Synopsis Soliciation .pdf

(i) This is a combined synopsis/solicitation for a commercial supply prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotations are being requested and a written solicitation will not be issued.

(ii) The solicitation number 127EAY23Q0007 is issued as a request for quotation (RFQ).

(iii) The solicitation document and incorporated provisions and clauses are those in effect through

Federal Acquisition Circular 2005-97.

(iv) This is a 100% Small Business Set-aside under NAICS code 238120 Precast Concrete

Contractors; the small business size standard is $15 million; the Product/Service code is 5410

Prefabricated and Portable Buildings.

(v)One line item will be applicable. (see attached contract schedule of items).

(vi) The Government is seeking to establish a purchase order contract for Prefabricated Concrete Vault Toilet for the Shasta Trinity National Forest.

(vii) Delivery of items to be expected around June/July 2023 time frame.

(viii) The provision at 52.212-1, Instructions to Offerors - Commercial Items, applies to this acquisition.

The Government intends to evaluate quotes and offer an award based on the quote submission; therefore, the quote should contain the best terms from a price and technical standpoint. The following are

SUBMISSION REQUIREMENTS:

1) Solicitation Number (127EAY23Q0007)

2) Offers due 19 January 2023 / 1300hrs Pacific Standard Time

3) Contractor name, address, DUNS number or UEI number

4) Pricing on the contract schedule of items

(ix) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

1) Pricing of Vault Toilet/Installation

2) Any applicable Warranties

3) Relevant Past Performance: Past Performance is a measure of the degree to which an offeror has satisfied its customers, complied with contract terms and conditions in addition to applicable laws and regulations. The Government may contact individuals and firms that you have performed services for, to evaluate your experience and past performance record.

(x)Responses shall submit a completed copy of 52.212-3, Offeror Representations and Certifications --

Commercial Items, unless it has an active entity registration with the certifications through the System for Award Management (SAM) website. (www.sam.gov )

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 http://www.sam.gov/ text of a clause may be accessed electronically at this/these address (es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oamm/oa/ars/policyreg/vaar/index.cfm

(xi) The clause at FAR 52.212-4 CONTRACT TERMS AND CONDITIONS--COMMERCIAL ITEMS applies to this contract

Addenda to this clause are as follows:

(xii) The clause at 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive

Orders -- Commercial Items (JAN 2018), applies to this acquisition with the following clauses checked

52.219-6, Notice of Total Small Business Set-Aside (NOV 2011) (15 U.S.C. 644).

52.222-3, Convict Labor (JUN 2003) (E.O. 11755).

52.222-19, Child Labor - Cooperation with Authorities and Remedies (JAN 2018) (E.O. 13126)

52.222-21, Prohibition of Segregated Facilities (APR 2015).

52.222-26, Equal Opportunity (SEP 2016) (E.O. 11246).

52.222-35, Equal Opportunity for Veterans (OCT 2015) (38 U.S.C. 4212).

52.222-36, Equal Opportunity for Workers with Disabilities (JUL 2014) (29 U.S.C. 793).

52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (AUG 2011)

(E.O. 13513).

52.232-33, Payment by Electronic Funds Transfer—System for Award Management (JUL 2013)

(31 U.S.C 3332).

52.222-50 Combating Trafficking in Persons

52.228-5 Insurance Work on A Government Installation (JAN 1997)

52.237-1 Site Visit (Apr 1984)

52.242-15 Stop Work Order (AUG 1989)

52.249-1 Termination for Convenience of the Government (Apr 1984)

52.252-2 Clauses incorporated by Reference (Feb 1998).

