Solicitation Medical Gas.pdf

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Attached to
Bulk Medical Oxygen and Nitrogen Federal contract opportunity
Solicitation number
W81K00-21-Q-0232
Issued by
Department of the Army Medical Command

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SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

0011670390

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

W81K0021Q0232 09-Aug-2021

7. FOR SOLICITATION a. NAME b. TELEPHONE NUMBER (No Collect Calls) 8. OFFER DUE DATE/LOCAL TIME

INFORMATION CALL: KIMBERLY R. MACIAS 210-221-4820 01:00 PM 20 Aug 2021

9. ISSUED BY CODE W81K00 10. THIS ACQUISITION IS UNRESTRICTED OR X SET ASIDE: 100 % FOR:

W40M USA HLTH CONTRACTING ACT

REGIONAL HEALTH CONTRACT OFF CENTRAL

POC: EMERITA TORRES

SMALL BUSINESS

HUBZONE SMALL

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

NAICS:

3551 ROGER BROOK DR BLDG 3600

FORT SAM HOUSTON TX 78234-6200

TEL: 210-221-5187

FAX:

11. DELIVERY FOR FOB DESTINA-

12. DISCOUNT TERMS

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

EDWOSB

8(A)

13b. RATING

325120

SIZE STANDARD:

1,000

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

15. DELIVER TO

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

CODE 16. ADMINISTERED BY

14. METHOD OF SOLICITATION

RFQ IFB RFP

CODE

17a.CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE

18a. PAY MENT WILL BE MADE BY CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

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

SUCH ADDRESS IN OFFER BELOW IS CHECKED SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

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

ADDENDA

ARE

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1 29. AWARD OF CONTRACT: REF.

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND OFFER DATED . Y OUR OFFER ON SOLICITATION

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER

(TYPE OR PRINT)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

TEL:

EMAIL:

(TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

X

X

X

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

CORRECT FOR

36. PAY MENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL FINAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAY MENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFY ING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

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

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 56 Each

STANDARD DELIVERY

FFP

STANDARD DELIVERY WEEKLY CHARGE OR PER DELIVERY

FOB: Destination

VENDOR PART NR:

PURCHASE REQUEST NUMBER: 0011670390

PSC CD: 6515

NET AMT

0002 80 Each

SURCHARGE VGL

FFP

ENERGY SURCHARGE FOR VGL /LIQUID O2/TANK

FOB: Destination

VENDOR PART NR:

0003 10 Each

CYLINDER VALVE

FFP

CYLINDER VALVE 3/4IN NEW

FOB: Destination

VENDOR PART NR:

PURCHASE REQUEST NUMBER:

0011670390 PSC CD: 6515

0004 3 Each

EMERGENCY DELIVERY

FFP

EMERGENCY DELIVERY - AS NEEDED

FOB: Destination

VENDOR PART NR:

HAZMAT

FFP

HAZARDOUS MATERIAL HANDLIING FEE - WEEKLY/PER DELIVERY

FOB: Destination

VENDOR PART NR:

HYDRO TEST

HYDROSTATIC TEST - AS NEEDED FOR TANK COMPLIANCE

FOB: Destination

VENDOR PART NR:

PURCHASE REQUEST NUMBER:0011670390

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE

0005 56 Each

0006 15 Each

REFILL AIR-E

MEDGAS, AIR, MEDICAL, "E" TANK REFILL USPS STANDARDS

FOB: Destination

VENDOR PART NR:

REFILL AIR-M60

MEDGAS, AIR, MEDICAL, 'M-60' TANK BABY TRANSPORTER USPS

STANDARD

FOB: Destination

NSN: REFILLAIR-M60

VENDOR PART NR:

0007 8 Each

0008 8 Each

REFILL CO2-E

CARBON DIOXIDE E-SIZE REFILL ONLY USPS STANDARD

FOB: Destination

VENDOR PART NR:

0010 80 Each

REFILL CO2-HSYPH

FFP

CO2 SIPHON TANK REFILL FOOD GRADE

FOB: Destination

NSN: REFILLCO2-HSY

VENDOR PART NR:

0009 36 Each

0011 20 Each

REFILL N2O-E

FFP

NITROUS OXIDE E-SIZE REFILL USPS STANDARD

FOB: Destination

VENDOR PART NR:

0012 10 Each

REFILL N2O-M

FFP

NITROUS OXIDE M-SIZE REFILL USPS STANDARD

FOB: Destination

VENDOR PART NR:

0013 5 Each

REFILL N-E

FFP

NITROGEN NF E-SIZE REFILL OIL-FREE

FOB: Destination

VENDOR PART NR:

