SOLICITATION W81K0023Q0097 5.23.2023.pdf

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Bulk Medical Oxygen Federal contract opportunity
Solicitation number
W81K0023Q0097
Issued by
Department of the Army Medical Command

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AMENDMENT 0001 SOLICITATION W81K0023Q0097 6.8.2023.pdf PDF

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SEE ADDENDUM

(No Collect Calls)

W81K0023Q0097 23-May-2023

b. TELEPHONE NUMBER

254-287-8900

8. OFFER DUE DATE/LOCAL TIME

11:00 AM 12 Jun 2023

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 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.

W81K009. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

SHENECQA N. SOARES

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

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

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

0011922739

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 OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

W40M USA HCA

MEDICAL READINESS CONTR OFFICE WEST

3160 MCINDOE BLDG 1103

JBSA FT SAM HOUSTON TX 78234-4504

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE HT0858 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

TEL: 254-287-1110 FAX:

FAX:

TEL: 210-221-1110 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

1,000

NAICS:

325120

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 OF93

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.

W81K0023Q0097

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

FY24 BULK MEDICAL OXYGEN

FFP

(INFORMATION CLIN ONLY) PERIOD OF PERFORMANCE: 1 OCT 2023

THRU 30 SEP 2024. VENDOR WILL PROVIDE MEDICAL-GRADE LIQUID

BULK OXYGEN FOR CARL R. DARNALL ARMY MEDICAL CENTER,

FORT CAVAZOS, TEXAS AND PROVIDE RENTAL OF BULK LIQUID

OXYGEN STORAGE TANKS AND ASSOCIATED EQUIPMENT. PLEASE

SEE ALL CLINS LINES AND SPECIALS TERMS AND CONDITIONS FOR

THE DETAILS OF THE REQUIREMENT. PLEASE SEE 52.212-1

ADDENDUM, INSTRUCTIONS TO OFFERORS AND 52.212-1 ADDENDUM,

EVALUATIONS.

MFR PART NR: OXYGEN

NET AMT

0001AA 15,833 Each

BULK MEDICAL OXYGEN REFILL

FFP

CONTRACTOR SHALL PROVIDE MEDICAL GRADE LIQUID OXYGEN

TWICE A MONTH, AND ON AN AS NEEDED BASIS, TO THE

GOVERNMENT IN ACCORDANCE WITH THE ATTACHED SPECIAL

TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

PURCHASE REQUEST NUMBER: 0011922739

PSC CD: 6835

0001AB 12 Months

STORAGE TANK RENTAL

FFP

CONTRACTOR SHALL PROVIDE ONE (1) THREE THOUSAND (3,000)

GALLON MEDICAL GRADE LIQUID OXYGEN BULK STORAGE TANK

AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE SIZE LIQUID

OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E., VAPORIZER

AND CONTROL EQUIPMENT), TO THE GOVERNMENT IN ACCORDANCE

WITH THE SPECIAL TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

0001AC 1 Each

ANNUAL FDA INSPECTION

FFP

CONTRACTOR SHALL PROVIDE AN ANNUAL FDA INSPECTION TO THE

GOVERNMENT IN ACCORDANCE WITH THE SPECIAL TERMS AND

CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

OPTION FY25 BULK MEDICAL OXYGEN

FFP

(INFORMATION CLIN ONLY) PERIOD OF PERFORMANCE: 1 OCT 2024

THRU 30 SEP 2025. VENDOR WILL PROVIDE MEDICAL-GRADE LIQUID

BULK OXYGEN FOR CARL R. DARNALL ARMY MEDICAL CENTER,

FORT CAVAZOS, TEXAS AND PROVIDE RENTAL OF BULK LIQUID

OXYGEN STORAGE TANKS AND ASSOCIATED EQUIPMENT. PLEASE

SEE ALL CLINS LINES AND SPECIALS TERMS AND CONDITIONS FOR

THE DETAILS OF THE REQUIREMENT.

