Solicitation - W912LQ26QA016 Professional Appearance.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

Virginia Dental Services BPAs - Southwest VirginiaInstrument Name:

Cancellation Ceiling Date and Description

USD 350,000 5/31/2031

W912LQ26QA016

Continuation of Supplies or Services and Prices/Costs

Additional Information/Notes

Continuation of Description

Requirements Blanket Purchase Agreement(s) for Dental Services to support service members based in Southwest Virginia

Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements.

2017-01

52.204-13 System for Award Management- Maintenance. (Deviation 2026- O0038)

2026-02

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded. (Deviation 2026- O0038)

2026-02

52.212-4 Terms and Conditions- Commercial Products and Commercial Services. (Deviation 2026-O0038)

2026-02

52.219-6 Notice of Total Small Business Set-Aside. (Deviation 2026- O0038)

2026-02

52.222-35 Equal Opportunity for Veterans.

(Deviation 2026-O0038)

2026-02

52.222-36 Equal Opportunity for Workers with Disabilities. (Deviation 2026- O0038)

2026-02

52.222-37 Employment Reports on Veterans. (Deviation 2026- O0038)

2026-02

52.222-41 Service Contract Labor Standards. (Deviation 2026- O0038)

2026-02

52.222-50 Combating Trafficking in Persons. (Deviation 2026-O0038)

2026-02

52.222-54 Employment Eligibility Verification. (Deviation 2026- O0038)

2026-02

52.222-62 Paid Sick Leave Under Executive Order 13706. (Deviation 2026- O0038)

2026-02

52.224-3 Privacy Training. 2017-01

52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving.

2024-05

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

2018-10

52.232-40 Providing Accelerated Payments to Small Business Subcontractors.

2023-03

52.233-3 Protest after Award. (Deviation 2026-O0038)

2026-02

52.233-4 Applicable Law for Breach of Contract Claim. (Deviation 2026- O0038)

2026-02

DFARS Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

252.203-7000 Requirements Relating to Compensation of Former DoD Officials.

2011-09

252.203-7002 Requirement to Inform Employees of Whistleblower Rights.

2022-12

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

2024-05

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

2023-01

252.225-7012 Preference for Certain Domestic Commodities.

2022-04

252.225-7056 Prohibition Regarding Business Operations with the Maduro Regime.

2023-01

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

2023-06

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports.

2018-12

252.232-7009 Mandatory Payment by 2018-05

Governmentwide Commercial Purchase Card.

252.232-7010 Levies on Contract Payments. 2006-12

252.247-7023 Transportation of Supplies by Sea.

2024-10

FAR Clauses Incorporated by Full Text

Date

Alternate Deviation

Variation Effective Date

52.222-42 Statement of Equivalent Rates for Federal Hires.

2014-05

Statement of Equivalent Rates for Federal Hires (May 2014)

In compliance with the Service Contract Labor Standards statute and the regulations of the Secretary of Labor ( 29 CFR Part 4), this clause identifies the classes of service employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C.

5341 or 5332.

This Statement is for Information Only: It is not a Wage Determination

Employee Class Monetary Wage-Fringe Benefits 12020 20.37 12025 40.46 (End of clause)

DFARS Clauses Incorporated by Full Text

Date

Alternate Deviation

Variation Effective Date

252.232-7006 Wide Area WorkFlow Payment Instructions.

2023-01

WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(a) Definitions. As used in this clause-

"Department of Defense Activity Address Code (DoDAAC)" is a six position code that uniquely identifies a unit, activity, or organization.

"Document type" means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

"Local processing office (LPO)" is the office responsible for payment certification when payment certification is done external to the entitlement system.

"Payment request" and "receiving report" are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall-

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web- Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the "Web Based Training" link on the WAWF home page at https://wawf.eb.mil/

(e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order:

(1) Document type. The Contractor shall submit payment requests using the following document type(s):

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items-

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

(Contracting Officer: Insert applicable invoice and receiving report document type(s) for fixed price line items that require shipment of a deliverable.)

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

Invoice 2In1

(Contracting Officer: Insert either "Invoice 2in1" or the applicable invoice and receiving report document type(s) for fixed price line items for services.)

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

(v) For commercial financing, submit a commercial financing request.

(2) ) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.

[Note: The Contractor may use a WAWF "combo" document type to create some combinations of invoice and receiving report in one step.]

(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill in applicable fields in WAWF when creating payment requests and receiving reports in the system.

Routing Data Table*

Field Name in WAWF Data to be entered in WAWF Pay Official DoDAAC HQ0670 Issue By DoDAAC W912LQ Admin DoDAAC W912LQ Inspect By DoDAAC W801GJ Ship To Code ____ Ship From Code ____ Mark For Code ____ Service Approver (DoDAAC) ____ Service Acceptor (DoDAAC) W801GJ Accept at Other DoDAAC ____ LPO DoDAAC ____ DCAA Auditor DoDAAC ____ Other DoDAAC(s) ____ (*Contracting Officer: Insert applicable DoDAAC information. If multiple ship to/acceptance locations apply, insert "See Schedule" or "Not applicable.")

(**Contracting Officer: If the contract provides for progress payments or performance-based payments, insert the DoDAAC for the contract administration office assigned the functions under FAR 42.302(a)(13).)

