Section V_with attachments.pdf

Section V Forms

STATEMENT AND ACKNOWLEDGMENT OMB Control Number: 9000-0066 Expiration Date: 4/30/2022

PART I - STATEMENT OF PRIME CONTRACTOR

1. PRIME CONTRACT NUMBER 2. DATE SUBCONTRACT

AWARDED

3. SUBCONTRACT NUMBER

15b. TITLE OF PERSON SIGNING

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1413 (REV. 4/2013)

Prescribed by GSA/FAR (48 CFR) 53.222(e)

4. PRIME CONTRACTOR 5. SUBCONTRACTOR

a. NAME a. NAME

b. STREET ADDRESS b. STREET ADDRESS

c. CITY d. STATE e. ZIP CODE c. CITY d. STATE e. ZIP CODE

6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."

7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm:

a. NAME OF AWARDING FIRM

b. DESCRIPTION OF WORK BY SUBCONTRACTOR

8. PROJECT 9. LOCATION

10a. NAME OF PERSON SIGNING 11. BY (Signature) 12. DATE SIGNED

10b. TITLE OF PERSON SIGNING

PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR

13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:

Contract Work Hours and Safety Standards Act - Overtime Compensation (If included in prime contract see Block 6) Payrolls and Basic Records Withholding of Funds Disputes Concerning Labor Standards Compliance with Construction Wage Rate Requirements and Related Regulations

Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY

A C

B D

15a. NAME OF PERSON SIGNING 16. BY (Signature) 17. DATE SIGNED

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number.

The OMB control number for this collection is 9000-0066. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

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Presentation Agent

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STATEMENT AND ACKNOWLEDGMENT

OMB Control Number: 9000-0066

Expiration Date: 4/30/2022

PART I - STATEMENT OF PRIME CONTRACTOR

1. PRIME CONTRACT NUMBER

2. DATE SUBCONTRACT AWARDED

3. SUBCONTRACT NUMBER

15b. TITLE OF PERSON SIGNING

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1413 (REV. 4/2013)

Prescribed by GSA/FAR (48 CFR) 53.222(e)

4. PRIME CONTRACTOR

5. SUBCONTRACTOR

a. NAME

a. NAME

b. STREET ADDRESS

b. STREET ADDRESS

c. CITY

d. STATE

e. ZIP CODE

c. CITY

d. STATE

e. ZIP CODE

6. The prime contract does, does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation."

7. The prime contractor states that under the contract shown in Item 1, a subcontract was awarded on the date shown in Item 2 to the subcontractor identified in item 5 by the following firm:

a. NAME OF AWARDING FIRM

b. DESCRIPTION OF WORK BY SUBCONTRACTOR

8. PROJECT

9. LOCATION

10a. NAME OF PERSON SIGNING

11. BY (Signature)

12. DATE SIGNED

10b. TITLE OF PERSON SIGNING

PART II - ACKNOWLEDGMENT OF SUBCONTRACTOR

13. The subcontractor acknowledges that the following clauses of the contract shown in Item 1 are included in this subcontract:

Contract Work Hours and Safety Standards Act - Overtime Compensation

(If included in prime contract see Block 6)

Payrolls and Basic RecordsWithholding of FundsDisputes Concerning Labor StandardsCompliance with Construction Wage Rate Requirements and Related Regulations

Construction Wage Rate Requirements Apprentices and Trainees Compliance with Copeland Act Requirements Subcontracts (Labor Standards) Contract Termination - Debarment Certification of Eligibility

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY

A

C

B

D

15a. NAME OF PERSON SIGNING

16. BY (Signature)

17. DATE SIGNED

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork

Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0066. We estimate that it will take .05 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

1. PRIME CONTRACT NUMBER:

4A. NAME:

4B. STREET ADDRESS:

4C. CITY:

7A. NAME OF AWARDING FIRM:

10A. NAME OF PERSON SIGNING:

