SPE5EC18Q0093.PDF

PDF 179 KB Posted May 10, 2018

Attached to: BOLT, SHEAR Federal contract opportunity
Solicitation number: SPE5EC18Q0093
Issued by: Defense Logistics Agency Troop Support Construction and Equipment

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REQUEST FOR QUOTATIONS THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

4. CERT.FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

5. ISSUED BY

7. DELIVERY

9. DESTINATION

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5 ON OR

BEFORE CLOSE OF BUSINESS (Date)

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (See Continuation Sheets)

12. DISCOUNT FOR PROMPT PAYMENT

d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN

QUOTATION

16. SIGNER

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not useable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

1. REQUEST NO.

SPE5EC-18-Q-0093

2. DATE ISSUED

2018 MAY 10

3. REQUISITION/PURCHASE REQUEST NO.

0071908523

RATING

DO-C9

DLA TROOP SUPPORT

HARDWARE (CSI)

700 ROBBINS AVENUE

PHILADELPHIA PA 19111

USA

Buyer: Clinton Williams PAA0246 Tel: 215-737-8685 Fax: 215-737-3215 Email: CLINTON.WILLIAMS@DLA.MIL

6. DELIVER BY (Date)

SEE SCHEDULE

8. TO:

c. CITY

d. STATE

b. STREET ADDRESS

a. NAME OF CONSIGNEE

e. ZIP CODE

a. 10 CALENDAR DAYS

b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS

15. DATE OF QUOTATION

a. NAME (Type or Print)

AREA CODE

c. TITLE (Type or Print)d. CITY

c. COUNTY

b. STREET ADDRESS

e. STATE f. ZIP CODE

See Schedule

2018 MAY 17

NUMBER

FOB DESTINATION

OTHER

(See Schedule)

CAGE

b. TELEPHONE

See attached schedule to complete quote information.

Quoter must also complete the following:

a. Quotation is valid for 90 days from date specified in Block 10 above unless otherwise indicated: _____________ .

b. Prices quoted are:

___ Contained in Commercial Catalog or Published Price List No. ___________________ dated _______________ page __________ .

___ Contained in Internal Price List No. _______________dated ____________________, which may be examined at our facility.

___ Commercial sales of comparable quantities: Quantity ____________ ; Price _____________;

___ Customer ________________________.

___ Other (provide basis) ______________________________________ _______________________________________ .

c. FOB Point: ____ Destination ____ Origin Shipping Point (City, State) _________________________________________ .

d. If delivery period shown in Block 6 is unacceptable, provide best possible delivery: _________________________________.

e. Remittance Address (Name, Street, City, State, ZIP): Same as Block 13 unless otherwise indicated below:

f. Vendor FAX Number: ____________________ Vendor Toll-Free Number: ____________________ Vendor E-mail: ______________________________

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 2 OF 10 PAGES

SPE5EC-18-Q-0093

CONTINUED ON NEXT PAGE

THIS SOLICITATION INCORPORATES THE TERMS AND CONDITIONS SET FORTH IN THE DLA MASTER SOLICITATION FOR EPROCUREMENT

AUTOMATED SIMPLIFIED ACQUISITIONS

(PART13) REVISION 45 (February 1, 2018) WHICH CAN BE FOUND ON THE WEB AT:

http://www.dla.mil/Portals/104/Documents/J7Acquisition/Master%20Solicitation %20Rev-45%20February-1-2018.pdf?ver=2018-01-31-124727-063

Government FAT required Government PLT required

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 10 PAGES

CONTINUED ON NEXT PAGE

SECTION B

SUPPLIES/SERVICES: 5306-01-317-4315

ITEM DESCRIPTION:

BOLT,SHEAR

RC001: DOCUMENTATION REQUIREMENTS FOR SOURCE APPROVAL REQUEST (SAR)

RP001: DLA PACKAGING REQUIREMENTS FOR PROCUREMENT

RA001: THIS DOCUMENT INCORPORATES TECHNICAL AND/OR QUALITY REQUIREMENTS

(IDENTIFIED BY AN 'R' OR AN 'I' NUMBER) SET FORTH IN FULL TEXT IN THE

DLA MASTER LIST OF TECHNICAL AND QUALITY REQUIREMENTS FOUND ON THE WEB

AT: http://www.dla.mil/HQ/Acquisition/Offers/eProcurement.aspx. FOR

SIMPLIFIED ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE

SOLICITATION ISSUE DATE OR THE AWARD DATE CONTROLS. FOR LARGE

ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE RFP ISSUE DATE

APPLIES UNLESS A SOLICITATION AMENDMENT INCORPORATES A FOLLOW-ON

REVISION, IN WHICH CASE THE AMENDMENT DATE CONTROLS.

