SPRHA222Q0051.pdf
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- Attached to
- ICBM Cable Assembly Federal contract opportunity
- Solicitation number
- SPRHA2-22-Q-0051
- Issued by
- Defense Logistics Agency Aviation
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AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 18 (Rev. 6-95) Previous edition not usable Prescribed by GSA - FAR (48 CFR) 53.215-1(a)
REQUEST FOR QUOTATION
(THIS IS NOT AN ORDER)
J
THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDEX
1. REQUEST NO.
SPRHA2-22-Q-0051
2. DATE ISSUED
3 JAN 2022
3. REQUISITION/PURCHASE REQUEST NO.
FD20202200051
4. CERT. FOR NAT. DEF.
UNDER BDSA REG. 2
AND/OR DMS REG.1
RATING
DO: A2
5a. ISSUED BY CODE: SPRHA2
DLA AVIATION - OGDEN, DLR PROCUREMENT OPS/AUB
6051 GUM LANE BLDG 1225
HILL AIR FORCE BASE UT 84056-5820
BUYER: Michelle Beus/DLA michelle.beus@us.af.mil Phone: (385) 519- 8534
6. DELIVERY BY (Date)
SEE SCHEDULE
SCD:C
5b. FOR INFORMATION CALL (NO COLLECT CALLS)
NAME
Michelle Beus
b. COMPANY
TELEPHONE NUMBER
AREA CODE
(385 )
NUMBER
519 -8534
8. TO
a. NAME
7. DELIVERY
FOB DESTINATION OTHER
(See Schedule) X
9. DESTINATION
a. NAME OF CONSIGNEE
b. STREET ADDRESS
c. CITY
d. STATE e. ZIP CODE
c. STREET ADDRESS
d. CITY e. STATE f. ZIP CODE
10. PLEASE FURNISH QUOTATIONS
TO THE ISSUING OFFICE IN BLOCK
5A ON OR BEFORE CLOSE OF
BUSINESS (Date)
24 JAN 2022
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 5A. 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 (Include applicable Federal, State and local taxes)
ITEM NO.
(a)
SUPPLIES/SERVICES
(b)
QUANTITY
(c)
UNIT
(d)
UNIT PRICE
(e)
AMOUNT
(f)
d. CITY e. STATE
c. COUNTY
c. TITLE (Type or print) NUMBER
b. STREET ADDRESS
a. NAME OF QUOTER
CAGE:
13. NAME AND ADDRESS OF QUOTER
NOTE: Additional provisions and representations are are not attached.X
14. SIGNATURE OF PERSON AUTHORIZED TO
SIGN QUOTATION
15. DATE OF QUOTATION
16. SIGNER
a. NAME (Type or print) b. TELEPHONE
AREA CODE
d. CALENDAR DAYS
NUMBER PERCENTAGE
c. 30 CALENDAR DAYS (%)b. 20 CALENDAR DAYS (%)a. 10 CALENDAR DAYS (%)12. DISCOUNT FOR PROMPT
PAYMENT
SEE SCHEDULE
ROUTINE
Subject to the terms and conditions stated herein, the Contractor agrees to hold its offered prices firm for 120 days.
NAICS CODE: 335311
SIZE STD: 750
Less than a truckload shipment is acceptable and authorized.
Early and partial deliveries are acceptable at no increase in cost to the government.
AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 18 (Rev. 6-95) Previous edition not usable Prescribed by GSA - FAR (48 CFR) 53.215-1(a)
FOLD FOLD
SOLICITATION NO. SPRHA222Q0051
DUE: 24 -JAN -2022
FROM: AFFIX
STAMP
HERE
TO:
ATTN: Michelle Beus/DLA
DLA AVIATION - OGDEN, DLR PROCUREMENT OPS/AUB
6051 GUM LANE BLDG 1225
HILL AIR FORCE BASE UT 84056-5820
SPRHA2-22-Q-0051
PART I - THE SCHEDULE
SECTION B
SUPPLIES OR SERVICES AND PRICES/COSTS
Item No.
NSN: 6150-00-005-1715 AH
CABLE ASSEMBLY,SPEC
Associated Document(s) Line Item(s)
FD20202200051 0001
Priority: R IUID Required: Yes Physical Item Markings:
IAW MIL-STD-130
Bid A - First Article Required Item No.
0001AA
Firm Fixed Price Quantity U/I Unit Price Amount
1 EA
CLIN ACRN ACRN Total
0001AA AA
FA
First Article
FIRST ARTICLE-SAME AS BASIC LINE ITEM ABOVE
Associated Document(s) Line Item(s)
FD20202200051 0001
Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)
Title Number Date Tailoring
ISO 9001-2008 2008
Buy American Act/Balance of Payments Program
Transportation From Continental United States CONUS (CONUS) Sources
TYPE / SHIP TO CODE F.O.B.
