Solicitation_N4215822QS022.pdf

SEE ADDENDUM

(No Collect Calls)

N4215822QS022 05-May-2022

b. TELEPHONE NUMBER

757-396-0442

8. OFFER DUE DATE/LOCAL TIME

04:30 PM 06 Jun 2022

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

N421589. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

HEIDI R. MILLER

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

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

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

N4215822RC20291

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

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

NORFOLK NAVAL SHIPYARD

ATTN: HEIDI MILLER

NNSY CONTRACTING

C400, BLDG 65, 2ND FLOOR

PORTSMOUTH VA 23709-1022

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS AX

13b. RATING

DO-A3

CODE15. DELIVER TO CODE N42158 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

NORFOLK NAVAL SHIPYARD

SEE TECHNICAL POC

FOR DELIVERY AND CONTACT INFORMATION

PORTSMOUTH VA 23709

TEL: TEL: WITHIN FAX:

FAX:

TEL: 757-396-0447

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

1,250

NAICS:

333996

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

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

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF73

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

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

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

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

N4215822QS022

Section SF 1449 - CONTINUATION SHEET

STATEMENT OF WORK

ROTATIONAL DEPLOYMENT MECHANISM (RDM) REPAIR KIT AND REFURBISHMENT

ITEMS THAT ARE STRUCK OUT IN THIS INDEX DO NOT APPLY TO THIS CONTRACT.

CATEGORY I FY-22 STANDARD ITEMS APPLICABLE TO THIS JOB ORDER WITHOUT FURTHER

REFERENCE.

ITEM NO. TITLE DATE

009-01 General Criteria; accomplish 01OCT2019

009-02 Environmental Compliance Report for Material Usage; accomplish 01OCT2019

009-03 Toxic and Hazardous Substance; control 01OCT2019

009-04 Quality Management System; provide 01OCT2019

009-05 Temporary Access; accomplish 01OCT2018

009-06 Maintaining Protection and Cleanliness from Non-Radioactive Operations;

accomplish

06MAR2020

009-07 Confined Space Entry, Certification, Fire Prevention and Housekeeping;

accomplish

01OCT2020

009-08 Shipboard Fire Protection and Fire Prevention; accomplish 01OCT2020

009-10 Asbestos – Containing Material (ACM); control 01OCT2020

009-18 Mine Warfare Ships Magnetic Material; control 30APR2018

009-19 Provisioning Technical Documentation (PTD); provide 01OCT2018

009-20 Government Property; control 01OCT2017

009-21 Alteration Verification, Logistics and Technical Data; provide 01OCT2018

009-23 Interferences; remove and install 01OCT2018

009-24

Authorization, Control, Isolation, Blanking, Tagging and Cleanliness;

accomplish

01OCT2019

009-34 Fire Protection of Unmanned Vessels at Contractor’s Facility; accomplish 01OCT2018

009-39 Technical Manual Contract Requirement (TMCR) for New Technical

Manuals for Commercial Equipment/Component; accomplish

01OCT2018

009-40 Contractor Crane, Multi-Purpose Machine and Material Handling

Equipment at a Naval Facility; provide

01OCT2019

009-60 Schedule and Associated Reports for Availabilities over 9 Weeks in

Duration; provide and manage

14JAN2020

009-61 Shipboard Use of Fluorocarbons; control 18JUL2014

009-67 Integrated Total Ship Testing; manage 30APR2018

009-69 Heavy Weather/Mooring Plan; provide 30APR2018

009-70 Confined Space Entry, Certification, Fire Protection, Fire Prevention and

Housekeeping for Unmanned Vessels; accomplish

01OCT2019

009-72 Physical Security at Private Contractor’s Facility; accomplish 01OCT2019

009-73 Shipboard Electrical/Electronic Cable Procedure; accomplish 01OCT2018

009-74 Occupational, Safety and Health Plan; accomplish 01OCT2020

009-79 Government Owned Material (GOM); Status for Multi-Ship Multi-Option availabilities; report

01OCT2018

009-80 Ship’s Facilities; maintain 18NOV2016

009-81 Compartment Closeout; accomplish 01OCT2019

009-82 Installation of Equal Component Vice Specified Component; report 26MAR2018

009-83 Wire Rope Assembly; fabricate 26MAR2018

009-84 Threaded Fastener Requirements; accomplish 06MAR2020

009-86 Recovery and Turn-In of Ozone Depleting Substance (ODS); accomplish 01OCT2017

