Solicitation HT940624R0009.docx

PEFORMANCE WORK STATEMENT

Dry Ice Pellets and Bin Delivery Naval Medical Center Portsmouth, VA

Vendor to supply items (Dry Ice), in a packaged ready to use condition.

• Vendor to warrant that all supplied items are free of manufactures defects. Dry Ice shall be received in a clean ready to use condition. Vendor shall replace any unsatisfactory items at vendor’s expense.

• Vendor to deliver 2 bins each of 500 pounds of Dry ice pellet per bin.

• Vendor price shall be inclusive of all cost including shipping / handling and hazmat fees.

• Requested items shall be “Dropped Shipped” on a Weekly basis. Items shall be shipped so that they arrive on the 1st business day of each week. Delivery shall be made inside the NMCP Warehouse (Build-250). If needed the Government shall retain the right to request bi-weekly shipment of dry ice. Bi-weekly shipments if requested shall be arranged in such a manner to evenly space out shipments.

Additionally selected vendor must have the ability to provide next day emergency delivery of product. For bidding purposes only it should be expected that a change in delivery schedule will be required 2 times per contract period (year)

• Dry Ice shall be defined as 3/4” pellets or equivalent. The Government shall retain the sole right to determine equivalent. (supplied ice must have similar size characteristics of a ¾” pellet as NMCP has determined that this size ice provides the best properties for the Government needs due to such factors as melt rate, and ability to “pack” ice in various containers.

• All items (Dry Ice) to be shipped in an insulated container that is affixed with wheels or other device to allow movement with ease. This shipping container shall remain at Naval Medical Center Portsmouth while Dry ice is in use. (I.e. vendor is to provide NMCP with a no cost lease of movable ice containers). Containers shall be designed to maintain dry ice (maximum extent possible) for the 1 week period between deliveries.

• All items received are to be certified for use (where applicable) in US based hospitals.

Period of Performance:

Base Period: 1 April 2024 – 31 March 2025 Option Period 1: 1 April 2025 – 31 March 2026 Option Period 2: 1 April 2026 – 31 March 2027 Option Period 3: 1 April 2027 – 31 March 2028 Option Period 4: 1 April 2028 – 31 March 2029

INSTRUCTION TO OFFERORS

INSTRUCTIONS TO OFFERORS

**Addendum to FAR 52.212-1, Instructions to Offerors – Commercial Products and Commercial Services (Mar 2023)**

1. GENERAL INSTRUCTIONS AND NOTICES

This requirement is being solicited in accordance with FAR Part 12 and FAR Part 13.5. In addition to FAR 52.212-1, this section specifies the format and content that Offerors shall use in responding to this Request for Proposal (RFP). The intent is to ensure a certain degree of uniformity in the format in the response for evaluation purposes. The proposal should be legible and comprehensive enough to provide the rating standards for a sound evaluation by the Government. Information provided should be precise, factual, and complete. Legibility, clarity, completeness, and responsiveness are of the utmost importance. If the proposal does not provide, at a minimum, that which is required in this solicitation it may be determined to be substantially incomplete and not warrant any further consideration. The offer shall also be compliant with all requirements as stated in the Essential Characteristics.

The Offeror’s initial proposal should contain the Offeror’s best terms from a cost or price and technical standpoint.

All offer information is subject to verification by the Government. Falsification of any offer submission, documents, or statements may subject the Offeror to civil or criminal prosecution under Section 1001 of Title 18 of the United States Code.

The Offeror shall comply with FAR 52.204-7, System for Award Management (SAM). In complying with this clause, the Offeror shall ensure that all representations and certifications contained in this solicitation are completed and uploaded to its SAM record at http://www.sam.gov by the date specified for receipt of the proposal. If the Offeror does not have an active SAM record or has a record that does not include all representations and certifications required in this solicitation, they may be considered ineligible for award.

Any data previously submitted in response to another solicitation to DHA SEM-CD or another agency shall be assumed to be unavailable during this proposal evaluation and source selection process. The Government will not reimburse the Offeror for costs incurred as a result of preparation and submission of an offer in response to this solicitation.