0014 10 Each

REFILL N-H

FFP

NITROGEN NF H-SIZE REFILL OIL-FREE

FOB: Destination

VENDOR PART NR:

0015 14 Each

REFILL N-LQ

FFP

NITROGEN LIQUID NF (E-SIZE) REFILL 20.5L

FOB: Destination

VENDOR PART NR:

REFILL O2-D

MEDGAS, OXYGEN, 'D' TANK (SMALL,GREEN) USPS STANDARD, HIGH

PURITY >99.5%

FOB: Destination

VENDOR PART NR:

0016 475 Each

REFILL O2-E

MEDGAS, OXYGEN, 'E' TANK USPS STANDARD, HIGH PURITY >99.5%

FOB: Destination

VENDOR PART NR:

REFILL O2-H

MEDGAS, OXYGEN, 'H' TANK (TALL, GREEN) USPS STANDARD, HIGH

PURITY >99.5%

FOB: Destination

VENDOR PART NR:

0017 25 Each

0018 36 Each

0019 80 Each

REFILL O2-LIQ 160

FFP

MEDGAS, OXYGEN, LIQUID, 160L USPS STANDARD

FOB: Destination

NSN: REFILLO2-LIQ1

VENDOR PART NR:

REFILL O2-M60

MEDGAS, OXYGEN, 'M-60' TANK FOR BABY TRANSPORTER USPS

STANDARD, HIGH PURITY >99.5%

FOB: Destination

VENDOR PART NR:

0020 8 Each

RENTAL LIQ SM

RENTAL LIQUID CYLINDER 100-200LT MONTHLY CHARGE

FOB: Destination

VENDOR PART NR:

0022 294 Each

SURCHARGE N2O LIQ

FFP

FUEL SURCHARGE FOR LIQ NITROGEN/LITER

FOB: Destination

VENDOR PART NR:

0021 144 Each

0023 12 Each

ADMIN FEE

FFP

ADMIN FEE FOR COMPLIANCE - MONTHLY

FOB: Destination

VENDOR PART NR:

1001 56 Each

OPTION STANDARD DELIVERY

FFP

STANDARD DELIVERY WEEKLY CHARGE OR PER DELIVERY

FOB: Destination

VENDOR PART NR:

1002 80 Each

OPTION SURCHARGE VGL

FFP

ENERGY SURCHARGE FOR VGL /LIQUID O2/TANK

FOB: Destination

VENDOR PART NR:

1003 10 Each

OPTION CYLINDER VALVE

FFP

CYLINDER VALVE 3/4IN NEW

FOB: Destination

VENDOR PART NR:

1004 3 Each

OPTION EMERGENCY DELIVERY

FFP

EMERGENCY DELIVERY - AS NEEDED

FOB: Destination

VENDOR PART NR:

OPTION HAZMAT

HAZARDOUS MATERIAL HANDLIING FEE - WEEKLY/PER DELIVERY

FOB: Destination

VENDOR PART NR:

1005 56 Each

OPTION HYDRO TEST

HYDROSTATIC TEST - AS NEEDED FOR TANK COMPLIANCE

FOB: Destination

VENDOR PART NR:

OPTION REFILL AIR-E

MEDGAS, AIR, MEDICAL, "E" TANK REFILL USPS STANDARDS

FOB: Destination

VENDOR PART NR:

1006 15 Each

1007 8 Each

OPTION REFILL AIR-M60

MEDGAS, AIR, MEDICAL, 'M-60' TANK BABY TRANSPORTER USPS

STANDARD

FOB: Destination

NSN: REFILLAIR-M60

VENDOR PART NR:

OPTION REFILL CO2-E

CARBON DIOXIDE E-SIZE REFILL ONLY USPS STANDARD

FOB: Destination

VENDOR PART NR:

1008 8 Each

1009 36 Each

1010 80 Each

OPTION REFILL CO2-HSYPH

FFP

CO2 SIPHON TANK REFILL FOOD GRADE

FOB: Destination

NSN: REFILLCO2-HSY

VENDOR PART NR:

1011 20 Each

OPTION REFILL N2O-E

FFP

NITROUS OXIDE E-SIZE REFILL USPS STANDARD

FOB: Destination

VENDOR PART NR:

1012 10 Each

OPTION REFILL N2O-M

FFP

NITROUS OXIDE M-SIZE REFILL USPS STANDARD

FOB: Destination

VENDOR PART NR:

1013 5 Each

OPTION REFILL N-E

FFP

NITROGEN NF E-SIZE REFILL OIL-FREE

FOB: Destination

VENDOR PART NR:

1014 10 Each

OPTION REFILL N-H

FFP

NITROGEN NF H-SIZE REFILL OIL-FREE

FOB: Destination

VENDOR PART NR:

1015 14 Each

OPTION REFILL N-LQ

FFP

NITROGEN LIQUID NF (E-SIZE) REFILL 20.5L

FOB: Destination

VENDOR PART NR:

OPTION REFILL O2-D

MEDGAS, OXYGEN, 'D' TANK (SMALL,GREEN) USPS STANDARD, HIGH

PURITY >99.5%

FOB: Destination

VENDOR PART NR:

OPTION REFILL O2-E

MEDGAS, OXYGEN, 'E' TANK USPS STANDARD, HIGH PURITY >99.5%

FOB: Destination

VENDOR PART NR:

1016 475 Each

1017 25 Each

OPTION REFILL O2-H

MEDGAS, OXYGEN, 'H' TANK (TALL, GREEN) USPS STANDARD, HIGH

PURITY >99.5%

FOB: Destination

VENDOR PART NR:

1019 80 Each

OPTION REFILL O2-LIQ160

FFP

MEDGAS, OXYGEN, LIQUID, 160L USPS STANDARD

FOB: Destination

NSN: REFILLO2-LIQ1

VENDOR PART NR:

1018 36 Each

OPTION REFILL O2-M60

MEDGAS, OXYGEN, 'M-60' TANK FOR BABY TRANSPORTER USPS

STANDARD, HIGH PURITY >99.5%

FOB: Destination

VENDOR PART NR:

OPTION RENTAL LIQ SM

RENTAL LIQUID CYLINDER 100-200LT MONTHLY CHARGE

FOB: Destination

VENDOR PART NR:

1020 8 Each

1021 144 Each

1022 294 Each

OPTION SURCHARGE N2O LIQ

FFP

FUEL SURCHARGE FOR LIQ NITROGEN/LITER

FOB: Destination

VENDOR PART NR:

1023 12 Each

OPTION ADMIN FEE

FFP

ADMIN FEE FOR COMPLIANCE - MONTHLY

FOB: Destination

VENDOR PART NR:

2001 56 Each

OPTION STANDARD DELIVERY

FFP

STANDARD DELIVERY WEEKLY CHARGE OR PER DELIVERY

FOB: Destination

2002 80 Each

OPTION SURCHARGE VGL

FFP

ENERGY SURCHARGE FOR VGL /LIQUID O2/TANK

2003 10 Each

OPTION CYLINDER VALVE

FFP

CYLINDER VALVE 3/4IN NEW

2004 3 Each

OPTION EMERGENCY DELIVERY

FFP

EMERGENCY DELIVERY - AS NEEDED

HAZARDOUS MATERIAL HANDLIING FEE - WEEKLY/PER DELIVERY

2005 56 Each

HYDROSTATIC TEST - AS NEEDED FOR TANK COMPLIANCE

MEDGAS, AIR, MEDICAL, "E" TANK REFILL USPS STANDARDS

MEDGAS, AIR, MEDICAL, 'M-60' TANK BABY TRANSPORTER USPS

STANDARD

2006 15 Each

2007 8 Each

2008 8 Each

CARBON DIOXIDE E-SIZE REFILL ONLY USPS STANDARD

2010 80 Each

OPTION REFILL CO2-HSYPH

FFP

CO2 SIPHON TANK REFILL FOOD GRADE

2009 36 Each

2011 20 Each

OPTION REFILL N2O-E

FFP

NITROUS OXIDE E-SIZE REFILL USPS STANDARD

2012 10 Each

OPTION REFILL N2O-M

FFP

NITROUS OXIDE M-SIZE REFILL USPS STANDARD

2013 5 Each

OPTION REFILL N-E

FFP

NITROGEN NF E-SIZE REFILL OIL-FREE

2014 10 Each

OPTION REFILL N-H

FFP

NITROGEN NF H-SIZE REFILL OIL-FREE

2015 14 Each

OPTION REFILL N-LQ

FFP

NITROGEN LIQUID NF (E-SIZE) REFILL 20.5L

MEDGAS, OXYGEN, 'D' TANK (SMALL,GREEN) USPS STANDARD, HIGH

PURITY >99.5%

2016 475 Each

MEDGAS, OXYGEN, 'E' TANK USPS STANDARD, HIGH PURITY >99.5%

MEDGAS, OXYGEN, 'H' TANK (TALL, GREEN) USPS STANDARD, HIGH

PURITY >99.5%

2017 25 Each

2018 36 Each

2019 80 Each

OPTION REFILL O2-LIQ160

FFP

MEDGAS, OXYGEN, LIQUID, 160L USPS STANDARD

MEDGAS, OXYGEN, 'M-60' TANK FOR BABY TRANSPORTER USPS

STANDARD, HIGH PURITY >99.5%

RENTAL LIQUID CYLINDER 100-200LT MONTHLY CHARGE

2020 8 Each

2021 144 Each

2022 294 Each

OPTION SURCHARGE N2O LIQ

FFP

FUEL SURCHARGE FOR LIQ NITROGEN/LITER

2023 12 Each

OPTION ADMIN FEE

FFP

ADMIN FEE FOR COMPLIANCE - MONTHLY

3001 56 Each

OPTION STANDARD DELIVERY

FFP

STANDARD DELIVERY WEEKLY CHARGE OR PER DELIVERY

3002 80 Each

OPTION SURCHARGE VGL

FFP

ENERGY SURCHARGE FOR VGL /LIQUID O2/TANK

3003 10 Each

OPTION CYLINDER VALVE

FFP

CYLINDER VALVE 3/4IN NEW

3004 3 Each

OPTION EMERGENCY DELIVERY

FFP

EMERGENCY DELIVERY - AS NEEDED

HAZARDOUS MATERIAL HANDLIING FEE - WEEKLY/PER DELIVERY

3005 56 Each

HYDROSTATIC TEST - AS NEEDED FOR TANK COMPLIANCE

MEDGAS, AIR, MEDICAL, "E" TANK REFILL USPS STANDARDS

MEDGAS, AIR, MEDICAL, 'M-60' TANK BABY TRANSPORTER USPS

STANDARD

3006 15 Each

3007 8 Each

3008 8 Each

CARBON DIOXIDE E-SIZE REFILL ONLY USPS STANDARD

3010 80 Each

OPTION REFILL CO2-HSYPH

FFP

CO2 SIPHON TANK REFILL FOOD GRADE

3009 36 Each

3011 20 Each

OPTION REFILL N2O-E

FFP

NITROUS OXIDE E-SIZE REFILL USPS STANDARD

3012 10 Each

OPTION REFILL N2O-M

FFP

NITROUS OXIDE M-SIZE REFILL USPS STANDARD

3013 5 Each

OPTION REFILL N-E

FFP

NITROGEN NF E-SIZE REFILL OIL-FREE

3014 10 Each

OPTION REFILL N-H

FFP

NITROGEN NF H-SIZE REFILL OIL-FREE

3015 14 Each

OPTION REFILL N-LQ

FFP

NITROGEN LIQUID NF (E-SIZE) REFILL

MEDGAS, OXYGEN, 'D' TANK (SMALL,GREEN) USPS STANDARD, HIGH

PURITY >99.5%

MEDGAS, OXYGEN, 'E' TANK USPS STANDARD, HIGH PURITY >99.5%

3016 475 Each

3017 25 Each

MEDGAS, OXYGEN, 'H' TANK (TALL, GREEN) USPS STANDARD, HIGH

PURITY >99.5%

3019 80 Each

OPTION REFILL O2-LIQ160

FFP

MEDGAS, OXYGEN, LIQUID, 160L USPS STANDARD

MEDGAS, OXYGEN, 'M-60' TANK FOR BABY TRANSPORTER USPS

STANDARD, HIGH PURITY >99.5%

3018 36 Each

3020 8 Each

RENTAL LIQUID CYLINDER 100-200LT MONTHLY CHARGE

3022 294 Each

OPTION SURCHARGE N2O LIQ

FFP

FUEL SURCHARGE FOR LIQ NITROGEN/LITER

3021 144 Each

3023 12 Each

OPTION ADMIN FEE

FFP

ADMIN FEE FOR COMPLIANCE - MONTHLY

4001 56 Each

OPTION STANDARD DELIVERY

FFP

STANDARD DELIVERY WEEKLY CHARGE OR PER DELIVERY

4002 80 Each

OPTION SURCHARGE VGL

FFP

ENERGY SURCHARGE FOR VGL /LIQUID O2/TANK

4003 10 Each

OPTION CYLINDER VALVE

FFP

CYLINDER VALVE 3/4IN NEW

4004 3 Each

OPTION EMERGENCY DELIVERY

FFP

EMERGENCY DELIVERY - AS NEEDED

HAZARDOUS MATERIAL HANDLIING FEE - WEEKLY/PER DELIVERY

HYDROSTATIC TEST - AS NEEDED FOR TANK COMPLIANCE

MEDGAS, AIR, MEDICAL, "E" TANK REFILL USPS STANDARDS

4005 56 Each

4006 15 Each

4007 8 Each

MEDGAS, AIR, MEDICAL, 'M-60' TANK BABY TRANSPORTER USPS

STANDARD

CARBON DIOXIDE E-SIZE REFILL ONLY USPS STANDARD

4008 8 Each

4009 36 Each

4010 80 Each

OPTION REFILL CO2-HSYPH

FFP

CO2 SIPHON TANK REFILL FOOD GRADE

4011 20 Each

OPTION REFILL N2O-E

FFP

NITROUS OXIDE E-SIZE REFILL USPS STANDARD

4012 10 Each

OPTION REFILL N2O-M

FFP

NITROUS OXIDE M-SIZE REFILL USPS STANDARD

4013 5 Each

OPTION REFILL N-E

FFP

NITROGEN NF E-SIZE REFILL OIL-FREE

4014 10 Each

OPTION REFILL N-H

FFP

NITROGEN NF H-SIZE REFILL OIL-FREE

4015 14 Each

OPTION REFILL N-LQ

FFP

NITROGEN LIQUID NF (E-SIZE) REFILL 20.5L

MEDGAS, OXYGEN, 'D' TANK (SMALL,GREEN) USPS STANDARD, HIGH

PURITY >99.5%

MEDGAS, OXYGEN, 'E' TANK USPS STANDARD, HIGH PURITY >99.5%

4016 475 Each

4017 25 Each

MEDGAS, OXYGEN, 'H' TANK (TALL, GREEN) USPS STANDARD, HIGH

PURITY >99.5%

4019 80 Each

OPTION REFILL O2-LIQ160

FFP

MEDGAS, OXYGEN, LIQUID, 160L USPS STANDARD

4018 36 Each

MEDGAS, OXYGEN, 'M-60' TANK FOR BABY TRANSPORTER USPS

STANDARD, HIGH PURITY >99.5%

RENTAL LIQUID CYLINDER 100-200LT MONTHLY CHARGE

4022 294 Each

OPTION SURCHARGE N2O LIQ

FFP

FUEL SURCHARGE FOR LIQ NITROGEN/LITER

4020 8 Each

4021 144 Each

4023 12 Each

OPTION ADMIN FEE

FFP

ADMIN FEE FOR COMPLIANCE - MONTHLY

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 01-OCT-2021 TO

30-SEP-2022

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

0002 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0003 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0004 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0005 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0006 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0007 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0008 POP 01-OCT-2021 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

W801A5

0009 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0010 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0011 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0012 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0013 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0014 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0015 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0016 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0017 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0018 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0019 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0020 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0021 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0022 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