009-87 Chemical Disinfection Procedures; accomplish 01OCT2017

009-88 Collection, Holding, and Transfer (CHT) and Motor Gasoline (MOGAS)

Tanks, Spaces, and Piping, including Sewage or MOGAS – Contaminated

Tanks, Spaces and Piping; certify

18NOV2016

009-90 Technical Representative; provide 24JUL2019

009-93 Emergency Planning and Community Right-to-Know Act (EPCRA) and

Pollution Prevention Act (PPA) Information; provide

06MAR2018

009-95 Mechanically Attached Fittings (MAF’s); install 01OCT2017

009-99 Ship Departure Report; provide 18JUL2014

009-100 Ship’s Stability; maintain 06MAR2018

009-101 Ship Transit and Berthing; accomplish 26MAR2018

009-103 Weight and Moment Change Data; provide 30APR2018

009-106 Work Authorization Form Coordinator (WAFCOR); provide 01OCT2017

009-109 Non-SUBSAFE Work on SUBSAFE-Certified Vessel; accomplish 01OCT2017

009-110 Non-Nuclear Work on a Nuclear Vessel; accomplish 18NOV2016

009-111 Scheduled and Associated Reports for Availabilities 9 Weeks or Less in

Duration; provide and manage

30APR2018

009-112 Prevention of Radiographic – Inspection Ionizing – Radiation Hazard;

accomplish

01OCT2018

009-117 Combat Systems Light-Off Support; provide 01OCT2019

009-118 CG Deck Loading; accomplish 18JUL2014

009-120 Fact Finding and Critique of Unplanned Events; manage 06MAR2018

009-121 Ship Assessment / Inspection; accomplish 18NOV2016

009-122 Temporary Padeye; install and remove 01OCT2018

009-123 Fiber Optic Component; remove, relocate, repair, and install 01OCT2018

1. SCOPE:

1.1. Title: Secondary Propulsion Unit – Rotational Deployment Mechanism (RDM)

1.2. Location of Work:

1.2.1. Contractor’s Facility

1.3. Identification:

1.3.1. Quantity: (One EA), Rotational Deployment Mechanism (RDM) (including the Training Motor and

Rotary Joint), Model P/5-4025-A1

2. REFERENCES:

2.1. Standard Items, (FY-22)

2.2. S9238-AF-MMA-010, Secondary Propulsion System Model P/5-4025-A1

2.3. 4D98024 – Rev. 10, Rotational Deployment Mechanism (RDM) Final Assembly

2.4. 8576C80 – Rev. 19, LVDT Position Indicator Assembly

2.5. 8575C88 – Rev. 2, Indicator Thread Rod

2.6. 4D98026 – Rev. 6, Hydraulic Motor & Int Worm with External Hydraulic Connections