SUBMISSION OF PROPOSALS: A proposal shall be submitted and received no later than 08 January 2024 by 1000 Eastern Time. The proposal shall be submitted electronically, via e-mail, to Mr. Joshua Grim, Contract Specialist at joshua.m.grim.civ@health.mil.

QUESTIONS: All questions shall be addressed in writing and submitted electronically to Mr. Joshua Grim, Contract Specialist at joshua.m.grim.civ@health.mil. Questions shall be submitted no later than 19 December 2023 by 1000 Eastern Time.

The Offeror’s proposal shall consist of four separate volumes. Each volume shall be separate and complete, so that the evaluation of each one may be accomplished independently and concurrently with evaluation of the others. Each Volume shall be an independent document, labeled accordingly. The volumes are:

Volume 1 – Past Performance Volume 2 – Price Volume 3 – Technical Documentation Volume 4 - Business

*No pricing information shall be included in Volume 1 – Past Performance, Volume 3 – Technical Documentation, or Volume 4 – Business.

Files shall not contain classified data. The use of hyperlinks in proposals is prohibited.

ELECTRONIC SUBMISSION: Proposals shall be electronically submitted to the POC above. Your submission shall include four (4) separate parts: (1) Past Performance, (2) Price (3) Technical Documentation and (4) Business. Volume 1 – Past Performance shall be submitted in MS Word 2000 or searchable PDF format. Volume 2 - Price shall be submitted in MS Excel 2000 or higher, but not greater than MS Excel 2007 format. Volume 3 – Technical Documentation may include items such as brochures or pictures. Volume 4 - Business may be submitted in MS Word 2000 or searchable PDF format. The firewall utilized by the Government contracting office does not authorize or accept zip files.

2. PROPOSAL FORMATTING & PACKAGING GUIDELINES

a. Format. The submission shall be clearly indexed and logically assembled. Each volume shall be clearly identified and shall begin at the top of a page. All pages of each volume shall be appropriately numbered and identified by the complete company name, date and solicitation number in the header and/or footer. The proposal shall be clear and legible. Attachments shall conform to the following guidelines:

- Type Font: 12-point, 10-pitch (Times New Roman)

- Spacing: Single-spacing between lines of text

- Margins: 1.0 inches on all sides

- Acronyms: Spell out all acronyms the first time when they are used. One page, following the proposal body, is allocated to spell out acronyms, abbreviations and symbols and will be excluded from the total page limits.

- Language: English

- Format: Microsoft Office Applications (i.e. MS Word, Excel) or Searchable PDF format

- Graphics & Tables: 10-point, 10-pitch (Time New Roman).

In addition, each paragraph should be separated by at least one blank line. A standard, Times New Roman, 12-point minimum font size applies. Tables and illustrations may use a reduced font size not less than 8-point and may be landscape.

b. File Packaging. None of the proposal files shall be compressed (zipped). Zipped files cannot be opened by the Contracting Office.

c. Page Limitations. Volume 3 – Technical is limited to 5 pages single sided. Pages shall be numbered consecutively throughout the document and not by sections. For Volume 3, pages exceeding the specified limit will be removed and not forwarded for evaluation. The page limitation does not include a title page, table of contents or Acronym/Abbreviations/Symbols page.

3. VOLUME CONTENT

a. Volume 1 – Past Performance

Offerors shall submit a Project Summary Sheet (PSS), Attachment 1, as part of Volume I. The PSS requires the offeror to identify contract/task orders that will be evaluated in accordance with the evaluation criteria identified herein. References cited shall be for work performed with the Federal Government and/or commercial customers that demonstrate recent and relevant past performance.

Volume I must contain a PSS, Attachment 1. If a PSS is not included, the offeror may not be considered for award. Ideally, the Government will receive not more than three (3) PPQs or CPARS reports that correspond to the contract/task orders identified on the PSS; however, the Government understands that offerors may ask customers to complete more than three (3) PPQs to ensure that three (3) are received by the response time. If the Government receives more than three (3) PPQs or the Offeror includes more than three PPQs or CPARS reports in its proposal, the Government will only consider the first three (3) contract/task orders identified on the PSS (considered the order of preference). The PSS is set-up to allow three (3) contract/task orders to be cited, but it can be edited by the offeror to identify more task orders. The PSS shall identify no more than one Point of Contact (POC) and if more than one POC is provided, only the first POC will be considered. The Government may contact the POCs listed on the PSS. POCs must be either Government personnel (civil service or military) or employees of private sector clients for whom you have provided services. Information provided by or for POCs who work directly for your company, or indirectly (i.e., in a prime/subcontractor or mentor/protégé relationship, etc.), will be determined not relevant.