B FB2029 ORIGIN
Type / Ship To PACRN Mark For
Bid A - First Article Required B FB2029 PAA First Article Do Not Post Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri
Required Delivery
B FB2029 1 EA *120 Calendar Days
Proposed Delivery
B FB2029 1 EA
Bid A - First Article Required Item No.
0001AB
Not Separately Priced Quantity U/I Unit Price
1 LO NSP
FATR
First Article Test Report
FIRST ARTICLE TEST REPORT
Associated Document(s) Line Item(s)
FD20202200051 0002
Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Exhibit: AB Quality Assurance: IAW 1423 (A001) Type / Ship To PACRN Mark For
B 1423 IAW 1423
Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri
Required Delivery
B 1423 1 LO *120 Calendar Days
Proposed Delivery
B 1423 1 LO
First Article Test Report shall be submitted concurrently with the First Article.
Although the Ship To code for this line item is B1423, for WAWF purposes only, the contractor will use Ship To code FB2029 when completing the receiving report.
Contractor will coordinate submission with contract administrator.
Bid A - First Article Required Item No.
0001AC
Firm Fixed Price Quantity U/I Unit Price Amount
Bid A - First Article Required
1 EA
CLIN ACRN ACRN Total
0001AC AA
PROD
Production Article
PRODUCTION ARTICLE - SAME AS BASIC LINE ITEM ABOVE
Associated Document(s) Line Item(s)
FD20202200051 0001
Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)
Transportation From Continental United States CONUS (CONUS) Sources
TYPE / SHIP TO CODE F.O.B.
A FB2029 ORIGIN
Type / Ship To PACRN Mark For A FB2029 PAA Account 9 Type / Ship To Quantity (U/I) *ARO Approval of
First Article _ Req No / Pri
Required Delivery
A FB2029 1 EA *120 Calendar Days
Proposed Delivery
A FB2029 1 EA
Bid B - First Article NOT Required Item No.
0001AD
Firm Fixed Price Quantity U/I Unit Price Amount
2 EA
CLIN ACRN ACRN Total
0001AD AA
PROD
Production Article
PRODUCTION ARTICLE - SAME AS BASIC LINE ITEM ABOVE
Associated Document(s) Line Item(s)
FD20202200051 0001
Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)
Bid B - First Article NOT Required
Transportation From Continental United States CONUS (CONUS) Sources
TYPE / SHIP TO CODE F.O.B.
A FB2029 ORIGIN
Type / Ship To PACRN Mark For A FB2029 PAA Account 09 Type / Ship To Quantity (U/I) On or Before _ Req No / Pri
Required Delivery
A FB2029 2 EA 28 OCT 2022
Proposed Delivery
A FB2029 2 EA
Item No.
Not Separately Priced Quantity U/I Unit Price Amount
1 LO NSP
Counterfeit Prevention Plan Associated Document(s) Line Item(s)
FD20202200051 0003
Priority: R
Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: IAW 1423 (A002) Type / Ship To PACRN Mark For
B 1423 IAW 1423
Type / Ship To Quantity (U/I) *ARO Contract Req No / Pri
Required Delivery
B 1423 1 LO *60 Calendar Days
Proposed Delivery
B 1423 1 LO
Although the Ship To code for this line item is B1423, for WAWF purposes only, the contractor will use Ship To code FB2029 when completing the receiving report.
Contractor will coordinate submission with contract administrator.
SHIP TO / PLACE OF PERFORMANCE
TYPE/CODE: A FB2029
FB2029 OO ALC DDHU CNTRL RCV
CP 385 519 8898
5851 F AVE BLDG 849W
HILL AFB UT 84056
HILL AFB UT 84056 49 84056-5713
USA
MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)
AWARD NUMBER:
TYPE/CODE: B 1423
IAW DD FORM 1423
MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)
AWARD NUMBER:
TYPE/CODE: B FB2029
809 MXSS/MXDEB
BLDG 849 ATTN: NON-ACCOUNTABLE BAY
(DEAR JOHN BAY)
TRANSPORTATION OFFICE
HILL AIR FORCE BASE UT 84056-5713
UNITED STATES
MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)
AWARD NUMBER:
PART I - THE SCHEDULE
SECTION D
PACKAGING AND MARKING
MIL-STD-130: Items shall be marked in accordance with MIL-STD-130. The National Stock Number (NSN), and when assigned, the Configuration Item Identifier (CII), serial number, and military type designation information shall be marked on major assemblies, units, groups, and sets. Special attention must be given to requirements governing the application of the actual manufacturer's Federal Supply Code for Manufacturers (FSCM) to the physical item. Items which are excluded in accordance with paragraph 1.1 of MIL-STD-130, Revision M, shall be marked in accordance with the appropriate document.
2. PACKAGE AND CONTAINER MARKING: Shipments will not be made until the NSN has been assigned, unless specifically authorized by the Contracting Officer.