15A. NAME OF PERSON SIGNING:

15B. TITLE OF PERSON SIGNING:

10B. TITLE OF PERSON SIGNING:

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line A.:

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line D.:

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line C.:

14. NAME(S) OF ANY INTERMEDIATE SUBCONTRACTORS, IF ANY. Line B.:

8. PROJECT:

9. LOCATION:

7B. DESCRIPTION OF WORK BY SUBCONTRACTOR:

5C. CITY:

4E. ZIP CODE:

5E. ZIP CODE:

4D. STATE:

5D. STATE:

3. SUBCONTRACT NUMBER:

5A. NAME:

5B. STREET ADDRESS:

2. DATE SUBCONTRACT AWARDED. Enter 2 digit month, 2 digit day and 4 digit year.:

12. DATE SIGNED. Enter 2 digit month, 2 digit day and 4 digit year.:

17. DATE SIGNED. Enter 2 digit month, 2 digit day and 4 digit year.:

6. The prime contract does contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation.": 0

6. The prime contract does not contain the clause entitled "Contract Work Hours and Safety Standards Act -- Overtime Compensation.": 0

11. BY. SIGNATURE. This is a protected field.:

16. BY. SIGNATURE. This is a protected field.:

RFP 25-042R

OFFEROR INFORMATION AND PRICING FORM

TO: PRINCETON PLASMA PHYSICS LABORATORY

JAMES FORRESTAL CAMPUS

P.O. BOX 451

PRINCETON, NEW JERSEY 08543 ATTENTION:

RFP 25-042R

JIMMY RUSSELL, PROCUREMENT SPECIALIST

SUBJECT: REQUEST FOR PROPOSALS RFP 25-042R FOR XQT-1 Transformer Replacement Project

(FIRM NAME)

(BUSINESS ADDRESS)

(1) For the performance of the requirements of RFP 25-042R we submit the following:

LINE ITEM QTY UNIT DESCRIPTION PRICE

001 1 JB

Provide all labor, tools, equipment and supervision required to prepare and paint floor and wall surfaces in accordance with SOW titled:

XQT-1 Transformer

Replacement Project

*Please include your projected Schedule of Values based on their proposed price as an attachment to this form.

(2) The following individual(s) are authorized to conduct discussions and provide information related to this proposal on behalf of the Offeror:

NAME: NAME:

TITLE: TITLE:

PHONE: PHONE:

FAX: FAX:

EMAIL: EMAIL:

jrussell

Inserted Text

RFP 24-042R

OFFEROR INFORMATION AND PRICING FORM

(3) Acceptance of Sample Subcontract terms and conditions. Please initial the applicable statement below in the space provided (initial one statement only):

I hereby affirm that I have reviewed the terms and conditions set forth in the Sample Subcontract Agreement set forth in RFP 24-042R and will accept the terms and conditions set forth therein without exception if a Subcontract is awarded to my firm.

I have reviewed the terms and conditions set forth in the Sample Subcontract Agreement set forth in Section II of RFP 24-042R. In the event that my firm is selected for award, I request that the exceptions and/or proposed revisions set forth in this proposal at Section _____ (attached additional sheets if required) be considered by PPPL. I understand that my proposal may be considered to be non-responsive depending on the extent and nature of the proposed exceptions/revisions and my firm’s willingness to discuss or negotiate these proposed exceptions/ revisions with PPPL.

(4) We acknowledge receipt of the following Amendments:

Amendment Number Date of Amendment

(5) By submission of this signed Offeror Information and Pricing Form, the undersigned hereby certifies that the information provided is current, accurate, and complete as of the date submitted. The

Offeror agrees that this proposal will remain valid for 90 days from the closing date specified for this

RFP.