2.7. 4D96606G01, RAD DEPLOY- BRG SHK MOUNT

2.8. 8575C35H02, INNER SLEEVE MACH. & COAT

2.9. 8576C08H02, INNER GUIDE SLEEVE MACH

2.10. 4541B03H02, ANTI-ROTATION PIN

2.11. 908A636H11, LOCTITE 85

2.12. 8577C07G01, GEAR SHOCK MOUNT MLD ASSY

2.13. 4D96344G01, AXIAL DEPLOY SHOCK MOUNT

2.14. 9393C51G01, POSITION INDICATOR LVDT

2.15. 4541B17H02, GRIP WASHER

2.16. 8575C32H01, THRUST BEARING RING

2.17. 4540B93H02, SLIP WASHER

2.18. 8576C58H01, SPHERICAL INSERT

2.19. P04902300, CAP SCREW

2.20. P04901000, COATED SLEEVE

2.21. 8576C08H01, INNER GUIDE SLEEVE

2.22. P05837500, PLAIN BEARING

2.23. P04901500, SETSCREW ASSY

2.24. P06555500, SPL DRIVE FLANGE

2.25. P06555600, DRIVING RING ROUGH MACHINING / DRIVING RING

2.26. P04903000, SETSCREW ASSY

2.27. P04900600, SEAL SUPPORT RING

2.28. U80071214, ROTARY VARISEAL

2.29. P04900700, SEALING SPACER

2.30. 4542B20H02, CAP SCREW 1.0-8 X 2.25LG

2.31. 4541B37H06, .375-16X2.00 LG. SLFLKG CAPSCREW

2.32. P05023000S01, THRUST COLLAR MATERIAL

2.33. 4542B34H01, CABLE CLAMP

2.34. 4542B11H01, HEX NUT - SLFLKG - .75-10

2.35. P05023100, RETAINING RING

2.36. 4D98024H57, PARKER PLUG 8P5N-M

2.37. 4541B08H04, BOLT -.375-16X1.38 SLFLKG

2.38. 4541B08H02, BOLT -.375-16X1.00 SLFLKG

2.39. 8576C45H02, OUTBOARD BRG SPACER CSTG

2.40. 8575C88H02, INDICATOR THREAD ROD

2.41. 4541B77H01, HEX NUT

2.42. 4542B10H03, CAP SCREW - SLFLKG SOC HD

2.43. P04901600, PLAIN WASHER

2.44. 4541B09H02, INDICATOR KEY MACHINING

2.45. U80140403, DOWEL PIN

2.46. P05036800, SHIM SET

2.47. U80163203, BACKUP RING

2.48. 4541B04H01, INDICATOR NUT

2.49. P04902800, DOWEL PIN

2.50. P04901400, SPRING ABUTMENT

2.51. P06556400, SHIM

2.52. U80163105, O-RING

2.53. 8575C87H02, INDICATOR THREAD BODY

2.54. 4538B51H02, PIN- THR SLV RAD DEPL BRG

2.55. U80163101, O-RING

2.56. 8577C32H01, RDM MOTOR SHIM MATERIAL

2.57. U80163204, BACKUP RING

2.58. 4540B72H02, ANTI-ROTATION PIN

2.59. U80134401, DOWEL PIN

2.60. U80035401, NEEDLE ROLLER BEARING

2.61. 4597B60H01, THRUST WASHER

2.62. 4397B60H01, THRUST WASHER

2.63. U80163100, O-RING

2.64. U80163102, O-RING

2.65. 8577C12H01, CABLE CLAMP STOPPER

2.66. 9392C39H01, STEEL BAR 1.0+.1 X4LG

2.67. U80163104, O-RING

2.68. U80163103, O-RING

2.69. U80163106, O-RING

2.70. 4541B05H02, LOCK PIN

2.71. U80045704, EXCLUDER

2.72. U80163201, BACKUP RING

2.73. U80163202, BACKUP RING

2.74. 4397B61H03, SLF LOCK BOLT -.50-13X1.5

2.75. U80163205, BACKUP RING

2.76. U80200902, SEAL

2.77. 4541B75H01, HEX NUT

2.78. U80034600, NEEDLE ROLLER BEARING

2.79. U80029511, BALLBEARING

2.80. U80200903, SEAL

2.81. U80163200, BACKUP RING

2.82. U80163206, BACKUP RING

2.83. 4542B13H01, GEAR HOUSING LIP SEAL

2.84. U80181400, O-RING

2.85. 4542B10H05, CAP SCREW - SLFLKG SOC HD

2.86. U80166500, SLOTTED SCREW

2.87. U80035411, NEEDLE BEARING WASHER

2.88. 8575C12H06, BACK-UP RING

2.89. U80056003, 3/8 SPHERICAL BALL

2.90. U80067400, CIRCLIP

2.91. U80051333, SPRING

2.92. U80067308, INTERNAL CIRCLIP

2.93. U80162100, EXTERNAL CIRCLIP

2.94. U80056002, SPHERICAL BALL

2.95. 8575C12H04, BACK-UP RING

2.96. 8575C12H05, BACK-UP RING

2.97. U80035412, WASHER

2.98. U80067310, INTERNAL CIRCLIP

2.99. 4542B12H01, INDICATOR LIP SEAL

2.100. 4397B26H06, O-RING - 3.100" I.D.

2.101. 922A676H02, LUBRICANT FEL-PRO C5-A

2.102. U80067309, INTERNAL CIRCLIP

2.103. 4397B26H04, O-RING - .984" I.D.

2.104. 4397B26H05, O-RING-1.484" I.D.