Provisions:

52.204-7, System for Award Management

52.204-16, Commercial and Government Entity Code Reporting

52.209-7, Information Regarding Responsibility Matters

52.209-12, Certification Regarding Tax Matters

52.222-56, Certification Regarding Trafficking in Persons Compliance Plan

(xiii) Use of Invoice Processing Platform (IPP) is Required

The "Submit Invoice-to" address for USDA orders is the Department of Treasury's Invoice

Processing Platform (IPP). All invoices shall be submitted via the electronic Invoice Processing

Platform. This platform is managed by the U.S. Department of Treasury and additional information is available at this website:

https://www.ipp.gov/ index .htm.

http://www.acquisition.gov/far/index.html http://www.va.gov/oamm/oa/ars/policyreg/vaar/index.cfm https://www.acquisition.gov/sites/default/files/current/far/html/52_223_226.html#wp1188603 https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1063838 https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1064275 https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1062621 https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#id186IE0DE0Y4 https://www.acquisition.gov/content/part-52-solicitation-provisions-and-contract-clauses#i1056889 http://www.ipp.gov/index.htm

(xv) Response Due Date and Contact Information:

Offers are due on 19 January 2023 no later than 1:00 pm. Eastern Standard Time.

(xvi) Quotations must be emailed to Jasmine Williams; jasmine.williams@usda.gov by the date and time above. Enter the solicitation number in the subject line of emails.

Point of Contact:

Jasmine Williams

Purchasing Agent

Jasmine.williams@usda.gov

Phone: 530-685-0765

Northern California Acquisition Service Area

Schedule of Items:

Quantity Item Specifications Total Cost

Single Stall Concrete Vault Toilet ADA Compliant

Specific layout, color and texture specifications will be determined after a vendor is selected.

Installation Location Goldfield Campground, approximately 5 miles west of Coffee Creek, CA.

Statement of Work

Shasta-Trinity National Forest (NF)

Concrete Vault Toilet Installation

1. DESCRIPTION

This project consists of furnishing a one (1) single stall, Americans with Disabilities Act (ADA) compliant, cement vault toilet and all the labor, equipment, materials, and incidentals necessary to complete the installation.

The Forest Service (FS) will prepare the hole for the installation to take place according to the specifications given by the contractor and backfill the hole after installation. The contractor will install the new vault toilet at a location designated on the ground by the Contracting Officer’s Representative (COR). The FS will remove any vegetation in the project site that restricts installation of the vault toilet.

2. PROJECT LOCATION

The project is located on the Trinity River Management Unit of the Shasta-Trinity National Forest. From Redding, CA, head East on California State Highway 299 to California State Highway to Coffee Creek Rd. From Coffee

Creek Rd turn left to Forest Service Rd. 37N19Y for approximately ¼ mile. A short truck option will be necessary to transport the vault toilets to the campground.

3. CONTRACT PERIOD OF PERFORMANCE

June 1,2023 to August 1, 2023. The installation of the vault toilet should only take 1-2 days. May be installed at different time as agreed to by the Government depending on site conditions.

4. SITE VISIT INFORMATION

Offerors may request a site visit at the Weaverville Ranger Station, between the hours of 9:00 am and 4:30 pm

Pacific Standard Time, Monday through Friday, except on weekends and federal holidays. To schedule a site visit contact Sally Cousins, (530) 551-1601, sally.cousins@usda.gov.

5. WORK REQUIREMENTS

The contractor shall provide one cement single vault ADA compliant toilet and install the one (1) single vault toilet at Goldfield Campground.

6. SPECIAL CONDITIONS AFFECTING THE WORK

a. Physical Conditions. The indications of physical conditions on the drawings and in the specifications are the result of site investigations and surveys performed by the Government. The road to the campground has a significant tight corner and full-sized low boy truck will not make the corner. A shorter bed truck, to be determined by the contractor, will need to be used to deliver the vault toilet to the job site.

b. Weather. Average temperatures from June to August range from highs in the 90s to lows in the 50s.

c. Safety, Emergency Communications and Evacuation. Contractor is responsible for the safety of the contractor’s employees including Subcontractors employees. Government employees associated with the project, and any visitors to the site both Government and private. The contractor shall submit a project safety plan to the Contracting Officer (CO) for review prior to commencement of any work. The project safety plan shall comply with the appropriate California Occupational Safety and Health Administration

(OSHA) and Federal OSHA rules and regulations and must include a medical evacuation and emergency communications plan.

d. Highway Permits. Contractor is responsible for securing any overload or over width limit permits required for the transport of materials or equipment to the project site. The contractor is responsible for conducting a thorough reconnaissance of all routes leading to the site.