1001AA 15,833 Each

OPTION BULK MEDICAL OXYGEN REFILL

FFP

CONTRACTOR SHALL PROVIDE MEDICAL GRADE LIQUID OXYGEN

TWICE A MONTH, AND ON AN AS NEEDED BASIS, TO THE

GOVERNMENT IN ACCORDANCE WITH THE ATTACHED SPECIAL

TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

1001AB 12 Months

OPTION STORAE TANK RENTAL

FFP

CONTRACTOR SHALL PROVIDE ONE (1) THREE THOUSAND (3,000)

GALLON MEDICAL GRADE LIQUID OXYGEN BULK STORAGE TANK

AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE SIZE LIQUID

OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E., VAPORIZER

AND CONTROL EQUIPMENT), TO THE GOVERNMENT IN ACCORDANCE

WITH THE SPECIAL TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

1001AC 1 Each

OPTION ANNUAL FDA INSPECTION

FFP

CONTRACTOR SHALL PROVIDE AN ANNUAL FDA INSPECTION TO THE

GOVERNMENT IN ACCORDANCE WITH THE SPECIAL TERMS AND

CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

OPTION FY26 BULK MEDICAL OXYGEN

FFP

(INFORMATION CLIN ONLY) PERIOD OF PERFORMANCE: 1 OCT 2025

THRU 30 SEP 2026. VENDOR WILL PROVIDE MEDICAL-GRADE LIQUID

BULK OXYGEN FOR CARL R. DARNALL ARMY MEDICAL CENTER,

FORT CAVAZOS, TEXAS AND PROVIDE RENTAL OF BULK LIQUID

OXYGEN STORAGE TANKS AND ASSOCIATED EQUIPMENT. PLEASE

SEE ALL CLINS LINES AND SPECIALS TERMS AND CONDITIONS FOR

2001AA 15,833 Each

OPTION BULK MEDICAL OXYGEN REFILL

FFP

CONTRACTOR SHALL PROVIDE MEDICAL GRADE LIQUID OXYGEN

TWICE A MONTH, AND ON AN AS NEEDED BASIS, TO THE

GOVERNMENT IN ACCORDANCE WITH THE ATTACHED SPECIAL

TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

2001AB 12 Months

OPTION STORAGE TANK RENTAL

FFP

CONTRACTOR SHALL PROVIDE ONE (1) THREE THOUSAND (3,000)

GALLON MEDICAL GRADE LIQUID OXYGEN BULK STORAGE TANK

AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE SIZE LIQUID

OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E., VAPORIZER

AND CONTROL CONTRACTOR SHALL PROVIDE ONE (1) THREE

THOUSAND (3,000) GALLON MEDICAL GRADE LIQUID OXYGEN BULK

STORAGE TANK AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE

SIZE LIQUID OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E.,

VAPORIZER AND CONTROL EQUIPMENT), TO THE GOVERNMENT IN

ACCORDANCE WITH THE SPECIAL TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

2001AC 1 Each

OPTION ANNUAL FDA INSPECTION

FFP

CONTRACTOR SHALL PROVIDE AN ANNUAL FDA INSPECTION TO THE

GOVERNMENT IN ACCORDANCE WITH THE SPECIAL TERMS AND

CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

OPTION FY27 BULK MEDICAL OXYGEN

FFP

(INFORMATION CLIN ONLY) PERIOD OF PERFORMANCE: 1 OCT 2026

THRU 30 SEP 2027. VENDOR WILL PROVIDE MEDICAL-GRADE LIQUID

BULK OXYGEN FOR CARL R. DARNALL ARMY MEDICAL CENTER,

FORT CAVAZOS, TEXAS AND PROVIDE RENTAL OF BULK LIQUID

OXYGEN STORAGE TANKS AND ASSOCIATED EQUIPMENT. PLEASE

SEE ALL CLINS LINES AND SPECIALS TERMS AND CONDITIONS FOR

3001AA 15,833 Each

OPTION BULK MEDICAL OXYGEN REFILL

FFP

CONTRACTOR SHALL PROVIDE MEDICAL GRADE LIQUID OXYGEN

TWICE A MONTH, AND ON AN AS NEEDED BASIS, TO THE

GOVERNMENT IN ACCORDANCE WITH THE ATTACHED SPECIAL

TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

3001AB 12 Months

OPTION STORAGE TANK RENTAL

FFP

CONTRACTOR SHALL PROVIDE ONE (1) THREE THOUSAND (3,000)

