Solicitation - W9124C26RA001 Tree Removal Services.pdf

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NUMBER 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect 8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NUMBER

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

OFFER

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

BELOW IS CHECKED

REQUEST

FOR QUOTE

(RFQ)

INVITATION

FOR BID

(IFB)

REQUEST

FOR

PROPOSAL

(RFP)

SEE ADDENDUM

19.

ITEM NUMBER

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH

AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND

ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS

SPECIFIED

29. AWARD OF CONTRACT: REFERENCE OFFER

DATED . . YOUR OFFER ON SOLICITATION

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

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

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

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

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

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NORTH AMERICAN

INDUSTRY CLASSIFICATION

STANDARD (NAICS):

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

THE DEFENSE PRIORITIES

AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FREE ON

BOARD (FOB) DESTINATION

UNLESS BLOCK IS MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

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

8(A)

ECONOMICALLY

DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

NOTE: OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30.

calls)

Solicitation/Contract Form Continuation

Post Wide Tree Removal ServicesInstrument Name:

52.202-1 Definitions.

As prescribed in 2.201 , insert the following clause:

Definitions (Jun 2020)

When a provision or uses a word or term that is defined in the solicitation contract clause Federal Regulation (FAR), the word or term has the same meaning as the definition Acquisition in FAR 2.101 in effect at the time the was issued, unless-solicitation

(a) The , or amended , provides a different definition;solicitation solicitation

(b) The parties agree to a different definition;contracting

(c) The part, subpart, or section of the FAR where the provision or clause is prescribed provides a different meaning;

(d) The word or term is defined in FAR part 31, for use in the cost principles and procedures; or

(e) The word or term defines an -related threshold, and if the threshold is adjusted acquisition for inflation as set forth in FAR 1.109(a), then the changed threshold applies throughout the remaining term of the contract, unless there is a subsequent threshold adjustment; see FAR 1.109(d).

(End of clause)

W9124C26RA001

52.209-11 Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law.

As prescribed in 9.104-7(d), insert the following provision:

Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law (Feb 2016)

(a) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, the Government will not enter into a contract with any corporation that-

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered or of the corporation and made a determination that suspension debarment or is not necessary to protect the interests of the Government; orsuspension debarment

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the , unless an agency has conviction considered or of the corporation and made a determination that this suspension debarment action is not necessary to protect the interests of the Government.

(b) The represents that-Offeror

(1) It is is not a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is is not a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

52.212-3 Offeror Representations and Certifications--Commercial Products and Commercial Services.

As prescribed in 12.301(b)(2), insert the following provision:

Offeror Representations and Certifications-- and Commercial Products Commercial Services (Oct 2025)

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

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

Covered telecommunications equipment or services has the meaning provided in the clause 52.204-25, Prohibition on for Certain Telecommunications and Video Surveillance Contracting 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 and who are economically disadvantaged in accordance United States with 13 CFR part 127, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300. 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 himself voluntarily; oroffer

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

Immediate owner means an entity, other than the , that has direct control of the . offeror 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 under 6 U.S.C. 395(b), applied in accordance with the rules inverted domestic corporation and definitions of 6 U.S.C. 395(c).

Manufactured end product means any in product and service codes (PSCs) 1000-end product 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 , Inedible;Products

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

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

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

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). do not include business operations Restricted 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

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 (SDVOSB) concern means a small business --concern

(1)

(i) Not less than 51 percent of which is owned and controlled 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 servicedisabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran; or

(2) A eligible under the SDVOSB Program in accordance with 13 CFR small business concern part 128 (see subpart 19.14).

(3) , as used in this definition, means a veteran as defined in 38 U.S.C. Service-disabled veteran 101(2), with a disability that is service connected, as defined in 38 U.S.C. 101(16), and who is registered in the Beneficiary Identification and Records Locator Subsystem, or successor system that is maintained by the Department of Veterans Affairs' Veterans Benefits Administration, as a service-disabled veteran.

