SPRTA1-23-R-0094.pdf

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CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Executive Services Directorate (0704-0188).

Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

B-2 / Light Assembly, Indicator

E. CONTRACT / PR NO.

FD20302300194

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

First Article Inspection Test Report

4. AUTHORITY

DI-NDTI-80809B/T

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

N/A

6. REQUIRING OFFICE

AFLCMC/LZPED

7. DD 250 REQ

NO

8. APP CODE

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

1 XTIME

11. AS OF DATE

Test Day

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Zilar, Dale NNAME: 09 FEB 2023DATE:

NSN: 6220-014572318FW

P/N: DAA3231P009-117

BLOCK 7: ALL INSPECTION AND ACCEPTANCE SHALL BE AT DESTINATION UTILIZING WAWF. A

COMBINATION OF AN INVOICE AND RECEIVING REPORT SHALL BE SUBMITTED THROUGH WAWF IN

ORDER TO RECEIVE PAYMENT FOR DATA REPORTS.

BLOCK 8: GOVERNMENT WRITTEN NOTICE OF APPROVAL/DISAPPROVAL IS DUE 60 DAYS AFTER

RECEIPT OF CONTRACTOR'S REPORT.

BLOCK 9: Distribution Statement A: Approved for public release; distribution is unlimited.

BLOCK 12: 180 DAYS AFTER CONTRACT AWARD.

SEE ATTACHED DD FORM 1664, DATA ITEM DESCRIPTION.

BLOCK 14: Deliveries shall be submitted on ISO-10149 compliant CD-ROM in Adobe Acrobat Portable Document Format.

Contractor format acceptable unless otherwise defined by applicable Data Item Description (DID).

A. THE PURPOSE OF THE FIRST ARTICLE INSPECTION IS TO GIVE OBJECTIVE EVIDENCE THAT ALL

ENGINEERING, DESIGN AND SPECIFICATION REQUIREMENTS ARE CORRECTLY UNDERSTOOD,

ACCOUNTED FOR, VERIFIED AND RECORDED.

B. SHOW COMPLETION OF INSPECTION AND RESULTS OF INSPECTION PERFORMED TO

DEMONSTRATE THAT THE FIRST ARTICLE UNIT(S) CONFORM TO THE APPLICABLE CONTRACT

TECHNICAL REQUIREMENTS.

C. REPORT SHALL DELINEATE THE SPECIFIC RESULTS OBTAINED, THE WITNESSES, AND ANY

OTHER PERTINENT OBSERVATIONS.

D. INSPECTION RESULTS SHALL BE THE APPLICABLE VARIABLE & ATTRIBUTE DATA IN THE FORM

OF RECORDINGS, INSTRUMENT READINGS AND RELATED DATA.

E. AS APPLICABLE, THE FIRST ARTICLE INSPECTION TEST REPORT SHOULD IDENTIFY ANY

DEVIATIONS OR LIMITATIONS IN THE FIRST ARTICLE UNIT(S) INVOLVED.

DELETE PARAS: 10.2.4(a), 10.2.5, 10.2.6.2, 10.2.6.3, 10.2.6.4.2(b-d), 10.2.6.5, 10.2.6.6, 10.2.7.2 & 10.2.8

AS 9102 FORMAT OR EQUIVALENT IS ACCEPTABLE.

REMARK APPLICABLE TO HAZARDOUS ITEMS ONLY: THE TESTS REQUIRED ARE AS

422 SCMS/GUEA

3001 Staff Drive Tinker Air Force Base, Oklahoma 73145

0 1 0

AFLCMC/LZPED

ATTN: FA Monitor DoDAAC

FA8111

3001 Staff Drive, Suite

1AB85A

Tinker AFB, OK 73145-3041

0 1 0

0 2 015. TOTAL

Page 1 of 2DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 01 Mar 2023

PREVIOUS EDITION MAY BE USED.

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

SPECIFIED IN CHAPTER 9 OF THE UNITED NATIONS TRANSPORT OF DANGEROUS GOODS (ORANGE

BOOK) RECOMMENDATIONS.

COORDINATORS:

G. PREPARED BY

Zilar, Dale N

424 SCMS / GUBAB

405-736-7976

H. DATE

09 FEB 2023

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Urchison, Kenneth L

422 SCMS / GUEA 405-582-5356 / 852-5356

J. DATE

09-FEB-23

Page 2 of 2DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 01 Mar 2023

PREVIOUS EDITION MAY BE USED.