RQ002: CONFIGURATION CHANGE MANAGEMENT - ENGINEERING CHANGE PROPOSAL

REQUEST FOR VARIANCE (DEVIATION OR WAIVER)

RQ009: INSPECTION AND ACCEPTANCE AT ORIGIN

RQ011: REMOVAL OF GOVERNMENT IDENTIFICATION FROM NON-ACCEPTED SUPPLIES

THIS IS A NAVY IDENTIFIED CRITICAL SAFETY ITEM

(CSI).

ALL REQUESTS FOR WAIVERS OR DEVIATIONS MUST BE

FORWARDED TO THE DSC CONTRACTING OFFICER FOR

REVIEW AND APPROVAL.

ALL ITEMS OF SUPPLY SHALL BE MARKED IAW

MIL-STD-129. IN ADDITION, EACH UNIT PACK WILL

BE MARKED WITH LOT AND SERIAL NUMBER (IF AVAILABLE),

CONTRACTOR'S CAGE CODE, ACTUAL MANUFACTURER'S

CAGE CODE AND PART NUMBER.

DATA IS PROPRIETARY OR INSUFFICIENT FOR

COMPETITIVE PROCUREMENT

QAP EQ003 APPLIES

THE ACCEPTABLE SOURCE(S) MUST MEET THE REQUIREMENTS

OF THE CURRENT REVISION OF THE OEM DRAWING

OFFERORS NOT CITED AS ACCEPTABLE SOURCES IN THE

PROCUREMENT ITEM DESCRIPTION ARE REQUIRED TO

OBTAIN SOURCE APPROVAL FROM THE DESIGN CONTROL

ACTIVITY. SOURCE APPROVAL REQUESTS/TECHNICAL

DATA PACKAGES MUST BE SUBMITTED TO DLA WITH

THE OFFER.

UNLESS OTHERWISE NOTED

FIRST ARTICLE TESTING IS REQUIRED

FAT AND PLT EXHIBITS AND CERTIFICATIONS SHALL BE SENT TO:

DODAAC:,,N65923,,

MCAS CHERRY POINT, NC,,

FLEET READINESS CENTER EAST,,

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 4 OF 10 PAGES

CONTINUED ON NEXT PAGE

SECTION B

SUPPLY/SERVICE: 5306-01-317-4315 CONT'D

RECEIVING OFFICER,,,,

BLDG 148, BAY C,,

BEACHEY ROAD,,

CHERRY POINT, NC 28533-5040,,,,,,

MARK FOR: TEST EXHIBITS. DO NOT POST.

CRITICAL APPLICATION ITEM

M.S. Aerospace Inc. 0UCY9 P/N 70209-27007-105 Preci-Manufacturing, Incorporated 66841 P/N 70209-27007-105

SPECIALTY TOOL COMPANY USA, LLC 56937 P/N 70209-27007-105

Sikorsky Aircraft Corporation DBA 78286 P/N 70209-27007-105 Acufast Aircraft Products Inc. 4GP55 P/N 70209-27007-105 Cambridge Specialty Co. Inc. 9E232 P/N 70209-27007-105

IAW REFERENCE DRAWING NR 78286 70209-27007

REVISION NR M DTD 03/27/2009

PART PIECE NUMBER:

IAW REFERENCE DRAWING NR 78286 70209-27007

REVISION NR AG DTD 05/17/2010

PART PIECE NUMBER:

IAW REFERENCE DRAWING NR 78286 70209-27007

REVISION NR G DTD 08/02/2010

PART PIECE NUMBER:

IAW REFERENCE QAP 14153 QAP-EQ003

REVISION NR B DTD 05/16/2013

PART PIECE NUMBER:

IAW REFERENCE QAP 76301 QAP-CSI013174315

REVISION NR C DTD 05/11/2016

PART PIECE NUMBER:

Critical Safety Item

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .

0001 5306-01-317-4315 2,200.000 EA $ ________________ $ ________________

BOLT,SHEAR

QTY VARIANCE: PLUS 0% MINUS 0%

INSPECTION POINT: ORIGIN

ACCEPTANCE POINT: ORIGIN

FOB: ORIGIN DELIVERY DATE: 90 DAYS ADO

PREP FOR DELIVERY:

PKGING DATA - MIL-STD-2073-1D, 15 DEC 1999

QUP:001 PRES MTHD:10 CLNG/DRY:1 PRESV MAT:00

WRAP MAT:00 CUSH/DUNN MAT:00 CUSH/DUNN THKNESS:0

UNIT CONT:10 OPI:O

INTRMDTE CONT:D3 INTRMDTE CONT QTY:AAA

PACK CODE:U

MARKING SHALL BE IN ACCORDANCE WITH MIL-STD-129.

SPECIAL MARKING CODE:00 -00 No special marking

PALLETIZATION SHALL BE IN ACCORDANCE WITH MD00100452 REV B DATED JULY 01, 2008

PARCEL POST ADDRESS:

SW3122

DLA DISTRIBUTION JACKSONVILLE

BLDG 175 SWAN ROAD

JACKSONVILLE FL 32212-0103

FOR TRANSPORTATION ASSISTANCE SEE DLAD PROC NOTE C19. FOR FIRST DESTINATION TRANSPORTATION (FDT) AWARDS SEE DLAD PROC

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 5 OF 10 PAGES

CONTINUED ON NEXT PAGE

SECTION B

SUPPLY/SERVICE: 5306-01-317-4315 CONT'D

NOTE C20 AND

CONTRACT INSTRUCTIONS.

FREIGHT SHIPPING ADDRESS:

SW3122

DLA DISTRIBUTION JACKSONVILLE

BLDG 175 SWAN ROAD

RAYMOND MORGAN 904-542-2743

JACKSONVILLE FL 32212-0103

Government First Article Test Government First Article Test – The number of units shown signifies the test requirement. See FAR clause 52.209-4 for the actual quantity required to be tested.

0002 0001 - S00000052 1.000 EA $ ________________ $ ________________

FOB: DELIVERY DATE: 120 DAYS ADO

PREP FOR DELIVERY:

Not Applicable

Production Lot Testing (Government)

0003 0001 - S00000061 1.000 EA $ ________________ $ ________________

INSPECTION POINT: ORIGIN

ACCEPTANCE POINT: ORIGIN

FOB: ORIGIN DELIVERY DATE: 120 DAYS ADO

PREP FOR DELIVERY:

Not Applicable

GOVT USE

External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date .

0001 0071908523 0001 N/A N/A N/A 12/04/2019

0002 N/A N/A N/A N/A N/A N/A

0003 N/A N/A N/A N/A N/A N/A

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 6 OF 10 PAGES

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SECTION A - SOLICITATION/CONTRACT FORM

52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (JUL 2016) FAR

SECTION E - INSPECTION AND ACCEPTANCE

Standard Element ZC_246_9085 has no Title

SECTION F - DELIVERIES OR PERFORMANCE

52.211-10 COMMENCEMENT, PROSECUTION, AND COMPLETION OF WORK (APR 1984) FAR

As prescribed in 11.404(b), insert the following clause in solicitations and contracts when a fixed-price construction contract is contemplated. The clause may be changed to accommodate the issuance of orders under indefinite-delivery contracts for construction.

The Contractor shall be required to (a) commence work under this contract within [Contracting Officer insert number] calendar days after the date the Contractor receives the notice to proceed, (b) prosecute the work diligently, and (c) complete the entire work ready for use not later than .* The time stated for completion shall include final cleanup of the premises.

(End of clause)

52.211-10 COMMENCEMENT, PROSECUTION, AND COMPLETION OF WORK (APR 1984), ALT I (APR 1984) FAR Alternate I (Apr 1984). If the completion date is expressed as a specific calendar date, computed on the basis of the contractor receiving the notice to proceed by a certain day, add the following paragraph to the basic clause:

The completion date is based on the assumption that the successful offeror will receive the notice to proceed by [Contracting Officer insert date]. The completion date will be extended by the number of calendar days after the above date that the Contractor receives the notice to proceed, except to the extent that the delay in issuance of the notice to proceed results from the failure of the Contractor to execute the contract and give the required performance and payment bonds within the time specified in the offer.