If a task order is identified on the PSS and a corresponding PPQ or CPARS report is not received, the Government will not make an attempt to evaluate the task order; however, the Government may use information already in its possession to evaluate the task order. In this situation, because performance is limited to no more than three (3) relevant task orders, the Government will only consider the first three (3) task orders identified on the PSS. If a PPQ or CPARS report is received for a task order not identified on the PSS, it may not be further considered.

Recent is defined as within the last three (3) years. Contracts/Task Orders cited must be current or have ended not more than three (3) years prior to the closing date of the solicitation. If the contract performance ended more than three (3) years prior to the closing date of the solicitation it will be determined to not be recent and not evaluated further. Relevant is defined as work similar to complexity and magnitude of the work described in the Performance Work Statement related to this solicitation.

A Past Performance Questionnaire (PPQ), Attachment 2, shall be submitted for each contract/task order identified on the PSS, Attachment 1. Contracts/task orders cited shall be for the prime, i.e., subcontractor performance shall not be submitted. The offeror shall complete the sections noted as “to be completed by the Offeror” prior to sending the PPQ to Government agencies requesting past performance information on applicable contract/task orders. PPQs cannot be completed by current or previous teaming partners. PPQs may be submitted by the offeror as part of the Volume I submission or submitted directly to the Government by the POC identified on the PPQ. If the PPQ is received from the offeror, the PPQ must contain an electronic signature (either a verified electronic signature or a scanned copy of the original signature) from the POC that completed the PPQ. Contract Performance Assessment Reporting System (CPARS) reports may also be submitted in lieu of PPQs as long as they were completed no more than three years prior to the closing date of this solicitation. For the purposes of this solicitation, the completion date of the CPARS report will be the date the Assessing Official signs the report. If a completed PPQ or CPARS report does not contain enough information to make a relevancy determination, the past performance reference cited may be determined to be not relevant and not evaluated.

NOTE: It is the responsibility of the offeror to track and ensure the completion/submission of the PPQs by the proposal due date. The Government may not accept incomplete or late PPQs. If available, an electronic copy of the completed PPQ(s) shall be submitted with the Volume I submission (Do not refer Government personnel to a previous PPQ without enclosing a copy).

The Government may also consider information obtained through other sources. Past performance information will be utilized to determine the quality of the offeror’s past performance as it relates to the probability of success of the required effort.

If the offeror does not possess relevant past performance, the offeror shall submit a statement affirming that it does not possess relevant Past Performance.

b. Volume 2 – Price

Pricing shall be submitted in the Excel workbook provided with the solicitation (Attachment 3). Offerors shall enter pricing in the highlighted cells only. The offeror shall complete all pricing required in the electronic workbook.

The completed file shall be submitted in the proposal as Volume 2. Please note that any reformatting of the pricing workbook may cause the offeror's proposal to no longer be considered. The price quote shall remain valid for a minimum of 90 days from the date of submission.

c. Volume 3 – Technical Documentation. Quoters are encouraged to submit product manufacturer specifications, pictures, brochures, or and other pertinent technical information of the quoted items to facilitate the evaluation.

The Offeror’s proposal response shall demonstrate the Offeror's understanding of tasks to be performed, as well as the basic functional approach and methodology that will be utilized in accomplishing any resultant award.