0023 POP 01-OCT-2021 TO

30-SEP-2022

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1001 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1002 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1003 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1004 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

1005 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1006 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1007 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1008 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1009 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1010 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1011 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1012 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1013 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1014 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1015 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1016 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1017 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1018 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1019 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1020 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1021 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

1022 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

1023 POP 01-OCT-2022 TO

30-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2001 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2002 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2003 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2004 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2005 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2006 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2007 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2008 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2009 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2010 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2011 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2012 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2013 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2014 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2015 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2016 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2017 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2018 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

2019 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2020 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2021 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2022 POP 01-OCT-2023 TO

30-SEP-2024

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

2023 POP 01-OCT-2023 TO

30-SEP-2024

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG

FORT IRWIN CA 92310

FOB: Destination

W801A5

3001 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

3002 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3003 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3004 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3005 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3006 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3007 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3008 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3009 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3010 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG

FORT IRWIN CA 92310

3011 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

3012 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3013 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3014 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 NORTH LOOP ROAD

FORT IRWIN, CA CA 92310

FOB: Destination

W801A5

3015 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

3016 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3017 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG

FORT IRWIN CA 92310

FOB: Destination

W801A5

3018 POP 01-OCT-2024 TO

30-SEP-2025

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

3019 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3020 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3021 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3022 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

3023 POP 01-OCT-2024 TO

30-SEP-2025

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4001 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4003 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4004 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4005 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4006 POP 01-OCT-2025 TO

30-SEP-2026

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG

FORT IRWIN CA 92310

FOB: Destination

W801A5

4007 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4008 POP 01-OCT-2025 TO

30-SEP-2026

N/A WEED ARMY COMMUNITY HOSPITAL

WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

W801A5

4009 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4010 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4011 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4012 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4013 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4014 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4015 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4016 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

4017 POP 01-OCT-2025 TO N/A WEED ARMY COMMUNITY HOSPITAL W801A5

30-SEP-2026 WEED ARMY COMMUNITY HOSPITAL

390 BLDG

FORT IRWIN CA 92310

FOB: Destination

4018 POP 01-OCT-2025 TO N/A WEED ARMY COMMUNITY HOSPITAL W801A5

30-SEP-2026 WEED ARMY COMMUNITY HOSPITAL

390 BLDG NORTH LOOP RD

FORT IRWIN CA 92310

FOB: Destination

4019 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4020 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4021 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4022 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