DATA ITEM DESCRIPTION I Form Approved OMB No.0704.0188

1.nTLE 2.IOENTIFICATIONNUMBER

TEST/ INSPECTION REPORT DI-NM’I-80809B

L OESCRIPTlOtVPURPOSE

3.1 The testl inspection report is used to document testl inspection results, findings, and analyses that will enable the government or contracting agency to evaluate compliance with system requirements, performance objectives, specifications, and test linspection plans.

1.APPROVALDATE 5.OFFICEOFPRIMARYRESPONSIBILITY(OPB) Ea.DTICAPPLICABLE 6b.CWIEP AppliCable

(YVMMOD)

F/AFMC-DCJP

970124

,.APPLlCAT\0NflNTER7iElAT10NSH1P

7.1 This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement

I as delineated in the contract.

I

7.2 This DID is applicable to engineering (developmental ), preliminary qualification, qualification, and acceptance testing.

7.3 This DID supersedes DI-NDTI-80809A and DI-MISC-80653

1.APPROVALLIMITATION 9a.APPLICABLEFORMS 9b.AMSCNUMBER

F7231

10,PREPARATIONlNSTRUCnONS

10.1 Format. Contractor format is acceptable.

paragraph 10.2 and its subparagraphs in a manner understanding

10.2 CQnL!aL. The test/inspection report shall

applicable.

Organize the information required by that facilitates presentation and contain the following information, as

10. 2.1 Cove. and tile uaae. The following information shall appear on the outside front :over and title page:

a. Report date.

b. Report number (contractor or government)

Contractor’ s name, address, and commercia 1 and government entity code.

Contract number and contract line item number or sequence number (if applicable)

e. ‘fvpe of test/inspection (for example. first article acceptance test, aualitv con formanc-e-inspection, d-evelopmental test-, qualification test, f Identification of item tested/inspected.

9. Date or period of test/inspection.

h. Name and address of requiring government activity.

i. Security classification, downgrading and declassifying environmental Lest) .“ information, if applicable.

(Continued on page 2 )

1.DIS77UBUTIONSTATEMEW

DISTRIBUTION STATEMRNT A : APPROVED FOR PUBLIC RELBASE; DISTRIBUTION IS UNLIMITED.

ID Form 1664,APR 89 PreviOLIsedtliomwe obsdem. Page 1 of & Pages 39123

DI-NDTI-80809B

Block 10, Preparation Instructions (continued)

10.2.2 ~. The table of contents shall identify the following:

a. The title and starting page of each major section, paragraph, and apPendix of the report.

b. The page, identifying number, and title of each illustration (for example; figure, table, photograph, chart, and drawing)

10 .2.3 -ductim. The introduction shall include the following information:

10.2 .3.1 obyectlve W. The specific test/ inspection objective (s) as specified in the contract tasking document.

10. 2.3.2 L.temls) tes~. Complete identification of the item(s) testedl inspected including the following:

a. Nomenclature.

b. National stock number.

Model number, part number t and serial number :: Type of item (for example, prototype, production item, laboratory model )

e. Serial or lot number.

f. Applicable engineering changes

9. Production item specification, if applicable.

h. Date of manufacture.

10.2 .3.3 Complete inspection requirements correlated to contractual

Required testl inspection parameters :: Performance requirements, acceptance or environmental criteria.

10.2.4 ~. Complete test/inspection report identification of the testl requirements including the compliance limits, and summary including the

a. A brief discussion of the significant test/inspection results, ObSerVati Qns, conclusions, and recommendations covered in greater detail elsewhere in the report.

b. Proposed corrective actions and schedules for failures or problems encountered.

c. Identification of deviations, departures, or limitations encountered, referenced to the contract requirements.

d. Tables, graphs, illustrations, or charts as appropriate to simplify the summary data.

10.2.5 ~. Complete identification of all documents referenced in the test finspection report including the following, as applicable:

a. Prior testf inspection reports on the same item.

b. Test /inspection plans and procedure documents

c. Prior certifications of compliance.

d. Contractor’ s file designation where test/ inspection records are maintained.

e. Input parameters used.

The applicable issue of the documents cited therein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

Page 2 of 4 Pages

10.2.6 ~. The body of the testlinspection report shall be as follows :

10 .2.6.1 KzZL_ + de.tlflca~.

Complete identification of each item of test equipment used in the testlinspection including the following:

a.

b.

c.

d.

e.

f.

9.

10. 2.6.2

Nomenclature.

Model number.

Serial number.

Manufacturer.

Calibration status.

Accuracy data.

Comments, if applicable.