The Government does not have a requirement for Offeror’s equipment to capture, store, and/or transmit DoD PII, PHI or CUI or connect to the MTF’s network at all. If Offeror’s equipment provides such capability the Offeror shall ensure the equipment is accredited in accordance with DoDI 8510.01, Risk Management Framework (RMF) for DoD IT and comply with annual Federal Information Security Modernization Act (FISMA) security control testing; or shall ensure the capability to capture, store, and/or transmit DoD PII, PHI or CUI is disabled when in use.

d. Volume 4 – Business. The Offeror’s Business Volume shall be a separate volume from the Past Performance and Price Volumes, and shall include the following:

1. Acknowledgement of all solicitation amendments (if applicable). An Acrobat PDF file shall be created to capture the signatures for submission. It is the offeror’s sole responsibility to periodically check the website for amendments and to ensure that all amendments issued prior to the closing date are acknowledged in accordance with instructions in Block 11 of the SF 30. If an offeror fails to acknowledge a material amendment, the offeror’s proposal will be determined incomplete and will result in rejection of the offeror’s entire proposal.

2. Offeror Representations and Certifications. The Offeror shall complete and submit only paragraph (b) of FAR 52.212-3 if annual representations and certifications has been completed electronically through the System for Award Management (SAM) at https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall compete and submit only paragraphs (c) through (u) of FAR 52.212-3. The Offeror shall also complete and return FAR 52.204-24, FAR 52.229-11, DFARS 252.204-7016 and DFARS 252.204-7017.

3. System for Award Management (SAM) Registration. The offeror must be registered in SAM, in accordance with FAR 52.204-7. The offeror shall verify its SAM record is current, accurate, complete, and applicable to this solicitation as of the date of the offer and is incorporated in the offer by reference.

EVALUATION CRITERIA

EVALUATION CRITERIA

**Addendum to FAR 52.212-2, Evaluation—Commercial Products and Commercial Services (Nov 2021)**

The Government will award one contract resulting from this solicitation to the offeror whose proposal, conforming to the solicitation, offers the best value to the Government, price and past performance considered. Past performance is more important than price. The Contracting Officer has broad discretion in determining which awardee shall receive a contract and reserves the right to pay a premium for past performance benefiting the Government.

1. Past Performance Evaluation Methodology. Past performance will be based on the PPQs or CPARS reports. Remaining offerors will be assigned an overall Performance Confidence Assessment (PCA), see below, which is based on an integrated assessment of the offeror’s relevant past performance. The resulting PCA represents an overall evaluation of offeror performance. Offerors without a record of relevant past performance or for whom information on past performance is so sparse that no meaningful confidence assessment rating can be reasonably assigned will not be evaluated favorably or unfavorably on past performance and, as a result, will receive a "Neutral Confidence" rating for the Past Performance factor.

*The Government reserves the right to use information from the PPQs and CPARS, as well as information obtained from other sources available to the Government, to include, but not limited to, Federal Awardee Performance and Integrity Information System (FAPIIS), or other databases; interviews with Program Managers, Contracting Officers, and commercial sources and/or non-Government sources.

Relevancy Assessment: An assessment of the past performance information will be made to determine if it is relevant. To be relevant, the contract/task order must be for Autotransfusion services and must be non-personal services and not inherently governmental or closely associated inherently governmental. Services performed by offeror personnel that supplement existing Government personnel and completed no more than three years prior to the closing date of this solicitation are considered relevant. Clinical (direct patient care), advisory and assistance, information technology, housekeeping or facility management services are not considered relevant. Examples of services considered not relevant include hands on, direct patient care services performed in a clinical setting. Task orders that are determined to be not relevant will not be further evaluated.

Performance Confidence Assessment (PCA): The Government will consider the performance quality of relevant efforts and assign an overall PCA. Offerors with experience providing Autotransfusion services in a higher number of FTEs may be rated more favorably. The confidence ratings noted in the table below will be used. For each relevant contract/task order reviewed, the performance quality of the work performed will be assessed using the PPQ, CPARS report and/or contact with the POC listed on the PPQ to obtain information regarding past performance as it relates to providing the services required under this solicitation, including but not limited to recruiting and retaining qualified contract employees. The Government is not restricted from evaluating and considering other relevant past performance information in its possession. Past performance information may be obtained from any other source available to the Government.

PERFORMANCE CONFIDENCE ASSESSMENTS

2. Price Evaluation Methodology. The factors to be considered in evaluating proposed prices will include:

A. Completeness. The Government will evaluate if Attachment 2 is complete, and all required pricing has been submitted. This includes all required pricing for the base period and all option periods. In the event that any of the pricing is incomplete, the Contracting Officer may exclude the offeror’s proposal from further evaluation.