MIL-STD-129/ASTM-D-3951:
a. Interior packages and shipping containers shall be marked in accordance with MIL-STD-129 when Military packing is specified and ASTM-D-3951 when commercial packaging is specified. The requirements of paragraph 2.h apply regardless of which packaging is utilized.
(1) Design manufacturer's name, trademark or manufacturer's code (from Cataloging Handbook H4-1 or H4-2), identifying number, and serial number, when applicable, shall be included in the identification marking.
(2) When applicable, the Air Force project designator code shall be included as the last line of the address marking and the project name related to the project code shall be marked in the clear on the exterior shipping container.
b. Tags and labels, when required, shall be contractor's tags or labels conforming to the requirements of MIL-STD-129 or as approved by the procuring activity. Contractor's forms which indicate serviceable condition shall not be any shade of green or red. Labels are authorized to be used on metal containers.
Items requiring technical order (T.O.) certification shall be annotated on inner and outer container tags or label with T.O. compliance.
c. When dummy containers are used in a unitized load, the dummy containers shall be clearly marked "DUMMY CONTAINER" and located in the load so that the marking will be plainly visible to receiving and storage personnel.
d. All interior packages and shipping containers for articles and materials classified as hazardous or restricted under provisions of Title 49, Code of Federal Regulations, or AFR 71-4/DLAM 4145.3/TM 38-250/NAVSUP PUB 505/MCO P 4030.19 shall be marked, regardless of exemption for mode of transportation, with proper shipping name of item; flash point of all liquids having a flash point of 200 degrees F. or below; and percentage concentration of acids and corrosive liquids. In addition, the quantity of each hazardous or restricted material included in a container shall be annotated adjacent to the shipping name of the item, e.g., Acetic Acid (80% concentration) -- 1 qt.
e. On shipments of firearms regardless of mode of transportation, selected elements of identification and contractor data markings shall be omitted or obliterated in accordance with the requirements of MIL-STD-129 regarding sensitive items and packing lists shall be placed only inside the containers.
f. Special markings for packages and containers when specified on AFMC Form 158 shall be complied with as a part of MIL-STD-129.
g. All special coated terneplate containers shall be marked with the legend "CAUTION--DO NOT REUSE AS
FOOD CONTAINERS."
h. Bar code markings in accordance with MIL-STD-129 shall apply to all units, intermediate and exterior containers for all items going into stock regardless of package size or levels of package specified (including commercial packaging). In addition to the NSN/NATO stock number, the exterior shipping container shall include the 13 digit contract number (plus, if applicable, the four digit call number). Excluded from Bar Code Marking are:
(1) Foreign Military Sales.
(2) Direct Vendor Delivery (DVD)/Government Furnished Equipment (GFE) shipments.
(3) Multipack Exterior Shipping Containers. (Unit and intermediate containers do require a bar coded NSN/NATO stock number. However, the next container (unit or intermediate) inside the multipack will also require a bar coded NSN/NATO stock number and contract number with call number, if applicable, in the lower right hand corner).
(4) All unpacked or uncrated items; e.g., vehicles, tires, etc.
i. Shipments of wheeled items weighing 2,000 pounds or more and scheduled for transportation by military aircraft will be marked with the individual axle weights in accordance with MIL-STD-129.
3. WARRANTED ITEMS: When the contract contains warranty requirements, warranty information shall be applied on containers and items as follows:
a. Container markings shall be as specified in MIL-STD-129. The period or conditions of the warranty shall be specifically stated, i.e., landings, flight hours, operating hours, days from shipping date, etc.
b. Items shall be marked in accordance with requirements of MIL-STD-130. Markings shall be located in a manner so as to be conspicuous to the person removing the item from service. When no deleterious effect or functional degradation is caused, the markings shall be black letters on yellow FED-STD-595 color 13655) background. The marking shall include the same period or condition required on the containers.
SHIPPING CONTAINER MARKING
All shipping containers shall be marked meeting the following criteria:
(a) MIL-STD-129 R, Standard Practice for Military Marking.
(b) Bar code format shall conform to bar code symbology Format 3 of 9, Code 39 as specified in MIL-STD-129 R.
(c) Additional marking and/or bar coding requirements exceeding those of MIL-STD-129 R , e.g., unit serial numbers, original equipment manufacturer’s (OEM) name, or OEM model number, as specified on the AFMC Form 158:
PACRN(s) Applicable
Additional Bar Coding or Marking Requirements (if applicable)
PAA Not Applicable
MILITARY PACKAGING AND MARKING
Items shall be packaged in accordance with MIL-STD-2073-1E, Standard Practice for Military Packaging. Shipping and storage markings shall be in accordance with MIL-STD-129R, Standard Practice for Military Marking.