W801A5

4023 POP 01-OCT-2025 TO

30-SEP-2026

N/A (SAME AS PREVIOUS LOCATION)

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government

0003 Destination Government Destination Government

0004 Destination Government Destination Government

0005 Destination Government Destination Government

0006 Destination Government Destination Government

0007 Destination Government Destination Government

0008 Destination Government Destination Government

0009 Destination Government Destination Government

0010 Destination Government Destination Government

0011 Destination Government Destination Government

0012 Destination Government Destination Government

0013 Destination Government Destination Government

0014 Destination Government Destination Government

0015 Destination Government Destination Government

0016 Destination Government Destination Government 0017 Destination Government Destination Government

0018 Destination Government Destination Government

0019 Destination Government Destination Government

0020 Destination Government Destination Government

0021 Destination Government Destination Government

0022 Destination Government Destination Government

0023 Destination Government Destination Government

1001 Destination Government Destination Government

1002 Destination Government Destination Government

1003 Destination Government Destination Government

1004 Destination Government Destination Government

1005 Destination Government Destination Government

1006 Destination Government Destination Government

1007 Destination Government Destination Government

1008 Destination Government Destination Government

1009 Destination Government Destination Government

1010 Destination Government Destination Government

1011 Destination Government Destination Government

1012 Destination Government Destination Government

1013 Destination Government Destination Government

1014 Destination Government Destination Government

1015 Destination Government Destination Government

1016 Destination Government Destination Government

1017 Destination Government Destination Government

1018 Destination Government Destination Government

1019 Destination Government Destination Government

1020 Destination Government Destination Government

1021 Destination Government Destination Government

1022 Destination Government Destination Government

1023 Destination Government Destination Government

2001 Destination Government Destination Government

2002 Destination Government Destination Government

2003 Destination Government Destination Government

2004 Destination Government Destination Government

2005 Destination Government Destination Government

2006 Destination Government Destination Government

2007 Destination Government Destination Government

2008 Destination Government Destination Government

2009 Destination Government Destination Government

2010 Destination Government Destination Government

2011 Destination Government Destination Government

2012 Destination Government Destination Government

2013 Destination Government Destination Government

2014 Destination Government Destination Government

2015 Destination Government Destination Government

2016 Destination Government Destination Government

2017 Destination Government Destination Government

2018 Destination Government Destination Government

2019 Destination Government Destination Government

2020 Destination Government Destination Government

2021 Destination Government Destination Government

2022 Destination Government Destination Government

2023 Destination Government Destination Government

3001 Destination Government Destination Government

3002 Destination Government Destination Government

3003 Destination Government Destination Government 3004 Destination Government Destination Government

3005 Destination Government Destination Government

3006 Destination Government Destination Government

3007 Destination Government Destination Government

3008 Destination Government Destination Government

3009 Destination Government Destination Government

3010 Destination Government Destination Government

3011 Destination Government Destination Government

3012 Destination Government Destination Government

3013 Destination Government Destination Government

3014 Destination Government Destination Government

3015 Destination Government Destination Government

3016 Destination Government Destination Government

3017 Destination Government Destination Government

3018 Destination Government Destination Government

3019 Destination Government Destination Government

3020 Destination Government Destination Government

3021 Destination Government Destination Government

3022 Destination Government Destination Government

3023 Destination Government Destination Government

4001 Destination Government Destination Government

4002 Destination Government Destination Government

4003 Destination Government Destination Government

4004 Destination Government Destination Government

4005 Destination Government Destination Government

4006 Destination Government Destination Government

4007 Destination Government Destination Government

4008 Destination Government Destination Government

4009 Destination Government Destination Government

4010 Destination Government Destination Government

4011 Destination Government Destination Government

4012 Destination Government Destination Government

4013 Destination Government Destination Government

4014 Destination Government Destination Government

4015 Destination Government Destination Government

4016 Destination Government Destination Government

4017 Destination Government Destination Government

4018 Destination Government Destination Government

4019 Destination Government Destination Government

4020 Destination Government Destination Government

4021 Destination Government Destination Government

4022 Destination Government Destination Government 4023 Destination Government Destination Government

CLAUSES INCORPORATED BY REFERENCE

52.212-4 Contract Terms and Conditions--Commercial Items OCT 2018

52.212-4 ADDENDUM

The Government may make unilateral modifications considered administrative in nature. These include, but are not limited to, changes in the accounting and appropriation data, payment and issuing office addresses, and other corrections that have no effect on the terms and conditions of the contract.