Testlinmection kuhtv mstd.b&mn and set–w. Complete description of the physical set-up used in conducting the test/inspection to include the following:

a. Location or orientation of the item.

b. Location. orientation, or settinm of test equipment and instrumentation.

c. Location, orientation, or settings of sensors and probes

d. Location or orientation of interconnections, cables, and hoop-ups.

e. Electrical power, pneumatic, fluidic, and hydraulic requirements.

Drawings, illustrations, and photographs maY be used for clarification.

10 .2.6.3 wrocedur~. Complete description of the procedures used in conducting the test/inspection to include the following:

a. Item selection and inspection that verified suitability for test/ inspection.

b. Summarized sequence of testing/inspection steps, including a description of how the item was operated during the test/inspection, and any control conditions imposed.

10 .2.6.4 A copy of all testlinspection results and analysis to include the following:

10.2.6 .4.1 ~. The actual recorded data (for example, log book entries, oscillographs, instrument readings, plotter graphs) If the recorded data is extensive, provide it in an appendix.

10. 2.6.4.2 Test/ insQec!iion resu. Identification of all testlinspection results to include the following:

a. Matrices comparing results achieved against test/inspection objectives or requirements

b. A discussion of these matrices as to their significance, and how they compare to any prior testlinspections.

Calculation examples.

;; Discussion of anomalies, deviations, discrepancies, or failures, including their impact, causes, and proposed corrective actions The discussion shall address discrepancies between design requirements and the tested/inspected Configuration.

10. 2.6.5 Conclusicxls Test/ inspection conclusions distinguished between objective and subjective to include the following:

a. The effectiveness of the testlinspection procedures in measuring item performance.

Page 3 of 4 Pages

b. The success or failure of the item to meet required test/inspection objectives.

c. The need for repeat, additional, or alternative tests linspections.

d. The need for item redesign or further development.

e. The need for improved test/inspection procedures, techniques, or facilities.

f. The adequacy and completeness of the test/inspection requirements.

10.2 .6.6 Recommendations appropriate to the test/inspection results and conclusions including the following:

a b.

c.

d.

e.

f.

9.

h.

Acceptability of the item tested/inspected (pass or fail) Additional testing/inspection required. ,.

Redesign required.

Problem resolution.

Test/inspection procedure or facility improvements Disposition of items tested/inspected.

Documentation changes required.

Testing/ inspection improvements

10.2.7 The following certifications shall be included, .as

applicable:

10.2 .7.1 A statement that the testlinspection was performed in accordance with applicable testlinspection plans and procedures, and that the results are true and accurate. The authentication shall include the signature of the contractor personnel that performed the test(s) /inspection(s) , a contractor representative authorized to make such certification, and any government witnesses

10.2 .7.2 A statement identifying those requirements not tested/inspected or measured that were previously validated.

Include identification of the data and method employed for such validation (for example, prior test/inspection, analytical verification, equivalent item, and so on) The authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness.

10.2 .7.3 A statement that the item tested/ inspected either passed or failed item acceptability requirements This authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness

10.2.8 Appendices shall be used to append detailed

test/inspection daia, drawings, photographs , or other documentation too voluminous to include in the main body of the report This includes referenced documentation not previously provided by the government, and test/ inspection reports from any associated test/inspection activity that may have performed some of the testing/inspecting requirements.

Page 4 of 4 Pages

PACKAGING REQUIREMENTS

PURCHASE INSTRUMENT NUMBER: FD20302300194-00 VERSION: 1

MIL-STD 129 REVISION: R MIL-STD 2073-1 REVISION: E

THE FOLLOWING STATEMENT IS IN COMPLIANCE WITH THE UNITED NATIONS-IMPLEMENTED RESTRICTIONS ON WOOD PACKAGING MATERIAL (WPM). THIS REQUIREMENT IS SPECIFICALLY CONCERNED WITH INVASIVE SPECIES SUCH AS THE PINEWOOD NEMATODE. WPM IS DEFINED AS WOOD PALLETS, SKIDS, LOAD BOARDS, PALLET COLLARS, WOODEN BOXES, REELS, DUNNAGE, CRATES, FRAMES, AND CLEATS. THE STATEMENT BELOW CITES THE REQUIREMENTS IN DETAIL AND COVERS LUMBER FOR BUILDING CONTAINERS AND PALLETS USED FOR DELIVERIES RESULTING IN SHIPMENTS WORLDWIDE (DIRECT, OR THROUGH AIR LOGISTICS CENTERS (ALC), CONTAINER CONSOLIDATION POINTS (CCP), OR OTHER BASES). WOODEN LUMBER, WOODEN

