S02_Attachment 0003_RFP 36C79126R0011_VAAR Clause 852.219-76_Limitations on Subcontracting_Fillable.docx

DOCX document 48 KB Posted

Attached to
Electro-Therapeutic Modalities for Pain Management (ETMPM) - Transcutaneous Electrical Nerve Stimulation (TENS) Procurement Program
Solicitation number
36C79126R0011
Issued by

About this file

This file is a Limitations on Subcontracting clause attachment (VAAR Clause 852.219-76) applicable to the ETMPM-TENS procurement. The document is a fillable template establishing subcontracting limitations and requirements for contractors awarded under this solicitation. As a clause template, it does not contain specific operational requirements but rather provides the regulatory framework governing subcontracting practices that successful offerors must comply with throughout contract performance.

The clause applies to this VA solicitation (36C79126R0011) for Electro-Therapeutic Modalities for Pain Management—specifically Transcutaneous Electrical Nerve Stimulation (TENS) devices—which was issued September 18, 2026, with a response deadline of October 19, 2026, at 3:00 PM CDT. The procurement utilizes the VA Tiered Set-Aside Evaluation Approach under 38 U.S.C. 8127, with evaluation priority sequenced through SDVOSB (Tier-1), VOSB (Tier-2), and other small business categories. The NAICS code is 334510 (Electromedical and Electrotherapeutic Apparatus Manufacturing) with a 1,250-employee small business size standard. Contractors selected must adhere to the specified subcontracting limitations outlined in this clause as a material term of contract award.

View the file

Other files

File Type Posted
S02_Attachment 0004_RFP 36C79126R0011_FAR Provision 52.225-2_Buy American Certificate_Fillable.docx DOCX document
S06_Solicitation Number 36C79126R0011_Amendment Number 0006_ETMPM-TENS Requirement_Final_Issued 26OCT2026_Fillable.pdf PDF
S02_Attachment 0003_RFP 36C79126R0011_VAAR Clause 852.219-76_Limitations on Subcontracting_Fillable.docx DOCX document
S02_Attachment 0005_RFP 36C79126R0011_FAR Provision 52.225-6_Trade Agreements Certificate_Updated 18SEP2026_Fillable.docx DOCX document
S02_Attachment 0006_RFP 36C79126R0011_Offeror Past Performance Questionnaire_Fillable.docx DOCX document
S02_Attachment 0001_RFP 36C79126R0011_Price Marix_Fillable.xlsx XLSX spreadsheet
S06_Solicitation Number 36C79126R0011_Amendment Number 0005_ETMPM-TENS Requirement_Conformed Copy_Issued_Dated 16OCT2026.pdf PDF
S02_Attachment 0004_RFP 36C79126R0011_FAR Provision 52.225-2_Buy American Certificate_Fillable.docx DOCX document
S06_Solicitation Number 36C79126R0011_Amendment Number 0004_ETMPM-TENS Requirement_Conformed Copy_Issued_Dated 15OCT2026.pdf PDF
S05_All Offerors Questions and All Government Responses_Solicitation Number 36C79126R0011_Final_Dated 09OCT2026.pdf PDF
S06_Solicitation Number 36C79126R0011_Amendment Number 0003_ETMPM-TENS Requirement_Combined Document_Issued 06OCT2026_Fillable.pdf PDF
S05_All Offerors Questions and All Government Responses_Solicitation Number 36C79126R0011_Posted To GPE Date 02OCT2026.pdf PDF
S02_Attachment 0003_RFP 36C79126R0011_VAAR Clause 852.219-76_Limitations on Subcontracting_Fillable.docx DOCX document
S02_Attachment 0001_RFP 36C79126R0011_Price Marix_Fillable.xlsx XLSX spreadsheet
S06_Solicitation Number 36C79126R0011_Amendment Number 0002_Combined Document_ETMPM-TENS Requirement_Issued 02OCT2026.pdf PDF
S02_Attachment 0001_RFP 36C79126R0011_Price Marix_Fillable.xlsx XLSX spreadsheet
S02_RFP Number 36C79126R0011_Amendment 0001_ETMPM-TENS Requirement_Issued 30SEP2026_Fillable.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_All Offerors Questions and All Government Responses_Posted at the GPE on 29SEP2026.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_All Offerors Questions and All Government Responses_Posted at the GPE on 28SEP2026 v2.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_All Offerors Questions and All Government Responses_Posted at the GPE on 28SEP2026.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_Q and As_Final_Posted at GPE_Dated 22SEP2026.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_Q and As_Final_Posted at GPE_Dated 21SEP2026.pdf PDF
S05_Prospective Offerors to RFP 36C79126R0011_Q and As_Final_Posted at GPE_Dated 19SEP2026.pdf PDF
S02_Attachment 0005_RFP 36C79126R0011_FAR Provision 52.225-6_Trade Agreements Certificate_Fillable.docx DOCX document
S02_Attachment 0001_Price Matrix_RFP 36C79126R0011_FY26 ETMPM-TENS_Fillable.xlsx XLSX spreadsheet
S02_Attachment 0006_RFP 36C79126R0011_Offeror Past Performance Questionnaire_Fillable.docx DOCX document
S02_Attachment 0005_RFP 36C79126R0011_FAR Provision 52.225-6_Trade Agreements Certificate_Fillable.docx DOCX document
S02_Attachment 0004_RFP 36C79126R0011_FAR Provision 52.225-2_Buy American Certificate_Fillable.docx DOCX document
S02_Attachment 0002_RFP 36C79126R0011_FAR Provision 52.212-3_Offeror Representations and Certifications_Fillable.docx DOCX document
S02_RFP Number 36C79126R0011_ETMPM-TENS Requirement_Fillable.pdf PDF
Show all 30

