SPRDL1-23-R-0095_0003.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing items 8 and 15, and returning ____________ copies of the amendments: (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. Accounting And Appropriation Data (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATIONS OF CONTRACTS/ORDERS

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: The Changes Set Forth In Item 14 Are Made In

The Contract/Order No. In Item 10A.

B. The Above Numbered Contract/Order Is Modified To Reflect The Administrative Changes (such as changes in paying office, appropriation data, etc.) Set

Forth In Item 14, Pursuant To The Authority of FAR 43.103(b).

C. This Supplemental Agreement Is Entered Into Pursuant To Authority Of:

D. Other (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return _______________ copies to the Issuing Office.

14. Description Of Amendment/Modification (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Except as provided herein, all terms and conditions of the document referenced in item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. Name And Title Of Signer (Type or print)

16A. Name And Title Of Contracting Officer (Type or print)

15B. Contractor/Offeror 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

0003 2023OCT06

SPRDL1

DLA LAND WARREN

WARREN, MI 48397-5000

RALPH MCCARTHY

EMAIL: RALPH.MCCARTHY@DLA.MIL

SPRDL1-23-R-0095

2023MAY10

X

X 2023OCT27 11:59pm

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: RALPH MCCARTHY

Buyer Office Symbol/Telephone Number: ZGAC/(586)467-1173

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

1. The purpose of Amendment 0003 to Solictation SPRDL1-23-R-0095 is to:

a. Increase the Maximum 5 Year Contract Quantity from 188 each to 200 each. Only the Guaranteed Minimum Quantity (25 each) is guaranteed.

b. Increase the Estimated Annual Procurement Quantity from 38 each to

40 each for each ordering year.

c. Update the following contract clauses:

1. FAR 52.204-8 "Annual representations and Certifications"

2. FAR 52.211-1 "Availability of Specifications Listed in the

GSA Index of Federal Specifications, Standards and

Commercial Items Descriptions, FPMR Part 101-29"

3. FAR 52.211-2 "Availability of Defense Specifications, Standards, and Data Item SEP/2023 Descriptions in the

Acquisition Streamlining and Standardization Information

System (ASSIST) Website"

4. FAR 52.219-8 "Utilization of Small Business Concerns"

5. FAR 52.219-9 "Small Business Subcontracting Plan"

6. FAR 52.219-28 "Post Award Small Business Program

Representation"

7. FAR 52.244-6 "Subcontracting for Commercial Products and

Commercial Services"

8. DFARS 252.204-7006 "Billing Instructions - Cost Vouchers"

9. DFARS 252.205-7000 "Provision of Information to Cooperative

Agreement Holders"

10. DFARS 252.215-7008 "Only One Offer"

11. DFARS 252.225-7060 "Prohibition on Certain procurements from the Xinjiang Uyghur Autonomous Region"

12. DFARS 252.227-7037 "Validation of restrictive Markings on

Technical Data"

d. Extend the solicitation closing date from 23 June 2023 to 27

October 2023.

2. All other terms and conditions remain the same.

*** END OF NARRATIVE A0004 ***

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SPRDL1-23-R-0095

PIIN/SIIN

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

IN THE FIRST FOUR DIGIT ITEM NUMBERS (CLINS) THAT

FOLLOW, THE NUMBERING SYSTEM THAT IS USED IS AS

FOLLOWS:

THE FIRST THREE DIGITS SIGNIFY THE ITEM. THE FOURTH

(LAST DIGIT) INDICATES THE CONTRACT YEAR, i.e., CLIN

0011 IS FOR THE FIRST ITEM - FIRST ORDERING YEAR,

CLIN 0012 IS FOR THE FIRST ITEM - SECOND ORDERING

YEAR, CLIN 0013 IS FOR THE FIRST ITEM - THIRD

ORDERING YEAR, ETC.

THE FINAL LINE ITEM(S) ASSOCIATED WITH EACH

PART, SUCH AS FAT, TECHNICAL MANUALS, SERVICES,

OR TRAINING, WILL BECOME THE LAST ITEM NUMBER

IN NUMERICAL SEQUENCE FOR EACH ITEM, e.g.

