SPE7M519Q0203.PDF

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Attached to: HEADSET-MICROPHONE Federal contract opportunity
Solicitation number: SPE7M519Q0203
Issued by: Defense Logistics Agency Land and Maritime

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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.

SPE7M5-19-Q-0203

2. DATE ISSUED

2018 NOV 14

3. REQUISITION/PURCHASE REQUEST NO.

0076777730

RATING

DO-C9

DLA LAND AND MARITIME

ACTIVE DEVICES DIVISION

PO BOX 3990

COLUMBUS OH 43218-3990

USA

Buyer: Corey Carter PMCM46M Email: Corey.Carter@dla.mil

6. DELIVER BY (Date)

289 DAYS ADO

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 NOV 23

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 9 PAGES

SPE7M5-19-Q-0203

CONTINUED ON NEXT PAGE

THIS SOLICITATION INCORPORATES THE TERMS AND CONDITIONS SET FORTH IN THE REVISION OF THE DLA MASTER SOLICITATION FOR EPROCUREMENT AUTOMATED SIMPLIFIED ACQUISITIONS IN EFFECT ON THE SOLICITATION ISSUE DATE. ALL REVISIONS OF THE DLA MASTER SOLICITATION FOR EPROCUREMENT AUTOMATED SIMPLIFIED ACQUISITIONS CAN BE FOUND ON THE WEB AT: http://www.dla.mil/ HQ/Acquisition/Offers/eProcurement.aspx

DLAD Procurement Notes are incorporated by reference, with the same force and effect as if they were in full text. The full text of a DLAD Procurement Note may be accessed electronically at http://www.dla.mil/HQ/Acquisition/Offers/ eProcurement.aspx and via 'References' on the DIBBS homepage.

This solicitation is issued under the First Destination Transportation (FDT) program to reduce the cost of transportation through the use of Government-arranged transportation utilizing Government contracts and rates. If this award is for FMS or has an APO/FPO ship-to address, these instructions do not apply.

For FDT Program Transportation Requirements, see Procurement Note C16 First Destination Transportation (FDT) Program, Government-Arranged Transportation for Manual Awards, C17 First Destination Transportation (FDT) Program – Shipments Originating from Outside the Contiguous United States, and Procurement Note C20 – Vendor Shipment Module (VSM).

Offers should be submitted based on FOB origin. For offerors whose shipments will originate from outside the contiguous United States, the offeror’s f.o.b. origin price shall include transportation to a contiguous United States location that the offeror selects based on cost-effectiveness or other variables at the offeror’s discretion.

Additional information about FDT can be found at http://www.dla.mil/LandandMaritime/Business/Selling/DLA-Land-and- Maritime-Procurement-Initiatives/FDTPI/

DFARS 252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)

(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.

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

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

acquisition.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 must use the following information when submitting payment requests and receiving reports in WAWF for this contract/order:

(1) Document type. The Contractor shall use the following document type(s).

An invoice and WAWF receiving report (RR) are both required. The invoice and receiving report may be submitted separately or together as a combo type document. See DFARS Appendix F for detailed instructions on preparing the WAWF

RR.

NOTE: For contracts in accordance with Fast Payment Procedures, a Fast Pay (FP) invoice must be connected with a receiving report (RR), so either submit a FP combo or submit a RR and follow with a FP invoice. If there is no registered acceptor, the RR portion of the combo cannot be processed. In this case, submit a stand-alone FP invoice (“accept by” DoDAAC/location is mandatory).

(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) in WAWF, as specified by the contracting officer.

See Award.

(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 WAWFData to be entered in WAWF Pay Official DoDAACSee Page 1 Issue By DoDAACSee Page 1 Admin DoDAACSee Page 1 Inspect By DoDAACSee Award Ship To CodeSee Award Ship From CodeSee Award/Purchase Order if applicable Mark For CodeSee Award/Purchase Order if applicable Service Approver (DoDAAC)See Award/Purchase Order if applicable Service Acceptor (DoDAAC)See Award/Purchase Order if applicable Accept at Other DoDAACSee Award/Purchase Order if applicable LPO DoDAAC DCAA Auditor DoDAAC Other DoDAAC(s)

(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includes appropriate contract line item and subline item descriptions of the work performed or supplies delivered, unit price/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F, (e.g. timesheets) in support of each payment request.

(5) WAWF email notifications. The Contractor shall enter the e-mail address identified below in the “Send Additional Email Notifications” field of WAWF once a document is submitted in the system.

Additional email notifications are not required.

(g) WAWF point of contact.

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 9 PAGES

CONTINUED ON NEXT PAGE

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

Contact the local contract administrator found in block 6 of the DD 1155, block 9 of the SF 1449, or block 5 of the SF 26.

(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.