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

ATTACHMENT 0004 – VAAR Clause 852.219-76

ATTACHMENT 0003 – VAAR CLAUSE 852.219-76

DEPARTMENT OF VETERANS AFFAIRS (VA)

VA’S FY26 ETMPM-TENS Procurement Program Recompete Solicitation Number 36C79126R0011

VAAR Clause 852.219-76, VA Notice of Limitations on Subcontracting - Certificate of Compliance for Supplies and Products.

Instructions to Offerors: Attachment 0003, VAAR Clause 852.219‑76, VA Notice of Limitations on Subcontracting – Certificate of Compliance for Supplies and Products, is a mandatory, fillable PDF document that each Offeror shall fully complete, sign, and submit with its proposal package. This certification is a material requirement of a responsive proposal. Incomplete, unsigned, undated, or partially filled attachments will not be accepted. Proposals that do not include a properly completed, signed, and dated Attachment 0003 will be deemed non‑responsive and ineligible for further evaluation or award. Complete Attachment 0003 as follows:

1. General Completion Requirements: Offerors must complete Attachment 0003 in its entirety, using the fields, checkboxes, and signature blocks provided in the fillable PDF. Offerors shall:

· Place check marks in all required selection boxes to indicate the Offeror’s correct status (e.g., Manufacturer or Nonmanufacturer).

· Complete all fill‑in fields requiring company information, representations, names, titles, addresses, and other identifying information.

· Attach a digital signature in the designated signature block.

· Enter the date signed in the designated field.

· Ensure all information provided is true, complete, and accurate, and fully consistent with the Offeror’s SAM.gov representations and FAR 52.212‑3 certifications.

2. Required Offeror Representations & Certifying Selections: Attachment 0003 contains multiple sections requiring the Offeror to select the appropriate certification options. Offerors must check the applicable boxes to indicate:

a. Compliance with Limitations on Subcontracting: Offerors must certify whether they will comply as a:

· Manufacturer/Producer; or

· Nonmanufacturer, including acknowledgment of the Nonmanufacturer Rule, employee size standards, domestic manufacturing requirements, or SBA waiver conditions as applicable.

b. Manufacturer or Nonmanufacturer Status: Offerors must check the applicable box indicating their status and certify compliance with the detailed requirements outlined in 13 CFR 121.406(b).

c. Nonmanufacturer Rule Requirements (If Applicable): A Nonmanufacturer must check each applicable box certifying it meets:

· Employee size standards;

· Engagement in retail/wholesale trade;

· Industry‑appropriate ownership/possession of items; and

· Compliance with domestic small business manufacturing or SBA waiver requirements.

d. Acknowledgment of Criminal Penalties for False Certifications: Offerors must acknowledge the consequences outlined under Title 18 U.S.C. § 1001.

3. Required Offeror Information Fields: Offerors must complete all fill‑in fields, the individual signing the form must be authorized to bind the company contractually, required fields include:

· Legal business name of Offeror;

· Printed name of authorized signatory;

· Printed title of authorized signatory;

· Company address; and

· Signature and date.

4. Digital Signature Requirements: Attachment 0005 must be signed using a digital signature compliant with commonly accepted electronic signature standards (e.g., Adobe, DocuSign, PKI, or other federally recognized formats). Handwritten or typed signatures are not acceptable unless inserted electronically as an authenticated digital image.

5. Submission Requirements: Offerors shall:

· Include the completed, signed, and dated PDF file within the Offeror’s proposal submission package;

· Label the document as: “Attachment 0003 – VAAR 852.219‑76 Certification – [Offeror Name]”;

· Submit Attachment 0003 as a standalone PDF, not embedded inside another document; and

· Ensure the information provided in Attachment 0003 matches all representations made elsewhere in the proposal and in SAM.gov.