0016 (5-YEAR LONG-TERM CONTRACT) OR 0014

(3-YEAR LONG-TERM CONTRACT).

THE FOLLOWING DEFINITIONS APPLY TO THE ENTIRE

SOLICITATION AND RESULTING CONTRACT:

FIRST ORDERING YEAR OF THE CONTRACT IS THE DATE OF___________________

AWARD PLUS 364 DAYS.

SECOND ORDERING YEAR OF THE CONTRACT IS 365 DAYS____________________

THROUGH 729 DAYS AFTER CONTRACT AWARD.

THIRD ORDERING YEAR OF THE CONTRACT IS 730 DAYS___________________

THROUGH 1,094 DAYS AFTER CONTRACT AWARD.

FOURTH ORDERING YEAR OF THE CONTRACT IS 1,095 DAYS____________________

THROUGH 1,459 DAYS AFTER CONTRACT AWARD.

FIFTH ORDERING YEAR OF THE CONTRACT IS 1,460 DAYS___________________

THROUGH 1,824 DAYS AFTER CONTRACT AWARD.

NOTE: THE PRICE APPLICABLE TO AN INDIVIDUAL ORDER IS

THE PRICE FOR THE ORDERING YEAR IN WHICH THE ORDER IS

ISSUED. THE DELIVERY DATE DOES NOT DETERMINE THE

ORDERING YEAR.

The information presented below applies to Item No.

0011 Through 0015:

Guaranteed Minimum 5 Year Quantity (GMQ): 25 EACH

(This will be awarded at the time of the basic contract award)

Maximum 5 Year Contract Quantity: 200 EACH

ONLY THE GMQ IS GUARANTEED.

NOTE: EACH ORDERING YEAR QUANTITY IS AN ESTIMATE.

(End of narrative A001)

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0011 FIRST ORDERING YEAR EST: 40 EA $ $ ___________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: PANEL, INDICATING, LIGHT

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

First Article Test is required. Waiver may be authorized; see waiver provision in Section L.

(End of narrative B001)

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 12918116

DATE: 04-JAN-2023

The Technical Data Package (TDP) for this item contains purchased parts. Refer to the product drawing(s) for details.

(End of narrative C001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING PROVISION FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(W562RP) SU ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

4 17

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

ANNISTON,AL,36201-4199

5 17

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0012 SECOND ORDERING YEAR EST: 40 EA $ $ ____________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: PANEL, INDICATING, LIGHT

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 12918116

DATE: 04-JAN-2023

The Technical Data Package (TDP) for this item contains purchased parts. Refer to the product drawing(s) for details.

(End of narrative C001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING PROVISION FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(W562RP) SU ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

ANNISTON,AL,36201-4199

6 17

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0013 THIRD ORDERING YEAR EST: 40 EA $ $ ___________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: PANEL, INDICATING, LIGHT

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 12918116

DATE: 04-JAN-2023

The Technical Data Package (TDP) for this item contains purchased parts. Refer to the product drawing(s) for details.

(End of narrative C001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING PROVISION FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(W562RP) SU ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

ANNISTON,AL,36201-4199

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0014 FOURTH ORDERING YEAR EST: 40 EA $ $ ____________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: PANEL, INDICATING, LIGHT

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 12918116

DATE: 04-JAN-2023

The Technical Data Package (TDP) for this item contains purchased parts. Refer to the product drawing(s) for details.

(End of narrative C001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING PROVISION FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(W562RP) SU ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

ANNISTON,AL,36201-4199

8 17

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0015 FIFTH ORDERING YEAR EST: 40 EA $ $ ___________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: PANEL, INDICATING, LIGHT

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 12918116

DATE: 04-JAN-2023

The Technical Data Package (TDP) for this item contains purchased parts. Refer to the product drawing(s) for details.