GALLON MEDICAL GRADE LIQUID OXYGEN BULK STORAGE TANK

AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE SIZE LIQUID

OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E., VAPORIZER

AND CONTROL EQUIPMENT), TO THE GOVERNMENT IN ACCORDANCE

WITH THE SPECIAL TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

3001AC 1 Each

OPTION ANNUAL FDA INSPECTION

FFP

CONTRACTOR SHALL PROVIDE AN ANNUAL FDA INSPECTION TO THE

GOVERNMENT IN ACCORDANCE WITH THE SPECIAL TERMS AND

CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

OPTION FY28 BULK MEDICAL OXYGEN

FFP

(INFORMATION CLIN ONLY) PERIOD OF PERFORMANCE: 1 OCT 2027

THRU 30 SEP 2028. VENDOR WILL PROVIDE MEDICAL-GRADE LIQUID

BULK OXYGEN FOR CARL R. DARNALL ARMY MEDICAL CENTER,

FORT CAVAZOS, TEXAS AND PROVIDE RENTAL OF BULK LIQUID

OXYGEN STORAGE TANKS AND ASSOCIATED EQUIPMENT. PLEASE

SEE ALL CLINS LINES AND SPECIALS TERMS AND CONDITIONS FOR

4001AA 15,833 Each

OPTION BULK MEDICAL OXYGEN REFILL

FFP

CONTRACTOR SHALL PROVIDE MEDICAL GRADE LIQUID OXYGEN

TWICE A MONTH, AND ON AN AS NEEDED BASIS, TO THE

GOVERNMENT IN ACCORDANCE WITH THE ATTACHED SPECIAL

TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

4001AB 12 Months

OPTION STORAGE TANK RENTAL

FFP

CONTRACTOR SHALL PROVIDE ONE (1) THREE THOUSAND (3,000)

GALLON MEDICAL GRADE LIQUID OXYGEN BULK STORAGE TANK

AND ONE (1) FIVE HUNDRED (500) GALLON RESERVE SIZE LIQUID

OXYGEN BULK TANK AND ASSOCIATED EQUIPMENT (I.E., VAPORIZER

AND CONTROL EQUIPMENT), TO THE GOVERNMENT IN ACCORDANCE

WITH THE SPECIAL TERMS AND CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

4001AC 1 Each

OPTION ANNUAL FDA INSPECTION

FFP

CONTRACTOR SHALL PROVIDE AN ANNUAL FDA INSPECTION TO THE

GOVERNMENT IN ACCORDANCE WITH THE SPECIAL TERMS AND

CONDITIONS.

NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

FOB: Destination

MFR PART NR: OXYGEN

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A N/A 0001AA Destination Government Destination Government 0001AB Destination Government Destination Government 0001AC Destination Government Destination Government 1001 N/A N/A N/A N/A 1001AA Destination Government Destination Government 1001AB Destination Government Destination Government 1001AC Destination Government Destination Government 2001 N/A N/A N/A N/A 2001AA Destination Government Destination Government 2001AB Destination Government Destination Government 2001AC Destination Government Destination Government 3001 N/A N/A N/A N/A 3001AA Destination Government Destination Government 3001AB Destination Government Destination Government 3001AC Destination Government Destination Government 4001 N/A N/A N/A N/A 4001AA Destination Government Destination Government 4001AB Destination Government Destination Government 4001AC Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 N/A N/A N/A N/A

0001AA 30-SEP-2024 15,833 AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

254-287-1110 FOB: Destination

HT0858

0001AB 30-SEP-2024 12 (SAME AS PREVIOUS LOCATION)

0001AC 30-SEP-2024 1 (SAME AS PREVIOUS LOCATION)

1001 N/A N/A N/A N/A

1001AA 30-SEP-2025 15,833 AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

254-287-1110

1001AB 30-SEP-2025 12 (SAME AS PREVIOUS LOCATION)

1001AC 30-SEP-2025 1 (SAME AS PREVIOUS LOCATION)

2001 N/A N/A N/A N/A

2001AA 30-SEP-2026 15,833 AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

254-287-1110

2001AB 30-SEP-2026 12 (SAME AS PREVIOUS LOCATION)

