI occupied facilities are high security facilities with strict requirements for access to and movement within the facilities for both persons and vehicles. The FBI reserves the right, at no additional cost to the FBI, to exclude or remove from any site or building any employee or agent of the Contractor or subcontractors that the FBI deems incompetent, careless, insubordinate, or who is otherwise objectionable, or fails to meet and obey security requirements. Persons who cannot produce acceptable identification, including those cleared for access but without proper identification and/or FBI Complex visitor badges in possession at the time, SHALL not be allowed to enter FBI occupied facilities.

6. The FBI SHALL not be liable for any direct and/or indirect costs and/or delays incurred by the Contractor or any subcontractor in the furnishing of required security information or in fully complying with the FBI's security requirements and procedures.

7. The Contractor agrees that no claim may be filed for delay of work due to Contractor or subcontractor employees failing to comply with/meet the FBI's security requirements.

8. The Contractor SHALL bear all responsibility for late, inadequate, or nonperformance because of denial of access to employees, subcontractors, or other individuals.

9. The Contractor SHALL allow for and advise subcontractors to allow for potential daily employee and/or delivery delays as a result of FBI security requirements and/or procedures. Delivery personnel SHALL fully comply with the FBI's security and access requirements and procedures. In addition, background and/or record checks on all contractor and subcontractor personnel SHALL be conducted by the FBI.

10. All necessary background data forms and paperwork are available upon request.

11. Security checks/background investigations, the scope of which SHALL be at the discretion of the FBI, SHALL be made by the FBI on all personnel working on this project. Falsification of the forms or violation of the facility security, safety or code of conduct requirements SHALL result in access to FBI occupied space and/or grounds being denied.

12. Contractor and subcontractor personnel SHALL be aware that willfully making a false statement or concealing a material fact constitutes a violation of Section 1001, Title 18, United States Code.

13. Random personnel and vehicle property inspections SHALL be conducted by FBI personnel at FBI occupied facilities.

14. Personnel movement within FBI occupied facilities and/or grounds SHALL be limited to those areas where work is actually being performed. Individuals found wandering/straying from work areas will be subject to revocation of access privileges.

15. Should the contractor or any subcontractor receive information regarding a contractor or subcontractor employee which may affect the access of that employee to an FBI occupied facility, i.e. knowledge of arrests, felony conviction, misdemeanor conviction, use of or addiction to drugs and/or chemicals, abuse of alcohol, indebtedness, a change in or treatment of mental health, or any behavior, activity or associations which tend to show that the individual is not reliable or trustworthy, etc.; the contractor SHALL advise the FBI immediately.

16. Contractor and subcontractor personnel having "escorted" access privileges to FBI Complex grounds shall be escorted at all times by at least one contractor employee having "unescorted" access privileges. Escort responsibility is entirely the contractor's.

17. "1 Time" Visitor Access - At the discretion of the FBI, 1 Day visitor access authorization lasting for no more than (1)8 hour workday to FBI Complex grounds may be granted. Under extenuating circumstances (note: the contractor's failure to reasonably plan ahead shall not constitute an "extenuating circumstance" for the purposes of this clause), the FBI shall consider - but does not guarantee - granting 1 day visitor access privileges to an individual(s) having a legitimate need for site access in connection to the performance of the services set forth herein. If" 1 Time" visitor privileges are granted by the FBI, such visitor;

a) Must be escorted at all times by contractor personnel having "unescorted access" privileges,

To request consideration for "1 Time" visitor access, the contractor's security representative SHALL: Provide the FBI project security/access point of contact with a written request at least 3 full working days in advance of the proposed date of the "1 Time" visit. Written request shall include the proposed 1 Time visitor's full first, middle and last name, SSN, DOB, employer's company name, date and time of visit along with the identity of the contractor person who shall be responsible for providing escort.

18. Right to Revoke Access: The FBI SHALL have full and complete control over granting, denying, withholding or terminating access for contractor and subcontractor employees at all times.