The MIL-STD-2073-1 / No Packaging Data Available is as follows:
PACRN PRESERVATION LVL PACKING LVL QUP
PAA MIL B 001
PACRN SUPPLEMENTAL PACKAGING
PAA NOT APPLICABLE
PART I - THE SCHEDULE
SECTION E
INSPECTION AND ACCEPTANCE
FIRST ARTICLE TEST, CERTIFICATION AND DISPOSITION REQUIREMENTS (FEB 1998)
(IAW FAR 9.308-2)
Test criteria are as follows:
Lot/Item Government Test/Inspection Requirements 0001AA Approval tests are contained in drawing 71D46266 and sub-tier engineering documents
Disposition of the First Article shall be as follows:
Lot/Item Approved 0001AA Forwarded to: Supply
Lot/Item Disapproved 0001AA Retained by: FAI Lab pending instructions from contractor.
(The above Clause/Provision has been modified.)
52.246-2 INSPECTION OF SUPPLIES--FIXED-PRICE (AUG 1996)
(IAW FAR 46.302)
52.246-11 HIGHER-LEVEL CONTRACT QUALITY REQUIREMENT (DEC 2014)
(IAW FAR 46.311, DFARS 246.202-4(1))
(a) The Contractor shall comply with the higher-level quality standard(s) listed below. [If more than one standard is listed, the offeror shall indicate its selection by checking the appropriate block.]*
*See Individual Line Item Schedule
52.246-16 RESPONSIBILITY FOR SUPPLIES (APR 1984)
(IAW FAR 46.316)
INSPECTION AND ACCEPTANCE (SEP 1999)
(IAW FAR 46.401(b), FAR 46.503) Government Contract Quality Assurance Inspection and Acceptance will be at (Final):
[CONTRACTOR FILL-IN]
Item No(s): See schedule for items with the following code(s) listed below :
Inspection Code and Address:
Government Contract Quality Assurance Inspection and Acceptance will be at destination(s) specified herein (Final).
Item No(s): 0001AB, 0003
PART I - THE SCHEDULE
SECTION F
DELIVERIES OR PERFORMANCE
52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)
(IAW FAR 42.1305(c))
52.247-65 F.O.B. ORIGIN, PREPAID FREIGHT--SMALL PACKAGE SHIPMENTS (JAN 1991)
(IAW FAR 47.303-17(f))
F.O.B. ORIGIN (OCT 1993)
(IAW FAR 47.305(b)) Any supply item applicable to this document shall be delivered F.O.B. at:
F.O.B. Address:
[CONTRACTOR FILL-IN]
COMMERCIAL BILL OF LADING SHIPMENTS – CARRIER’S RATES
The contractor shall ensure that proposed carrier’s rates are equal to or better than rates available to the Government. Contact the transportation officer for this contract, as identified by the administrative contracting officer, for confirmation that the proposed carrier’s rates are no higher than those otherwise available to the government. List the shipping costs on the invoice to the government and attach a copy of the carrier’s billing.
Failure to properly annotate the invoice and provide a copy of the carrier’s billing may result in those cost not being reimbursed or only partially reimbursed.
UNILATERAL AMENDED SHIPPING INSTRUCTIONS (ASIs), F.O.B. ORIGIN
(a) An ASI is a change to the shipping instructions of one or more units or shipment lots of a contract line item.
Multiple ASIs for multiple contract line items may be issued under one document.
(b) Unilateral ASIs with changes only to the "Ship To and Mark For" instructions, issued 20 calendar days or more before the contract scheduled delivery date, shall be accepted by the Contractor at no change in contract price.
(c) All other ASIs, including those requiring a change to the "Ship To and Mark For" which are issued 19 days or less before the contract scheduled delivery date; and those for changes to the preservation, packaging, and packing requirements or the f.o.b. point, shall be subject to the negotiation of an equitable adjustment under the contract.
PART I - THE SCHEDULE
SECTION G
CONTRACT ADMINISTRATION DATA
252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (DEC 2018)
(IAW DFARS 232.7004(b), PGI 232.7004(b)(1), DFARS 212.301(f)(liii))
(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.
___________Combo__________________________________
(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.
________Not applicable______________________________
(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 item financing, submit a commercial item financing request.
(2) Fast Pay requests are only permitted when Federal Acquisition Regulation (FAR) 52.213-1 is included in the contract.
(f) [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 See block 15 Issue By DoDAAC See block 6 Admin DoDAAC See block 7 Inspect By DoDAAC See Section B Ship To Code See Section B Ship From Code See Section B Mark For Code See Section B Service Approver (DoDAAC) N/A Service Acceptor (DoDAAC) N/A Accept at Other DoDAAC N/A LPO DoDAAC N/A DCAA Auditor DoDAAC N/A Other DoDAAC(s) N/A
(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.
__________________Not applicable_____________________________________________ (Contracting Officer: Insert applicable information or “Not applicable.”)