2.105. P05026400, WORM SHAFT SLEEVE

2.106. 9394C43H01, RDM REFURB NAME PLATE

2.107. 4542B10H01, SELFLOCK SCREW

2.108. 4D96754G01, DOOR AXLE SHOCK MOUNT

2.109. 8575C89G01, SHIPSIDE BREECHLOCK SHOCK MOUNT

2.110. 8577C33G01, DOORSIDE BREECHLOCK SHOCK MOUNT

2.111. 4541B76H01, STUD

2.112. 8579C96H02, ANTI-ROTATION PIN

2.113. NAVSEA S9505-AM-GYD-010 – Rev. 9, Submarine Fastening Criteria (Nonnuclear)

3. REQUIREMENTS:

3.1. The contractor shall provide a bill of materials required for the refurbishment of the equipment listed in paragraph 1.3.1. Utilize references 2.1 through 2.6 for development of bill of materials.

3.2. The contractor shall provide acquisition and inspection services for the material identified in paragraph 3.1 to be used in the refurbishment of the RDM.

3.2.1. Material shall meet the requirements of references identified in paragraph 2, any discrepancies shall be reported to Norfolk Naval Shipyard with vendor recommendations, associated technical details, and the necessary supporting Objective Quality Evidence.

3.3. The contractor shall accomplish the requirements of 009-90 and 2.1, for the disassembly, inspection, and repair of the equipment listed in 1.3.1, in the location listed in 1.2.1. Utilize material identified in paragraph

3.1.

3.3.1. The contractor shall provide an electronic copy of the RDM refurbishment repair procedure and execution schedule for all contractor assigned work to the Project Team no later than 30 days prior to commencement of work.

3.3.2. The contractor shall provide to the Project Team documentation that all received material identified in

3.1. for contractor assigned work has been inspected by the contractor, and is in ready for installation

(RFI) condition no later than 30 days prior to the commencement of work.

3.3.2.1. The contractor shall provide weekly updates for Expected Delivery Dates for all material that will be received in parallel with execution of assigned work. Updates shall meet the reporting requirements of

009-01 paragraph 3.4. The contractor shall provide documentation that all material has been inspected by the contractor, and is in ready for installation (RFI) condition within 48 hours of inspection completion.

3.3.3. The contractor shall submit one legible copy, in electronic media, of a report listing the results of 3.3.

through 3.3.2.1. to the Project Team.

3.3.4. The contractor shall source or fund any additional replacement material and labor as required to correct damaged caused to the equipment identified in paragraph 1.3.1., resulting from improper workmanship.

3.3.5. The contractor shall provide the services of an Original Equipment Manufacturer (OEM) or authorized

OEM repair facility capable of providing technical engineering and troubleshooting services to disassemble, clean free of corrosion, and inspect, the equipment listed in 1.3.1, in accordance with the requirements of 2.2, and 2.3. Record the inspection results. Any deviation in parts noted during inspection from the original drawings or repair procedures shall be immediately reported to the project team.

3.3.5.1. The contractor shall provide weekly status reports on the progress of the work to the Project Team in accordance with 009-60.

3.3.5.2. The contractor shall submit one legible copy, in electronic media, of a report listing the results of 3.3.5., to the Project Team within 48 hours of inspection completion.

3.4. The contractor shall remove existing components procured in paragraph 3.1. to facilitate refurbishment of the Rotational Deployment Mechanism. Install new components procured in 3.1. Work in accordance with the requirements of 2.2, 2.3.

3.4.1. The contractor shall upgrade the motor drive ring as necessary to correct for damage or slot misalignment.

3.4.2. The contractor shall provide engineering support as necessary to analyze mechanical issues experienced by the RDM, determined root cause(s), and identify corrective actions to resolve issues. Contractor shall include a description of these issues and corrective actions in the final report identified in paragraph 3.6.

3.5. The contractor shall test the RDM including the Training Motor and Rotary Joint using Submarine

Maintenance Standard (SMS) 2380-081-029, Rev. B as a guide.

3.6. The contractor shall provide a final report on refurbishment of the RDM as required within (30) calendar days after shipping of the RDM.

3.7. The contractor shall ship the RDM asset and any excess materials to NNSY as soon as refurbishment, modifications, and testing has been accomplished. If contractor has completed the repairs sooner than the

POP end date, the contractor is to prepare and ship the item before the end date. Shipment of RDM shall meet the requirements of paragraph 6 of this contract.