PALLET AND PACKAGING/CONTAINER STATEMENT:

ALL WOODEN LUMBER, WOODEN PALLET'S, AND WOODEN CONTAINERS PRODUCED ENTIRELY OR IN PART OF WOOD PACKING MATERIAL (WPM) SHALL BE CONSTRUCTED FROM DEBARKED WOOD IN ADDITION TO THE APPLICATION OF HEAT-TREATED (HT) MATERIAL (HT TO 56 DEGREES CENTIGRADE OR 133 DEGREES FAHRENHEIT FOR 30 MINUTES). CERTIFICATION/MARKING IS REQUIRED BY AN ACCREDITED AGENCY RECOGNIZED BY THE AMERICAN LUMBER STANDARDS COMMITTEE (ALSC). FOR REFERENCE DOCUMENTATION, SEE LATEST REVISION OF "INTERNATIONAL STANDARDS FOR PHYTOSANITARY MEASURES" (ISPM)NO.15), "REGULATION OF WOOD PACKAGING MATERIAL IN INTERNATIONAL TRADE."

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAA MIL Long Line Packaging MIL B

ITEM(S):

6220014572318FW 6220DTH2300C9FW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

LENGTH

WIDTH

DEPTH

CUBE OPI

1 000 GX 1 00 K3 NB A NV 00 B ZZ 11.00 21.0 15.0 9.3 1.695 M

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

ZZ - SMC: ESD, REUSABLE CONTAINER AND HARDNESS CRITICAL ITEM.

VENDOR PACKAGING INSTRUCTIONS:

Military Packaging and Marking Items shall be packaged in accordance with MIL-STD-2073-1, Standard Practice for Military Packaging. Shipping and storage markings shall be in accordance with MIL-STD-129, Standard Practice for Military Marking.

Shipping Container Marking Shipping containers shall be marked meeting the following criteria: (a) MIL-STD-129, Standard Practice for Military Marking. (b) Additional marking and/or bar coding requirements exceeding those of MIL-STD-129 (e.g., unit serial numbers, original equipment manufacturers (OEM) name, or OEM model number, as specified on the AFMC Form 158.

ORGANIZATION / OFFICE SYMBOL:

406 SCMS / GULAA

PACKAGING SPECIALIST:

Chartney, TJ

PHONE NUMBER:

405-582-6047 / 312-6047

SIGNATURE:

//SIGNED//Chartney, TJ

DATE:

23044 - 13 FEB 2023

Page 1 of 1AFMC 158 Version 1Generated by PRPS using Jasper Reports on 01 Mar 2023

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1447 (REV. 8/2016)

PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.214(d)

23. ACCOUNTING AND APPROPRIATION DATA

SEE SCHEDULE

24. TOTAL AWARD AMOUNT (For Government Use Only)

TELEPHONE NUMBER

UNIQUE ENTITY

IDENTIFIER

CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

NO COLLECT CALLS

4. SOLICITATION NUMBER

SPRTA1-23-R-0094

6.SOLICITATION ISSUE DATE

8. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

HUBZONE SMALL

BUSINESS EDWOSB

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS NAICS: 336413

8(A) SIZE STANDARD: 1,250

DATE SIGNED

28. UNITED STATES OF AMERICA (Signature of Contracting Officer)

26. AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION NUMBER

SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS OR CHANGES WHICH

ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

Subject to the terms and conditions stated herein, the Contractor agrees to hold its offered prices firm for 120 days.

FIRST ARTICLE REQUIRED

SEE LINE ITEM SCHEDULE

22.

AMOUNT

16. AUTHORITY FOR USING OTHER THAN 10 USC 2304 41 USC 253

FULL AND OPEN COMPETITION (c) (1 ) (c) ( )

DATE SIGNED

27. SIGNATURE OF OFFEROR/CONTRACTOR

20.

UNIT

21.

UNIT PRICE

19.

QUANTITY

13. CONTRACTOR OFFEROR CODE FACILITY CODE

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT WITHIN * ___ CALENDAR DAYS (60 CALENDAR

DAYS UNLESS OFFEROR INSERTS A DIFFERENT PERIOD) FROM THE DATE SET FORTH IN BLOCK 9

ABOVE, THE CONTRACTOR AGREES TO HOLD ITS OFFERED PRICES FIRM FOR THE ITEMS

SOLICITED HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO THE TERMS AND

CONDITIONS STATED HEREIN. *120

RATING

DX: A1

3. AWARD/EFFECTIVE DATE

SPRTA1

2. CONTRACT NUMBER

X

17.