(2) Contact the WAWF helpdesk at 866-618-5988, if assistance is needed
ACCOUNTING AND APPROPRIATION DATA (AUG 1998)
Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable
AA 97 X4930 .FC04 64 2 47 GH 25133G 01N000 00000 EERRCT 503000 F03000 $0.00
PSR: K27858 FSR: 001679 DSR: 230250 CIN: F2DCCW1341A1060000AA
ACRN TOTAL $ 0.00
TRANSPORTATION APPROPRIATION CHARGEABLE
The Transportation Allotment Identification (TAI) relates directly to the above ACRN(s). For example the TAI "TAA" is for the same line item(s) as ACRN "AA".
TAI ATAC
TAA FRS3
PART II - CONTRACT CLAUSES
SECTION I
CONTRACT CLAUSES
5352.201-9101 OMBUDSMAN (OCT 2019)
(IAW AFFARS 5301.9103)
(a) An ombudsman has been appointed to hear and facilitate the resolution of concerns from offerors, potential offerors, and others for this acquisition. When requested, the ombudsman will maintain strict confidentiality as to the source of the concern. The existence of the ombudsman does not affect the authority of the program manager, contracting officer, or source selection official. Further, the ombudsman does not participate in the evaluation of proposals, the source selection process, or the adjudication of protests or formal contract disputes. The ombudsman may refer the interested party to another official who can resolve the concern.
(b) Before consulting with an ombudsman, interested parties must first address their concerns, issues, disagreements, and/or recommendations to the contracting officer for resolution. Consulting an ombudsman does not alter or postpone the timelines for any other processes (e.g., agency level bid protests, GAO bid protests, requests for debriefings, employee-employer actions, contests of OMB Circular A-76 competition performance decisions).
(c) If resolution cannot be made by the contracting officer, the interested party may contact the ombudsman, Kristina Lenderman at 385 519 -8209 , FAX 000 000 -0000 , email kristina.lenderman@us.af.mil . Concerns, issues, disagreements, and recommendations that cannot be resolved at the Center/MAJCOM/DRU/SMC ombudsman level, may be brought by the interested party for further consideration to the Air Force ombudsman, Associate Deputy Assistant Secretary (ADAS) (Contracting), SAF/AQC, 1060 Air Force Pentagon, Washington DC 20330-1060, phone number (571) 256-2395, facsimile number (571) 256-2431.
(d) The ombudsman has no authority to render a decision that binds the agency.
(e) Do not contact the ombudsman to request copies of the solicitation, verify offer due date, or clarify technical requirements. Such inquiries shall be directed to the contracting officer.
52.203-19 PROHIBITION ON REQUIRING CERTAIN INTERNAL CONFIDENTIALITY
AGREEMENTS OR STATEMENTS (JAN 2017)
(IAW FAR 3.909-3 (b))
252.203-7000 REQUIREMENTS RELATING TO COMPENSATION OF FORMER DOD OFFICIALS
(SEP 2011)
(IAW DFARS 203.171-4(a), DFARS 212.301(f)(ii))
252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS
(SEP 2013)
(IAW DFARS 203.970)
52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER SUBCONTRACT
AWARDS (JUN 2020)
(IAW FAR 4.1403(a))
52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2018)
(IAW FAR 4.1105(b))
52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (AUG 2020)
(IAW FAR 4.1804(c), FAR 12.301(d))
52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS
(DEC 2014)
(IAW FAR 4.1202(b))
52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS
(JUN 2016)
(IAW FAR 4.1903)
52.204-23 PROHIBITION ON CONTRACTING FOR HARDWARE, SOFTWARE, AND SERVICES
DEVELOPED OR PROVIDED BY KASPERSKY LAB AND OTHER COVERED
ENTITIES (JUL 2018)
(IAW FAR 4.2004)
52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND
VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (AUG 2020)
(IAW 4.2105(b))
252.204-7000 DISCLOSURE OF INFORMATION (OCT 2016)
(IAW DFARS 204.404-70(a))
252.204-7002 PAYMENT FOR SUBLINE ITEMS NOT SEPARATELY PRICED (APR 2020)
(IAW DFARS 204.7109(a))
252.204-7003 CONTROL OF GOVERNMENT PERSONNEL WORK PRODUCT (APR 1992)
(IAW DFARS 204.404-70(b))
252.204-7012 SAFEGUARDING COVERED DEFENSE INFORMATION AND CYBER INCIDENT
REPORTING (DEC 2019)
(IAW DFARS 204.7304(c))
252.204-7015 NOTICE OF AUTHORIZED DISCLOSURE OF INFORMATION FOR LITIGATION
SUPPORT (MAY 2016)
(IAW DFARS 204.7403(b), DFARS 212.301(f)(i)(F))
252.204-7018 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE
TELECOMMUNICATIONS EQUIPMENT OR SERVICES (JAN 2021)
(IAW DFARS 204.2105(c))
252.204-7020 NIST SP 800-171 DOD ASSESSMENT REQUIREMENTS (NOV 2020)
(IAW DFARS 204.7304(e))
252.204-7022 EXPEDITING CONTRACT CLOSEOUT (MAY 2021)
(IAW DFARS 204.804-70)
(a) At the conclusion of all applicable closeout requirements of Federal Acquisition Regulation 4.804, the Government and Contractor shall mutually agree on the residual dollar amount remaining on the contract. Both the Government and Contractor agree to waive payment of any residual dollar amount of $1,000 or less to which either party may be entitled at the time of contract closeout.