3.7.1. The contractor is to ship out the RDM in operable condition in the same manner as received by NNSY.

The contractor is to ensure the condition of the received packaging will still protect the asset in shipment in the same manner as received by NNSY.

4. GOVERNMENT RESPONSIBILITIES:

4.1. NNSY as the Lead Maintenance Authority will provide final evaluation and disposition (approval or disapproval) of identified non-conformances.

4.1.1. NNSY will provide engineering services as the Lead Technical Authority for this availability which includes, but is not limited to; review of Departures From Specification (DFS), Liaison Action Request

(LAR) with VIRGINIA Class Planning Yard (VAPY), communications with NAVSEA Technical

Authority (NAVSEA 05), communication with Naval Reactors Representative Office (NRRO, NAVSEA

08), and communications with Reactor Plant Planning Yard (RPPY).

5. GOVERNMENT FURNISHED MATERIAL (GFM):

5.1. (One EA), Rotational Deployment Mechanism (RDM) (including the Training Motor and Rotary Joint), Model P/5-4025-A1

5.2. Push Material:

5.2.1. None

5.3. Kitted Material:

5.3.1. None

6. PERIOD OF PERFORMANCE:

6.1. The Required Delivery Date for the Repair Kit Material is 19 APR 2023. The Period of Performance (POP) for the Refurbishment is 20 APR 2023 through 27 SEP 2023.

6.2. NNSY shall ship the removed RDM to the contractor facility no later than RM00. Estimated RM00 date is

20 APR 2023.

6.3. The contractor shall ship the refurbished and tested RDM back to NNSY no later than 6 months prior to

UD48. Estimated UD48 date is 27 MAR 2024.

6.4. Final schedule shall be determined at the time of award but shall adhere to all delivery guidelines identified in paragraphs 6.1 through 6.3.

7. AUTHORIZATION OF ADDITIONAL WORK

7.1. Any additional work outside the scope of this contract/purchase order shall have written authorization from the Contracting Officer prior to executing any additional work. Any work performed without the written authorization of the Contracting Officer shall be considered “At-Risk” and the Government will have no legal obligation to pay for the work performed. Pursuant to 13.004(b), once you have initiated performance of the work, this shall constitute your acceptance of the contract/purchase order.

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Kit RDM Repair Kit

FFP

Rotational Deployment Mechanism Repair Kit

FOB: Destination

MILSTRIP: N4215822RC20291

PURCHASE REQUEST NUMBER: N4215822RC20291

PSC CD: 2010

NET AMT

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0002 1 Job RDM Refurbishment

FFP

RDM Refurbishment services in accordance with the SOW performance requirements. This includes shipping of RDM back to NNSY.

FOB: Destination

MILSTRIP: N4215822RC20291

PURCHASE REQUEST NUMBER: N4215822RC20291

PSC CD: J020

NET AMT

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

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 19-APR-2023 1 NORFOLK NAVAL SHIPYARD

SEE TECHNICAL POC

FOR DELIVERY AND CONTACT

INFORMATION

PORTSMOUTH VA 23709

TEL: WITHIN

FOB: Destination

N42158

0002 POP 20-APR-2023 TO

27-SEP-2023

N/A (SAME AS PREVIOUS LOCATION)

FOB: Destination

N42158

CLAUSES INCORPORATED BY REFERENCE

52.202-1 Definitions JUN 2020

52.203-3 Gratuities APR 1984

52.203-12 Limitation On Payments To Influence Certain Federal

Transactions

JUN 2020

52.203-17 Contractor Employee Whistleblower Rights and Requirement

To Inform Employees of Whistleblower Rights

JUN 2020

52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber

Content Paper

MAY 2011

52.204-7 System for Award Management OCT 2018

52.204-13 System for Award Management Maintenance OCT 2018

52.204-16 Commercial and Government Entity Code Reporting AUG 2020

52.204-18 Commercial and Government Entity Code Maintenance AUG 2020

52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.211-17 Delivery of Excess Quantities SEP 1989