Service-disabled veteran-owned small business (SDVOSB) concern eligible under the SDVOSB

Program means an SDVOSB concern that--

(1) Effective January 1, 2024, is designated in the ) as System for Award Management (SAM certified by the Small Business Administration (SBA) in accordance with 13 CFR 128.300; or

(2) Has represented that it is an SDVOSB concern in SAM and submitted a complete application for certification to SBA on or before December 31, 2023.

Service-disabled veteran-owned small business (SDVOSB) Program means a program that authorizes to limit competition, including award on a sole-source basis, to contracting officers SDVOSB concerns eligible under the SDVOSB Program.

Small business concern--

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

(2) , as used in this definition, means business concerns, one of whom directly or Affiliates 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. , consistent with 13 CFR 124.1001, means a Small disadvantaged business concern small business concern under the size standard applicable to the , that--acquisition

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

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

(ii) Each individual claiming economic disadvantage has a net worth not exceeding the threshold at 13 CFR 124.104(c)(2) after taking into account the applicable exclusions set forth at 13 CFR124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.

CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

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

(1) Directly by a parent corporation; or

(2) Through another of a parent corporationsubsidiary

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

(1) Not less than 51 percent of which is owned and controlled 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. means a concern which is at least 51 percent Women-owned business concern owned by one or more women; or in the case of any publicly owned business, at least 51 percent of 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 least51 percent of the stock of which is owned by one or more women; and

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

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 , and the United States concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300.

(b)

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

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

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

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

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

(c) complete the following representations when the resulting contract is for Offerors must to be delivered or services to be performed in the or its , supplies United States outlying areas or when the officer has applied part 19 in accordance with 19.000(b)(1)(ii). Check all contracting that apply.

(1) . The represents as part of its that--Small business concern offeror offer

(i) It is, is not a small business concern; or

(ii) It is, is not a small business joint venture that complies with the requirements of 13 CFR

121.103(h) and 13 CFR 125.8(a) and (b). [ The offeror shall enter the name and unique entity identifier of each party to the joint venture: ____________.]

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

(3) [SDVOSB concern. Complete only if the offeror represented itself as a veteran-owned small ] The represents that it is, is notbusiness concern in paragraph (c)(2) of this provision. offeror an SDVOSB concern.

(4) . The represents SDVOSB concern joint venture eligible under the SDVOSB Program offeror that it is, is not an SDVOSB joint venture eligible under the SDVOSB Program that complies with the requirements of 13 CFR 128.402. [Complete only if the offeror represented itself as an

] [SDVOSB concern in paragraph (c)(3) of this provision. The offeror shall enter the name and .]unique entity identifier of each party to the joint venture: ____________

(5) Small disadvantaged business concern. [Complete only if the offeror represented itself as a The represents that it is, is small business concern in paragraph (c)(1) of this provision.] offeror not a as defined in 13 CFR 124.1001. small disadvantaged business concern

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

(7) The represents that it is, is WOSB joint venture eligible under the WOSB Program. offeror not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [ The offeror shall enter the name and unique entity identifier of each party to the joint venture:

(8) The Economically disadvantaged women-owned small business (EDWOSB) joint venture.

represents that it is, is not a joint venture that complies with the requirements of 13 CFRofferor

127.506(a) through (c). [The offeror shall enter the name and unique entity identifier of each .]partyto the joint venture: ____________

Note to paragraphs (c)(9) and (10): Complete paragraphs (c)(9) and (10) only if this solicitation is expected to exceed the .simplified acquisition threshold

(9) ). [Women-owned business concern (other than small business concern Complete only if the offeror is a women-owned business concern and did not represent itself as a small business

.] The represents that it is a women-owned concern in paragraph (c)(1) of this provision offeror business concern.