(4) Payment request. The Contractor shall ensure a payment request includes documentation appropriate to the type of payment request in accordance with the payment clause, contract financing clause, or Federal Acquisition Regulation 52.216-7, Allowable Cost and Payment, as applicable.

(5) Receiving report. The Contractor shall ensure a receiving report meets the requirements of DFARS Appendix F.

(g) WAWF point of contact.

(1) The Contractor may obtain clarification regarding invoicing in WAWF from the following contracting activity's WAWF point of contact.

To be provided at time of award

(Contracting Officer: Insert applicable information or "Not applicable.")

(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed.

(End of clause)

Addendum to Contract Clauses

FAR Clauses Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations.

(Deviation 2026-O0038)

2026-02

52.217-2 Cancellation Under Multi-year Contracts.

1997-10

52.222-3 Convict Labor. (Deviation 2026- O0038)

2026-02

52.223-23 Sustainable Products. (Deviation 2026-O0038)

2026-02

52.240-91 Security Prohibitions and Exclusions. (Deviation 2026- O0038)

2026-02

52.244-6 Subcontracts for Commercial Products and Commercial Services. (Deviation 2026-O0038)

2026-02

DFARS Clauses Incorporated by Reference

Date

Alternate Deviation

Variation Effective Date

252.237-7010 Prohibition on Interrogation of Detainees by Contractor Personnel.

2023-01

Identifier Document Name

Document Description

Reference Identifier

Date Line Item

Page Numbers

Document Type

Provided Under Separate Cover

0001 Wage Deter mination S

WVA

17APR2

Wage Determination

Service Contract Act WD # 2015-4317

Apr

Attachment No

0002 SW Virgini a PWS Dent al Service s

- Final -

17APR202

Performance Work Statement

Apr

Attachment No

0003 Addendum t o 52.212-1 , Instruct ions to Of ferors

– C ommercial Products a nd Commerc ial Servic es

Addendum to 52.212-1, Instructions to Offerors – Commercial Products and Commercial Services

Apr

Attachment No

Solicitation Provisions

FAR Provisions Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.204-7 System for Award Management- Registration. (Deviation 2026- O0038)

2026-02

52.212-1 Instructions to Offerors- Commercial Products and Commercial Services. (Deviation 2026-O0038)

DFARS Provisions Incorporated by Reference

Date

Alternate Deviation

Variation Effective Date

252.203-7005 Representation Relating to Compensation of Former DoD Officials.

2022-09

252.204-7008 Compliance with Safeguarding Covered Defense Information Controls.

2016-10

252.204-7024 Notice on the Use of the Supplier Performance Risk System.

2023-03

252.225-7055 Representation Regarding Business Operations with the Maduro Regime.

2022-05

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

2023-06

DFARS Provisions Incorporated by Full Text

Date

Alternate Deviation

Variation Effective Date

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

2021-05

PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE TELECOMMUNICATIONS

EQUIPMENT OR SERVICES-REPRESENTATION (MAY 2021)

The Offeror is not required to complete the representation in this provision if the Offeror has represented in the provision at 252.204-7016, Covered Defense Telecommunications Equipment or Services-Representation, that it "does not provide covered defense 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."

(a) Definitions. "Covered defense telecommunications equipment or services," "covered mission," "critical technology," and "substantial or essential component," as used in this provision, have the meanings given in the 252.204-7018 clause, Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services, of this solicitation.

(b) Prohibition. Section 1656 of the National Defense Authorization Act for Fiscal Year 2018 (Pub. L. 115-91) prohibits agencies from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service to carry out covered missions that uses covered defense telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system.

(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) at https://www.sam.gov for entities that are excluded when providing any equipment, system, or service to carry out covered missions that uses covered defense telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system, unless a waiver is granted.

(d) Representation. If in its annual representations and certifications in SAM the Offeror has represented in paragraph (c) of the provision at 252.204-7016, Covered Defense Telecommunications Equipment or Services-Representation, that it "does" provide covered defense 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, then the Offeror shall complete the following additional representation:

The Offeror represents that it [ ] will [ ] will not provide covered defense telecommunications equipment or services as a part of its offered products or services to DoD in the performance of any award resulting from this solicitation.

(e) Disclosures. If the Offeror has represented in paragraph (d) of this provision that it "will provide covered defense telecommunications equipment or services," the Offeror shall provide the following information as part of the offer:

(1) A description of all covered defense telecommunications equipment and services offered (include brand or manufacturer; product, such as model number, original equipment manufacturer (OEM) number, manufacturer part number, or wholesaler number; and item description, as applicable).

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

(3) For services, the entity providing the covered defense telecommunications services (include entity name, unique entity identifier, and Commercial and Government Entity (CAGE) code, if known).

(4) For equipment, the entity that produced or provided the covered defense telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known).

(End of provision)

Addendum to Solicitation Provisions

FAR Provisions Incorporated by Reference

Number Title Effective Date

Alternate Deviation

Variation Effective Date

52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions.

2024-09

52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements- Representation.

2017-01

52.240-90 Security Prohibitions and Exclusions Representations and Certifications. (Deviation 2026- O0038)

KO FOR VAARNG DO NOT DELETE, WSH15H DSCR 8000 JEFFERSON DAVIS HW

RICHMOND, VA 23297-0000

UNITED STATES

WESLEY SPENCER, EMAIL: WESLEY.SPENCERJR2.CIV@ARMY.MIL TELEPHONE: 434-298-6219