(End of clause)

DFARS 252.246-7008 Sources of Electronic Parts (OCT 2016)

FAR 52.203-18Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements--Representation FAR 52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements

DFARS 252.225-7001, BUY AMERICAN ACT--BALANCE OF PAYMENTS PROGRAM APPLIES

52.219-6 Notice of Total Small Business Set-Aside.

52.219-28 Post-Award Small Business Program Representation

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 4 OF 9 PAGES

CONTINUED ON NEXT PAGE

SECTION B

SUPPLIES/SERVICES: 5965-01-204-8505

ITEM DESCRIPTION:

HEADSET-MICROPHONE

RQ002: CONFIGURATION CHANGE MANAGEMENT - ENGINEERING CHANGE PROPOSAL

REQUEST FOR VARIANCE (DEVIATION OR WAIVER)

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.

RQ011: REMOVAL OF GOVERNMENT IDENTIFICATION FROM NON-ACCEPTED SUPPLIES

RQ016: COMPONENT QUALIFIED PRODUCTS LISTS (QPL)/QUALIFIED MANUFACTURERS

LISTS (QML). THIS ITEM CONTAINS ONE OR MORE COMPONENTS DEFINED BY A

SPECIFICATION(S) WITH AN ASSOCIATED QUALIFIED PRODUCTS LIST (QPL) OR

QUALIFIED MANUFACTURERS LIST (QML). QUALIFICATION REQUIREMENTS IN

PROCUREMENT NOTE H02 "COMPONENT QUALIFIED PRODUCTS LIST (QPL)/QUALIFIED

MANUFACTURERS LIST (QML)" APPLY.

THIS NSN CONTAINS ONE OR MORE COMPONENTS WHICH MUST MEET QPL/QML

REQUIREMENTS. BY SUBMITTING AN OFFER, THE OFFEROR AGREES TO PROVIDE

QPL/QML COMPONENTS ONLY FROM SOURCES QUALIFIED ON THE APPLICABLE

QPL(S)/QML(S).

THE REQUIRED ITEM IS (M87819/1-01) MANUFACTURED BY A QUALIFIED QPD

SOURCE IAW MIL-PRF-87819. COMMERCIAL SUBSTITUTES ARE NOT ACCEPTABLE

WITHOUT PRIOR WRITTEN APPROVAL BY THE GOVERNMENT.

THE USE OF ANY CLASS I OZONE-DEPLETING SUBSTANCE

(ODS) IN THE DESIGN, MANUFACTURING, TESTING,

CLEANING, OR ANY OTHER PROCESS FOR THIS ITEM

UNDER ANY MILITARY OR FEDERAL SPECIFICATION,

STANDARD OR DRAWING REFERENCED IN THIS ITEM

DESCRIPTION IS "PROHIBITED" UNLESS THE SEPARATE

WRITTEN APPROVAL OF THE CONTRACTING OFFICER IS

OBTAINED. THIS PROHIBITION SUPERSEDES ALL

SPECIFICATION REQUIREMENTS BUT DOES NOT

ALLEVIATE ANY PRODUCT PERFORMANCE REQUIREMENTS.

THIS DOES NOT APPLY TO COMMERCIAL ITEMS, AS

DEFINED IN "FAR 11.001" OR TO PART-NUMBERED-

ONLY ITEMS.

PILFERABLE MATERIAL-SEE MIL-STD 129 INSTRUCTIONS

FOR MARKING OF ITEMS AND PACKAGES.

CRITICAL APPLICATION ITEM

IAW BASIC SPEC NR MIL-PRF-87819B(2)

REVISION NR B DTD 05/18/2017

PART PIECE NUMBER: M87819/1-01

IAW REFERENCE SPEC NR MIL-PRF-87819/1B(1)

REVISION NR B DTD 02/23/2015

PART PIECE NUMBER: M87819/1-01

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 5 OF 9 PAGES

CONTINUED ON NEXT PAGE

SUPPLY/SERVICE: 5965-01-204-8505 CONT'D

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

0001 5965-01-204-8505 127.000 EA $ ________________ $ ________________

PRICING TERMS: Firm Fixed Price

QTY VARIANCE: PLUS 0% MINUS 0%

INSPECTION POINT: DESTINATION

ACCEPTANCE POINT: DESTINATION

FOB: ORIGIN DELIVERY DATE: 289 DAYS ADO

PREP FOR DELIVERY:

PKGING DATA-QUP:001

SHALL BE PACKAGED IN ACCORDANCE WITH HAZARDOUS

MATERIALS PACKAGING REQUIREMENTS.