2001AC 30-SEP-2026 1 (SAME AS PREVIOUS LOCATION)

3001 N/A N/A N/A N/A

3001AA 30-SEP-2027 15,833 AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

254-287-1110

3001AB 30-SEP-2027 12 (SAME AS PREVIOUS LOCATION)

3001AC 30-SEP-2027 1 (SAME AS PREVIOUS LOCATION)

4001 N/A N/A N/A N/A

4001AA 30-SEP-2028 15,833 AMC DARNALL HOOD - PA

DIR DEL SEE LINE ITEM(S)

SANTE FE AVE

BLDG 36065

FORT HOOD TX 76544-4752

254-287-1110

4001AB 30-SEP-2028 12 (SAME AS PREVIOUS LOCATION)

4001AC 30-SEP-2028 1 (SAME AS PREVIOUS LOCATION)

52.212-4 ADDENDUM

Paragraph 52.212-4(w) is hereby added:

(w) The non-FAR Part 12 discretionary FAR and 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.

(End of Addendum)

CLAUSES INCORPORATED BY REFERENCE

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

Commercial Services

DEC 2022

52.204-7 System for Award Management OCT 2018

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

JUN 2020

52.204-13 System for Award Management Maintenance OCT 2018 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 52.204-17 Ownership or Control of Offeror AUG 2020 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020 52.204-23 Prohibition on Contracting for Hardware, Software, and

Services Developed or Provided by Kaspersky Lab and Other Covered Entities

NOV 2021

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

NOV 2021

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment

NOV 2021

52.219-6 Notice Of Total Small Business Set-Aside NOV 2020 52.222-3 Convict Labor JUN 2003 52.222-19 Child Labor -- Cooperation with Authorities and Remedies DEC 2022 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-50 Combating Trafficking in Persons NOV 2021 52.222-54 Employment Eligibility Verification MAY 2022 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 52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran-- Representation and Certifications.

JUN 2020

52.232-18 Availability Of Funds APR 1984 52.232-33 Payment by Electronic Funds Transfer--System for Award

Management

OCT 2018

52.232-40 Providing Accelerated Payments to Small Business Subcontractors

MAR 2023

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 DEC 2022 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7006 Billing Instructions OCT 2005 252.204-7016 Covered Defense Telecommunications Equipment or Services

-- Representation

DEC 2019

252.204-7017 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services -- Representation

MAY 2021

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

JAN 2023

252.204-7019 Notice of NIST SP 800-171 DoD Assessment Requirements MAR 2022 252.204-7020 NIST SP 800-171 DoD Assessment Requirements JAN 2023 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

252.223-7006 Prohibition On Storage, Treatment, and Disposal of Toxic or Hazardous Materials

SEP 2014

252.223-7008 Prohibition of Hexavalent Chromium JAN 2023 252.225-7001 Buy American And Balance Of Payments Program--Basic JAN 2023

252.225-7002 Qualifying Country Sources As Subcontractors MAR 2022 252.225-7012 Preference For Certain Domestic Commodities APR 2022 252.225-7036 Buy American--Free Trade Agreements--Balance of

Payments Program--Basic

JAN 2023

252.225-7048 Export-Controlled Items JUN 2013 252.225-7055 Representation Regarding Business Operations with the

Maduro Regime

MAY 2022

252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime

JAN 2023

252.225-7059 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region - Certification

DEC 2022

252.225-7060 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region

JAN 2023

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991

CLAUSES INCORPORATED BY FULL TEXT

52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

(MAR 2023)

(a) North American Industry Classification System (NAICS) code and small business size standard. The NAICS code(s) and small business size standard(s) for this acquisition appear elsewhere in the solicitation. However, the small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition--

(1) Is set aside for small business and has a value above the simplified acquisition threshold;

(2) Uses the HUBZone price evaluation preference regardless of dollar value, unless the offeror waives the price evaluation preference; or

(3) Is an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-aside or sole-source award regardless of dollar value.