ITEM NUMBER

12. ADMINISTERED BY CODE

Total

SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK: 14 EFT:T

SCD:A

NAME AND TITLE OF SIGNER (Type or Print) NAME OF CONTRACTING OFFICER

5. SOLICITATION TYPE

SEALED BIDS NEGOTIATED

(IFB) (RFP)

15. PROMPT PAYMENT DISCOUNT

25. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SETFORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY CONTINUATION SHEETS SUBJECT

THE TERMS AND CONDITIONS SPECIFIED HEREIN.

10. ITEMS TO BE PURCHASED (Brief Description)

SUPPLIES SERVICES Other Aircraft Part and Auxiliary Equipment Manufacturing7

9. (Agency Use)

23-JUNE-2025 4:00PM

18.

SCHEDULE OF SUPPLIES/SERVICES

14. PAYMENT WILL BE MADE BY CODE

(SEE ESP CLAUSE 252.232-7003.)

CODE7. ISSUED BY

DLA AVIATION AT OKLAHOMA CITY, OK

DLR PROCUREMENT OPERATIONS (AO)

3001 STAFF DRIVE

TINKER AFB OK 73145-3070

BUYER: Christine Turnage DLA-AOBB christine.turnage@us.af.mil Phone: (405) 855-3075

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)SOLICITATION/CONTRACT

BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27.

J

20230418

STANDARD FORM 1447 (REV. 8/2016) BACK

NO RESPONSE FOR REASONS CHECKED

TYPE OR PRINT NAME AND TITLE OF SIGNER

SIGNATURENAME AND ADDRESS OF FIRM (Include Zip Code)

WE DO NOT DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF

ITEMS INVOLVED

WE DO

OTHER (Specify)

UNABLE TO IDENTIFY THE ITEM(S)

CANNOT COMPLY WITH SPECIFICATIONS CANNOT MEET DELIVERY REQUIREMENT

DO NOT REGULARILY MANUFACTURE OR SELL THE TYPE

OF ITEMS INVOLVED

DATE AND LOCAL TIME 23 June 2025 4:00 PM

SOLICITATION NUMBER SPRTA123R0094

FROM: AFFIX

STAMP

HERE

TO:

ATTN: Christine Turnage/DLA-AOBB

DLA AVIATION AT OKLAHOMA CITY, OK

DLR PROCUREMENT OPERATIONS (AO)

3001 STAFF DRIVE

TINKER AFB OK 73145-3070

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

INFORMATION CLIN

Item No.

NSN: 6220-01-457-2318

B-2 Indicator Lignt Assembly Manufacturer Part Number 22830 711140-8 Associated Document(s) Line Item(s)

FD20302300194 0001

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

GOVERNMENT TEST FIRST ARTICLE

Bid A - First Article Required

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

2 EA

First Article

FIRST ARTICLE - SAME AS BASIC ITEM ABOVE

The quantity of first articles for this item number may be considered part of the contract quantity if the first articles are approved by the Government and are inspected/accepted by the Government as required by FAR clause 52.209-4.

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: WAWF 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 OR EQUIVALENT

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

B FY2303 FAGT DESTINATION

Type / Ship To PACRN Mark For B FY2303 FAGT PAB First Article Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

B FY2303 FAGT 2 EA *180 Calendar Days Non-MilStrip

Proposed

B FY2303 FAGT 2 EA

The First Articles (FAs) offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the FA is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each FA which is offered. The detailed Government Testing will include Form, Fit, and Function (FFF) testing in the applicable End Item in accordance with TO 8D15-9-31-2 procedures. All data is contained in Symetrics Industries Specification Control Drawing and associated Symetrics drawings and specifications.

Deliver FAs TO: DDOO SOP First Article (FY2303)

7330 Sentry Blvd.

Bldg. 469 Door 12

TAFB, OK 73145

First Articles (ensure words "First Articles" are marked on outside of box. Do not Post, Non Accountable; Do not put into Supply

CONTRACTOR FIRST ARTICLE TEST/INSPECTION REPORT

Refer to the Attached CDRL for Instructions

0001AB

Quantity U/I Unit Price Amount

1 LO

Data Contractor First Article Test Report Required Type / Ship To PACRN Mark For

A FA8117 FA MONT

Type / Ship To Quantity (U/I) IAW 260 Req No / Pri

A FA8117 1 LO IAW 260

CONTRACTOR FIRST ARTICLE TEST/INSPECTION REPORT

Refer to the Attached CDRL for Instructions

A FA8117 1 LO

The First Article Test report will be shipped to DODAAC FA8117 at the same time the 2 First Article Units are Shipped