PACKAGING: PACKAGING FOR HAZARDOUS MATERIALS

SHALL COMPLY WITH APPLICABLE REGULATIONS, I.E.,

TITLE 49 CODE OF FEDERAL REGULATIONS,

INTERNATIONAL CIVIL AVIATION ORGANIZATION (ICAO)

TECHNICAL INSTUCTIONS (EXCLUDING PARAGRAPH 1.4

OF CHAPTERS 1 AND 3), AND INTERNATIONAL MARITIME

DANGEROUS GOODS CODE (IMDG). BOTH ICAO AND IMDG

COMPLY WITH UNITED NATIONS (UN) RECOMMENDATIONS

ON TRANSPORT OF DANGEROUS GOODS. WHEN A);

CONTRACT/ORDER FOR HAZARDOUS MATERIALS REQUIRES

SHIPMENT THROUGH A MILITARY AERIAL PORT FOR

TRANSPORT VIA MILITARY AIRCRAFT, PACKAGING SHALL

COMPLY WITH DLAI 4145.3, PREPARING HAZARDOUS

MATERIALS FOR MILITARY AIR SHIPMENT.

LABELING AND MARKING: ALL INTERIOR AND EXTERIOR

CONTAINERS SHALL BE LABELED AND MARKED AS

SPECIFIED IN THE REFERENCED PRODUCT

SPECIFICATION, AND/OR AS SPECIFIED IN SECTION D

OF THE CONTRACT OR ORDER. IN ADDITION, ALL

LABELING AND MARKING SHALL COMPLY WITH THE

REQUIREMENTS OF MIL-STD-129, 49 CFR, 29 CFR,

AND, AS APPLICABLE, ICAO TECHNICAL INSTRUCTIONS,

IMDG ANNEX 1, AND/OR DLAI 4145.3.

CERTIFICATION: ALL PACKAGING PERFORMANCE TEST

REQUIREMENTS SHALL BE SUPPORTED BY CERTIFICATES

AND REPORTS ATTESTING TO DATE OF TESTING AND

DATA RESULTS OBTAINED FROM TESTING. THE

CONTRACTOR'S SIGNED CERTIFICATION THAT PACKAGE

CONFIGURATION MEETS 49 CFR, AND, AS APPLICABLE,

ICAO, IMDG AND/OR DLAI 4145.3 REQUIREMENTS,

SHALL BE INCLUDED ON THE DD FORM 250 (MATERIAL

INSPECTION AND RECEIVING REPORT), OR ANY

SUITABLE ALTERNATE COMMERCIAL PACKING LIST. ALL

CERTIFICATES/REPORTS SHALL BE AVAILABLE FOR

INSPECTION BY AUTHORIZED U. S. GOVERNMENT

REPRESENTATIVES FOR A PERIOD OF NOT LESS THAN 3

YEARS FROM THE DATE OF SHIPMENT.

IF THE MATERIAL IS NOT CONSIDERED HAZARDOUS,

IN ACCORDANCE WITH FED-STD-313, THE MATERIAL

SHALL BE COMMERCIALLY PACKAGED IN ACCORDANCE

WITH "ASTM D3951."

Markings Paragraph When ASTM D3951, Commercial Packaging is specified, the following apply:

•,,All Section “D” Packaging and Marking Clauses take precedence over

ASTM D3951.

•,,In addition to requirements in MIL-STD-129, when Commercial Packaging is used, the Method of Preservation for all MIL-STD-129 marking and labeling shall be “CP” Commercial Pack.

•,,The Unit of Issue (U/I) and Quantity per Unit Pack (QUP) as specified in the contract take precedence over QUP in ASTM D3951.

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 6 OF 9 PAGES

CONTINUED ON NEXT PAGE

SUPPLY/SERVICE: 5965-01-204-8505 CONT'D

PARCEL POST ADDRESS:

SW3210

DLA DISTRIBUTION DEPOT HILL

7537 WARDLEIGH RD

HILL AFB UT 84056-5734

FOR TRANSPORTATION SEE DLAD DLAD PROC NOTE C19. FOR FIRST DESTINATION TRANSPORTATION SEE DLAD PROC NOTE C20 AND

CONTRACT

FREIGHT SHIPPING ADDRESS:

SW3210

DLA DISTRIBUTION DEPOT HILL

7537 WARDLEIGH RD BLDG 849W

CML 385 519 8898

HILL AFB UT 84056-5734

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

0002 5965-01-204-8505 777.000 EA $ ________________ $ ________________

PRICING TERMS: Firm Fixed Price

QTY VARIANCE: PLUS 0% MINUS 0%

INSPECTION POINT: DESTINATION

ACCEPTANCE POINT: DESTINATION

FOB: ORIGIN DELIVERY DATE: 289 DAYS ADO

PREP FOR DELIVERY:

PKGING DATA-QUP:001

SHALL BE PACKAGED IN ACCORDANCE WITH HAZARDOUS

MATERIALS PACKAGING REQUIREMENTS.