19. Individuals initially permitted access may be excluded at a later date upon discovery of disqualifying factors resulting from detailed verification of submitted security paperwork/ information.

20. The FBI reserves the right to revoke access to its facilities or property of any individual, where such access is no longer clearly consistent with the FBI's mission and responsibilities. Contractor agrees to immediately remove that individual from the job site in such circumstances.

21. All personnel who should fail a security screening SHALL NOT have access to any FBI occupied facility or site.

Access to Federal Bureau of Investigation (FBI) Locations:

Performance under this contract may require access to FBI locations to provide some service, product, or perform some other official function of interest to the FBI. Requirements, as identified below, to include approval by the FBI's Security Division, must be satisfied prior to access.

Contractors who will require escorted access, to include short-term, intermittent, or infrequent access, to an FBI facility must complete an "Access of Non-FBI Personnel to FBI Facilities, Background Data Information Form," (FD 816), a "Privacy Act of 1974 Acknowledgment Form" (FD 484) and two Fingerprint Cards (FD 258). Completed forms should be provided to the assigned Contracting Officer's Representative (COR) at least 10 days prior to required access.

Individuals requiring unescorted access to an FBI facility must complete the Standard Form 86 (SF-86), Questionnaire for National Security Positions, using the Office of Personnel Management’s Electronic Questionnaires for Investigations Processing (e-QIP) and provide two Fingerprint Cards (FD 258). e-QIP is a secure website that can be accessed from any computer system which has an Internet connection. Only the signed release forms and FD 258 will need to be mailed to the identified Chief Security Officer, the SF-86 itself will be transmitted to the FBI electronically.

To complete the SF-86 using e-QIP, the individual requiring unescorted access to the FBI facility must contact (insert Chief Security Officer, Division, and telephone number) in order to be initiated into e-QIP. Once this action has been accomplished, the individual should be able to access e-QIP at the following link in order to initiate and complete the electronic process: http://www.opm.gov/e-qip/browser-check.asp. Thoroughly read and follow the instructions for completing the SF-86. NOTE: To fully address suitability/security issues, the FBI requires individuals to provide responses to questions on the SF-86 for the last ten years. Failure to complete the application as instructed may lead to significant delays in processing the required investigation and approval for unescorted access.

Upon logging onto e-QIP, there will be a prompt to answer three “Golden” security questions to establish the user account. After completing the electronic SF-86, please print and sign the (1) Certification Form (CER) - Certify Completeness and Accuracy of your Investigation Request; (2) Medical Release Form (MEL) - Authorization for Release of Medical Information; and (3) Release Form (REL) - Authorization for Release of Information. In addition to these SF 86 release forms, the completion of a Non-Personnel Consent to Release Information (FD-979a), the United States Department of Justice Disclosure and Authorization Pertaining to Consumer Reports (DOJ 555) are required. Annotation of the assigned e-QIP Investigation Request Number on the upper right corner of each document transmitted to the identified Chief Security Officer is required for coordination with the electronic transmission and to facilitate the investigative process. The e-QIP Investigation Request Number, automatically generated by e-QIP, is located on both the header and footer of the signature forms. These release forms (five total) and FD 258 should be mailed via Federal Express or UPS Express mail directly to the following address: (insert name and address of Chief Security Officer). The use of regular U.S. mail channels may cause significant delays in processing the unescorted access request.

Upon completion of processing the facility access request, the individual will be required to execute a non-disclosure agreement suitable for their approved access.

Contractor Suitability Requirement

Access to FBI facilities and information is subject to specific security and suitability requirements. The FBI reserves the right and prerogative to deny and/or restrict facility and information access of any contractor employee determined by the FBI, at any time prior to or during performance, to be unsuitable for access and/or present a risk of compromising sensitive government information to which he or she would have access to under this contract. Contractors will be allotted a reasonable amount of time, determined by the government, to replace the employee found not suitable for contract performance. Failure to replace the employee may result in a no cost termination by the government

DOJ Residency Requirement

All contractor personnel employed within the United States, both United States citizens and non-United States citizens, are required to meet the following residency requirements:

For three of the five years immediately prior to applying for the specific contract position, the individual must have 1) resided in the United States; 2) worked for the United States overseas in a Federal or military capability; or 3) be a dependent of a Federal or military employee serving overseas.