Signature of Authorized Individual

Typed Name

Title

Date

AFFIX

CORPORATE

SEAL

CORPORATE

E-Verify Cert; Rev. 0; 8/1/2011 Page 1 of 1

E-VERIFY FLOW-DOWN REQUIREMENTS CERTIFICATION

a. The offeror hereby certifies that it will ( ) or will not ( ) further subcontract commercial or non-commercial services or construction with a value in excess of $3,000 for work to be performed in the United States.

b. If the answer to paragraph (a) is affirmative, the offeror hereby certifies that it will flow down the provisions of Federal Acquisition Regulation (FAR) clause 52.222-54, “Employment Eligibility Verification” to all such lower-tier subcontractors, and require its direct subcontractors to flow the clause down to their qualifying subcontractors at any tier.

c. To ensure the compliance of its lower-tier subcontractors, the offeror agrees that within 10 calendar days of award of each eligible lower-tier subcontract for services or construction, it will provide PPPL with proof of enrollment in the E-Verify system for each subcontractor by submitting copies of the subcontractor’s “Edit Company Profile” page in E-Verify.

If the offeror provides a negative response in paragraph (a) above, the offeror agrees that if it subsequently determines to subcontract for services or construction in excess of $3,000 in the performance of this work, it will immediately inform the PPPL Subcontract Administrator, and will submit the necessary proofs of its lower-tier subcontractor’s E-Verify compliance.

BY SIGNATURE HEREUNDER, THE BIDDER/OFFEROR AGREES THAT THE

FOREGOING CERTIFICATION IS TRUE AND CORRECT.

Name of Official:

Signature:

Title: Date:

Name of Company/Organization:

Address (Include Zip Code):

PRINCETON PLASMA PHYSICS LABORATORY

REPRESENTATIONS & CERTIFICATIONS BOOKLET

PPL-PD-RC2; Rev. 11; 09-2013 Page 1 of 15

RFP/PURCHASE ORDER/SUBCONTRACT NO.____RFP 22-028-R__________

Note: This booklet must be executed by an official authorized to sign on behalf of your organization and returned as soon as possible. When standard, off-the-shelf or construction items are being furnished, the following items should be marked “Not Applicable” if they do not apply:

Item No. Title N/A

17 Rights to Proposal Data [ ] 18. Representation of Limited Rights Data and Restricted Computer Software [ ]

19. Royalty Payments and Information [ ]

20. Notice of Right to Request Patent Waiver [ ]

The offeror represents and certifies as part of its offer that (check all items that apply):

1.

NAME OF COMPANY/ORGANIZATION

STREET ADDRESS

CITY, COUNTY, STATE, AND ZIP/POSTAL CODE (AS APPLICABLE)

COUNTRY

2. TYPE OF BUSINESS ORGANIZATION

Operates as [ ] an individual, [ ] a sole proprietorship, [ ] partnership, [ ] a nonprofit organization, [ ] a joint venture, or [ ] a corporation, incorporated under the laws of the State of ________________________, with principal place of business located at __________________________________________________________________________.

DUNS Contractor Establishment Number:

Taxpayer Identification Number (TIN):

Social Security Number (Individuals only):

Offeror is [ ] not owned or controlled by a common parent (a corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a mem-ber). OR:

Name of Common Parent: _____________________________ TIN No. of Common Parent: _______________

3. SMALL BUSINESS PROGRAM REPRESENTATIONS (APR 2012)

***************************************This certification is derived from FAR 52.219-1**************************************

(a)(1) The North American Industry Classification System (NAICS) code for this acquisition is _335931_ [to be insert-ed by PPPL].

(2) The small business size standard is ____750 _____________ [to be inserted by PPPL].

(3) The small business size standard for a concern which submits an offer in its own name, other than on a con-struction or service contract, but which proposes to furnish an end product which it did not itself manufacture, is 500 employees.

(b) Representations.

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

(2) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provi-sion.] The offeror represents, for general statistical purposes, that it [ ] is, [ ] is not, a small disadvantaged busi-ness concern as defined in 13 CFR 124.1002.