(b) A residual dollar amount includes all money owed to either party at the end of the contract and as a result of the contract, excluding amounts connected in any way with taxation or a violation of law or regulation.
(c) For purposes of determining residual dollar amounts, offsets (e.g., across multiple contracts or orders) may be considered only to the extent permitted by law.
52.209-4 FIRST ARTICLE APPROVAL--GOVERNMENT TESTING (SEP 1989)
(IAW FAR 9.308-2(a)(1), FAR 9.308-2(b)(1))
(a) The Contractor shall deliver ** units(s) of Lot/Item * within *** calendar days from the date of this contract to the Government at **** 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.
First Article Item **Quantity ***Calendar Days ****Type/Location
0001AA 1 120 BFB2029
(b) Within ** 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.
*Lot/Item **Approval Days ELIN No.
001AA 120
(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) above. 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) above, 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.
52.209-4 FIRST ARTICLE APPROVAL--GOVERNMENT TESTING -- ALTERNATE I (JAN 1997)
(IAW FAR 9.308-2(a)(2), FAR 9.308-2(b)(2))
52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS
(NOV 2015)
(IAW FAR 9.108-5(b))
52.211-5 MATERIAL REQUIREMENTS (AUG 2000)
(IAW FAR 11.304)
52.211-15 DEFENSE PRIORITY AND ALLOCATION REQUIREMENTS (APR 2008)
(IAW FAR 11.604(b)) This is a rated order certified for national defense, emergency preparedness, and energy program use, and the Contractor shall follow all the requirements of the Defense Priorities and Allocations System regulation (15 CFR 700).
252.211-7003 ITEM UNIQUE IDENTIFICATION AND VALUATION (MAR 2016)
(IAW DFARS 211.274-6(a)(1), DFARS 212.301(f)(xii))
(a) Definitions. As used in this clause—
“DoD recognized unique identification equivalent” means a unique identification method that is in commercial use and has been recognized by DoD. All DoD recognized unique identification equivalents are listed at http://www.acq.osd.mil/dpap/pdi/uid/iuid/equivalents.html .
“Unique item identifier type” means a designator to indicate which method of uniquely identifying a part has been used. The current list of accepted unique item identifier types is maintained at http://www.acq.osd.mil/dpap/pdi/uid/uii_types.html .
(c) Unique item identifier.
(1) The Contractor shall provide a unique item identifier for the following:
(i) Delivered items for which the Government’s unit acquisition cost is $5,000 or more, except for the following line items:
Contract Line, Subline, or Exhibit Line Item Number
Item Description
See Schedule as Applicable
(ii) Items for which the Government’s unit acquisition cost is less than $5,000 that are identified in the Schedule or the following table:
Contract Line, Subline, or Exhibit Line Item Number
Item Description
*Items less than $5000, which require UID, will be specifically identified in the schedule.
See Schedule as Applicable
(iii) Subassemblies, components, and parts embedded within delivered items, items with warranty requirements, DoD serially managed reparables and DoD serially managed nonreparables as specified in Attachment Number _____( or See Schedule as Applicable).
(iv) Any item of special tooling or special test equipment as defined in FAR 2.101 that have been designated for preservation and storage for a Major Defense Acquisition Program as specified in Attachment Number _____( or See Schedule as Applicable).
(v) Any item not included in paragraphs (c)(1)(i), (ii), (iii), or (iv) of this clause for which the contractor creates and marks a unique item identifier for traceability.
(f) The Contractor shall submit the information required by paragraphs (d) and (e) of this clause as follows:
(1) End items shall be reported using the receiving report capability in Wide Area WorkFlow (WAWF) in accordance with the clause at 252.232-7003. If WAWF is not required by this contract, and the contractor is not using WAWF, follow the procedures at http://dodprocurementtoolbox.com/site/uidregistry/ .
(2) Embedded items shall be reported by one of the following methods—
(i) Use of the embedded items capability in WAWF;
(ii) Direct data submission to the IUID Registry following the procedures and formats at http://dodprocurementtoolbox.com/site/uidregistry/; or
(iii) Via WAWF as a deliverable attachment for exhibit line item number ______, Unique Item Identifier Report for Embedded Items, Contract Data Requirements List, DD Form 1423.
