SOL_75H70722Q00054 MSU Dental Supply Agreement.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

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

OFFEROR

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

IHSMSU CODE 16. ADMINISTERED BYCODE

X

X

X

339114

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

06/22/2022 1200 MT

06/08/2022

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70722Q00054

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 18 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Mescalero New Mexico 88340 318 Abalone Loop Dental Department Mescalero Service Unit

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Solicitation# 75H70722Q00054 is issued to provide a dental supply agreement at the Mescalero Service Unit Dental Department.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

ERIC K. WRIGHT

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

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

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

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

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

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

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

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT:

REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

18 2 of

75H70722Q00054, MSU Dental Supply Agreement

SF-1449 continued, page 3 of 18

PURPOSE

The contractor will provide a variety of dental supplies needed for direct patient care to the following Albuquerque Area Indian Health Service Facility:

1. Mescalero Service Unit

Dental Department 318 Abalone Loop Mescalero, NM 88340

Acquisition will be for a 12-month base year with 4 one year options for renewal.

DESCRIPTION OF SUPPLIES

The contractor shall be in accordance with all Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

Contractor will provide dental supplies listed below, underpricing. This is not an all-inclusive list, there may be other times purchased but would be only for Dental Clinic use only.

Contractor will provide prompt notification, within a day of ordering, if items are on back order or have been discontinued.

PERIOD OF PERFORMANCE

The items required under this contract shall commence NLT 10 days after award.

PRICING

Offers for a Dental Supply agreement will be provided to the specified Albuquerque Area Indian Health Service Center in the following Format:

Item # Description Min Qty.

Max Qty.

Base Year Option Year #1

Option Year #2

Option Year #3

Option Year #4

Fixed Price/Unit

2020372 Channels Access Bur 21 mm Round Friction Grip 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1000227 Endoflex K-File Size 10 25 Mm Stainless Steel Purple 6/Box 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1001109 Endoflex K-File Size 15 25 Mm Stainless Steel White 6/Box 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1006481 Gates Glidden Drill 32 mm Size 2 Right Angle 6/VI 8 10 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1125166 Diamond Bur Friction Grip Fine 859-014F 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8507SA SharpSafety Sharps Container 2gal Red EA 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6433500 Wypall X60n Professional Wipes 9.1 in x 16.8 in Hydroknit 126/Bx 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9991527 Carbide Bur Trimming & Finishing Friction Grip 8378 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1125175 Diamond Bur Friction Grip Medium 379-018M 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2288210 Septocaine Articaine HCI 4% Epinephrin 1:100,000 50/Bx 15 17 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8909789 Curity Sponge Gauze 100% Cotton 2x2" 8 Ply Sterile LF 100/Bx 240 300 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7770137 3M Filtek Supreme Ultra Capsule A3B Body Refill 20/Bt 1 2 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7770220 3M Filtek Supreme Ultra Capsule A3E Enamal Refill 10/Bt 1 2 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7770215 3M Filtek Supreme Ultra Capsule C4D Dentin Refill 10/Bt 1 2 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1956835 Beautifil Flow Prebent Needle Tips Black 50/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1003347 CSR Wrap 12 in x 12 in Light Blue 100/Bx 3 5 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1025193 CSR Wrap 15 in x 15 in Light Blue 100/Bx 3 5 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1190188 DentiCare Fluoride Rince 2 % NAF 64 oz Mint 64oz/Bt 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2220395 Palodent Plus Wedges Large Blue Refill 100/Bxand, other Palodent Products 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2282602 Septoject Needle Plastic Hub 30n Gauge Short Blue 100/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1247649 Vella Varnish Fluoride 5% NaF 0.5 mL Carmel Clear 100/Bx 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