PPL-PD-RC2; Rev. 11; 09-2013 Page 2 of 15

(3) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provi-sion.] The offeror represents as part of its offer 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 offe-ror represented itself as a women-owned small business concern in paragraph (b)(3) of this provision.] The offeror represents as part of its offer that—

(i) It [_] is, [_] is not a WOSB concern eligible under the WOSB Program, has provided all the required doc-uments 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 repre-sentation in paragraph (b)(4)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern el-igible 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 sub-mit a separate signed copy of the WOSB representation.

(5) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a women-owned small business concern eligible under the WOSB Program in (b)(4) of this provision.] The offeror represents as part of its offer 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 represen-tation in paragraph (b)(5)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: _____________.] Each EDWOSB concern participating in the joint ven-ture shall submit a separate signed copy of the EDWOSB representation.

(6) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provi-sion.] The offeror represents as part of its offer that it [ ] is, [ ] is not a veteran-owned small business concern.

(7) [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (b)(4) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern.

(8) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provi-sion.] The offeror represents, as part of its offer, that-

(i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no mate-rial change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified in accordance with 13 CFR part 126; and

(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 126, and the representa-tion in paragraph (b)(8)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the name of each of the HUBZone small business con-cerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern partic-ipating in the joint venture shall submit a separate signed copy of the HUBZone representation.

(c) Definitions. As used in this provision-

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business con-cern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business concern eligible under the WOSB Program.

PPL-PD-RC2; Rev. 11; 09-2013 Page 3 of 15

"Service-disabled veteran-owned small business concern"-

(1) Means a small business concern-

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a veteran with permanent and severe disability, the spouse or permanent caregiv-er of such veteran.

(2) “Service-disabled veteran” means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

“Small business concern” means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small busi-ness under the criteria in 13 CFR Part 121 and the size standard in paragraph (a) of this provision.

“Veteran-owned small business concern” means a small business concern-

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

“Women-owned small business concern” means a small business concern-

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

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

(d) Notice.

(1) If this solicitation is for supplies and has been set aside, in whole or in part, for small business concerns, then the clause in this solicitation providing notice of the set-aside contains restrictions on the source of the end items to be furnished.

(2) Under 15 U.S.C. 645(d), any person who misrepresents a firm's status as a small, HUBZone small, small disadvantaged, service-disabled veteran-owned small, economically disadvantaged women-owned small, or women-owned small business concern eligible under the WOSB Program in order to obtain a contract to be awarded under the preference programs established pursuant to section 8, 9, 15, 31 or 36 of the Small Busi-ness Act or any other provision of Federal law that specifically references section 8(d) for a definition of pro-gram eligibility, shall-

(i) Be punished by imposition of fine, imprisonment, or both;

(ii) Be subject to administrative remedies, including suspension and debarment; and

(iii) Be ineligible for participation in programs conducted under the authority of the Act.

PPL-PD-RC2; Rev. 11; 09-2013 Page 4 of 15

4. USE OF RADIOACTIVE MATERIALS (For purposes of these questions, “radiation” includes particles capable of causing ionization of material or changes in nuclear characteristics of material. It does not include laser, IR, UV or microwave radiation.)

(a) Is there any planned or potential use of radioactive material under the proposed subcontract?

Yes [] No []

(b) Is there any planned or potential use of a radiation-producing device (e.g., accelerator, reactor, x-ray machine, fusion device)?

Yes [] No []

If (a) or (b) above is answered “yes,” please provide the following information:

Principal Investigator Name______________________________________ Phone

No._________________ Health Physicist/Rad. Safety Officer

Name______________________________________________ ________ Phone No._________________

5. GOVERNMENT OWNED FACILITIES

Will Offeror’s personnel perform any part of the work at a Government-Owned, Contractor-Operated (GOCO) facility, or at a Government-Owned, Government-Operated (GOGO) facility?