SECTION H - SPECIAL CONTRACT REQUIREMENTS

252.223-7001 HAZARD WARNING LABELS (DEC 1991) DFARS

(c) The Offeror shall list which hazardous material listed in the Hazardous Material Identification and Material Safety Data clause of this contract will be labelled in accordance with one of the Acts in paragraphs (b)(1) through (5) of this clause instead of the Hazard Communication Standard. Any hazardous material not listed will be interpreted to mean that a label is required in accordance with the Hazard Communication Standard.

MATERIAL (If None, Insert “None”)

ACT

https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%2011_4.html

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 7 OF 10 PAGES

SECTION H - SPECIAL CONTRACT REQUIREMENTS (CONTINUED)

CONTINUED ON NEXT PAGE

MATERIAL (If None, Insert “None”)

ACT

SECTION I - CONTRACT CLAUSES

52.204-14 SERVICE CONTRACT REPORTING REQUIREMENTS (OCT 2016) FAR

52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR INDEFINITE-DELIVERY CONTRACTS (OCT 2016) FAR

52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (JUL 2016) FAR

52.204-20 PREDECESSOR OF OFFEROR (JUL 2016) FAR

As prescribed in 4.1804(d), insert the following provision:

(a) Definitions. As used in this provision -

“Commercial and Government Entity (CAGE) code” means -

(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity; or

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

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

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

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

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

Predecessor CAGE code:

Predecessor legal name:

(Do not use a “doing business as” name)

(End of provision)

252.204-7000 DISCLOSURE OF INFORMATION (AUG 2013) DFARS

52.209-4 FIRST ARTICLE APPROVAL - GOVERNMENT TESTING (SEP 1989) FAR

As prescribed in 9.308-2(a) and (b), insert the following clause:

[Contracting Officer shall insert details] https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%204_18.html https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%209_3.html

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 8 OF 10 PAGES

SECTION I - CONTRACT CLAUSES (CONTINUED)

CONTINUED ON NEXT PAGE

(a) The Contractor shall deliver 2 unit(s) of Lot/Item 5306-01-317-4315 within 120 calendar days from the date of this contract to the

Government at Fleet Readiness Center East Receiving Officer Beachey Road Bldg 148 Bay C MCAS Cherry Point, NC 28533-5040 [insert name and address of the testing facility] for first article tests. The shipping documentation shall contain this contract number and the Lot/Item identification. The characteristics that the first article must meet and the testing requirements are specified elsewhere in this contract.

(b) Within 120 calendar days after the Government receives the first article, the Contracting Officer shall notify the Contractor, in writing, of the conditional approval, approval, or disapproval of the first article. The notice of conditional approval or approval shall not relieve the

Contractor from complying with all requirements of the specifications and all other terms and conditions of this contract. A notice of conditional approval shall state any further action required of the Contractor. A notice of disapproval shall cite reasons for the disapproval.

(c) If the first article is disapproved, the Contractor, upon Government request, shall submit an additional first article for testing. After each request, the Contractor shall make any necessary changes, modifications, or repairs to the first article or select another first article for testing.

All costs related to these tests are to be borne by the Contractor, including any and all costs for additional tests following a disapproval. The

Contractor shall furnish any additional first article to the Government under the terms and conditions and within the time specified by the

Government. The Government shall act on this first article within the time limit specified in paragraph (b) of this clause. The Government reserves the right to require an equitable adjustment of the contract price for any extension of the delivery schedule or for any additional costs to the Government related to these tests.

(d) If the Contractor fails to deliver any first article on time, or the Contracting Officer disapproves any first article, the Contractor shall be deemed to have failed to make delivery within the meaning of the Default clause of this contract.

(e) Unless otherwise provided in the contract, the Contractor -

(1) May deliver the approved first article as a part of the contract quantity, provided it meets all contract requirements for acceptance and was not consumed or destroyed in testing; and

(2) Shall remove and dispose of any first article from the Government test facility at the Contractor's expense.

(f) If the Government does not act within the time specified in paragraph (b) or (c) of this clause, the Contracting Officer shall, upon timely written request from the Contractor, equitably adjust under the Changes clause of this contract the delivery or performance dates and/or the contract price, and any other contractual term affected by the delay.

(g) The Contractor is responsible for providing operating and maintenance instructions, spare parts support, and repair of the first article during any first article test.

(h) Before first article approval, the acquisition of materials or components for, or the commencement of production of, the balance of the contract quantity is at the sole risk of the Contractor. Before first article approval, the costs thereof shall not be allocable to this contract for (1) progress payments, or (2) termination settlements if the contract is terminated for the convenience of the Government.