52.213-4 TERMS AND CONDITIONS--SIMPLIFIED ACQUISITIONS (OTHER THAN
COMMERCIAL ITEMS) (JUL 2021)
(IAW FAR 13.302-5(d))
(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses that are incorporated by reference:
(1) The clauses listed below implement provisions of law or Executive order:
(i) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L.
113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).
(ii) 52.204-23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab and Other Covered Entities (JUL 2018) (Section 1634 of Pub. L. 115-91).
(iii) 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (AUG 2020) (Section 889(a)(1)(A) of Pub. L. 115-232).
(iv) 52.222-3, Convict Labor (JUN 2003) (E.O. 11755).
(v) 52.222-21, Prohibition of Segregated Facilities (APR 2015).
(vi) 52.222-26, Equal Opportunity (SEP 2016) (E.O. 11246).
(vii) 52.225-13, Restrictions on Certain Foreign Purchases (FEB 2021) (E.O.s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).
(viii) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).
(ix) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Pub. L. 108-77, 108-78 (19 U.S.C.
3805 note).
(2) Listed below are additional clauses that apply:
(i) 52.232-1, Payments (APR 1984).
(ii) 52.232-8, Discounts for Prompt Payment (FEB 2002).
(iii) 52.232-11, Extras (APR 1984).
(iv) 52.232-25, Prompt Payment (JAN 2017).
(v) 52.232-39, Unenforceability of Unauthorized Obligations (JUN 2013).
(vi) 52.232-40, Providing Accelerated Payments to Small Business Subcontractors (DEC 2013).
(vii) 52.233-1, Disputes (MAY 2014).
(viii) 52.244-6, Subcontracts for Commercial Items (NOV 2020)
(ix) 52.253-1, Computer Generated Forms (Jan 1991).
(b) The Contractor shall comply with the following FAR clauses, incorporated by reference, unless the circumstances do not apply:
(1) The clauses listed below implement provisions of law or Executive order:
(i) 52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUN 2020) (Pub. L.
109-282) (31 U.S.C. 6101 note) (Applies to contracts valued at or above the threshold specified in FAR 4.1403(a) on the date of award of this contract).
(ii) 52.222-19, Child Labor—Cooperation with Authorities and Remedies (JAN 2020) (E.O. 13126) (Applies to contracts for supplies exceeding the micro-purchase threshold, as defined in FAR 2.101 on the date of award of this contract).
(iii) 52.222-20, Contracts for Materials, Supplies, Articles, and Equipment (JUN 2020) (41 U.S.C. chapter 65) (Applies to supply contracts over the threshold specified in FAR 22.602 on the date of award of this contract, in the United States, Puerto Rico, or the U.S. Virgin Islands).
(iv) 52.222-35, Equal Opportunity for Veterans (JUN 2020) (38 U.S.C. 4212) (Applies to contracts valued at or above the threshold specified in FAR 22.1303(a) on the date of award of this contract).
(v) 52.222-36, Equal Employment for Workers with Disabilities (JUN 2020) (29 U.S.C. 793) (Applies to contracts over the threshold specified in FAR 22.1408(a) on the date of award of this contract, unless the work is to be performed outside the United States by employees recruited outside the United States). (For purposes of this clause, “United States” includes the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and Wake Island.)
(vi) 52.222-37, Employment Reports on Veterans (JUN 2020)(38 U.S.C. 4212) (Applies to contracts valued at or above the threshold specified in FAR 22.1303(a) on the date of award of this contract).
(vii) 52.222-41, Service Contract Labor Standards (AUG 2018) (41 U.S.C. chapter 67) (Applies to service contracts over $2,500 that are subject to the Service Contract Labor Standards statute and will be performed in the United States, District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S.
Virgin Islands, Johnston Island, Wake Island, or the outer Continental Shelf).
(viii)(A) 52.222-50, Combating Trafficking in Persons (OCT 2020) (22 U.S.C. chapter 78 and E.O. 13627) (Applies to all solicitations and contracts).
(B) Alternate I (MAR 2015) (Applies if the Contracting Officer has filled in the following information with regard to applicable directives or notices: Document title(s), source for obtaining document(s), and contract performance location outside the United States to which the document applies).
(ix) 52.222-55, Minimum Wages Under Executive Order 13658 (NOV 2020) (Applies when 52.222-6 or 52.222-41 are in the contract and performance in whole or in part is in the United States (the 50 States and the District of Columbia)).
(x) 52.222-62, Paid Sick Leave Under Executive Order 13706 (JAN 2017) (E.O. 13706) (Applies when 52.222-6 or 52.222-41 are in the contract and performance in whole or in part is in the United States (the 50 States and the District of Columbia.))
(xi) 52.223-5, Pollution Prevention and Right-to-Know Information (MAY 2011) (E.O. 13423) (Applies to services performed on Federal facilities).