(b) Submission of offers. Submit signed and dated offers to the office specified in this solicitation at or before the exact time specified in this solicitation. Offers may be submitted on the SF 1449, letterhead stationery, or as otherwise specified in the solicitation. As a minimum, offers must show--

(1) The solicitation number;

(2) The time specified in the solicitation for receipt of offers;

(3) The name, address, and telephone number of the offeror;

(4) A technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in the solicitation. This may include product literature, or other documents, if necessary;

(5) Terms of any express warranty;

(6) Price and any discount terms;

(7) "Remit to" address, if different than mailing address;

(8) A completed copy of the representations and certifications at Federal Acquisition Regulation (FAR) 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

(9) Acknowledgment of Solicitation Amendments;

(10) Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information); and

(11) If the offer is not submitted on the SF 1449, include a statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offers that fail to furnish required representations or information, or reject the terms and conditions of the solicitation may be excluded from consideration.

(c) Period for acceptance of offers. The offeror agrees to hold the prices in its offer firm for 30 calendar days from the date specified for receipt of offers, unless another time period is specified in an addendum to the solicitation.

(d) Product samples. When required by the solicitation, product samples shall be submitted at or prior to the time specified for receipt of offers. Unless otherwise specified in this solicitation, these samples shall be submitted at no expense to the Government, and returned at the sender's request and expense, unless they are destroyed during preaward testing.

(e) Multiple offers. Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with FAR subpart 4.10), or alternative commercial products or commercial services for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately.

(f) Late submissions, modifications, revisions, and withdrawals of offers:

(1) Offerors are responsible for submitting offers, and any modifications, revisions, or withdrawals, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that offers or revisions are due.

(2)(i) Any offer, modification, revision, or withdrawal of an offer received at the Government office designated in the solicitation after the exact time specified for receipt of offers is “late” and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late offer would not unduly delay the acquisition; and--

(A) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of offers; or

(B) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or

(C) If this solicitation is a request for proposals, it was the only proposal received.

(ii) However, a late modification of an otherwise successful offer, that makes its terms more favorable to the Government, will be considered at any time it is received and may be accepted.

(3) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the offer wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel.

(4) If an emergency or unanticipated event interrupts normal Government processes so that offers cannot be received at the Government office designated for receipt of offers by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation or other notice of an extension of the closing date, the time specified for receipt of offers will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume.

(5) Offers may be withdrawn by written notice received at any time before the exact time set for receipt of offers.

Oral offers in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile offers, offers may be withdrawn via facsimile received at any time before the exact time set for receipt of offers, subject to the conditions specified in the solicitation concerning facsimile offers. An offer may be withdrawn in person by an offeror or its authorized representative if, before the exact time set for receipt of offers, the identity of the person requesting withdrawal is established and the person signs a receipt for the offer.

(g) Contract award (not applicable to Invitation for Bids). The Government intends to evaluate offers and award a contract without discussions with offerors. Therefore, the offeror's initial offer should contain the offeror's best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received.

(h) Multiple awards. The Government may accept any item or group of items of an offer, unless the offeror qualifies the offer by specific limitations. Unless otherwise provided in the Schedule, offers may not be submitted for quantities less than those specified. The Government reserves the right to make an award on any item for a quantity less than the quantity offered, at the unit prices offered, unless the offeror specifies otherwise in the offer.

(i) Availability of requirements documents cited in the solicitation.

(1)(i) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to--GSA Federal Supply Service Specifications Section, Suite 8100, 470 East L'Enfant Plaza, SW, Washington, DC 20407, Telephone (202) 619-8925, Facsimile (202) 619-8978.

(ii) If the General Services Administration, Department of Agriculture, or Department of Veterans Affairs issued this solicitation, a single copy of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained free of charge by submitting a request to the addressee in paragraph (i)(1)(i) of this provision.

Additional copies will be issued for a fee.

(2) Most unclassified Defense specifications and standards may be downloaded from the following ASSIST websites:

(i) ASSIST (https://assist.dla.mil/online/start/).

(ii) Quick Search (http://quicksearch.dla.mil/).

(3) Documents not available from ASSIST may be ordered from the Department of Defense Single Stock Point (DoDSSP) by--

(i) Using the ASSIST Shopping Wizard (https://assist.dla.mil/wizard/index.cfm);

(ii) Phoning the DoDSSP Customer Service Desk (215) 697-2179, Mon-Fri, 0730 to 1600 EST; or

(iii) Ordering from DoDSSP, Building 4, Section D, 700 Robbins Avenue, Philadelphia, PA 19111-5094, Telephone

(215) 697-2667/2179, Facsimile (215) 697-1462.