6. Impact of Non‑Submission: Failure to submit a fully completed and signed Attachment 0005 will result in:

· Immediate rejection of the Offeror’s proposal as non‑responsive;

· No further evaluation under technical or price factors; and

· Ineligibility for award under Solicitation 36C79126R0011.

As prescribed in VAAR 819.7011(c), insert the following clause. The Contracting Officer shall tailor the clause in paragraph (a)(2)(iii) as appropriate:

VA Notice of Limitations on Subcontracting—Certificate of Compliance for Supplies and Products (NOV 2022)

(a) Pursuant to 38 U.S.C. 8127(k)(2), the offeror certifies that—

(1) If awarded a contract (see FAR 2.101 definition), it will comply with the limitations on subcontracting requirement as provided in the solicitation and the resultant contract, as follows [Offeror fill-in—check each applicable box below. The offeror must select the applicable provision below, identifying itself as either a manufacturer or nonmanufacturer]:

(i) ☐ In the case of a contract for supplies or products (other than from a non-manufacturer of such supplies), it will not pay more than 50% of the amount paid by the Government to it to firms that are not VIP-listed SDVOSBs as set forth in VAAR 852.219-73 or VOSBs as set forth in VAAR 852.219-74. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(ii) ☐ In the case of a contract for supplies from a nonmanufacturer, it will supply the product of a domestic small business manufacturer or processor, unless a waiver as described in 13 CFR 121.406(b)(5) is granted [SBA Non-Manufacturer Class Waiver Granted Version June 2022_NAICS Code 334510_Waiver Effective Date/Posted Date 20DEC2007]. The Offeror understands that, as provided in 13 CFR 121.406(b)(7), such a waiver has no effect on requirements external to the Small Business Act, such as the Buy American Act or the Trade Agreements Act.

(2) Manufacturer or nonmanufacturer representation and certification. [Offeror fill-in—check each applicable box below. The offeror must select the applicable provision below, identifying itself as either a manufacturer or nonmanufacturer]:

i. ☐ Manufacturer or Producer. The Offeror certifies that it is the manufacturer or producer of the end item being procured, and the end item is manufactured or produced in the United States, in accordance with paragraph (a)(1)(i).

ii. ☐ Nonmanufacturer. The offeror certifies that it qualifies as a nonmanufacturer in accordance with the requirements of 13 CFR 121.406(b) and paragraph (a)(1)(ii). The Offeror further certifies it meets each element below as required in order to qualify as a nonmanufacturer.

iii. ☐ The Offeror certifies that it does not exceed 500 employees (or 150 employees for the Information Technology Value Added Reseller exception to NAICS code 541519, which is found at 13 CFR 121.201, footnote 18).

iv. ☐ The Offeror certifies that it is primarily engaged in the retail or wholesale trade and normally sells the type of item being supplied.

v. ☐ The Offeror certifies that it will take ownership or possession of the item(s) with its personnel, equipment, or facilities in a manner consistent with industry practice.

(3) The Offeror acknowledges that this certification concerns a matter within the jurisdiction of an Agency of the United States. The Offeror further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

(4) If VA determines that an SDVOSB/VOSB awarded a contract pursuant to 38 U.S.C. 8127 did not act in good faith, such SDVOSB/VOSB shall be subject to any or all of the following:

i. Referral to the VA Suspension and Debarment Committee;

ii. A fine under section 16(g) of the Small Business Act (15 U.S.C. 645(g)(1)); and

iii. Prosecution for violating section 1001 of title 18.

(b) The Offeror represents and understands that by submission of its offer and award of a contract it may be required to provide copies of documents or records to VA that VA may review to determine whether the offeror complied with the limitations on subcontracting requirement specified in the contract or to determine whether the offeror qualifies as a manufacturer or nonmanufacturer in compliance with the limitations on subcontracting requirement. Contracting officers may, at their discretion, require the contractor to demonstrate its compliance with the limitations on subcontracting at any time during performance and upon completion of a contract if the information regarding such compliance is not already available to the contracting officer. Evidence of compliance includes, but is not limited to, invoices, copies of subcontracts, or a list of the value of tasks performed.

(c) The Offeror further agrees to cooperate fully and make available any documents or records as may be required to enable VA to determine compliance. The offeror understands that failure to provide documents as requested by VA may result in remedial action as the Government deems appropriate.

(d) Offeror completed certification/fill-in required. The formal certification must be completed, signed and returned with the offeror's bid, quotation, or proposal.

The Government will not consider offers for award from offerors that do not provide the certification, and all such responses will be deemed ineligible for evaluation and award.

Certification:

I hereby certify that if awarded the contract [insert name of Offeror], _____________________ will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of [insert name of offeror], ____________________.

Printed Name of Signee: ___________________________________.

Printed Title of Signee: ____________________________________.

Signature: ___________________________.

Date: _______________.

Company Name and Address: __________________________________________________

(End of Clause)

File details come from the government source that posted it. Updated .