The requirement may be waived for short term contractor personnel (performing duties for a cumulative total of 14 days or less) if there is a critical need for their specialized and unique skills. These individuals must, however, be United States citizens or Permanent Resident Aliens.

2.7 REQUIREMENTS FOR QUOTE PREPARATION

2.7.1 General Instructions

Each quote shall be in two (2) separate and distinct parts: Part I – The Price Quote, and Part II – Technical Requirement.

The offeror shall, through an e-mail to Nancy.beck@ic.fbi.gov, submit both Parts on the due date and time indicated on the SF-1449. The electronic copy, submitted through e-mail, shall be considered the intended version for review by the Government in response to this RFQ. Quotes shall have RFQ-5476 in the subject line of the e-mail. Offerors are hereby notified that if their quote is not received by the date, time and location specified in this announcement, it will not be considered by the agency.

Telephone questions or requests will not be accepted.

Offerors are expected to examine this entire RFQ, failure to do so will be at the Offeror’s own risk.

The Government may make award based on initial quotes received, without discussion of such quotes. Quotes shall set forth full, accurate, and complete information as required by this solicitation package (including Attachments). The penalty for making false statements in quotes is prescribed in 18 U.S.C. 1001.

Part I - The Price Quote shall contain the following:

a. SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS - Request for Quotation (SF 1449). When completed and signed by the offeror, this document, constitutes the offeror's acceptance of the terms and conditions of the proposed contract. Therefore, the form must be executed by representatives of the offeror authorized to commit the offeror to contractual obligations. Offerors shall sign the SF 1449 in Block # 30a. This document can be found in Section 2.12, Attachment One (1).

b. PRICING - The offeror shall indicate itemized prices for all services required to comply with the requirements of this contract.

Part II - The Technical Requirement shall contain the following:

· Technical Information to show that the services offered meet and are in compliance with the technical specifications/descriptions as listed in Section 2.0.

· Past Performance – the Contractor shall supply the contact information for three contracts that are similar in size and scope as this one that demonstrate the Contractors understanding and ability to perform the requirements as listed in this RFQ. The information required is: the name of the Company/Agency, the POC’s name and e-mail/phone number, name of the contract, contract value and a brief description of work covered by the contract..

· Qualifications – certificates of training, qualifications or certifications for proposed technicians

· Completed Attachments from Section 2.12.

2.7.2 Restrictive Data

Offerors submitting restrictive data in their quote that they do not want disclosed to the public for any purpose or used by the Government except for evaluation purposes, shall:

Mark the title page with the following legend: “This quote includes date that shall not be disclosed outside the Government and shall not be duplicated, used or disclosed – in whole or in part – for any purpose other than to evaluate this quote or quotation. If, however, a contract is awarded to this offeror as a result of – or in connection with – the submission of this data, and the

Government incorporates the quote as part of the award, the Government shall have the right to duplicate, use, or disclose data. Also, this restriction does not limit the Government’s right to use information contained in this data if it is obtained from another source without restriction. The data subject to the restriction is contained in page (insert numbers or other identification of pages); and Mark each pages of data that is restricted with the following legend: “Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this quote.”

The Government assumes no liability for disclosure or use of unmarked data and may use or disclose the data for any purpose. Unless restricted, information submitted in response to this request may become subject to disclosure to the public pursuant to the provisions of the Freedom of Information Act (5 U.S.C. 551).

2.7.3 Technical Assumptions

Offerors shall identify and address assumptions affecting the technical proposal citing the component(s) of the proposal to which they pertain. The Government reserves the right to reject any quote that includes any assumption that adversely impacts the Government’s requirements.