(4) Nongovernment (voluntary) standards must be obtained from the organization responsible for their preparation, publication, or maintenance.

(j) Unique entity identifier. (Applies to all offers that exceed the micro-purchase threshold, and offers at or below the micro-purchase threshold if the solicitation requires the Contractor to be registered in the System for Award Management (SAM).) The Offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation "Unique Entity Identifier" followed by the unique entity identifier that identifies the Offeror's name and address. The Offeror also shall enter its Electronic Funds Transfer (EFT) indicator, if applicable. The EFT indicator is a four-character suffix to the unique entity identifier. The suffix is assigned at the discretion of the Offeror to establish additional SAM records for identifying alternative EFT accounts (see FAR subpart 32.11) for the same entity. If the Offeror does not have a unique entity identifier, it should contact the entity designated at www.sam.gov for unique entity identifier establishment directly to obtain one. The Offeror should indicate that it is an offeror for a Government contract when contacting the entity designated at www.sam.gov for establishing the unique entity identifier.

(k) Reserved.

(l) Debriefing. If a post-award debriefing is given to requesting offerors, the Government shall disclose the following information, if applicable:

(1) The agency's evaluation of the significant weak or deficient factors in the debriefed offeror's offer.

(2) The overall evaluated cost or price and technical rating of the successful and the debriefed offeror and past performance information on the debriefed offeror.

(3) The overall ranking of all offerors, when any ranking was developed by the agency during source selection.

(4) A summary of the rationale for award;

(5) For acquisitions of commercial products, the make and model of the product to be delivered by the successful offeror.

(6) Reasonable responses to relevant questions posed by the debriefed offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency.

(End of provision)

52.212-1 ADDENDUM

ADDENDUM TO 52.212-1

I. GENERAL

A. The Solicitation will be posted to SAM.gov website.

B. Solicitation POCs: The Contracting Officer and Contract Specialist are the sole points of contact for this procurement. Questions regarding this solicitation are to be submitted electronically to the Contract Specialist, Shenecqua Soares at shenecqua.n.soares.civ@health.mil.

C. Questions: Deadline for *Questions about the solicitation will be no later than 30 May 2023 at 4:00 PM central standard time to shenecqua.n.soares.civ@health.mil and Answers to those questions will be submitted on https://sam.gov/content/home no later than 31 May 2023 at 4:00 PM central standard time.

D. Offerors shall submit quotes to arrive no later than the date and time stated in block 8 of the SF1449. Quotes need to be submitted via email to shenecqua.n.soares.civ@health.mil.

Electronic (e-mail) offers are the only methods for submitting proposals. Offer shall clearly identify each part of their proposal, as described above. Please completely read section II.

ADMINISTRATIVE below for details.

II. ADMINISTRATIVE

A. Contractor shall complete and return the following:

1. Request for Quotes. The Offeror must include a copy of the completed SF 1449, with the signature and include the name of the offeror, address, phone and fax numbers in blocks 12, 17 (to include CAGE Code and DUNS number), 30A-C with the signature of a corporate officer authorized to negotiate for the company. Electronic signature is acceptable. All amendments SF 30, Blocks 8 and 15A-C (for all amendments issued, if any).

2. Provide a Statement that the offeror will hold its quote firm for at least 60 days from the due date for receipt of offers, subject to any changes that may occur as a result of discussions (if applicable).

3. Pricing for the Base and All Option Years. Submit pricing for all Contract Line Item Numbers

(CLINs) and sub-CLINs (as applicable) for the base year and all option years. Provide total pricing for the base year and each option year, as well as a grand total for the price of your entire quote.

4. Technical: The technical quote shall be addressed in sufficient written detail for the Government to determine if the offeror’s product(s) adequately perform the specific requirements as stated in solicitation and must meet the salient physical, functional, or performance characteristics specified in the solicitation and the Special Terms and Conditions (Delivery of Medical Oxygen, rental of Storage Tanks, and Annual FDA Inspection). Clearly describe any modification the offeror plan to make in a product to make it conform to the solicitation requirements. Mark any descriptive material to clearly show the modification. Please review CLIN lines and Specail Terms and Conditions.