e. Toilets. No toilets and no shower facilities are available on site.

f. Camping. Contractor may use a self-contained travel trailer or recreational vehicle to camp on NF System lands near the project sites subject to the approval of the COR. All waste material must be transported off-site to a station equipped to handle such waste.

g. Security. Contractor is responsible for the contractor’s equipment and materials supplied to the site. All equipment not equipped with a key lock system shall be secured in such a manner as to make it inoperable to the average person at the end of each working day. All hand tools and other equipment shall be secured at the end of each working day. All debris, trash, and refuse shall be properly stored in dumpsters or trash bins or removed from the site.

h. Protection of Existing Resources, Structures, Improvements, and Utilities.

1) The contractor shall preserve and protect all existing vegetation and landform on or adjacent to the work sites, which are not to be removed and which do not unreasonably interfere with the work required under this contract.

2) The contractor shall protect from damage all existing structures, improvements, and utilities 1) at or near the work site and, 2) on adjacent property of a third party, the locations of which are made known to or should be known by the contractor. The contractor shall repair any damage to those facilities, including those that are the property of a third party, resulting from failure to comply with the requirements of this contract or failure to exercise reasonable care in performing the work.

3) If the contractor fails or refuses to repair the damage promptly, the CO may have the necessary work performed and charge the cost to the contractor.

7. EQUIPMENT CLEANING

a. On NF Service project, all equipment shall be cleaned prior to entering FS land to prevent introduction of invasive plant and animal species. The following will be required at all project sites:

b. All equipment and machinery except passenger vehicles such as trucks, vans, pickups, and cars used for transport of personnel, shall be cleaned prior to entering FS land. If equipment is moved from FS land, used on a project elsewhere and returned to FS land, cleaning is also required before returning to FS land.

This includes wheels, tires, tracks, buckets, stabilizers, undercarriages, and bumpers. All washing must take place off NF land or in designated wash areas where rinse water is collected and disposed of in either a sanitary sewer, a landfill, or other facility authorized to accept such rinse water. Depending on the nature of the debris, the equipment may be cleaned using mechanical methods (brushing, scraping, prying), compressed air, high-pressure water, or steam. Visual inspection of the equipment shall not show plant material, seeds, dirt clods, or other such debris.

c. Contractor shall notify the designated FS contact at least 2 working days prior to moving each piece of equipment on to NF land or the project area immediately adjacent to FS land, unless otherwise agreed by the COR. Notification will include vehicle washing information. Upon request of FS, arrangement will be made for FS to inspect each piece of equipment prior to it being placed in service. Work on FS land may not commence until documentation of cleaning has been obtained unless otherwise agreed by the COR.

d. Any equipment, tools, or vehicles that have been staged off established roads or created ground disturbance within areas that the FS has identified as containing invasive plant species, shall be cleaned to remove dirt and vegetation that could contain weed seed or root fragments before leaving the site of infestation.

Depending on the nature of the debris, the equipment shall be cleaned using mechanical methods (brushing, scraping, prying), or compressed air.

e. Contractor shall certify in writing compliance with the terms of provision prior to each start-up of operations. The FS may direct equipment operator to remove any equipment from FS land if certification of compliance has not been obtained.

f. Any new infestations of invasive species, identified by the contractor or FS, on NF land in the work area or on the access route shall be promptly reported to the other party.

8. PROJECT SITE CLEANUP

a. Project site cleanup includes the removal and proper disposal of all trash, debris, and residue off NF land.

b. Contractor shall have hazardous spill clean-up kit available at all sites and shall be available during construction equipment operation. All spills of petroleum products including leak spots from parked vehicles shall be removed and properly disposed according to all local, State, and Federal rules, regulations, and laws governing such disposal.

River (14) - CON - Facilities, Concrete Toilet Installation, Goldfield CG

Trinity County, CA

The project is located on the Trinity River Management Unit of the Shasta-Trinity National Forest.