NEW MANUFACTURED MATERIAL

PRODUCTION UNITS

0001AC

Estimated Quantity

U/I Unit Price Amount

8 EA

Quantity Range

1 EA

Quantity Range B

8 EA

Production Article

PRODUCTION ARTICLE - SAME AS BASIC ITEM ABOVE

Limitations of Liability: Other Than High Value Item

Inspection/Acceptance Report: WAWF Quality Assurance: Standard Inspection Type / Ship To PACRN Mark For

A SW3211 PAC ACCT 09

Type / Ship To Quantity (U/I) To be determined _ Req No / Pri

A SW3211 8 EA TBD Non-MilStrip

A SW3211 8 EA

NEW UNUSED GOV'T/COMMERCIAL SURPLUS

Estimated Quantity

U/I Unit Price Amount

8 EA

Part Number 711140-8 Line Item(s)

EA

B

8 EA

NSN: 6220-01-457-2318 FW

LIGHT ASSEMBLY,INDI

Manufacturer 22830 Associated Document(s)

FD20302300194PLN 0001

Quality Assurance: Standard Inspection Government or Commercial Surplus Acceptable Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 PAA Account 09 Type / Ship To Quantity (U/I) On or Before Req No / Pri

A SW3211 8 EA TBD

A SW3211 8 EA

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A FA8117

FA8117 AFSC PZABA

CP 405 739 3450

3001 STAFF DR STE 1AC4 97E

TINKER AFB OK 73145-3303 73145-3303

USA

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

TYPE/CODE: A SW3211

DLA DISTRIBUTION DEPOT OKLAHOMA

3301 F AVE CEN REC BLDG 506 DR 22

TINKER AFB OK 73145-8000

TINKER AFB OK 73145-8000

TYPE/CODE: B FY2303 FAGT

DEPARTMENT OF THE AIR FORCE

OC-ALC ATTN DD00-SOP/1ST ARTICLE

BLDG. 469 DOOR 12

7330 SENTRY BLVD.

TINKER AFB OK 73145-9156

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 The detailed Government Testing will include Form, Fit, and Function (FFF) testing in the applicable End

Item in accordance with TO 8D15-9-31-2 procedures

Lot/Item Contractor Test/Inspection Requirements 0001AB Refer to the Attached CDRL for Instructions

Contractor Testing Requirements

The First Articles (FAs) offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the FA is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each FA which is offered.

Government Testing Requirements

The detailed Government Testing will include Form, Fit, and Function (FFF) testing in the applicable End Item in accordance with TO 8D15-9-31-2 procedures. All data is contained in Symetrics Industries Specification Control Drawing and associated Symetrics drawings and specifications.

Disposition of the First Article shall be as follows:

Lot/Item Approved 0001AA Forwarded to USAF Supply

Lot/Item Disapproved 0001AA Returned to the 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.]*

Title Number Date Tailoring *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): 0001AA

SECTION F

DELIVERIES OR PERFORMANCE

52.211-17 DELIVERY OF EXCESS QUANTITIES (SEP 1989)

(IAW FAR 11.703(b))

52.242-15 STOP-WORK ORDER (AUG 1989)

(IAW FAR 42.1305(b)(1))

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

(IAW FAR 42.1305(c))

52.247-29 F.O.B. ORIGIN (FEB 2006)

(IAW FAR 47.303-1(c))

52.247-30 F.O.B. ORIGIN, CONTRACTOR'S FACILITY (FEB 2006)

(IAW FAR 47.303-2(c))

52.247-34 F.O.B. DESTINATION (NOV 1991)

(IAW FAR 47.303-6(c))

52.247-48 F.O.B. DESTINATION--EVIDENCE OF SHIPMENT (FEB 1999)

(IAW FAR 47.305-4(c)) Applicable Item No(s)

0001AA

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]

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))

(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).

(Contracting Officer: Insert applicable document type(s).

Note: If a “Combo” document type is identified but not supportable by the Contractor’s business systems, an “Invoice” (stand-alone) and “Receiving Report” (stand-alone) document type may be used instead.)

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

(Contracting Officer: Insert inspection and acceptance locations or “Not applicable.”)

(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 Issue By DoDAAC Admin DoDAAC Inspect By DoDAAC Ship To Code Ship From Code Mark For Code Service Approver (DoDAAC) Service Acceptor (DoDAAC) Accept at Other DoDAAC LPO DoDAAC DCAA Auditor DoDAAC Other DoDAAC(s) (*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)

(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.

(Contracting Officer: Insert applicable email addresses or “Not applicable.”)