Yes [] No []; if Yes check appropriate type facility GOCO [] or GOGO []

6. BUY AMERICAN CERTIFICATE (FEB 2009)

****************************************This certification is derived from FAR 52.225-2*************************************

(a) The offeror certifies that each end product, except those listed in paragraph (b) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.”

The terms “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American Act— Supplies.”

(b)

(b) Foreign End Products:

Line Item No. Country of Origin

[Attach a continuation sheet if necessary]

(c) Princeton will evaluate offers in accordance with the evaluation criteria (if any) and the Basis of Award outlined in the solicitation.

7. CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

***************************************This certification is derived from FAR 52.203-2**************************************

(a) The offeror certifies that--

(1) The prices in this offer have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other offeror or competitor relating to (i) those prices, (ii) the intention to submit an offer, or (iii) the methods or factors used to calculate the prices offered;

(2) The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

PPL-PD-RC2; Rev. 11; 09-2013 Page 5 of 15

(b) Each signature on the offer is considered to be a certification by the signatory that the signatory--

(1) Is the person in the offeror's organization responsible for determining the prices being offered in this bid or pro-posal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; or

(2)(i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) above ________________________ [insert full name of person(s) in the offeror's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror's organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) above have not partici-pated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision;

and

(iii) As an agent, has not personally participated, and will not participate, in any action contrary to subparagraphs

(a)(1) through (a)(3) above.

(c) If the offeror deletes or modifies subparagraph (a)(2) above, the offeror must furnish with its offer a signed state-ment setting forth in detail the circumstances of the disclosure.

8. REPORTING EXECUTIVE COMPENSATION (August 2012) (Applicable for Agreements exceeding $25,000)

**************************************This certification is derived from FAR 52.204-10**************************************

To receive any subcontract award for supplies or services (including construction) valued at $25,000 or more, offeror must provide the names and total compensation of each of the five most highly compensated executives for the offe-ror’s preceding completed fiscal year, if --

(i) in the offeror’s preceding fiscal year, the offeror received—

(A) 80 percent or more of its annual gross revenues in Federal contracts (and subcontracts), loans, grants

(and subgrants) and cooperative agreements; and

(B) $25,000,000 or more in annual gross revenues from Federal contracts (and subcontracts), loans, grants

(and subgrants) and cooperative agreements; and

(ii) The public does not have access to information about the compensation of the executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has access to the com-pensation information, see the U.S. Security and Exchange Commission total compensation filings at http://www.sec.gov/answers/execomp.htm.)

(iii) Definitions. As used in this clause:

“Executive” means officers, managing partners, or any other employees in management positions.

“Total compensation” means the cash and noncash dollar value earned by the executive during the offeror’s preceding fiscal year and includes the following (for more information see 17 CFR 229.402(c)(2)):

(1) Salary and bonus.

(2) Awards of stock, stock options, and stock appreciation rights. Use the dollar amount recognized for financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of Financial Accounting Standards No. 123 (Revised 2004) (FAS 123R), Shared Based Payments.

(3) Earnings for services under non-equity incentive plans. This does not include group life, health, hospi-talization or medical reimbursement plans that do not discriminate in favor of executives and are available generally to all salaried employees.

(4) Change in pension value. This is the change in present value of defined benefit and actuarial pension plans.

http://www.sec.gov/answers/execomp.htm

PPL-PD-RC2; Rev. 11; 09-2013 Page 6 of 15

(5) Above-market earnings on deferred compensation which is not tax-qualified.

(6) Other compensation, if the aggregate value of all such other compensation (e.g., severance, termina-tion payments, value of life insurance paid on behalf of the employee, perquisites or property) for the ex-ecutive exceeds $10,000.

[CHECK ONE]

Offeror did not receive 80% or more of its annual gross revenues in Federal contracts (and subcontracts), loans, grants (and subgrants) and cooperative agreements.

Offeror did not receive $25,000,000 or more in annual gross revenues from Federal contact (and subcontracts), loans, grants (and subgrants) and cooperative agreements.