(i) The Government may waive the requirement for first article approval test where supplies identical or similar to those called for in the schedule have been previously furnished by the Offeror/Contractor and have been accepted by the Government. The Offeror/Contractor may request a waiver.

52.223-3 HAZARDOUS MATERIAL IDENTIFICATION AND MATERIAL SAFETY DATA (JAN 1997) FAR

(b) The offeror must list any hazardous material, as defined in paragraph (a) of this clause, to be delivered under this contract. The hazardous material shall be properly identified and include any applicable identification number, such as National Stock Number or Special Item Number.

This information shall also be included on the Material Safety Data Sheet submitted under this contract.

Material (If none, insert “None”)

Identification No.

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 9 OF 10 PAGES

SECTION I - CONTRACT CLAUSES (CONTINUED)

CONTINUED ON NEXT PAGE

Material (If none, insert “None”)

Identification No.

52.223-11 OZONE-DEPLETING SUBSTANCES AND HIGH GLOBAL WARNING POTENTIAL HYDROFLUOROCARBONS (JUN 2016)

FAR

As prescribed in 23.804(a)(1), insert the following clause:

Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Jun 2016)

(a) Definition. As used in this clause -

“Global warming potential” means how much a given mass of a chemical contributes to global warming over a given time period compared to the same mass of carbon dioxide. Carbon dioxide's global warming potential is defined as 1.0.

“High global warming potential hydrofluorocarbons” means any hydrofluorocarbons in a particular end use for which EPA's Significant New Alternatives Policy (SNAP) program has identified other acceptable alternatives that have lower global warming potential. The SNAP list of alternatives is found at 40 CFR Part 82 subpart G with supplemental tables of alternatives available at (http://www.epa.gov/snap/).

“Hydrofluorocarbons” means compounds that only contain hydrogen, fluorine, and carbon.

“Ozone-depleting substance,” means any substance the Environmental Protection Agency designates in 40 CFR Part 82 as -

(1) Class I, including, but not limited to, chlorofluorocarbons, halons, carbon tetrachloride, and methyl chloroform; or

(2) Class II, including, but not limited to, hydrochlorofluorocarbons.

(b) The Contractor shall label products that contain or are manufactured with ozone-depleting substances in the manner and to the extent required by 42 U.S.C. 7671j (b), (c), (d), and (e) and 40 CFR part 82, subpart E, as follows:

WARNING

Contains (or manufactured with, if applicable) * , a substance(s) which harm(s) public health and environment by destroying ozone in the upper atmosphere.

* The Contractor shall insert the name of the substance(s).

(c) Reporting. For equipment and appliances that normally each contain 50 or more pounds of hydrofluorocarbons or refrigerant blends containing hydrofluorocarbons, the Contractor shall -

(1) Track on an annual basis, between October 1 and September 30, the amount in pounds of hydrofluorocarbons or refrigerant blends containing hydrofluorocarbons contained in the equipment and appliances delivered to the Government under this contract by -

(i) Type of hydrofluorocarbon (e.g., HFC-134a, HFC-125, R-410A, R-404A, etc.);

(ii) Contract number; and

(iii) Equipment/appliance;

(2) Report that information to the Contracting Officer for FY16 and to www.sam.gov, for FY17 and after -

(i) Annually by November 30 of each year during contract performance; and

(ii) At the end of contract performance.

(d) The Contractor shall refer to EPA's SNAP program (available at http://www.epa.gov/snap) to identify alternatives. The SNAP list of alternatives is found at 40 CFR part 82 subpart G with supplemental tables available at http://www.epa.gov/snap.

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS

https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%2023_8.html http://www.epa.gov/snap http://uscode.house.gov/ https://www.acquisition.gov/sites/default/files/current/far/html/www.sam.gov https://www.epa.gov/snap https://www.epa.gov/snap

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 10 OF 10 PAGES

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS (CONTINUED)

52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016) FAR

As prescribed in 4.1804(b), use the following provision:

(a) Definitions. As used in this provision -

“Commercial and Government Entity (CAGE) code” means -

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

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

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

Immediate owner CAGE code:

Immediate owner legal name:

(Do not use a “doing business as” name)

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

(d) If the Offeror indicates “yes” in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:

Highest-level owner CAGE code:

Highest-level owner legal name:

(Do not use a “doing business as” name)

(End of provision) https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%204_18.html

CONTINUATION SHEET