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

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

(i) It is, is not a listed, on the date of this representation, as HUBZone small business concern having been certified by SBA as a in the Dynamic Small HUBZone small business concern Business Search and SAM, and will attempt to maintain an employment rate of HUBZone residents of 35 percent of its employees during performance of a (see 13 HUBZone contract CFR 126.200(e)(1)); and

(ii) It is, is not a joint venture that complies with the requirements of 13 CFRHUBZone

126.616(a) through (c). [The offeror shall enter the name and unique entity identifier of each .] Each participating in the party to the joint venture: ______ HUBZone small business concern joint venture provide representation of its status.HUBZone shall HUBZone

(d) Representations required to implement provisions of Executive Order 11246-

(1) Previous contracts and compliance. The represents that(offeror

i) It has, has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this ; andsolicitation

(ii) It has, has not filed all required compliance reports.

(2) . The represents that-Affirmative Action Compliance offeror

(i) It has developed and has on file, has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of

Labor (41 CFR parts 60-1 and 60-2), or

(ii) It has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 http://uscode.house.

. (Applies only if the contract is expected to exceed $200,000.) By submission gov/ U.S.C. 1352) of its , the certifies to the best of its knowledge and belief that no Federal offer offeror appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the with respect to this contract, the offeror complete and submit, with its , OMB Standard Form LLL, Disclosure of offeror shall offer Lobbying Activities, to provide the name of the registrants. The need not report regularly offeror employed officers or employees of the to whom payments of reasonable compensation offeror were made.

(f) . (Applies only if the clause at Federal Regulation (FAR) Buy American Certificate Acquisition 52.225-1, Buy American- , is included in this .)Supplies solicitation

(1)

(i) The certifies that each , except those listed in paragraph (f)(2) of this Offeror end product provision, is a domestic and that each domestic listed in paragraph (f)end product end product

(3) of this provision contains a critical .component

(ii) The list as foreign those manufactured in the Offeror shall end products end products United that do not qualify as domestic . For those foreign that do notStates end products end products consist wholly or predominantly of iron or steel or a combination of both, the alsoOfferor shall indicate whether these foreign exceed 55 percent domestic content, except for end products those that are COTS items. If the percentage of the domestic content is unknown, select "no".

(iii) The separately list the of domestic that contain Offeror shall line item numbers end products a critical (see FAR 25.105).component

(iv) The terms "commercially available off-the-shelf (COTS) item," "critical ," component "domestic end product," " ," "foreign ," and " " are defined in end product end product United States the clause of this entitled "Buy American- ."solicitation Supplies

(2) Foreign :End Products

No. Country of Origin Exceeds 55% domestic content (yes/no)Line Item

[ ]List as necessary

(3) Domestic containing a critical :end products component

Line Item No. ___

[ ]List as necessary

(4) The Government will evaluate in accordance with the policies and procedures of FAR offers part

25.

(g)

(1) . (Applies only if the Buy American-Free Trade Agreements-Israeli Trade Act Certificate clause at FAR 52.225-3, Buy American-Free Trade Agreements-Israeli Trade Act, is included in this .)solicitation

(i)

(A) The certifies that each , except those listed in paragraph (g)(1)(ii) or (iii) Offeror end product of this provision, is a domestic end product and that each domestic listed in end product paragraph

(g)(1)(iv) of this provision contains a critical .component

(B) The terms "Bahraini, Moroccan, Omani, Panamanian, or Peruvian ," end product "commercially available off-the-shelf (COTS) item," "critical ," "domestic end component product," " ," "foreign end product," "Free Trade Agreement country," "Free Trade end product Agreement country ," "Israeli ," and " " are defined in the end product end product United States clause of this entitled "Buy American-Free Trade Agreements-Israeli Trade Act."solicitation

(ii) The certifies that the following are Free Trade Agreement country Offeror supplies end (other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian ) or products end products

Israeli as defined in the clause of this entitled "Buy American-Free end products solicitation

Trade Agreements- Israeli Trade Act." Free Trade Agreement Country (Other End Products than Bahraini, Moroccan, Omani, Panamanian, or Peruvian ) or End Products Israeli End