5. The offerors must provide information below regarding points of contact (POCs) for administration of the Contract during quoter’s normal business hours and after normal business hours. The POC for other than normal business hours will be contacted only in the event of an emergency. Accordingly, the named individuals should possess sufficient corporate authority to effectively deal with emergency situations and the telephone number provided should be functioning at all times other than normal business hours. If there are different POCs for different conditions, such as weekdays, weekends, holidays, etc., please furnish all and explain.

a) Quoter’s normal business hours/days:

b) POCs during normal business hours: Name(s): Telephone Number(s):

c) POCs during other than normal business hours: Name(s): Telephone Number(s):

6. Representations and Certifications. Offeror must be registered in the System for Award

Management (SAM) with the appropriate NAICS Code and shall not have any Active Exclusions listed within SAM to be eligible for award.

7. Contractors shall submit, sign SF 1449, signed SF 30 (if applicable) and return all information requested in Addendum to 52.212-1 listed above no later than the date and time stated in block 8 of the SF1449 to shenecqua.n.soares.civ@health.mil.

(m) The non-FAR Part 12 discretionary FAR and DFARS provisions included herein are incorporated into this solicitation either by reference or in full text. If incorporated by reference, see provision 52.252-1 herein for locations where full text can be found.

(End of Addendum)

52.212-2 EVALUATION--COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

See Addendum to 52.212-2

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

52.212-2 ADDENDUM

Paragraph (a) is hereby replaced with the following:

Award will be made using the lowest price technically acceptable (LPTA) source selection process. The Government will award a contract resulting from this solicitation to the responsible offeror whose quote meets all Technical evaluation factors and whose price has been determined fair and reasonable. Award will be made to the responsible offeror on the basis of the lowest evaluated price of proposals meeting or exceeding the acceptability standards for non-cost factors. Award may be made without discussions with offerors (except communications conducted for the purpose of minor clarification). Therefore, each initial offer should contain the offeror's best terms from a technical and price standpoint. However, the Government reserves the right to conduct discussions if it is later determined by the contracting officer to be necessary.

EVALUATION PROCESS:

The government will initially list offers from lowest to highest price. The government will evaluate the lowest priced offer first. If that offer is determined technically unacceptable, the government will evaluate the next lowest priced offer and continue in that manner until an offer is rated Technically Acceptable. If an offer is rated Technically Unacceptable, the Government will not evaluate any other subfactors. USING THIS PROCEDURE, THE GOVERNMENT

MIGHT NOT EVALUATE ALL OFFERS.

The following evaluation factors shall be used to evaluate offers:

1. Technical Acceptability: Offer will be found technically acceptable if the offer meets the performance requirements in the Special Terms and Conditions and all of the factors outline in the Solicitation. (Delivery of Medical Oxygen, rental of Storage Tanks, and Annual FDA Inspection)

RATING TABLE

RATING DEFINITION

Acceptable Documentation provided clearly meets the minimum requirements of the solicitation and specials terms and conditions.

Unacceptable Documentation provided does not meet the minimum requirements of the solicitation and specials terms and conditions.

*Any technical factor rated technically unacceptable makes the offeror ineligible for award.

2. Price. Pricing must be determined to be fair and reasonable.

(a) Once the offeror has received at least an acceptable overall technical rating, Price will be evaluated using various price analysis techniques and procedures IAW FAR 15.404-1(b) including, but not limited to, comparison of proposed price received in response to the solicitation. An offeror’s pricing must be determined to be fair and reasonable in order to be considered for contract award.

( b) Quotes must be submitted NL T the offer due date/local time CST by e-mailing to:

shenecqua.n.soares.civ@health.mil. No telephonic questions will be accepted, only through email. A signed SF form 1449 with completed pricing data must be submitted. E-mail is the only method.

(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.

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

2020)

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

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

(c) Representations.

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

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

52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS--

REPRESENTATION (NOV 2015)

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

(b) Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with either an inverted domestic corporation, or a subsidiary of an…

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