B. Reasonableness. The degree to which the proposed prices (base period and option periods) compare to the prices a reasonably prudent person would expect to incur for the same or similar services.

An offeror with pricing that is determined to be questionable for reasonableness (for any period of performance) may not be further considered for award.

ATTACHMENTS

EXHIBIT/ATTACHMENT TABLE OF CONTENTS

Attachment 1 – Project Summary Sheet Project Summary Sheet Provide the following information for each past performance reference submitted in response to this solicitation. Offerors are allowed to edit this sheet to identify more than three (3) task orders by copying one of the blank tables included below.

PPQ #1:

Offeror Name:

Contract Number:

Task Order Number:

PPQ #2:

Offeror Name:

Contract Number:

Task Order Number:

PPQ #3:

Offeror Name:

Contract Number:

Task Order Number:

Attachment 2 – Past Performance Questionnaire Past Performance Questionnaire

The Defense Health Agency (DHA) Southeastern Contracting Division (SEM-CD) is conducting an acquisition for the services noted below. The offeror has identified you as a reference to validate past performance.

Solicitation HT940624R0009 is for supplies; delivery of Dry Pellets ¾” weekly at the Naval Medical Center Portsmouth located in Portsmouth, VA.

Please complete the following questionnaire to assist our evaluation of the offeror’s past performance and return via email no later than 10:00 am Eastern Time on Thursday, 08 January 2024 via email to joshua.m.grim.civ@health.mil. Please reference “Solicitation HT940624R0009” in the subject of the email.

RESPONDENT INFORMATION (to be completed by the Offeror):

Contracting Activity/Customer:

Point of Contact (POC):

Title of POC:

Telephone:

Email:

CONTRACT INFORMATION (to be completed by the Offeror):

Contract Number:

Task Order Number (if applicable):

Performance Period: (Base plus any options):

Description of Services (included position description(s)):

REQUIREMENT DESCRIPTION

Number of FTEs/description of required schedule:

Facility Type Services performed for (i.e., Hospital/Clinic):

All information from here down shall be completed by the Reference POC. The Reference POC shall also verify the information completed by the Offeror and make any necessary corrections before signing this form.

Please refer to the following assessment definitions to assess the Offeror’s performance in each of the areas listed in this questionnaire:

(E) Exceptional - The Offeror’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Offeror were highly effective.

(V) Very Good - The Offeror’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Offeror were effective.

(S) Satisfactory - The Offeror’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Offeror appear or were resolved satisfactorily.

(M) Marginal - Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the Offeror has not yet identified corrective actions or the Offeror’s proposed actions appear only marginally effective or were not fully implemented.

(U) Unsatisfactory - Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the Offeror’s corrective actions appear or were ineffective.

(N) Not Applicable – Unable to assess the area.

Overall Fill Rate (CPARS “Quality of Service” Rating Area)

Provided qualified contract personnel IAW the terms and conditions of the contract.

Ensured that qualified contract personnel remained filled IAW the terms and conditions of the contract.

Recruited, placed and retained qualified contract personnel with minimal disruption for hard-to-fill (specialty) positions or at remote locations.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

On-Time Fill Percentage (CPARS “Schedule” Rating Area)

Provided qualified contract personnel on time IAW the terms and conditions of the contract.

Provided complete, current and accurate qualifying package for each contract personnel IAW the terms and conditions of the contract.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Turnover Rate (CPARS “Management” Rating area)

Retained qualified contract personnel without frequent turnover and minimal operations disruption IAW the terms of the contract.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Replenishment Rate (CPARS “Management” Rating area)

Planned for and provided replacement candidates during the life of the contract to, include pre-planned/unplanned absences and extended leave of absence to avoid disruption of services and/or work schedule IAW the terms of the contract.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Would you award this firm another contract:

If you answered “No” provide an explanation:

Was the contract terminated for default or cause:

If you answered “Yes” provide an explanation:

Additional Comments:

Signature: _________________________________________ Date: __________________

Print Name: ________________________________________

Title: ______________________________________________

Telephone: _________________________________________

Thank you for your participation in providing a detailed and accurate history of past performance for this offeror.