:Products

No. Country of OriginLine Item

[ ]List as necessary

(iii) The list those that are foreign (other than those listed in Offeror shall supplies end products paragraph (g)(1)(ii) of this provision) as defined in the clause of this entitled "Buy solicitation American-Free Trade Agreements-Israeli Trade Act." The list as other foreign Offeror shall end those end manufactured in the that do not qualify as domestic products products United States . For those foreign that do not consist wholly or predominantly of iron end products end products or steel or a combination of both, the also indicate whether these foreign Offeror shall end exceed 55 percent domestic content, except for those that are COTS items. If the products percentage of the domestic content is unknown, select "no". :Other Foreign End Products

No. Country of Origin Exceeds 55% domestic content (yes/no)Line Item

[List as necessary]

(iv) The list the of domestic end that contain a critical Offeror shall line item numbers products (see FAR 25.105).component

Line Item No. ___

[List as necessary]

(v) The Government will evaluate in accordance with the policies and procedures of FAR offers part 25.

(2) . If Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II Alternate II to the clause at FAR 52.225-3 is included in this , substitute the following paragraphsolicitation

(g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The certifies that the following are Israeli as defined in offeror supplies end products the clause of this entitled "Buy American--Free Trade Agreements--Israeli Trade solicitation Act":

Israeli End Products:

No.Line Item

[ ]List as necessary

(3) . If Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III Alternate III to the clause at 52.225-3 is included in this , substitute the following paragraphs (g)solicitation (1)(i)(B) and (g)(1)(ii) for paragraphs (g)(1)(i)(B) and (g)(1)(ii) of the basic provision: (g)(1)(i)(B) The terms "Korean ", " ," "critical end product commercially available off-the-shelf (COTS) item

," "domestic ," " ," "foreign ," "Free Trade component end product end product end product Agreement country," "Free Trade Agreement country ," "Israeli ," and "end product end product

" are defined in the clause of this entitled "Buy American--Free Trade United States solicitation Agreements--Israeli Trade Act."

(g)(1)(ii) The certifies that the following are Korean or Israeli Offeror supplies end products end as defined in the clause of this entitled "Buy American--Free Tradeproducts solicitation

Agreements--Israeli Trade Act":

Korean or Israeli :End Products End Products

No. Country of OriginLine Item

[ ]List as necessary

(4) . (Applies only if the clause at FAR 52.225-5, Trade Trade Agreements Certificate Agreements, is included in this .)solicitation

(i) The certifies that each , except those listed in paragraph (g)(4)(ii) of this offeror end product provision, is a U.S.-made or designated country , as defined in the clause of this end product entitled "Trade Agreements."solicitation

(ii) The list as other those that are not U.S.-made or offeror shall end products end products designated country end .products

Other End Products:

No. Country of OriginLine Item

[ ]List as necessary

(iii) The Government will evaluate in accordance with the policies and procedures of FAR offers part 25. For line items covered by the WTO GPA, the Government will evaluate of U.S.-offers made or designated country without regard to the restrictions of the Buy American end products statute. The Government will consider for award only of U.S.-made or designated country offers unless the determines that there are no for such end products Contracting Officer offers or that the for such are insufficient to fulfill the requirements of the products offers products .solicitation

(h) ). (Applies only if the Certification Regarding Responsibility Matters (Executive Order 12689 contract value is expected to exceed the .) The certifies, simplified acquisition threshold offeror to the best of its knowledge and belief, that the and/or any of its principals-offeror

(1) Are, are not presently debarred, suspended, proposed for , or declared debarment ineligible for the award of contracts by any Federal agency;

(2) Have, have not, within a three-year period preceding this , been convicted of or had a offer civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of ; or commission of embezzlement, theft, forgery, bribery, falsification or offers destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property;

(3) Are, are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) Have, have not, within a three-year period preceding this , been notified of any offer delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) . The liability is finally determined if it has been The tax liability is finally determined assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) . A taxpayer is delinquent if the taxpayer has The taxpayer is delinquent in making payment failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) .Examples

(A) The taxpayer has received a statutory notice of deficiency, under I.R.C. (S)6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. the taxpayer seek Tax Court review, Should this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. (S)6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability.

This is not a delinquent tax because it is not a final tax liability. the taxpayer seek tax Should court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. (S)6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. (S)362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(1) Listed end products.