(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.

(Contracting Officer: Insert applicable information or “Not applicable.”)

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

PART II - CONTRACT CLAUSES

SECTION I

CONTRACT CLAUSES

5352.201-9101 OMBUDSMAN (OCT 2019)

(IAW AFFARS 5301.9103)

DLA OMBUDSMAN (APR 2010)

(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 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).

The Competition Advocate (CA) at each contracting activity/office (as defined in DLAD 2.101) shall act as the ombudsman and attempt to resolve contractor complaints. DLA AVIATION – AOCA’s CA/ombudsman can be reached at (405) 855-3556.

Complaints which cannot be so resolved shall be forwarded to the HQ through J-72 for resolution by the DLA competition advocate. Each activity is responsible for developing procedures for executing the duties and responsibilities of its

(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.

(End of clause)

52.202-1 DEFINITIONS (JUN 2020)

(IAW FAR 2.201)

52.203-3 GRATUITIES (APR 1984)

(IAW FAR 3.202)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

(IAW FAR 3.404)

52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT (JUN 2020)

(IAW FAR 3.503-2)

52.203-7 ANTI-KICKBACK PROCEDURES (JUN 2020)

(IAW FAR 3.502-3)

52.203-8 CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS FOR ILLEGAL OR

IMPROPER ACTIVITY (MAY 2014)

(IAW FAR 3.104-9(a))

52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY (MAY 2014)

(IAW FAR 3.104-9(b))

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS

(JUN 2020)

(IAW FAR 3.808(b))

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))

252.203-7001 PROHIBITION ON PERSONS CONVICTED OF FRAUD OR OTHER

DEFENSE-CONTRACT-RELATED FELONIES (DEC 2008)

(IAW DFARS 203.570-3)

252.203-7002 REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER RIGHTS

(SEP 2013)

(IAW DFARS 203.970)

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON RECYCLED PAPER (MAY 2011)

(IAW FAR 4.303)

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

(NOV 2021)

(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 (NOV 2021)

(IAW FAR 4.2004)

52.204-25 PROHIBITION ON CONTRACTING FOR CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

(IAW 4.2105(b))

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 (MAR 2022)

(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 2 EA 180 FY2303

(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.

0001AA 60

(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)) "The First Article offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the First Article is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each First Article which is offered."

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

(IAW FAR 9.308-2(a)(3), FAR 9.308-2(b)(3)) As prescribed in 9.308-2(a)(3) and (b)(3), substitute the following paragraph (h) for paragraph (h) of the basic clause:

(h) Before first article approval, the Contracting Officer may, by written authorization, authorize the Contractor to acquire specific materials or components or to commence production to the extent essential to meet the delivery schedules. Until first article approval is granted, only costs for the first article and costs incurred under this authorization are allocable to this contract for (1) progress payments, or (2) termination settlements if the contract is terminated for the convenience of the Government. If first article tests reveal deviations from contract requirements, the Contractor shall, at the location designated by the Government, make the required changes or replace all items produced under this contract at no change in the contract price.

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH

CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT

(NOV 2021)

(IAW FAR 9.409)

52.209-9 UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (OCT 2018)

(IAW FAR 9.104-7(c))

52.209-10 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS

(NOV 2015)

(IAW FAR 9.108-5(b))

252.209-7004 SUBCONTRACTING WITH FIRMS THAT ARE OWNED OR CONTROLLED BY THE

GOVERNMENT OF A COUNTRY THAT IS A STATE SPONSOR OF TERRORISM

(MAY 2019)

(IAW DFARS 209.409)

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).

52.215-2 AUDIT AND RECORDS--NEGOTIATION (JUN 2020)

(IAW FAR 15.209(b)(1))

52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT (OCT 1997)

(IAW FAR 15.209(h), AFFARS 53.15.209(h))

52.215-14 INTEGRITY OF UNIT PRICES (NOV 2021)

(IAW FAR 15.408(f)(1))

52.215-14 INTEGRITY OF UNIT PRICES -- ALTERNATE I (OCT 1997)

(IAW FAR 15.408(f)(2))

52.219-8 UTILIZATION OF SMALL BUSINESS CONCERNS (OCT 2022)

(IAW FAR 19.708(a))

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN (OCT 2022)

(IAW FAR 19.708(b))

52.219-9 SMALL BUSINESS SUBCONTRACTING PLAN - ALTERNATE III (JUN 2020)

(IAW FAR 19.708(b)(1))

52.219-16 LIQUIDATED DAMAGES--SUBCONTRACTING PLAN (SEP 2021)

(IAW FAR 19.708(b)(2))

52.219-28 POST-AWARD SMALL BUSINESS PROGRAM REREPRESENTATION (OCT 2022)

(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) 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) and 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.]