2.8 EVALUATION AND AWARD PROCESS

52.212-2 Evaluation—Commercial Items (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation is the lowest priced technically acceptable. The following factors shall be used to evaluate offers: (i) technical capability to meet the Government requirement; (ii) price; (iii) past performance; Technical and past performance, when combined, are equally as important as price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer’s specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

The Offeror:

1. Submits a Technical Proposal that addresses the major elements of the SOW.

2. Demonstrates the ability to complete satisfactorily the following requirements for the PM checklist: provide all internal and external components, parts, assemblies, and subassemblies forming each system or necessary for its safe operation, adjust, lubricate, repair, or replace as necessary to insure system is functioning as designed.

3. Demonstrate the ability to respond to routine and emergency service calls

4. Provide the names and contact information of three (3) references to provide past performance information to the FBI. With this, include experience regarding similar work described in this requirement performed during the last five (5) years. Provide a description of work performed, contract's value, client identification (agency name or company name), COR (or equivalent), telephone number and email address. If offeror's are proposing to use subcontractors for a portion of the work, the same past performance information should be provided to enable the Government to assess their experience.

5. Submited prices are in accordance with GSA Schedule pricing if applicable and/or may include an associated discount.

6. Overall, the Government will take into consideration the offeror's proposal quality, detail and relevance of information presented in response to this RFQ. The contract will be awarded to the lowest priced technically acceptable offer.

2.9 PROCESS SCHEDULE

2.9.1 Site Survey

Site visit attendance is highly encouraged. The site visit will be scheduled upon response from this RFQ. The location of the site visit will be Deployment Facility – 1 Maj Preddy Dr., Sandston, VA.

List of personnel who plan to attend the site visit must be provided to CO via e-mail (Nancy.beck@ic.fbi.gov) no later than May 30, 2017 at 11:00 AM EST. List shall include full name of individual, date of birth, social security number. No more than two (2) individuals may attend from each company.

2.9.2 Questions

Offerors are requested to submit their questions grouped by RFQ section and make reference to the particular section/subsection number. Questions must be received before Friday, June 9, 2017 at 11:00 AM EST. Questions or requests for an extension submitted after the cut-off date will not be considered.

Any information given to a prospective Offeror concerning this solicitation will be furnished promptly to other prospective Offerors as an amendment to the solicitation.

2.9.2 RFQ Response

Quotes not received by 11:00 AM EST, Friday, June 16, 2017 will not be considered. No Courier or Mailed copies will be accepted or considered. Questions are due on or before 11:00 AM EST, Friday, June 9, 2017.

2.9.3 Meetings After Award of Contract

FBI representatives and contractor shall meet within the first 10 days following award of the contract, at the Quantico Complex.

2.9.4 Written Communications To FBI

Upon Award, a copy of all written communications to the FBI SHALL be mailed or otherwise furnished, CONCURRENTLY, to the TPOC and to the CO. All written communications SHALL make reference to the Contract number.

2.10 POINTS OF CONTACT

2.10.1 Contracting Officer (CO)

The CO for this contract is Nancy J. Beck and she may be contacted at:

Washington, DC 20535 Telephone: (202) 324-2947 Email: Nancy.beck@ic.fbi.gov

The functions inherent to this contract shall be performed by the CO listed above. The assigned TPOC shall ensure all actions pertaining to this contract are requested via the CO.

2.10.2 TPOC

a) TBD is hereby designated to act as TPOC under this contract.

b) The TPOC is responsible, as applicable, for: receiving all deliverables, inspecting and accepting the supplies or services provided hereunder in accordance with the terms and conditions of this contract; providing direction to the contractor which clarifies the contract effort, fills in details or otherwise serves to accomplish the contractual Scope of Work; evaluating performance; and certifying all invoices/vouchers for acceptance of the supplies or services furnished by payment.

c) The TPOC does not have the authority to alter the contractor’s obligations under the contract, and/or modify any of the expressed terms, conditions, specifications, or cost of the agreement. If as a result of technical discussions it is desirable to alter/change contractual obligations or the Scope of Work, the Contracting Offices shall issue such changes.