(w) The non-FAR Part 12 discretionary FAR, DFARS clauses included herein are incorporated into this contract either by reference or in full text. If incorporated by reference, see clause 52.252-2 herein for locations where full text can be found.

52.204-23 Prohibition on Contracting for Hardware, Software, and

Services Developed or Provided by Kaspersky Lab and Other Covered Entities.

JUL 2018

52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

AUG 2020

52.222-50 Combating Trafficking in Persons OCT 2020

52.223-2 Affirmative Procurement of Biobased Products Under Service and Construction Contracts

SEP 2013

52.223-3 Hazardous Material Identification And Material Safety Data FEB 2021

52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011

52.223-18 Encouraging Contractor Policies To Ban Text Messaging While Driving

JUN 2020

52.225-13 Restrictions on Certain Foreign Purchases FEB 2021

52.232-18 Availability Of Funds APR 1984

52.232-33 Payment by Electronic Funds Transfer--System for Award Management

OCT 2018

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business Subcontractors

DEC 2013

52.233-3 Protest After Award AUG 1996

52.233-4 Applicable Law for Breach of Contract Claim OCT 2004

252.203-7000 Requirements Relating to Compensation of Former DoD Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013

252.204-7003 Control Of Government Personnel Work Product APR 1992

252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services

JAN 2021

252.225-7048 Export-Controlled Items JUN 2013

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

DEC 2018

252.232-7006 Wide Area WorkFlow Payment Instructions DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006

252.232-7017 Accelerating Payments to Small Business Subcontractors-- Prohibition on Fees and Consideration

APR 2020

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

CLAUSES INCORPORATED BY FULL TEXT

52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the

Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the

Contractor within 60 days before contract expires.

(End of clause)

52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within 30 days provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 60 months.

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (NOV 2020)

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

Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority.

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 the size standard in paragraph (d) of this clause. Such a concern is "not dominant in its field of operation" when it does not exercise a controlling or major influence on a national basis in a kind of business activity in which a number of business concerns are primarily engaged. In determining whether dominance exists, consideration shall be given to all appropriate factors, including volume of business, number of employees, financial resources, competitive status or position, ownership or control of materials, processes, patents, license agreements, facilities, sales territory, and nature of business activity.

(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.

(b) If the Contractor represented that it was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, upon occurrence of any of the following:

(1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract.

(2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract.

(3) For long-term contracts--

(i) Within 60 to 120 days prior to the end of the fifth year of the contract; and

(ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter.

(c) If the Contractor represented that it was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, when the Contracting Officer explicitly requires it for an order issued under a multiple-award contract.

(d) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North American Industry Classification System (NAICS) code(s) assigned to this contract. The small business size standard corresponding to this NAICS code(s) can be found at https://www.sba.gov/document/support--table-size-standards.

(e) The small business size standard for a Contractor providing a product which it does not manufacture itself, for a contract other than a construction or service contract, is 500 employees.

(f) Except as provided in paragraph (h) of this clause, the Contractor shall make the representation(s) required by paragraph (b) and (c) of this clause by validating or updating all its representations in the Representations and

Certifications section of the System for Award Management (SAM) and its other data in SAM, as necessary, to ensure that they reflect the Contractor's current status. The Contractor shall notify the contracting office in writing within the timeframes specified in paragraph (b) of this clause, or with its offer for an order (see paragraph (c) of this clause), that the data have been validated or updated, and provide the date of the validation or update.

(g) If the Contractor represented that it was other than a small business concern prior to award of this contract, the

Contractor may, but is not required to, take the actions required by paragraphs (f) or (h) of this clause.

(h) If the Contractor does not have representations and certifications in SAM, or does not have a representation in

SAM for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

(1) The Contractor represents that it [X] is, [ ] is not a small business concern under NAICS Code 325120 assigned to contract number TBD.

(2) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002.

(3) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not a women-owned small business concern.

(4) Women-owned small business (WOSB) concern eligible under the WOSB Program. [Complete only if the

Contractor represented itself as a women-owned small business concern in paragraph (h)(3) of this clause.] The Contractor 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 http://www.sba.gov/document/support--table-size-standards http://www.sba.gov/document/support--table-size-standards

(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(4)(i) of this clause is accurate for each WOSB concern eligible under the WOSB

Program participating in the joint venture.

[The Contractor 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.

(5) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the

Contractor represented itself as a women-owned small business concern eligible under the WOSB Program in (h)(4) of this clause.] The Contractor represents that--

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

(ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (h)(5)(i) of this clause is accurate for each EDWOSB concern participating in the joint venture. [The Contractor 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.