From Redding, CA, head East on California State Highway 299 to California State Highway to Coffee Creek Rd. From Coffee Creek Rd turn lef to Forest Service Rd. 37N19Y for approximately ¼ mile. A short truck option will be necessary to transport the vault toilets to the campground.

2 - Section 2 4 - Section 4

2 - Section 2

52.204-7 System for Award Management. (OCT 2018)

52.204-13 System for Award Management Maintenance. (OCT 2018)

52.204-16 Commercial and Government Entity Code Reporting. (AUG 2020)

52.204-21 Basic Safeguarding of Covered Contractor Information Systems. (NOV 2021)

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment. (NOV 2021)

52.209-7 Information Regarding Responsibility Matters. (OCT 2018)

(a) Definitions. As used in this provision-

Administrative proceeding means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceedings at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables.

Federal contracts and grants with total value greater than $10,000,000 means-

(1) The total value of all current, active contracts and grants, including all priced options;

and

(2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules).

Principal means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The offeror [ ] has [ ] does not have current active Federal contracts and grants with total value greater than $10,000,000.

(c) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction.

(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more.

(iii) In an administrative proceeding, a finding of fault and liability that results in-

(A) The payment of a monetary fine or penalty of $5,000 or more; or

(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management, which can be accessed via https://www.sam.gov (see 52.204-7).

(End of provision)

52.209-12 Certification Regarding Tax Matters. (OCT 2020)

52.212-1 Instructions to Offerors - Commercial Products and Commercial Services. (NOV 2021)

52.212-3 Offeror Representations and Certifications-Commercial Products and Commercial Services. (OCT 2022)

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.

(a) Definitions. As used in this provision-

Covered telecommunications equipment or services has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Economically disadvantaged women-owned small business (EDWOSB) concern means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

Forced or indentured child labor means all work or service-

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

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

Immediate owner means an entity, other than the offeror, that has direct control of the offeror.

Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

Inverted domestic corporation means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

Manufactured end product means any end product in product and service codes (PSCs) 1000- 9999, except-

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620, Minerals, Natural and Synthetic; and

(10) PSC 9630, Additive Metal Materials.

Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture.

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

Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.

Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L. 110-174). Restricted business operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan Accountability and Divestment Act of 2007) conducting the business can demonstrate-

(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;

(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in the Department of the Treasury, or are expressly exempted under Federal law from the requirement to be conducted under such authorization;

(3) Consist of providing goods or services to marginalized populations of Sudan;

(4) Consist of providing goods or services to an internationally recognized peacekeeping force or humanitarian organization;

(5) Consist of providing goods or services that are used only to promote health or education; or

(6) Have been voluntarily suspended.

Sensitive technology-

(1) Means hardware, software, telecommunications equipment, or any other technology that is to be used specifically-

(i) To restrict the free flow of unbiased information in Iran; or

(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and

(2) Does not include information or informational materials the export of which the President does not have the authority to regulate or prohibit pursuant to section 203(b)(3) of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).

Service-disabled veteran-owned small business concern-

(1) Means a small business concern-

(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and

(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran.

(2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

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

(2) Affiliates, as used in this definition, means business concerns, one of whom directly or indirectly controls or has the power to control the others, or a third party or parties control or have the power to control the others. In determining whether affiliation exists, consideration is given to all appropriate factors including common ownership, common management, and contractual relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.

Small disadvantaged business concern, consistent with 13 CFR 124.1002, means a small business concern under the size standard applicable to the acquisition, that-

(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by-

(i) One or more socially disadvantaged (as defined at 13 CFR 124.103) and economically disadvantaged (as defined at 13 CFR 124.104) individuals who are citizens of the United States; and

(ii) Each individual claiming economic disadvantage has a net worth not exceeding $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

(2) The management and daily business operations of which are controlled (as defined at 13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition.

Subsidiary means an entity in which more than 50 percent of the entity is owned-

(1) Directly by a parent corporation; or

(2) Through another subsidiary of a parent corporation.

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

Veteran-owned small business concern means a small business concern-

(1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and

(2) The management and daily business operations of which are controlled by one or more veterans.

Women-owned business concern means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of its stock is owned by one or more women; and whose management and daily business operations are controlled by one or more women.