(End of narrative C001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING PROVISION FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(W562RP) SU ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

ANNISTON,AL,36201-4199

9 17

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0016 FIRST ARTICLE TEST - SEPARATELY PRICED 1 EA $ $ ______________________________________ ______________ __________________

NSN: 6220-01-537-6002

COMMODITY NAME: FIRST ARTICLE TEST REPORT

Mfr CAGE: 19200

Mfr Part Number: 12918116-4

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

Government Approval/Disapproval Days: 30

Deliveries or Performance _________________________

FOB POINT: Destination

SHIP TO:

(SPRDL1) DLA LAND WARREN

ZGA

6501 EAST ELEVEN MILE ROAD

WARREN,MI,48397-5000

10 17

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION I - CONTRACT CLAUSES

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

I-1 CHANGED 52.219-8 Utilization of Small Business Concerns (Sep 2023) SEP/2023

I-2 CHANGED 52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN (SEP 2023) SEP/2023

I-3 CHANGED 52.244-6 SUBCONTRACTS FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES(SEP SEP/2023

2023)

I-4 CHANGED 252.204-7006 BILLING INSTRUCTIONS?COST VOUCHERS (MAY 2023) MAY/2023

I-5 CHANGED 252.205-7000 PROVISION OF INFORMATION TO COOPERATIVE AGREEMENT HOLDERS (JUN 2023) JUN/2023

I-6 CHANGED 252.225-7060 PROHIBITION ON CERTAIN PROCUREMENTS FROM THE XINJIANG UYGHUR JUN/2023

AUTONOMOUS REGION (JUN 2023)

I-7 CHANGED 252.227-7037 VALIDATION OF RESTRICTIVE MARKINGS ON TECHNICAL DATA(JAN 2023) JAN/2023

I-8 CHANGED 52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REPRESENTATION (SEP 2023) SEP/2023

(a) Definitions. As used in this clause

Long-term contract means a contract of more than five years in duration, including options. However, the term does not include contracts that exceed five years in duration because the period of performance has been extended for a cumulative period not to exceed six months under the clause at 52.217-8, Option to Extend Services, or other appropriate authority.

Small business concern

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

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or 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.

(b) If the Contractor represented that it was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, upon occurrence of any of the following:

(1) Within 30 days after execution of a novation agreement or within 30 days after modification of the contract to include this clause, if the novation agreement was executed prior to inclusion of this clause in the contract.

(2) Within 30 days after a merger or acquisition that does not require a novation or within 30 days after modification of the contract to include this clause, if the merger or acquisition occurred prior to inclusion of this clause in the contract.

(3) For long-term contracts-

(i) Within 60 to 120 days prior to the end of the fifth year of the contract; and

(ii) Within 60 to 120 days prior to the date specified in the contract for exercising any option thereafter.

(c) If the Contractor represented that it was any of the small business concerns identified in 19.000(a)(3) prior to award of this contract, the Contractor shall rerepresent its size and socioeconomic status according to paragraph (f) of this clause or, if applicable, paragraph (h) of this clause, when the Contracting Officer explicitly requires it for an order issued under a multiple-award contract.

(d) The Contractor shall rerepresent its size status in accordance with the size standard in effect at the time of this rerepresentation that corresponds to the North American Industry Classification System (NAICS) code(s) assigned to this contract. The small business size standard corresponding to this NAICS code(s) can be found at https://www.sba.gov/document/support--table-size-standards .

(e) The small business size standard for a Contractor providing an end item that it does not manufacture, process, or produce itself, for a contract other than a construction or service contract, is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition

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

(2) Used the HUBZone price evaluation preference regardless of dollar value, unless the Contractor waived the price evaluation preference; or

(3) Was an 8(a), HUBZone, service-disabled veteran-owned, economically disadvantaged women-owned, or women-owned small business set-

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aside or sole-source award regardless of dollar value.

(f) Except as provided in paragraph (h) of this clause, the Contractor shall make the representation(s) required by paragraph (b) and

(c) of this clause by validating or updating all its representations in the Representations and Certifications section of the System for

Award Management (SAM) and its other data in SAM, as necessary, to ensure that they reflect the Contractor's current status. The

Contractor shall notify the contracting office in writing within the timeframes specified in paragraph (b) of this clause, or with its offer for an order (see paragraph (c) of this clause), that the data have been validated or updated, and provide the date of the validation or update.