The public does have access to information about the compensation of the executives through periodic re-ports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986. (To determine if the public has access to the compensa-tion information, see the U.S. Security and Exchange Commission total compensation filings at http://www.sec.gov/answers/execomp.htm.)

Information required is as follows:

1. Name _________________________ Total Compensation _____________________

2. Name _________________________ Total Compensation _____________________

3. Name _________________________ Total Compensation _____________________

4. Name _________________________ Total Compensation _____________________

5. Name _________________________ Total Compensation _____________________

9. CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL

TRANSACTIONS (SEP 2007) (Applicable for agreements exceeding $150,000)

**************************************This certification is derived from FAR 52.203-11**************************************

(a) Definitions. As used in this provision— “Lobbying contact” has the meaning provided at 2 U.S.C. 1602(8). The terms “agency,” “influencing or attempting to influence,” “officer or employee of an agency,” “person,” “reasonable compensation,” and “regularly employed” are defined in the FAR clause of this solicitation entitled “Limitation on Payments to Influence Certain Federal Transactions” (52.203-12).

(b) Prohibition. The prohibition and exceptions contained in the FAR clause of this solicitation entitled “Limitation on Payments to Influence Certain Federal Transactions” (52.203-12) are hereby incorporated by reference in this provi-sion.

(c) Certification. The offeror, by signing its offer, hereby certifies to the best of its knowledge and belief that no Feder-al appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Mem-ber of Congress on its behalf in connection with the awarding of this subcontract.

(d) Disclosure. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this subcontract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regu-larly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(e) Penalty. Submission of this certification and disclosure is a prerequisite for making or entering into this subcon-tract imposed by 31 U.S.C. 1352. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, for each such failure.

http://www.sec.gov/answers/execomp.htm

PPL-PD-RC2; Rev. 11; 09-2013 Page 7 of 15

10. CERTIFICATION REGARDING RESPONSIBILITY MATTERS (APR 2010) (Applicable for agreements ex-ceeding $30,000)

**************************************This certification is derived from FAR 52.209-5***************************************

(a)(1) The Offeror certifies, to the best of its knowledge and belief, that-

(i) The Offeror and/or any of its Principals-

(A) Are [ ], are not [ ] presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have [ ] have not [ ], within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving sto-len property; and

(C) Are [ ] are not [ ] presently indicted for, or otherwise criminally or civilly charged by a governmental enti-ty with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision.

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

(1) Federal taxes are considered delinquent if both of the following criteria apply:

(i) The tax liability is finally determined. The liability is finally determined if it has been assessed. A lia-bility is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(ii) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(2) Examples.

(i) The taxpayer has received a statutory notice of deficiency, under I.R.C. §6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(ii) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the tax-payer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS deter-mines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the un-derlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(iii) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delin-quent because the taxpayer is not currently required to make full payment.

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

(ii) The Offeror has [ ], has not [ ] within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

PPL-PD-RC2; Rev. 11; 09-2013 Page 8 of 15

(2) "Principal," for the purposes of this certification, means an officer; director; owner; partner; and, a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager;

head of a division or business segment; and similar positions).

This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Section 1001, Title 18, United States Code.

(b) The Offeror shall provide immediate written notice to Princeton if, at any time prior to contract award, the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circum-stances.

(c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Offeror's responsibility. Failure of the Offeror to furnish a certification or provide such additional information as requested by Princeton may render the Offeror nonresponsible.

(d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of an Offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to Princeton, Princeton may terminate the contract resulting from this solicitation for default.

11. COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION (MAY 2012)

**************************************This certification is derived from FAR 52.230.1***************************************

Note: This notice does not apply to small businesses or foreign governments. This notice is in three parts, identified by Roman Numerals I through III.

Offerors shall examine each part and provide the requested information in order to determine Cost Accounting Standards (CAS) requirements applicable to any resultant subcontract.