Dry Ice 3/4" Pellets

FFP

Dry Ice 3/4" Pellets FOB: Destination

PURCHASE REQUEST NUMBER: 0012016418-0001

NET AMT

Dry ice bins

Dry ice bins FOB: Destination

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Delivery

Delivery FOB: Destination

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FFP

Dry Ice 3/4" Pellets FOB: Destination

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Dry ice bins

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Delivery

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Dry Ice 3/4" Pellets

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Dry ice bins

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Delivery

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FFP

Dry Ice 3/4" Pellets

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FFP

Dry ice bins

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Dry Ice 3/4" Pellets

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Dry ice bins

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INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

31-MAR-2025

NAV MED CNT PORTSMOUTH VA - MM

ATTN SUPPLY OFFICER BLDG 250

54 LEWIS MINOR STREET

PORTSMOUTH VA 23708-2297

HT0242

31-MAR-2025

HT0242

31-MAR-2025

HT0242

31-MAR-2026

HT0242

31-MAR-2026

HT0242

31-MAR-2026

HT0242

31-MAR-2027

HT0242

31-MAR-2027

HT0242

31-MAR-2027

HT0242

31-MAR-2028

HT0242

31-MAR-2028

HT0242

31-MAR-2028

HT0242

31-MAR-2029

HT0242

31-MAR-2029

HT0242

31-MAR-2029

HT0242

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (AUG 2020)

(a) Definitions. As used in this provision--

Commercial and Government Entity (CAGE) code means—

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity by unique location; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

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.

(b) The Offeror represents that it [ ___ ] has or [ ___ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture.

(c) If the Offeror indicates ``has'' in paragraph (b) of this provision, enter the following information:

Immediate owner CAGE code:

Immediate owner legal name: ___

(Do not use a ``doing business as'' name)

Is the immediate owner owned or controlled by another entity?:

[ ___ ] Yes or [ ___ ] No.

(d) If the Offeror indicates ``yes'' in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest-level owner CAGE code:

Highest-level owner legal name:

(Do not use a ``doing business as'' name)

(End of provision)

52.204-20 Predecessor of Offeror (AUG 2020)

(a) Definitions. As used in this provision--

Commercial and Government Entity (CAGE) code means--

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity by unique location; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

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

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.

(b) The Offeror represents that it [____] is or [____] is not a successor to a predecessor that held a Federal contract or grant within the last three years.

(c) If the Offeror has indicated “is” in paragraph (b) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order):

Predecessor CAGE code: ____ (or mark “Unknown”).

Predecessor legal name: ____.

(Do not use a “doing business as” name).

52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services--Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products and Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.

(a) Definitions. As used in this provision-

Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Prohibition.

(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to--

(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or

(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services."

(d) Representations. The Offeror represents that--

(1) It [ ___ ] will, [ ___ ] will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that--

It [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.

(e) Disclosures.

(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(ii) For covered services--

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.

(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:

(i) For covered equipment--

(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);

(B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and

(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

(ii) For covered services--

(A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or

(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES--REPRESENTATION (OCT

2020)

(a) Definitions. As used in this provision, “covered telecommunications equipment or services” and "reasonable inquiry" have the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

(b) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for “covered telecommunications equipment or services”.

(c) Representations.

(1) The Offeror represents that it [ ___ ] does, [ ___ ] does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument.

(2) After conducting a reasonable inquiry for purposes of this representation, the offeror represents that it [ ___ ] does, [ ___ ] does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services.

52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS--REPRESENTATION (NOV 2015)

(a) Definitions. Inverted domestic corporation and subsidiary have the meaning given in the clause of this contract entitled Prohibition on Contracting with Inverted Domestic Corporations (52.209-10).

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance with the procedures at 9.108-4.

(c) Representation. The Offeror represents that--

(1) It [ ___ ] is, [ ___ ] is not an inverted domestic corporation; and

(2) It [ ___ ] is, [ ___ ] is not a subsidiary of an inverted domestic corporation.

52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

(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…