Listed End Product Listed Countries of Origin

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

(i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

(ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) (Does not apply unless the is predominantly for the Place of manufacture. solicitation of .) For statistical purposes only, the acquisition manufactured end products offeror shall indicate whether the place of manufacture of the it expects to provide in response end products to this is predominantly-solicitation

(1) In the (Check this box if the total anticipated price of offered United States end products manufactured in the exceeds the total anticipated price of offered end United States products manufactured outside the ); orUnited States

(2) Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards

(Certification by the as to its compliance with respect to the contract also constitutes its offeror certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [

]The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.

(1) 22.1003-4(c)Maintenance, calibration, or repair of certain equipment as described in FAR (1).

The does does not certify that-offeror

(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the (or subcontractor in the case of offeror an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

(2) 22.1003-4(d)(1). The does does not certify that-Certain services as described in FAR offeror

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the (or subcontractor in the case of an exempt offeror subcontract) to the general public in substantial quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and

(iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers.

(3) If paragraph (k)(1) or (k)(2) of this clause applies-

(i) If the does not certify to the conditions in paragraph (k)(1) or (k)(2) and the offeror did not attach a Service Contract Labor Standards wage determination to Contracting Officer the , the notify the as soon as possible; andsolicitation offeror shall Contracting Officer

(ii) The Officer not make an award to the if the fails to execute Contracting may offeror offeror the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(l) 26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if Taxpayer Identification Number (TIN) ( the is required to provide this information to the SAM to be eligible for award.)offeror

(1) All submit the information required in paragraphs (l)(3) through (l)(5) of this offerors must provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the Internal Revenue Service (IRS).

(2) The TIN be used by the Government to collect and report on any delinquent amounts may arising out of the 's relationship with the Government (31 U.S.C. 7701(c)(3)). If the offeror resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder be matched with IRS records to verify the accuracy of the 's may offeror

TIN.

(3) .Taxpayer Identification Number (TIN)

TIN: ________________________________.

TIN has been applied for.

TIN is not required because:

Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

Offeror is an agency or instrumentality of a foreign government;

Offeror is an agency or instrumentality of the Federal Government.

(4) .Type of organization

Sole proprietorship;

Partnership;

Corporate entity (not tax-exempt);

Corporate entity (tax-exempt);

Government entity (Federal, State, or local);

Foreign government;

International organization per 26 CFR1.6049-4;

Other ________________________________.

(5) .Common parent

Offeror is not owned or controlled by a common parent;

Name and TIN of common parent:

Name ________________________________.

TIN _________________________________.

(m) . By submission of its , the certifies that Restricted business operations in Sudan offer offeror the does not conduct any restricted business operations in Sudan.offeror

(n) Prohibition on with .Contracting Inverted Domestic Corporations

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

(2) . The represents that-Representation Offeror

(i) It is, is not an inverted domestic corporation; and

(ii) It is, is not a of an .subsidiary inverted domestic corporation

(o) Prohibition on with entities engaging in certain activities or transactions relating contracting to Iran.

(1) The e-mail questions concerning to the Department of offeror shall sensitive technology State at CISADA106@state.gov.

(2) . Unless a waiver is granted or an exception applies as Representation and Certifications provided in paragraph (o)(3) of this provision, by submission of its , the -offer offeror

(i) Represents, to the best of its knowledge and belief, that the does not export any offeror to the government of Iran or any entities or individuals owned or controlled sensitive technology by, or acting on behalf or at the direction of, the government of Iran;

(ii) Certifies that the , or any person owned or controlled by the , does not engage offeror offeror in any activities for which sanctions be imposed under section 5 of the Iran Sanctions Act; may and

(iii) Certifies that the , and any person owned or controlled by the , does not offeror offeror knowingly engage in any transaction that exceeds the threshold at FAR 25.703-2(a)(2) with Iran's Revolutionary Guard Corps or any of its officials, agents, or , the property and affiliates interests in property of which are blocked pursuant to the International Economic Emergency Powers Act (et seq.) (see OFAC's Specially Designated Nationals and Blocked Persons List at