52.212-1 Instructions to Offerors--Commercial Products and

Commercial Services

DEC 2021

52.212-2 Evaluation - Commercial Items DEC 2021

52.212-4 Contract Terms and Conditions--Commercial Products and

Commercial Services

DEC 2021

52.222-41 Service Contract Labor Standards AUG 2018

52.223-6 Drug-Free Workplace MAY 2001

52.232-39 Unenforceability of Unauthorized Obligations JUN 2013

52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2021

52.242-13 Bankruptcy JUL 1995

52.243-1 Changes--Fixed Price AUG 1987

52.245-1 Government Property SEP 2021

52.245-9 Use And Charges APR 2012

52.247-34 F.O.B. Destination NOV 1991

252.201-7000 Contracting Officer's Representative DEC 1991

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

252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

DEC 2019

252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

252.204-7018 Prohibition on the Acquisition of Covered Defense

Telecommunications Equipment or Services

JAN 2021

252.209-7004 Subcontracting With Firms That Are Owned or Controlled By

The Government of a Country that is a State Sponsor of

Terrorism

MAY 2019

252.211-7003 Item Unique Identification and Valuation MAR 2016

252.211-7007 Reporting of Government-Furnished Property AUG 2012

252.215-7013 Supplies and Services Provided by Nontraditional Defense

Contractors.

JAN 2018

252.219-7003 Small Business Subcontracting Plan (DOD Contracts) DEC 2019

252.223-7008 Prohibition of Hexavalent Chromium JUN 2013

252.225-7001 Buy American And Balance Of Payments Program-- Basic DEC 2017

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2017

252.225-7048 Export-Controlled Items JUN 2013

252.225-7972 (Dev) Prohibition on the Procurement of Foreign-Made Unmanned

Aircraft Systems (DEVIATION 2020-O0015)

MAY 2020

252.226-7001 Utilization of Indian Organizations and Indian-Owned

Economic Enterprises, and Native Hawaiian Small Business

Concerns

APR 2019

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

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

252.237-7010 Prohibition on Interrogation of Detainees by Contractor

Personnel

JUN 2013

252.243-7001 Pricing Of Contract Modifications DEC 1991

252.243-7002 Requests for Equitable Adjustment DEC 2012

252.244-7000 Subcontracts for Commercial Items JAN 2021

252.245-7001 Tagging, Labeling, and Marking of Government-Furnished

Property

APR 2012

252.245-7002 Reporting Loss of Government Property JAN 2021

252.245-7003 Contractor Property Management System Administration APR 2012

252.245-7004 Reporting, Reutilization, and Disposal DEC 2017

252.246-7003 Notification of Potential Safety Issues JUN 2013

252.247-7023 Transportation of Supplies by Sea FEB 2019

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)

52.204-24 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.

52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

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

Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian

Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a

Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

Federal contracts and grants with total value greater than $10,000,000 means--

(1) The total value of all current, active contracts and grants, including all priced options; and

(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).

Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The offeror ( ) has ( ) does not have current active Federal contracts and grants with total value greater than

$10,000,000.

(c) If the offeror checked “has” in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the

Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(iii) In an administrative proceeding, a finding of fault and liability that results in--

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management, which can be accessed via https://www.sam.gov (see 52.204-7).

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (NOV 2021) ALTERNATE I (OCT 2014)

https://www.sam.gov/

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

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

"Covered telecommunications equipment or services" has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

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

"Forced or indentured child labor" means all work or service—

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

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

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

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

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

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

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

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

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

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

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

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

(8) PSC 9610, Ores;

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

(10) PSC 9630, Additive Metal Materials.

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

"Reasonable inquiry" has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain

Telecommunications and Video Surveillance Services or Equipment.

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

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

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

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

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

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

(6) Have been voluntarily suspended.

"Sensitive technology"—

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

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

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

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

(50 U.S.C. 1702(b)(3)).

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

(1) Means a small business concern—

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

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

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

"Small business concern"—

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

CFR part 121 and size standards in this solicitation.

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

"Small disadvantaged business concern, consistent with 13 CFR 124.1002," means a small business concern under the size standard applicable to the acquisition, that--

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

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

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

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

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

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

"Veteran-owned small business concern" means a small business concern—

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

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

"Women-owned business concern" means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

"Women-owned small business concern" means a small business concern --

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

51 percent of the stock of which is owned by one or more women; and

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

"Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127)," means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the

United States.

(b)

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

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and

Certifications--Commercial Products and Commercial Services, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs __.

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

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

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

(c) Offerors must complete the following representations when the resulting contract is to be performed in the

United States or its outlying areas. Check all that apply.

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

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

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

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.]The offeror represents that it [ ___ ] is, [ ___ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002.

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

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

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

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

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB

Program participating in the joint venture.