If the offeror is an educational institution, Part II does not apply unless the contemplated subcontract will be subject to full or modified CAS coverage pursuant to 48 CFR 9903.201-2(c)(5) or 9903.201-2(c)(6), respectively.

I. DISCLOSURE STATEMENT-COST ACCOUNTING PRACTICES AND CERTIFICATION

(a) Any subcontract in excess of $700,000 resulting from this solicitation will be subject to the requirements of the Cost Accounting Standards Board (48 CFR Chapter 99), except for those contracts which are exempt as specified in

48 CFR 9903.201-1.

(b) Any offeror submitting a proposal which, if accepted, will result in a subcontract subject to the requirements of 48 CFR Chapter 99 must, as a condition of contracting, submit a Disclosure Statement as required by 48 CFR 9903.202.

When required, the Disclosure Statement must be submitted as a part of the offeror's proposal under this solicitation unless the offeror has already submitted a Disclosure Statement disclosing the practices used in connection with the pricing of this proposal. If an applicable Disclosure Statement has already been submitted, the offeror may satisfy the requirement for submission by providing the information requested in paragraph (c) of Part I of this provision.

CAUTION: In the absence of specific regulations or agreement, a practice disclosed in a Disclosure Statement shall not, by virtue of such disclosure, be deemed to be a proper, approved, or agreed-to practice for pricing proposals or accumulating and reporting contract performance cost data.

(c) Check the appropriate box below:

[ ] (1) Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows:

(i) Original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and

PPL-PD-RC2; Rev. 11; 09-2013 Page 9 of 15

(ii) One copy to the cognizant Federal auditor.

(Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable. Forms may be obtained from the cognizant ACO or Federal official and/or from the loose-leaf version of the Federal Acquisition Regulation.)

Date of Disclosure Statement: __________________ Name and Address of Cognizant ACO or Federal Official Where Filed: ______________________________

The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

[ ] (2) Certificate of Previously Submitted Disclosure Statement. The offeror hereby certifies that the required Disclosure Statement was filed as follows:

Date of Disclosure Statement: __________________ Name and Address of Cognizant ACO or Federal Official Where Filed: ________________________

The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

[ ] (3) Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divi-sions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime con-tracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise Princeton immediately.

[ ] (4) Certificate of Interim Exemption. The offeror hereby certifies that (i) the offeror first exceeded the mone-tary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR 9903.202-1, the of-feror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award result-ing from this proposal has not been made within 90 days after the end of that period, the offeror will immedi-ately submit a revised certificate to Princeton, in the form specified under paragraph (c)(1) or (c)(2) of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

CAUTION: Offerors currently required to disclose because they were awarded a CAS-covered prime contract or subcontract of $50 million or more in the current cost accounting period may not claim this exemption (4). Fur-ther, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

II. COST ACCOUNTING STANDARDS-ELIGIBILITY FOR MODIFIED CONTRACT COVERAGE

If the offeror is eligible to use the modified provisions of 48 CFR 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause.

[ ] The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Ac-counting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAS-covered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this pro-posal, the offeror will advise Princeton immediately.

CAUTION: An offeror may not claim the above eligibility for modified contract coverage if this proposal is ex-pected to result in the award of a CAS-covered contract of $50 million or more or if, during its current cost ac-counting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more.

III. ADDITIONAL COST ACCOUNTING STANDARDS APPLICABLE TO EXISTING CONTRACTS

The offeror shall indicate below whether award of the contemplated contract would, in accordance with paragraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts. [ ] Yes [ ] No

PPL-PD-RC2; Rev. 11; 09-2013 Page 10 of 15

12. PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

*************************************This certification is derived from FAR 52.222-22***************************************

The offeror represents that--

(a) It [ ] has [ ] has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation.

(b) It [ ] has [ ] has not filed all required compliance reports; and

(c) Representations indicating submission of required compliance reports, signed by proposed lower tier subcontrac-tors, will be obtained before lower tier subcontract awards.