SF-1449 continued, page 4 of 18

1369613 Printer Thermal For M9 / MII Steam Sterilizer Ea 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1027712 Latex-Free Rubber Dam 6 in x 6 in Standard package 15/Bx 10 12 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5700360 Benzo-Jel Topical Anesthetic Gel Strawberry 1oz/Jr 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1357269 Bid-Eze Bid Holder Disposable Plastic White 250/Pk 8 10 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1951097 BeautiSealant Pit & Fissure Sealant 1.25Gm 3mL Cmplt Kt SC Tooth Colored Ea 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3120103 FlashTips Air / Water Syringe Tip Assorted 1200/Bg 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1150163 Isolators Cotton Roll Holder Purple Disposable 50/Box 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7720988 Midwest Once Sterile Operative Carbide Single Use Friction Grip 245 25/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5702003 40% Phosphoric Acid Dentin and Enamal Etching Gel 12 Gm Bulk Syringe Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1951429 Beautifil Flow Plus X Syringe A3 Ea 3 5 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1070258 Dri-Angles Cotton Roll Substitute Plain Large 320/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5702070 Natural Elegance Pit & Fissure Sealant Syr Deliv Prcdr Kt LC WO No BPA 4/Pk 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1952027 OneGloss Silicon Polisher Midi Point 0182 f/Crwn/Cmpst/Cmnt/Stn Rmvl Rfl 50/Pk 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1012270 Surgical Aspirator Tip White 6.5 in 1/8 in 25/Pk 12 14 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1380257 Hydrim C Washer Detergent 750 mL 8/Ca 1 2 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3787875 RC-Prep Cleanser Urea Peroxide and EDTA 3 cc Syringe Kit Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9452431 VivaPen Snap-On Cannulas Refill 100/Pk 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1248732 Liquid Ultra Waterline Shock Treatment 10/Bx 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1001403 Barbed Broaches Size 3 Red X-Fine 21 mm 10/Pk 1 2 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1126146 Compress Cold Instant Disposable 5x7" 48/Ca 8 10 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6002236 Enzymax Spray Gel Detergent 710 mL Lemon 24oz/Bt 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5701509 Tape Indicator 1 in Disposable Autoclave Wraps Beige Ea 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6060325 DiaPaste Temporary Filling Material Paste Complete Kit 2 Gm Ea 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7120094 GUM Proxabrush Interdental Brush Moderate #612BC Refill 200/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6006497 IMS Autoclave Monitor Tape 60 yd Green Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6003392 IMS Autoclave Monitor Tape 60 yd Purple Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6004110 IMS Autoclave Monitor Tape 60 yd Restorative Roll 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6006258 IMS Autoclave Montior tape 60 yd Yellow Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6006538 IMS Autoclave Tape Tape 60 yd Blue Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6002902 IMS Nitrile Utility Gloves Latex-Free Size 10 X-Large Reusable 3Pair/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6002896 IMS Nitrile Utility Gloves Latex-Free Size 7 Small Reusable 3Pair/Pk 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6010819 IMS Steam Sterilization Integrator 2in 100/Bg 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2226509 IRM Temporary Filling Material 14 mL Liquid 14ml/Bt 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

4995880 Opti-Cide 3 Disinfectant Wipes 100/Cn 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9457975 OptraGate 3D Lip & Cheek Retractor Regular Adult White 80/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1028721 Spray & Clean Synthetic Lubricant 6 oz Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1048066 Three Way Syringe Tip 3102 6/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

4430204 Op-D-Op II Visor Sheild Mini Tinted 6/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1014737 Op-D-Op Replacement Sheild Mini Clear Disposable 6/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3332891 GC Fuji Capsule Applier Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3335326 GC Fuji Triage EP 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3333464 GC Fuji II LC Capsule A2 Refill 48/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1004092 Saliva Ejectors Clear Blue Tip 100/Pk 12 14 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3865728 Speed-clean Autoclave Cleaner Liquid 16oz/Bt 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9911587 BluTab Waterline Tablets Bottle 750 mL 50/Bx 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1013716 Chair Sleeve 48 in x 56 in 150/Bx 15 17 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1126742 Essentials Bib 13 in x 18 in 2 Ply Lavendar Horizontal Embossed 500/Ca 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5472070 Hygenic Endo Ice Pulp Vitality Test 6 oz Can Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