PACKAGING: PACKAGING FOR HAZARDOUS MATERIALS

SHALL COMPLY WITH APPLICABLE REGULATIONS, I.E.,

TITLE 49 CODE OF FEDERAL REGULATIONS,

INTERNATIONAL CIVIL AVIATION ORGANIZATION (ICAO)

TECHNICAL INSTUCTIONS (EXCLUDING PARAGRAPH 1.4

OF CHAPTERS 1 AND 3), AND INTERNATIONAL MARITIME

DANGEROUS GOODS CODE (IMDG). BOTH ICAO AND IMDG

COMPLY WITH UNITED NATIONS (UN) RECOMMENDATIONS

ON TRANSPORT OF DANGEROUS GOODS. WHEN A);

CONTRACT/ORDER FOR HAZARDOUS MATERIALS REQUIRES

SHIPMENT THROUGH A MILITARY AERIAL PORT FOR

TRANSPORT VIA MILITARY AIRCRAFT, PACKAGING SHALL

COMPLY WITH DLAI 4145.3, PREPARING HAZARDOUS

MATERIALS FOR MILITARY AIR SHIPMENT.

LABELING AND MARKING: ALL INTERIOR AND EXTERIOR

CONTAINERS SHALL BE LABELED AND MARKED AS

SPECIFIED IN THE REFERENCED PRODUCT

SPECIFICATION, AND/OR AS SPECIFIED IN SECTION D

OF THE CONTRACT OR ORDER. IN ADDITION, ALL

LABELING AND MARKING SHALL COMPLY WITH THE

REQUIREMENTS OF MIL-STD-129, 49 CFR, 29 CFR,

AND, AS APPLICABLE, ICAO TECHNICAL INSTRUCTIONS,

IMDG ANNEX 1, AND/OR DLAI 4145.3.

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 7 OF 9 PAGES

CONTINUED ON NEXT PAGE

SECTION B

SUPPLY/SERVICE: 5965-01-204-8505 CONT'D

CERTIFICATION: ALL PACKAGING PERFORMANCE TEST

REQUIREMENTS SHALL BE SUPPORTED BY CERTIFICATES

AND REPORTS ATTESTING TO DATE OF TESTING AND

DATA RESULTS OBTAINED FROM TESTING. THE

CONTRACTOR'S SIGNED CERTIFICATION THAT PACKAGE

CONFIGURATION MEETS 49 CFR, AND, AS APPLICABLE,

ICAO, IMDG AND/OR DLAI 4145.3 REQUIREMENTS,

SHALL BE INCLUDED ON THE DD FORM 250 (MATERIAL

INSPECTION AND RECEIVING REPORT), OR ANY

SUITABLE ALTERNATE COMMERCIAL PACKING LIST. ALL

CERTIFICATES/REPORTS SHALL BE AVAILABLE FOR

INSPECTION BY AUTHORIZED U. S. GOVERNMENT

REPRESENTATIVES FOR A PERIOD OF NOT LESS THAN 3

YEARS FROM THE DATE OF SHIPMENT.

IF THE MATERIAL IS NOT CONSIDERED HAZARDOUS,

IN ACCORDANCE WITH FED-STD-313, THE MATERIAL

SHALL BE COMMERCIALLY PACKAGED IN ACCORDANCE

WITH "ASTM D3951."

Markings Paragraph When ASTM D3951, Commercial Packaging is specified, the following apply:

•,,All Section “D” Packaging and Marking Clauses take precedence over

ASTM D3951.

•,,In addition to requirements in MIL-STD-129, when Commercial Packaging is used, the Method of Preservation for all MIL-STD-129 marking and labeling shall be “CP” Commercial Pack.

•,,The Unit of Issue (U/I) and Quantity per Unit Pack (QUP) as specified in the contract take precedence over QUP in ASTM D3951.

PARCEL POST ADDRESS:

SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET

BLDG 376

ROBINS A F B GA 31098-1887

FOR TRANSPORTATION SEE DLAD DLAD PROC NOTE C19. FOR FIRST DESTINATION TRANSPORTATION SEE DLAD PROC NOTE C20 AND

CONTRACT

FREIGHT SHIPPING ADDRESS:

SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET BLDG 376

ROBINS A F B GA 31098-1887

GOVT USE

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

0001 0076777730 0001 N/A N/A N/A 11/25/2019

0002 0076777730 0002 N/A N/A N/A 11/25/2019

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 8 OF 9 PAGES

CONTINUED ON NEXT PAGE

SECTION A - SOLICITATION/CONTRACT FORM

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

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)

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS

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 -

(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency

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

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS (CONTINUED)

(NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.

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

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

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

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)

CONTINUATION SHEET