2.11 ATTACHMENTS

All attachments are required as a part of the Offeror’s quote.

ATTACHMENT 1: STANDARD FORM (SF) 1449

ATTACHMENT 2: CONTRACTOR CERTIFICATION OF TAX REQUIREMENTS

ATTACHMENT 3: INVERTED DOMESTIC CORPORATIONS FORM

RFQ-5476 Page 2 image1.jpeg image2.png image3.emf

SF-1449 CABLE TV.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

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4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

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25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS

UNRESTRICTED OR

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ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

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

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

STANDARD FORM 1449 (REV. 3/2005) BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

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

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE PARTIAL FINAL

Printing C:\FORMFLOW\FORMS\SF\S1449_3.FRP

BarbMWilliams

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

PAGE 1 OF

2. CONTRACT NO.

3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO

16. ADMINISTERED BY

CODE

18a. PAYMENT WILL BE MADE BY

CODE

17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

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

RFQ

IFB

RFP

SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print)

30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print)

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS

UNRESTRICTED OR

NAICS:

SIZE STANDARD:

13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700)

SET ASIDE:

% FOR:

SMALL BUSINESS

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

EMERGING SMALL

BUSINESS

8 (A)

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE

ARE NOT ATTACHED

ARE

ARE NOT ATTACHED

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

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

\\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg

STANDARD FORM 1449 (REV. 3/2005)

BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED

INSPECTED

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

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

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

42d. TOTAL CONTAINERS

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER

34. VOUCHER NUMBER

35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL

FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NO.

39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE

PARTIAL

FINAL

1. REQUISITION NUMBER: DJF-17-2200-PR-0005476

PAGE 1 OF: 1

2. CONTRACT NUMBER:

4. ORDER NUMBER:

5. SOLICITATION NUMBER: RFQ-5476

7. FOR SOLICITATION INFORMATION CALL: a. NAME: Nancy J. Beck, Contracting Officer

7. FOR SOLICITATION INFORMATION CALL: b. TELEPHONE NUMBER (No collect calls): 202-324-2947

9. ISSUED BY CODE:

% For : 100

12. DISCOUNT TERMS:

13b. RATING:

15. DELIVER TO: FBI JEH Building, 935 Pennsylvania Ave., NW Washington, DC 20535

16. ADMINISTERED BY CODE:

16. ADMINISTERED BY: Same as Block 9

17a. CONTRACTOR/ OFFEROR CODE:

17a. CONTRACTOR/ OFFEROR:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER:

18a. PAYMENT WILL BE MADE BY: U.S. Treasury Department

19. ITEM NUMBER. Line 1 of 8.: 1.00000000

20. SCHEDULE OF SUPPLIES/ SERVICES: Cable TV and Internet Services Base Year

21. QUANTITY: 12.00000000

22. UNIT: mo

23. UNIT PRICE:

24. AMOUNT: 0.00000000

19. ITEM NUMBER. Line 2 of 8.: 2.00000000

20. SCHEDULE OF SUPPLIES/ SERVICES: Cable TV and Internet Services - Option Year One

21. QUANTITY: 12.00000000

22. UNIT: mo

23. UNIT PRICE:

24. AMOUNT: 0.00000000

19. ITEM NUMBER. Line 3 of 8.: 3.00000000

20. SCHEDULE OF SUPPLIES/ SERVICES: Cable TV and Internet Services - Option Year Two

21. QUANTITY: 12.00000000

22. UNIT: mo

23. UNIT PRICE:

24. AMOUNT: 0.00000000

19. ITEM NUMBER. Line 4 of 8.: 4.00000000

20. SCHEDULE OF SUPPLIES/ SERVICES: Cable TV and Internet Services - Option Year Three

21. QUANTITY: 12.00000000

22. UNIT: mo

23. UNIT PRICE:

24. AMOUNT: 0.00000000

19. ITEM NUMBER. Line 5 of 8.: 5.00000000

20. SCHEDULE OF SUPPLIES/ SERVICES: Cable TV and Internet Services - Option Year Four

21. QUANTITY: 12.00000000

22. UNIT: mo

23. UNIT PRICE:

24. AMOUNT: 0.00000000

19. ITEM NUMBER. Line 6 of 8.:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 7 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 8 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