(g) If the Contractor represented that it was other than a small business concern prior to award of this contract, the Contractor may, but is not required to, take the actions required by paragraphs (f) or (h) of this clause.

(h) If the Contractor does not have representations and certifications in SAM, or does not have a representation in SAM for the NAICS code applicable to this contract, the Contractor is required to complete the following rerepresentation and submit it to the contracting office, along with the contract number and the date on which the rerepresentation was completed:

(1) The Contractor represents that it ? is, ? is not a small business concern under NAICS Code _____ assigned to contract number _____.

(2) [ Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause.] The Contractor represents that it ? is, ? is not, a small disadvantaged business concern as defined in 13 CFR 124.1001.

(3) [ Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause. ] The

Contractor represents that it ? is, ? is not a women-owned small business concern.

(4) Women-owned small business (WOSB) joint venture eligible under the WOSB Program. The Contractor represents that it ? is, ? is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [ The Contractor shall enter the name and unique entity identifier of each party to the joint venture: __.]

(5) Economically disadvantaged women-owned small business (EDWOSB) joint venture. The Contractor represents that it ? is, ? is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [ The Contractor shall enter the name and unique entity identifier of each party to the joint venture: __ .]

(6) [ Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause. ] The

Contractor represents that it ? is, ? is not a veteran-owned small business concern.

(7) [ Complete only if the Contractor represented itself as a veteran-owned small business concern in paragraph (h)(6) of this clause.]

The Contractor represents that it ? is, ? is not a service-disabled veteran-owned small business concern.

(8) [ Complete only if the Contractor represented itself as a small business concern in paragraph (h)(1) of this clause. ] The

Contractor represents that

(i) It ? is, ? is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone

Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and

(ii) It ? is, ? is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (h)(8)(i) of this clause is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [ The

Contractor shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: _____.] Each

HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

[ Contractor to sign and date and insert authorized signer's name and title.____________________________ ]

(End of clause)

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Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

K-1 CHANGED 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS(MAR 2023) MAR/2023

(a)

(1) The North American Industry Classification System (NAICS) code for this acquisition is 336320.

(2) The small business size standard is 750.

(3) The small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce is 500 employees, or 150 employees for information technology value-added resellers under NAICS code 541519 if the acquisition

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

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

or

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

(b)

(1) If the provision at 52.204-7, System for Award Management, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the provision at 52.204-7, System for Award Management, is not included in this solicitation, and the Offeror has an active registration in the System for Award Management (SAM), the Offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The Offeror shall indicate which option applies by checking one of the following boxes:

___ (i) Paragraph (d) applies.

___ (ii) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c)

(1) The following representations or certifications in SAM are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless

(A) The acquisition is to be made under the simplified acquisition procedures in part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.203-18, Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements-

Representation. This provision applies to all solicitations.

(iv) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, System for Award Management.

(v) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that-

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

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PIIN/SIIN MOD/AMD

(C) Are for contracts that will be performed in the United States or its outlying areas.

(vi) 52.204-26, Covered Telecommunications Equipment or Services-Representation. This provision applies to all solicitations.

(vii) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations-Representation.

(viii) 52.209-5, CertificationRegarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

(ix) 52.209-11, Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any Federal Law. This provision applies to all solicitations.

(x) 52.214-14, Place of Performance-Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(xi) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the

Government.

(xii) 52.219-1, Small Business Program Representations (Basic, Alternates I, and II). This provision applies to solicitations when the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(C) The provision with its Alternate II applies to solicitations that will result in a multiple-award contract with more than one NAICS code assigned.

(xiii) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii).

(xiv) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-

26, Equal Opportunity.

(xv) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xvi) 52.222-38, Compliance with Veterans Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial products or commercial services.

(xvii) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of

USDAdesignated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction

Contracts.

(xviii) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPAdesignated items.