4673005 Mepivacaine HCI 3% Plain Tan 50/Bx 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

SF-1449 continued, page 5 of 18

1386410 Replacement Sheild Only Bulk Refill Clear 10/Bg 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9007637 Suture 4-0 Chromic Gut C-6 Undyed Beige 18" Monofilament 12/Bx 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5430251 Colgate Peroxyl Mouth Sore Rinse 32 oz Mild Mint Alcohol Free 32oz/Bt 12 14 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1382616 Adjustable Shield Clear / Blue Reusable With 10 Replacement Shields Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6830048 Aquasafe Water Test Kit With 8 Units 8/Bx 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9007979 Curing Light Shield Universal Disposable 400/Bag 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2220690 Palodent Plus EZ Coat Sectional Matrices 6.5 mm 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2220382 Palodent Plus Sectional Matrices 5.5 mm 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1071130 Quick-Stat FS Gel 1.2 mL Standard Kit 4/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1673820 Seal&Protect Protective Sealant Patient Dose Kit Kit 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8957469 TIDI Drinking Cup Plastic 5 oz Blue 1000/Ca 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3867846 Midmark Printer Cartridge Ea 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3672868 Scatter Print Bags Brush Floss and Smile 2 Sided Print Clear 7 in x 10 in 100/Bx 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1026332 Maxitest Strip Indicator 250/Bx 12 14 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1004683 CSR Wrap 18 in x 18 in Light Blue 100/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1006950 CSR Wrap 24 in x 24 in Light Blue 100/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6060327 DiaPaste Temporary Filling Material paste Syringe Refill 2 Gm Ea 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1079729 DiaPex Temporary Filling Material Refill Tips 20/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3337681 Fuji TRIAGE Pit & Fissure Sealant Capsule Refill Self Cure White 50/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8950134 TIDIShield Curing Light Sleeve For Ultradent Valo 100\Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1000934 Tray Cover 8.5 in x 12.25 in White Disposable 1000/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1202571 Steriking Sterilization Pouch 5 in x 10.5 in 1000/Ca 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1950007 OneGloss Mandrel Right Angle Refill 6/Bx 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1074108 MM Marked Paper Points Size Assorted XX-Fine/X-Coarse Cell Package 200/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9991712 Calcimol LC Cavity Liner Complete Kit Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9995660 Carbider Bur Safe End Frinction Grip SE8/20 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7013771 Diamond Bur Friction Grip 3512.10VF Very Fine 25/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7726148 Midwest Plus Cleaner 1000mL 1lt/Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1125546 Sensor Sheaths Size 2 C;ear 500/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7774656 3M Attest Biological In Office Monitor Steam Ampule 48 Hour 25/Bx 10 12 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1003941 Absorbent Points Fine Cell Strip Package #504 200/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6400017 CaviCide1 Srfc Liq Dsnfctnt & Dcntmnt Rfl Btl Frgrnc Fr 2.5 Gallon 2Bt/Ca 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1124857 SelfSeal Sterilization Pouch 3.5 in x 5.25 in No Md frm Ltx 200/Bx 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1942242 Monoject Endo Needle 27 Gauge 1 1/4 in 25/Box 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1124859 SelfSeal Sterilization Pouch 2.25 in x 4 in No Md frm Ltx 200/Bx 8 10 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8900092 Monoject Syringe 20cc Luer Lock w/o Needle_50/Bx 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1125696 Maestro Finishing & Polishing Strips Coarse / Medium Ultra Thin Refill 100/Box 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1940159 Monoject Needle Plastic Hub 25 Gauge Short Red 100/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

Polodent Plus EZ Coat Sectional Matrix System refill packs 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1048776 Prebent Infusor Tips 100/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3333522 GC Fuji PLUS Cement Capsules Refill Package 48/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2280649 Vivacaine Bupivaine 0.5% Epinephrine 1:200,000 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1188745 Barbed Broaches Size 20 Purple XXXX-Fine 21 mm 6/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1000386 Endoflex K-file Size 20 25 Mm Stainless Steel Yellow 6/Box 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9450214 VivaPen Sleeves Refill 300/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7124196 GUM Proxabrush Interdental Brush Handle Single Ended 12/Pk 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5559843 REACH Floss Waxed 5 Yards Mint Patient Size 144/Ca 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9450577 AdheSE Universal VivaPen Adhesive Light Cure Refill 2mL/Ea 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

7123098 GUM Proxabrush Interdental Brush Wide #614BB Refill 200/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9450215 VivaPen Snap-On Cannulas Refill 100/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

SF-1449 continued, page 6 of 18

1125165 Diamond Bur Friction Grip Fine 859-010F 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6400018 CaviCide1 Srfc Liq Disinfectant & Decontaminant Spry Btl Frgrnc Fr 24 oz 24 oz/Bt 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1001215 Endoflex K-File Size 15-40 25 mm Stainless steel Assorted 6/box 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1028480 EndoFlex K-File Size 15-40 31 mm Stainless Steel Assorted 6/Box 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1008509 EndoFlex K-File Size 8 25 Mm Stainless Steel Grey 6/Box 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1007177 Mylar Matrix Strips Straight 0.002 in 1000/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

SDR Flow+ Bulk Fill Universal Compula Tip refill packs Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2220860 SDR Flow+ Bulk Fill Universal Compula Tip Refill 15/Pk Components 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1384743 PacDent Disposable Isolation Gown AAMI Level 1 X-Large Blue 10/Bg 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