Women-owned small business concern means a small business concern-

(1) That is at least 51 percent owned by one or more women; or, in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and

(2) Whose management and daily business operations are controlled by one or more women.

Women-owned small business (WOSB) concern eligible under the WOSB Program (in accordance with 13 CFR part 127), means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States, and the concern is certified by SBA or an approved third-party certifier in accordance with 13 CFR 127.300.

(b)(1) Annual Representations and Certifications. Any changes provided by the Offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications in SAM.

(2) The offeror has completed the annual representations and certifications electronically in SAM accessed through http://www.sam.gov. After reviewing SAM information, the Offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications-Commercial Products and Commercial Services, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard(s) applicable to the NAICS code(s) referenced for this solicitation), at the time this offer is submitted and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs _________.

[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has completed for the purposes of this solicitation only, if any.

These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted electronically on

SAM.]

(c) Offerors must complete the following representations when the resulting contract is for supplies to be delivered or services to be performed in the United States or its outlying areas, or when the contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii). Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that-

(i) It ___ is, ___ is not a small business concern; or

(ii) It ___ is, ___ is not a small business joint venture that complies with the requirements of 13 CFR 121.103(h) and 13 CFR 125.8(a) and (b). [The offeror shall enter the name and unique entity identifier of each party to the joint venture: _________.]

(2) Veteran-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents as part of its offer that it ___ is, ___ is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that-

(i) It ___ is, ___ is not a service-disabled veteran-owned small business concern;

or

(ii) It ___ is, ___ is not a joint venture that complies with the requirements of 13 CFR 125.18(b)(1) and (2). [The offeror shall enter the name and unique entity identifier of each party to the joint venture: _________.] Each service-disabled veteran-owned small business concern participating in the joint venture shall provide representation of its service-disabled veteran-owned small business concern status.

(4) Small disadvantaged business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ___ is, ___ is not a small disadvantaged business concern as defined in 13 CFR 124.1002.

(5) Women-owned small business concern. (Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ___ is, ___ is not a women-owned small business concern.

(6) WOSB joint venture eligible under the WOSB Program. The offeror represents that it ___ is, ___ is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [The offeror shall enter the name and unique entity identifier of each party to the joint venture: _______________.]

(7) Economically disadvantaged women-owned small business (EDWOSB) joint venture.

The offeror represents that it ___ is, ___ is not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [The offeror shall enter the name and unique entity identifier of each party to the joint venture: _____________.]

(8) Women-owned business concern (other than small business concern). (Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.) The offeror represents that it ___ is, a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price: ____________________.

(10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that-

(i) It ___ is, ___ is not a HUBZone small business concern listed, on the date of this representation, as having been certified by SBA as a HUBZone small business concern in the Dynamic Small Business Search and SAM, and will attempt to maintain an employment rate of HUBZone residents of 35 percent of its employees during performance of a HUBZone contract (see 13 CFR 126.200(e)(1)); and

(ii) It ___ is, ___ is not a HUBZone joint venture that complies with the requirements of 13 CFR 126.616(a) through (c). [The offeror shall enter the name and unique entity identifier of each party to the joint venture: _________.] Each HUBZone small business concern participating in the HUBZone joint venture shall provide representation of its HUBZone status.

(d) Representations required to implement provisions of Executive Order 11246-

(1) Previous contracts and compliance. The offeror represents that-

(i) It ___ has, ___ has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(ii) It ___ has, ___ has not filed all required compliance reports.

(2) Affirmative Action Compliance. The offeror represents that-

(i) It ___ has developed and has on file, ___ has not developed and does not have on file, at each establishment, affirmative action programs required by rules and regulations of the Secretary of Labor (41 CFR parts 60-1 and 60-2), or

(ii) It ___ has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352).

(Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American-Supplies, is included in this solicitation.)

(1)(i) The Offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that each domestic end product listed in paragraph (f)(3) of this provision contains a critical component.

(ii) The Offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products.