13. EQUAL OPPORTUNITY/AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

*************************************This certification is derived from FAR 52.222-25***************************************

The offeror represents that (a) it [ ] has developed and has on file, [ ] has not developed and does not have on file, at each establishment, equal opportunity/affirmative action programs required by the rules and regulations of the Sec-retary of Labor (41 CFR 60-1 and 60-2), or (b) it [ ] has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

14. NOTICE OF REQUIREMENT FOR AFFIRMATIVE ACTION TO ENSURE EQUAL EMPLOYMENT

OPPORTUNITY FOR CONSTRUCTION (FEB 1999)

*************************************This certification is derived from FAR 52.222-23***************************************

(a) The offeror's attention is called to the Equal Opportunity clause and the Affirmative Action Compliance Require-ments for Construction clause of this solicitation.

(b) The goals for minority and female participation, expressed in percentage terms for the Subcontractor's aggregate workforce in each trade on all construction work in the covered area, are as follows:

Goals for minority participation for each trade: Goals for female participation for each trade:

5.8% 6.9%

These goals are applicable to all the Subcontractor's construction work performed in the covered area. If the Subcon-tractor performs construction work in a geographical area located outside of the covered area, the Subcontractor shall apply the goals established for the geographical area where the work is actually performed. Goals are published periodically in the Federal Register in notice form, and these notices may be obtained from any Office of Federal Contract Compliance Programs office.

(c) The Subcontractor's compliance with Executive Order 11246, as amended, and the regulations in 41 CFR 60-4 shall be based on (1) its implementation of the Equal Opportunity clause, (2) specific affirmative action obligations required by the clause entitled "Affirmative Action Compliance Requirements for Construction," and (3) its efforts to meet the goals. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade. The Subcontractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from subcontrac-tor to subcontractor, or from project to project, for the sole purpose of meeting the Subcontractor's goals shall be a violation of the contract, Executive Order 11246, as amended, and the regulations in 41 CFR 604. Compliance with the goals will be measured against the total work hours performed.

(d) The Subcontractor shall provide written notification to the Deputy Assistant Secretary for Federal Contract Com-pliance, U.S. Department of Labor, within 10 working days following award of any construction subcontract in excess of $10,000 at any tier for construction work under the subcontract resulting from this solicitation. The notification shall list the-

(1) Name, address, and telephone number of the subcontractor;

(2) Employer's identification number of the subcontractor;

(3) Estimated dollar amount of the subcontract;

PPL-PD-RC2; Rev. 11; 09-2013 Page 11 of 15

(4) Estimated starting and completion dates of the subcontract; and

(5) Geographical area in which the subcontract is to be performed.

(e) As used in this Notice, and in any subcontract resulting from this solicitation, the "covered area" is Plainsboro Township, Middlesex County, New Jersey.

15. BIOBASED PRODUCT CERTIFICATION (MAY 2012)

****************************************This certification is derived from FAR 52.223-1*************************************

As required by the Farm Security and Rural Investment Act of 2002 and the Energy Policy Act of 2005 (7 U.S.C.

8102(c)(3)), the offeror certifies, by signing this offer, that biobased products (within categories of products listed by the United States Department of Agriculture in 7 CFR part 3201, subpart B) to be used or delivered in the perfor-mance of the subcontract, other than biobased products that are not purchased by the offeror as a direct result of this subcontract, will comply with the applicable specifications or other contractual requirements.

16. RECOVERED MATERIAL CERTIFICATION (MAY 2008)

****************************************This certification is derived from FAR 52.223-4*************************************

As required by the Resource Conservation and Recovery Act of 1976 (42 U.S.C. 6962(c)(3)(A)(i)), the offeror certi-fies, by signing this offer, that the percentage of recovered materials content for EPA-designated items to be deliv-ered or used in the performance of the contract will be at…