5650014 Ultraform Nitrile Gloves Latex-Free Small Non-Sterile Cobalt Blue 300/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1382807 Disposable Isolation Gown AAMI Level 2 PE+PP Size X-Large Yellow 10/Bg 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1383028 AlphaTex Disposable Isolation Gown AAMI Lvl2 Spnbnd Plyprpyln Sz L/XL Wt 10/Bg 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6545663 Surgifoam Sponge Hemostatic 2x6cm 7mm Gelatin Sterile LF 12/Ca 2 4 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8747640 Gingi-Plain MAX Twisted Plain Size 1 Thin Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1381507 Disposable Isolation Gown AAMI Level 1 PET Size X-Large Blue 10/Bg 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1135423 Super Sani-Cloth Surface Wipe Disinfectant Large Canister 160/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1078257 Isofluid Mask ASTM Level 1 Blue 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1043809 Procedure Mask ASTM Level 1 Pleated Flat Blue 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1047799 Procedure Mask ASTM Level 2 Size Blue One Size Fits Most 50/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6438346 Microcool Gown Surgical XL Blue/Red Neckband Sterile Ea 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

2670038 Sani-Cloth AF3 Wipes Disinfectant X-Large Canister 65/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6408482 CaviWipes Disinfectant Towelette X-Large 65/Cn 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6402805 CaviWIpes Surface Disinfectant Towelette Large 160/Cn 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1005806 Disposable Cover Gown SMS / Polypropylene Size X-Large Blue 10/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1126304 Maxi-Gard Protective Lab Coat SMS X-Large Purple 10/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1238508 Herculite XRV Unidose A3 Enamal Refill 20/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

6001130 DenTex Easy Brush Cleaners Standard Refill Value Bag 144/Pk 3 5 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1953073 OneGloss Silicon Polisher Invrtd Cone 0183 f/Crwn/Cmpst/Cmnt/Stn Rmvl Rfl 50/Pk 5 7 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

8904792 SharpStar Sharps Container 5qt Horizontal Drop Translucent Red Ea 6 8 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

9001159 Etching Gel Syringe Tips Blue 22 Gauge Refill 100/Pk 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1073219 Pivot Disposable Tapered Prophy Angle Brush White Latex-Free 144/Bx 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1125182 Diamond Bur Friction Grip Medium 801-018M 5/Pk 9 11 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

1223320 Endozime Dual Enzymatic Detergent 1 Gallon Floral 4/Ca 1 3 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

3869214 Printer Refill Kit each 4 6 $_____.__ $_____.__ $_____.__ $_____.__ $_____.__

The Contractor's pricing/cost includes all mandatory Federal, State and Local taxes and delivery/shipping costs. It is the sole responsibility of the Contractor to collect and pay for all New Mexico State Gross Receipt Taxes for business/work performed in the State of New Mexico, regardless of county the business/service/work was performed. A firm fixed-price contract will be awarded for a base year, with four, one-year options for renewal. Total contract award shall not exceed one year unless options exercised. Option renewals will be on the basis of satisfactory services provided and contingent upon availability of funds for the appropriate fiscal year.

PERIOD OF PERFORMANCE

The items required under this contract shall commence NLT 10 days after award:

Start End Base TBD/2022 TBD/2023

Option Year 1 TBD/2023 TBD/2024

SF-1449 continued, page 7 of 18

Option Year 2 TBD/2024 TBD/2025 Option Year 3 TBD/2025 TBD/2026 Option Year 4 TBD/2026 TBD/2027

Performance shall be for the period of TBD/2022 to TBD/2023 unless the period is changed by written modification in accordance with FAR 52.217-9, Option to Extend the Term of the Contract.

Total contract award shall not exceed 5 years. Option year renewals will be based on services provided satisfactorily, availability of funds for the appropriate fiscal year, and on the basis of existing requirements.

EVALUATION CRITERIA

The quote shall be evaluated to determine the Offeror's ability to complete all requirements necessary for successful performance under the contract. The Government will award a Fixed-Price contract resulting from this solicitation to the responsible Offeror whose offer, conforming to this solicitation; will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

(1) Past Performance

a. Documentation must be provided of past performance required for the past 5 years for services similar in scope and type.

(2) Price

An award will be made on a best value basis; both price and other factors considered. Offeror's quote is found to be technically acceptable, based upon the evaluation criteria, and the Offeror is determined responsive and responsible in accordance with the terms and conditions of this solicitation.