For those foreign end products that do not consist wholly or predominantly of iron or steel or a combination of both, the Offeror shall also indicate whether these foreign end products exceed 55 percent domestic content, except for those that are COTS items. If the percentage of the domestic content is unknown, select "no".

(iii) The Offeror shall separately list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).

(iv) The terms "commercially available off-the-shelf (COTS) item," "critical component," "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Supplies."

(2) Foreign End Products:

Line item No. Country of origin Exceeds 55% domestic content (yes/no)

[List as necessary]

(3) Domestic end products containing a critical component:

Line Item No. ____________

(4) The Government will evaluate offers in accordance with the policies and procedures of FAR part 25.

(g)(1) Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if the clause at FAR 52.225-3, Buy American-Free Trade Agreements-Israeli Trade Act, is included in this solicitation.)

(i)(A) The Offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (iii) of this provision, is a domestic end product and that each domestic end product listed in paragraph (g)(1)(iv) of this provision contains a critical component.

(B) The terms "Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product," "commercially available off-the-shelf (COTS) item," "critical component," "domestic end product," "end product," "foreign end product," "Free Trade Agreement country," "Free Trade Agreement country end product," "Israeli end product," and "United States" are defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

(ii) The Offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act."

Line item No. Country of origin

[List as necessary]

(iii) The Offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act." The Offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products.

For those foreign end products that do not consist wholly or predominantly of iron or steel or a combination of both, the Offeror shall also indicate whether these foreign end products exceed 55 percent domestic content, except for those that are COTS items. If the percentage of the domestic content is unknown, select "no".

Other Foreign End Products:

Line item No. Country of origin Exceeds 55% domestic content (yes/no)

(iv) The Offeror shall list the line item numbers of domestic end products that contain a critical component (see FAR 25.105).

Line Item No. ____________

[List as necessary]

(v) The Government will evaluate offers in accordance with the policies and procedures of FAR part 25.

(2) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Canadian End Products:

Line item No.

[List as necessary]

(3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II. If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Canadian end products or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Canadian or Israeli End Products:

Line item No. Country of origin

[List as necessary]

(g)(4) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III.

If Alternate III to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

(g)(1)(ii) The offeror certifies that the following supplies are Free Trade Agreement country end products (other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act":

Free Trade Agreement Country End Products (Other than Bahrainian, Korean, Moroccan, Omani, Panamanian, or Peruvian End Products) or Israeli End Products:

Line item No. Country of origin

[List as necessary]

(5) Trade Agreements Certificate. (Applies only if the clause at FAR 52.225-5, Trade Agreements, is included in this solicitation.)

(i) The offeror certifies that each end product, except those listed in paragraph (g)(5)(ii) of this provision, is a U.S.-made or designated country end product, as defined in the clause of this solicitation entitled "Trade Agreements".

(ii) The offeror shall list as other end products those end products that are not U.S.-made or designated country end products.

Other End Products:

Line item No. Country of origin

[List as necessary]

(iii) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. For line items covered by the WTO GPA, the Government will evaluate offers of U.S.-made or designated country end products without regard to the restrictions of the Buy American statute. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to the best of its knowledge and belief, that the offeror and/or any of its principals-

(1) ___ Are, ___ are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(2) ___ Have, ___ have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property,

(3) ___ Are, ___ are not presently indicted for, or otherwise criminally or civilly charged by a Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) ___ Have, ___ have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) for which the liability remains unsatisfied.

(i) Taxes are considered delinquent if both of the following criteria apply:

(A) The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge to the liability, the liability is not finally determined until all judicial appeal rights have been exhausted.

(B) The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded.

(ii) Examples. (A) The taxpayer has received a statutory notice of deficiency, under I.R.C. § 6212, which entitles the taxpayer to seek Tax Court review of a proposed tax deficiency. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek Tax Court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. § 6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. § 6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. 362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). (The Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).)

(1) Listed end products.

Listed end product Listed countries of origin

[List as necessary]

(2) Certification. (If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.)

___ (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

___ (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly-

(1) ___ In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) ___ Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) (The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.)

(1) [ ] Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror ___ does ___ does not certify that-

(i) The items of equipment to be serviced under this contract are used regularly for other than Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market…