(xix) 52.223-22, Public Disclosure of Greenhouse Gas Emissions and Reduction Goals-Representation. This provision applies to solicitations that include the clause at 52.204-7.)

(xx) 52.225-2, Buy American Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(xxi) 52.225-4, Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Basic, Alternates II and III.) This provision applies to solicitations containing the clause at 52.225-3.

(A) If the acquisition value is less than $50,000, the basic provision applies.

(B) If the acquisition value is $50,000 or more but is less than $92,319, the provision with its Alternate II applies.

(C) If the acquisition value is $92,319 or more but is less than $100,000, the provision with its Alternate III applies.

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(xxii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xxiii) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan-Certification. This provision applies to all solicitations.

(xxiv) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran-

Representation and Certifications. This provision applies to all solicitations.

(xxv) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions.

(2) The following representations or certifications are applicable as indicated by the Contracting Officer:

[Contracting Officer check as appropriate.]

_X_ (i) 52.204-17, Ownership or Control of Offeror.

_X_ (ii) 52.204-20, Predecessor of Offeror.

__ (iii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

__ (iv) 52.222-48, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or

Repair of Certain Equipment- Certification.

__ (v) 52.222-52, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Certification.

__ (vi) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPADesignated Products (Alternate I only).

__ (vii) 52.227-6, Royalty Information.

__ (A) Basic.

__ (B) Alternate I.

__ (viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

(d) The offeror has completed the annual representations and certifications electronically in SAM website accessed through https://www.sam.gov . After reviewing the SAM information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. 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.

FAR Clause # Title Date Change

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 on SAM.

(End of provision)

Alternate I (Mar 2023). As prescribed in 4.1202(a) , substitute the following paragraph (a) for paragraph (a) of the basic provision:

(a)(1) The North American Industry Classification System (NAICS) codes and corresponding size standards for this acquisition are as follows; the categories or portions these NAICS codes are assigned to are specified elsewhere in the solicitation:

NAICS Code Size standard

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[Contracting Officer to insert NAICS codes and size standards].

(2) The small business size standard for a concern that submits an offer, other than on a construction or service acquisition, but proposes to furnish an end item that it did not itself manufacture, process, or produce, (i.e., nonmanufacturer), is 500 employees, or

150 employees for information technology value-added resellers under NAICS code 541519, if the acquisition

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

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

or

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

(End of provision)

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SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

L-1 CHANGED 252.215-7008 ONLY ONE OFFER (DEC 2022) DEC/2022

L-2 CHANGED 52.211-1 AVAILABILITY OF SPECIFICATIONS LISTED IN THE GSA INDEX OF FEDERAL SEP/2023

SPECIFICATIONS, STANDARDS AND COMMERCIAL ITEM DESCRIPTIONS, FPMR PART

101-29 (Sep 2023)

(a) The GSA Index of Federal Specifications, Standards and Commercial Item Descriptions, FPMR Part 101-29, and copies of specifications, standards, and commercial item descriptions cited in this solicitation may be obtained for a fee by submitting a request to--

GSA Federal Supply Service

Specifications Section, Suite 8100

470 East LEnfant Plaza SW

Washington, DC 20407

Telephone (202) 619-8925

Facsimile (202) 619-8978.

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

(End of Provision)

L-3 CHANGED 52.211-2 Availability of Defense Specifications, Standards, and Data Item SEP/2023

Descriptions in the Acquisition Streamlining and Standardization

Information System (ASSIST) Website (Sep 2023)

Availability of Defense Specifications, Standards, and Data Item Descriptions in the Acquisition Streamlining and Standardization

Information System (ASSIST) Website (Sep 2023)

(a) Most unclassified Defense specifications and standards may be downloaded from the ASSIST website at https://assist.dla.mil .

(b) Defense documents not available from ASSIST may be requested from the Defense Standardization Program Office by--

(1) Using the ASSIST feedback module (https://assist.dla.mil/feedback ); or

(2) Contacting the Defense Standardization Program Office by telephone at 571-767-6888 or email at assisthelp@dla.mil.

(End of Provision)

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