(xii) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (JUN 2016) (E.O. 13693)(applies to contracts for products as prescribed at FAR 23.804(a)(1)).
(xiii) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (JUN 2016) (E.O. 13693) (Applies to maintenance, service, repair, or disposal of refrigeration equipment and air conditioners).
(xiv) 52.223-15, Energy Efficiency in Energy-Consuming Products (MAY 2020) (42 U.S.C. 8259b) (Unless exempt pursuant to 23.204, applies to contracts when energy-consuming products listed in the ENERGY STAR® Program or Federal Energy Management Program (FEMP) will be—
(A) Delivered;
(B) Acquired by the Contractor for use in performing services at a Federally-controlled facility;
(C) Furnished by the Contractor for use by the Government; or
(D) Specified in the design of a building or work, or incorporated during its construction, renovation, or maintenance).
(xv) 52.223-20, Aerosols (JUN 2016) (E.O. 13693) (Applies to contracts for products that may contain high global warming potential hydrofluorocarbons as a propellant or as a solvent; or contracts for maintenance or repair of electronic or mechanical devices).
(xvi) 52.223-21, Foams (JUN 2016) (E.O. 13693) (Applies to contracts for products that may contain high global warming potential hydrofluorocarbons or refrigerant blends containing hydrofluorocarbons as a foam blowing agent;
or contracts for construction of buildings or facilities.
(xvii) 52.225-1, Buy American—Supplies (JAN 2021) (41 U.S.C. chapter 67) (Applies to contracts for supplies, and to contracts for services involving the furnishing of supplies, for use in the United States or its outlying areas, if the value of the supply contract or supply portion of a service contract exceeds the micro-purchase threshold, as defined in FAR 2.101 on the date of award of this contract, and the acquisition—
(A) Is set aside for small business concerns; or
(B) Cannot be set aside for small business concerns (see 19.502-2), and does not exceed $25,000).
(xviii) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (JUN 2020) (42 U.S.C. 1792) (Applies to contracts greater than the threshold specified in FAR 26.404 on the date of award of this contract, that provide for the provision, the service, or the sale of food in the United States).
(xix) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (OCT 2018) (Applies when the payment will be made by electronic funds transfer (EFT) and the payment office uses the System for Award Management (SAM) as its source of EFT information).
(xx) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (JUL 2013) (Applies when the payment will be made by EFT and the payment office does not use the SAM database as its source of EFT information.)
(xxi) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (FEB 2006) (46 U.S.C. 55305) (Applies to supplies transported by ocean vessels (except for the types of subcontracts listed at 47.504(d).)
(2) Listed below are additional clauses that may apply:
(i) 52.204-21, Basic Safeguarding of Covered Contractor Information Systems (JUN 2016) (Applies to contracts when the contractor or a subcontractor at any tier may have Federal contract information residing in or transiting through its information system.
(ii) 52.209-6, Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (JUN 2020) (Applies to contracts over the threshold specified in FAR 9.405-2(b) on the date of award of this contract).
(iii) 52.211-17, Delivery of Excess Quantities (SEP 1989) (Applies to fixed-price supplies).
(iv) 52.247-29, F.o.b. Origin (FEB 2006) (Applies to supplies if delivery is f.o.b. origin).
(v) 52.247-34, F.o.b. Destination (NOV 1991) (Applies to supplies if delivery is f.o.b. destination).
(c) FAR 52.252-2, Clauses Incorporated by Reference (FEB 1998). This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):
https://www.acquisition.gov/browse/index/far https://www.acquisition.gov/dfars https://www.acquisition.gov/affars
(d) Inspection/Acceptance. The Contractor shall tender for acceptance only those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. The Government must exercise its postacceptance rights—
(1) Within a reasonable period of time after the defect was discovered or should have been discovered; and
(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.
(e) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence, such as acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.
(f) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges that the Contractor can demonstrate to the satisfaction of the Government, using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred that reasonably could have been avoided.
(g) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance. In the event of termination for cause, the Government shall not be liable to the Contractor for any amount for supplies or services not accepted, and the Contractor shall be liable to the Government for any and all rights and remedies provided by law. If it is determined that the Government improperly terminated this contract for default, such termination shall be deemed a termination for convenience.
(h) Warranty. The Contractor warrants and implies that the items delivered hereunder are merchantable and fit for use for the particular purpose described in this contract.
52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT (OCT 1997)
(IAW FAR 15.209(h), AFFARS 53.15.209(h))
52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE (NOV 2020)
(IAW FAR 19.507(c))
52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (SEP 2021)
(IAW FAR 19.309(c))
(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 124.1002.
(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) concern eligible under the WOSB Program.
[Complete only if the Contractor represented itself as a women-owned small business concern in paragraph (h)(3) of this clause.] The Contractor represents that—
(i) It [ ] is, [ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and
(ii) It [ ] is, [ ] is not is not a joint venture that complies with the…
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