25. ACCOUNTING AND APPROPRIATION DATA:

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED. INITIALS : 1

29. AWARD OF CONTRACT: REFERENCE OFFER:

DATE. YOUR OFFER ON SOLICITATION

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS.:

30b. NAME OF SIGNER (Type or print):

30b. TITLE OF SIGNER (Type or print):

31b. NAME OF CONTRACTING OFFICER (Type or print): NANCY J. BECK

10. THIS ACQUISITION IS UNRESTRICTED: 0

10. THIS ACQUISITION IS SET ASIDE:: 0

10. THIS ACQUISITION IS SMALL BUSINESS: 1

10. THIS ACQUISITION IS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS: 0

10. THIS ACQUISITION IS HUBZONE SMALL BUSINESS: 0

10. THIS ACQUISITION IS EMERGING SMALL BUSINESS : 0

10. THIS ACQUISITION IS 8 (A): 0

11. DELIVERY FOR FOB DESTINATION UNLESS BLOCK IS MARKED SEE SCHEDULE: 0

13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700): 0

14. METHOD OF SOLICITATION RFQ: 1

10. THIS ACQUISITION IS NAICS:: 515210

10. THIS ACQUISITION IS SIZE STANDARD:: $38.5 Million

14. METHOD OF SOLICITATION IFB: 0

14. METHOD OF SOLICITATION RFP: 0

18a. PAYMENT WILL BE MADE BY CODE:

18a. PAYMENT WILL BE MADE BY CODE: 11:00 AM EST

18a. PAYMENT WILL BE MADE BY CODE: Federal Bureau of Investigation Attention: Nancy J. Beck 935 Pennsylvania Avenue, NW Washington, DC 20525

29. AWARD OF CONTRACT : 1

29. AWARD OF CONTRACT : 0

29. AWARD OF CONTRACT : 1

29. AWARD OF CONTRACT : 0

27a. ARE ATTACHED: 1

27a. ARE NOT ATTACHED: 0

27b. ARE ATTACHED: 0

27b. ARE NOT ATTACHED: 0

42c. DATE RECEIVED. Enter 2 digit month, 2 digit day and 4 digit year.: 2017-05-24

42c. DATE RECEIVED. Enter 2 digit month, 2 digit day and 4 digit year.: 2017-06-16

3. AWARD/ EFFECTIVE DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

32B SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE. THIS IS A PRTECTED FIELD.:

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK IS CHECKED SEE ADDENDUM: 1

26. TOTAL AWARD AMOUNT (FOR GOVT. USE ONLY):

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER : 0

41b. SIGNATURE OF CERTIFYING OFFICER. :

19. ITEM NUMBER. Line 1 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 2 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 3 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 4 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 5 of 28.:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 6 f 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 7 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

24. AMOUNT:

19. ITEM NUMBER. Line 8 of 28.:

19. ITEM NUMBER. Line 9 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 10 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 11 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 12 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 13 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line14 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 15 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 16 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 17 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 18 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 19 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 20 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 21 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 22 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 23 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 24 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 25 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 26 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 27 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 28 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

32a. QUANTITY IN COLUMN 21 HAS BEEN ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32d. PRINTED NAME OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32d. PRINTED TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE.:

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32F. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32G. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

33. SHIP NUMBER:

34. VOUCHER NUMBER:

35. AMOUNT VERIFIED CORRECT FOR:

37. CHECK NUMBER:

38. S/R ACCOUNT NUMBER:

39. S/R VOUCHER…