252.219-7003 SMALL BUSINESS SUBCONTRACTING PLAN (DoD CONTRACTS) (DEC 2019)

(IAW DFARS 219.708(b)(1)(A), DFARS 219.708(b)(1)(A)(1))

252.219-7003 SMALL BUSINESS SUBCONTRACTING PLAN (DoD CONTRACTS)--ALTERNATE I

(DEC 2019)

(IAW DFARS 219.708(b)(1)(A)(2), DFARS 219.708(b)(1)(A)(1))

252.219-7004 SMALL BUSINESS SUBCONTRACTING PLAN (TEST PROGRAM) (MAY 2019)

(IAW DFARS 219.708(b)(1)(B))

52.222-19 CHILD LABOR COOPERATION WITH AUTHORITIES AND REMEDIES (DEVIATION

2020-O0019) (JAN 2022)

(IAW Deviation 2020-O0019 Rev. 2)

(a) Applicability. This clause does not apply to the extent that the Contractor is supplying end products mined, produced, or manufactured in—

(1) Israel, and the anticipated value of the acquisition is $50,000 or more;

(2) Mexico, and the anticipated value of the acquisition is $92,319 or more; or

(3) Armenia, Aruba, Australia, Austria, Belgium, Bulgaria, Canada, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, Iceland, Ireland, Italy, Japan, Korea, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Moldova, Montenegro, Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Taiwan, Ukraine, or the United Kingdom and the anticipated value of the acquisition is $183,000 or more.

(b) Cooperation with Authorities. To enforce the laws prohibiting the manufacture or importation of products mined, produced, or manufactured by forced or indentured child labor, authorized officials may need to conduct investigations to determine whether forced or indentured child labor was used to mine, produce, or manufacture any product furnished under this contract. If the solicitation includes the provision 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products, or the equivalent at 52.212-3(i), the Contractor agrees to cooperate fully with authorized officials of the contracting agency, the Department of the Treasury, or the Department of Justice by providing reasonable access to records, documents, persons, or premises upon reasonable request by the authorized officials.

(c) Violations. The Government may impose remedies set forth in paragraph (d) for the following violations:

(1) The Contractor has submitted a false certification regarding knowledge of the use of forced or indentured child labor for listed end products.

(2) The Contractor has failed to cooperate, if required, in accordance with paragraph (b) of this clause, with an investigation of the use of forced or indentured child labor by an Inspector General, Attorney General, or the Secretary of the Treasury.

(3) The Contractor uses forced or indentured child labor in its mining, production, or manufacturing processes.

(4) The Contractor has furnished under the contract end products or components that have been mined, produced, or manufactured wholly or in part by forced or indentured child labor. (The Government will not pursue remedies at paragraph (d)(2) or paragraph (d)(3) of this clause unless sufficient evidence indicates that the Contractor knew of the violation.)

(d) Remedies.

(1) The Contracting Officer may terminate the contract.

(2) The suspending official may suspend the Contractor in accordance with procedures in FAR Subpart 9.4.

(3) The debarring official may debar the Contractor for a period not to exceed 3 years in accordance with the procedures in FAR Subpart 9.4.

52.222-21 PROHIBITION OF SEGREGATED FACILITIES (APR 2015)

(IAW FAR 22.810(a)(1))

52.222-26 EQUAL OPPORTUNITY (SEP 2016)

(IAW FAR 22.810(e))

52.222-35 EQUAL OPPORTUNITY FOR VETERANS (JUN 2020)

(IAW FAR 22.1310(a)(1), DFARS 222.1310(a)(1))

(a) Definitions. As used in this clause-- “Active duty wartime or campaign badge veteran,” “Armed Forces service medal veteran,” “disabled veteran,” “protected veteran,” “qualified disabled veteran,’ and “recently separated veteran” have the meanings given at Federal Acquisition Regulation (FAR) 22.1301.

(b) Equal opportunity clause. The Contractor shall abide by the requirements of the equal opportunity clause at 41 CFR 60-300.5(a), as of March 24, 2014. This clause prohibits discrimination against qualified protected veterans, and requires affirmative action by the Contractor to employ and advance in employment qualified protected veterans.

(c) Subcontracts. The Contractor shall insert the terms of this clause in subcontracts valued at or above the threshold specified in FAR 22.1303(a) on the date of subcontract award, unless exempted by rules, regulations, or orders of the Secretary…