(6) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it [ ] is, [ ] is not a veteran-owned small business concern.

(7) [Complete only if the Contractor represented itself as a veteran-owned small business concern in paragraph

(h)(6) of this clause.] The Contractor represents that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern.

(8) [Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents 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 (h)(8)(i) of this clause is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The Contractor shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: .] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

[Contractor to sign and date and insert authorized signer's name and title.]

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(es): https://acquisition.gov

52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (NOV 2020)

(a) The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the date of the clause.

(b) The use in this solicitation or contract of any DoD FAR Supplement (48 CFR Chapter 2) clause with an authorized deviation is indicated by the addition of "(DEVIATION)" after the name of the regulation.

252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

DEC 2019

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

MAY 2016

252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION (MAR 2016)

(a) Definitions. As used in this clause-

Automatic identification device means a device, such as a reader or interrogator, used to retrieve data encoded on machine-readable media.

Concatenated unique item identifier means--

(1) For items that are serialized within the enterprise identifier, the linking together of the unique identifier data elements in order of the issuing agency code, enterprise identifier, and unique serial number within the enterprise identifier; or

(2) For items that are serialized within the original part, lot, or batch number, the linking together of the unique identifier data elements in order of the issuing agency code; enterprise identifier; original part, lot, or batch number;

and serial number within the original part, lot, or batch number.

Data Matrix means a two-dimensional matrix symbology, which is made up of square or, in some cases, round modules arranged within a perimeter finder pattern and uses the Error Checking and Correction 200

(ECC200) specification found within International Standards Organization (ISO)/International Electrotechnical

Commission (IEC) 16022.

Data qualifier means a specified character (or string of characters) that immediately precedes a data field that defines the general category or intended use of the data that follows.

DoD recognized unique identification equivalent means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at http://www.acq.osd.mil/dpap/pdi/uid/iuid_equivalents.html.

DoD item unique identification means a system of marking items delivered to DoD with unique item identifiers that have machine-readable data elements to distinguish an item from all other like and unlike items. For items that are serialized within the enterprise identifier, the unique item identifier shall include the data elements of the enterprise identifier and a unique serial number. For items that are serialized within the part, lot, or batch number within the enterprise identifier, the unique item identifier shall include the data elements of the enterprise identifier; the original part, lot, or batch number; and the serial number.

Enterprise means the entity (e.g., a manufacturer or vendor) responsible for assigning unique item identifiers to items.

Enterprise identifier means a code that is uniquely assigned to an enterprise by an issuing agency.

Government's unit acquisition cost means--

(1) For fixed-price type line, subline, or exhibit line items, the unit price identified in the contract at the time of delivery;

(2) For cost-type or undefinitized line, subline, or exhibit line items, the Contractor's estimated fully burdened unit cost to the Government at the time of delivery; and

(3) For items produced under a time-and-materials contract, the Contractor's estimated fully burdened unit cost to the Government at the time of delivery.

Issuing agency means an organization responsible for assigning a globally unique identifier to an enterprise, as indicated in the Register of Issuing Agency Codes for ISO/IEC 15459, located at http://www.aimglobal.org/?Reg_Authority15459.

Issuing agency code means a code that designates the registration (or controlling) authority for the enterprise identifier.

Item means a single hardware article or a single unit formed by a grouping of subassemblies, components, or constituent parts.

Lot or batch number means an identifying number assigned by the enterprise to a designated group of items, usually referred to as either a lot or a batch, all of which were manufactured under identical conditions.

Machine-readable means an automatic identification technology media, such as bar codes, contact memory buttons, radio frequency identification, or optical memory cards.

Original part number means a combination of numbers or letters assigned by the enterprise at item creation to a class of items with the same form, fit, function, and interface.

Parent item means the item assembly, intermediate component, or subassembly that has an embedded item with a unique item identifier or DoD recognized unique identification equivalent.

Serial number within the enterprise identifier means a combination of numbers, letters, or symbols assigned by the enterprise to an item that provides for the differentiation of that item from any other like and unlike item and is never used again within the enterprise.

Serial number within the part, lot, or batch number means a combination of numbers or letters assigned by the enterprise to an item that provides for the differentiation of that item from any other like item within a part, lot, or batch number assignment.

http://www.acq.osd.mil/dpap/pdi/uid/iuid_equivalents.html http://www.aimglobal.org/?Reg_Authority15459

Serialization within the enterprise identifier means each item produced is assigned a serial number that is unique among all the tangible items produced by the enterprise and is never used again. The enterprise is responsible for ensuring unique serialization within the enterprise identifier.

Serialization within the part, lot, or batch number…

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