List/Pages/default.aspx).https://www.treasury.gov/resource-center/sanctions/SDN

(3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if-

(i) This includes a trade agreements certification ( , 52.212-3(g) or a comparable solicitation e.g.

agency provision); and

(ii) The has certified that all the offered to be supplied are designated country offeror products .end products

(p) . (Applies in all when there is a requirement to Ownership or Control of Offeror solicitations be registered in SAM or a requirement to have a in the ).unique entity identifier solicitation

(1) The represents that it has or does not have an . If the has Offeror immediate owner Offeror more than one (such as a joint venture), then the respond to immediate owner Offeror shall paragraph (2) and if applicable, paragraph (3) of this provision for each participant in the joint venture.

(2) If the indicates "has" in paragraph (p)(1) of this provision, enter the followingOfferor information:

Immediate owner CAGE code: ____________________.

Immediate owner legal name: _____________________.

(Do not use a "doing business as" name)

W9124C26RA001

https://www.treasury.gov/resource-center/sanctions/SDN

Is the owned or controlled by another entity: Yes or No.immediate owner

(3) If the indicates "yes" in paragraph (p)(2) of this provision, indicating that the Offeror is owned or controlled by another entity, then enter the following information:immediate owner

Highest-level owner CAGE code: __________________.

Highest-level owner legal name: ___________________.

( )Do not use a "doing business as" name

(q) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law.

(1) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent appropriations acts, The Government will not enter into a contract with any corporation that-

(i) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless an agency has considered or of the corporation and made a determination that suspension debarment or is not necessary to protect the interests of the Government; orsuspension debarment

(ii) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the , unless an agency has conviction considered or of the corporation and made a determination that this suspension debarment action is not necessary to protect the interests of the Government.

(2) The represents that-Offeror

(i) It is is not a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(ii) It is is not a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(r) (Applies in all that include the provision at 52.204-16, Predecessor of Offeror. solicitations Commercial and Government Entity Code Reporting.)

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

(2) If the has indicated "is" in paragraph (r)(1) of this provision, enter the following Offeror information for all that held a Federal contract or grant within the last three years predecessors (if more than one , list in reverse chronological order):predecessor

Predecessor CAGE code: (or mark "Unknown").

Predecessor legal name: ____.

( ).Do not use a "doing business as" name

(s) [Reserved].

(t) . Applies in all Public Disclosure of Greenhouse Gas Emissions and Reduction Goals that require to register in SAM (12.301(d)(1)).solicitations offerors

(1) This representation be completed if the received $7.5 million or more in shall Offeror contract awards in the prior Federal fiscal year. The representation is optional if the Offeror received less than $7.5 million in Federal contract awards in the prior Federal fiscal year.

(2) Representation. [ to check applicable block(s) in paragraph (t)(2)(i) and (ii)].Offeror

(i) The (itself or through its or highest-level owner) does, does not Offeror immediate owner publicly disclose greenhouse gas emissions, i.e., makes available on a publicly accessible website the results of a greenhouse gas inventory, performed in accordance with an accounting standard with publicly available and consistently applied criteria, such as the Greenhouse Gas Protocol Corporate Standard.

(ii) The (itself or through its or highest-level owner) does, does not Offeror immediate owner publicly disclose a quantitative greenhouse gas emissions reduction goal, i.e., make available on a publicly accessible website a target to reduce absolute emissions or emissions intensity by a specific quantity or percentage.

(iii) A publicly accessible website includes the 's own website or a recognized, third-party Offeror greenhouse gas emissions reporting program.

(3) If the checked "does" in paragraphs (t)(2)(i) or (t)(2)(ii) of this provision, respectively, Offeror the provide the publicly accessible website(s) where greenhouse gas emissions Offeror shall and/or reduction goals are reported: .____________

(u)

(1) In accordance with section 743 of Division E, Title VII, of the Consolidated and Further

Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its provisions in successor subsequent appropriations acts (and as extended in continuing resolutions), Government agencies are not permitted to use appropriated (or otherwise made available) funds for contracts with an entity that requires employees or subcontractors…