RELATIVE IMPORTANCE OF EVALUATION CRITERIA

Factors 1-2, when combined, are significantly more important than price. The award will be made on a best-value basis;

both price and other factors considered. 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 has 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.

CONTRACT OFFICER REPRESENTATIVE (COR)

Deena Evans, (575) 464-3808, is hereby designated as Contract Officer’s Representative for this service. The Contract Officer Representative responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer’s Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer’s Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

QUESTIONS

In accordance with FAR 15.201 Exchanges with Industry before receipt of quotes, please refer to solicitation #(RFP19- 242-SOL-00016) when requesting information regarding the solicitation via e-mail to eric.wright@ihs.gov, facsimile: (505) 256-6848 or phone: (505) 256-6752. Any questions will need to be submitted at least 5 business days prior to the solicitation close date for a response.

SUBCONTRACTS:

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the Contracting Officer.

PAYMENT OFFICE

The payment office is: Electronic Funds Transfer (EFT) Disbursed by:

Albuquerque Indian Health Service U S Department of Treasury

SF-1449 continued, page 8 of 18

Division of Accounting Services Office of Disbursements 4101 Indian School Road NE, Suite 225 Austin, TX 73301 Albuquerque, NM 87110

INVOICE.

Invoices shall be submitted in accordance with the contract terms, i.e., payment schedule, progress payments, partial payments, deliverables, etc. All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice. Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

The Contractor shall submit proper invoices (excluding patient identifiers i.e. patient name, etc.) and all required back-up documentation to:

a. COR: Deena Evans, Deena.evans@ihs.gov

b. IPP: http://www.ipp.gov

Do not send non-invoice related documents (i.e. deliverables, reports, and balance statements) to the Buyer or Albuquerque Finance. Failure to submit required documents directly to the offices as listed above will delay prompt payment of your invoice.

FAR 52.212-4(G):

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors.

Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

http://www.ipp.gov/

SF-1449 continued, page 9 of 18

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

METHOD OF PAYMENT:

- Payment shall be made in arrears upon receipt of invoices in ARREARS;

- Electronic Funds Transfer (EFT) shall be utilized as method for processing payment;

- Upon receipt of a properly prepared Contractor invoice, the COR is responsible for certifying the invoice for acceptance of service and contacting a UFMS receiver to request a receiving receipt.

CONTRACTOR PERFORMANCE EVALUATION REPORT

During the life of this contract, the contractor’s performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. Evaluation will become part of the contract file and will be used as past performance information in evaluating the Contractor’s, and any significant subcontractors’ or affiliates, past performance on future contracts.

Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report.

After review by the Contracting Officer, the report becomes a permanent record of the Contractor’s past performance.

FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address: https://www.acquisition.gov/?q=/browse/far/52

FAR TITLE DATE

52.212-4 Contract Terms and Conditions—Commercial Items (OCT 2018) 52.246-4 Inspection of Services – Fixed-Price (AUG 1996)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021) The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v)) of this provision.

(a) Definitions. As used in this provision— "Covered telecommunications equipment or services" has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern 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 eligible under the WOSB Program.

Forced or indentured child labor means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

Immediate owner means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

Inverted domestic corporation, means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Manufactured end product means any end product in product and service codes (PSCs) 1000-9999, except—

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

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

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

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

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

(8) PSC 9610, Ores;

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

(10) PSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

Predecessor means an entity that is replaced by a successor and includes any predecessors of the predecessor.

Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate—

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

https://www.acquisition.gov/?q=/browse/far/52

SF-1449 continued, page 10 of 18

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended."Sensitive technology"— Sensitive technology—

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically—

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3)of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business concern—

(1) Means a small business concern—

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

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

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

Small business concern—

(1) Means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR part 121 and size standards in this solicitation.

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

Small disadvantaged business concern, consistent with13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that—

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—

(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Subsidiary means an entity in which more than 50 percent of the entity is owned—

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation Successor means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term "successor" does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.

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 (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127), means a small business concern 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.

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 least51 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.

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

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

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on SAM.]

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

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

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it □ is, □ is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, that it □ is, □ is not a small disadvantaged business concern as defined in 13 CFR124.1002.

(5) Women-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is, □ is not a women-owned small business concern.

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

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

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: __________.] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

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

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

SF-1449 continued, page 11 of 18

(ii) It □ is, □ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: __________.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

Note: Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it □ is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:____________________________________

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that–

(i) It □ is, □ is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR Part 126; and

(ii) It □ is, □ is not a HUBZone joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern…