TIRWR17Q00006.pdf

OMB Control No. 1505-0081

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

Multiple Requisitions

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

TIRWR-17-Q-00006

6. SOLICITATION ISSUE

DATE

2017-02-21

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

CARMEN LATANYA EVANS-TATE

b. TELEPHONE NUMBER (No collect calls)

5109075080

8. OFFER DUE DATE/

LOCAL TIME

2017-03-03, 11:00 a.m.PST

9. ISSUED BY CODE 26899 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR

DEPARTMENT OF TREASURY (DY) I.R.S., PROCUREMENT OS:A:P:B:W SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

1301 CLAY STREET SUITE 810S OAKLAND , CA 94612-5272 HUBZONE SMALL BUSINESS EDWOSB NAICS: 322211

CARMEN LATANYA EVANS-TATE 5109075080 SERVICE-DISABLED VETERAN

OWNED SMALL BUSINESS

8(A) SIZE STANDARD: 500

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

12. DISCOUNT TERMS 13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR700)

13b. RATING

SEE SCHEDULE

NET 30

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE

MULTI 16. ADMINISTERED BY CODE 26899

See Shipping Instructions for Details

DEPARTMENT OF TREASURY (DY)

I.R.S., PROCUREMENT OS:A:P:B:W

1301 CLAY STREET SUITE 810S

OAKLAND , CA 94612-5272

17a. CONTRACTOR/

CODE FACILITY

18a. PAYMENT WILL BE MADE BY CODE 11355

OFFEROR CODE

To All Offerors www.IPP.gov

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED. SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

0001 AUTO BOTTOM 1040 BOXES - BOX SPECIFICATIONS: 0.00 LO __________ __________

CORRUGATED BOXES-SINGLE WALL-WITH CUT OUT

HAND HOLDS, AUTO BOTTOM. SIZE: 9IN X 12IN X

12IN, EDGE CRUSH TEST 32LBS.

PRIMARY SITE POINT OF CONTACT IS ALMA AVILA

559/500-7007. ALTERNATE IS JAMES YENSER 559/500-7033.

ALL DELIVERIES MUST BE SCHEDULED

APPROXIMATELY THE 10TH DAY OF EACH MONTH.

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4, FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5).

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

30c. DATE SIGNED

31b NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

X http://www.ipp.gov/

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE (US$)

24.

AMOUNT (US$)

(CONTINUE)

SHIPMENT SHALL BE DELIVERED EVERY 4-WEEKS.

ALL DELIVERIES WILL BE SHIPPED TO: INTERNAL

REVENUE SERVICES, 3211 S NORTHPOINTE DRIVE,

FRESNO, CA 93725

SEE THE BELOW INDIVIDUAL LINE ITEMS 0002 -

0008 FOR COMPELTE DETAILS.

Payment will be by the Invoice Processing

Platform at www.IPP.gov.

Receipt & Acceptance is: LISA TORRES

559/454-6407.

REQUIRED WITH QUOTE - please provide pictures/photos including measuring specification, literature and part number.

Price is per each unit, $________.

ALL QUOTES MUST BE EMAILED ONLY TO:

LaTanya.Evans-Tate@irs.gov and Reference

TIRWR-17-Q-00006 (BOXES)

THE CLOSING DATE FOR QUOTES is 3/3/17 at

11:00 a.m. California Time. Please complete and return pages 1, 2, 3, 4 and 10. Complete block numbers 17a (page 1), #20 - 24 (page 2 - 3), and # 30a, 30b, and

30c on page 1. Page 1, block #24 total contract quote amount)

0002 FIRST DELIVERY: MARCH 2017 SHIP 14,400 14,400.00 EA __________ __________

BOXES ALL DELIVERIES WILL BE TO: 3211 S

NORTHPOINTE DRIVE, FRESNO, CA 93725

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER

34. VOUCHER NUMBER 35.AMOUNT VERIFIED

CORRECT FOR

36. PAYMENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL

FINAL

38. S/R ACCOUNT NUMBER 39.S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42.a. RECEIVED BY (Print) 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42.c DATE REC’D (YY/MM/DD)

42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 3/2005) BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE (US$)

24.

AMOUNT (US$)

(CONTINUE)

0003 APRIL 2017 SHIP 14,400 BOXES ALL DELIVERIES 14,400.00 EA __________ __________

WILL BE TO: 3211 S NORTHPOINTE DRIVE,

0004 MAY 2017 SHIP 14,400 BOXES ALL DELIVERIES 14,400.00 EA __________ __________

0005 JUNE 2017 SHIP 14,400 BOXES ALL DELIVERIES 14,400.00 EA __________ __________

0006 JULY 2017 SHIP 14,400 BOXES ALL DELIVERIES 14,400.00 EA __________ __________

0007 AUGUST 2017 SHIP 14,400 BOXES ALL 14,400.00 EA __________ __________

DELIVERIES WILL BE TO: 3211 S NORTHPOINTE

DRIVE, FRESNO, CA 93725

0008 SEPTEMBER 2017 SHIP 14,400 BOXES ALL 14,400.00 EA __________ __________

DELIVERIES WILL BE TO: 3211 S NORTHPOINTE

DRIVE, FRESNO, CA 93725

FORM 1449 CONTINUE SHEET 1

52.252-2 Clauses Incorporated by Reference (Feb 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contacting Officer will make their full text available.

Also, the full text of a clause may be accessed electronically at this/these address(es):http://www.arnet.gov/far/

Federal Acquisition Regulation (48 CFR Chapter 1) Clauses Incorporated by Reference

NUMBER TITLE DATE

52.212-4 Contract Terms and Conditions-Commercial Items (May 2015)

AB 12-01-1009.104 Representation by Corporations Regarding an Unpaid

Delinquent Tax Liability or a Felony Conviction under Federal Law (FEB 2012)

This provision is a deviation to the Federal Acquisition Regulations (FAR), Subpart 1.4.

(1) The offeror does [ __] does [ __] does not have any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.

(2) The offeror, [ __] has [ __] has not been convicted of a felony criminal violation under any Federal law within the preceding 24 months.

2. No Treasury employee shall use funds provided under the Consolidated Appropriations Act to award a contract, memorandum of understanding, or cooperative agreement with, make a grant to, or provide a loan or loan guarantee to, any corporation that provides an affirmative response to the above representations, except pursuant to a determination under paragraph 4, below.

3. No Treasury employee shall use funds provided under the Consolidated Appropriations Act to award a contract, memorandum of understanding, or cooperative agreement with, make a grant to, or provide a loan or loan guarantee to, any offeror or applicant that that has an affirmative listing in the System for Awards Management (SAM) of an outstanding federal debt without a review by the Suspension and Debarment Official. Please refer this to Suspension and Debarment for review.

4. Contracting officers and other Treasury employees that receive information indicating the existence of a felony criminal violation under a federal law within the preceding 24 months or an unpaid federal tax liability, which all judicial and administrative remedies have been exhausted or have lapsed, shall refer the matter to Suspension and Debarment or relevant Inspector General. No award shall be made or agreement entered into unless the Suspension and Debarment Official makes a determination in writing that further action is not necessary to protect the interests of the Government.

http://www.arnet.gov/far/

5. Contracting officers and other Treasury employees that receive information indicating the existence of an outstanding federal debt through the use of SAM will provide all relevant information available from the entity overview page in SAM.gov to Suspension and Debarment at the contact below or at:

http://www.treasurv.gov/serviceslreport-fwa/Pages/Report-Fraud-or-Misconduct-Related-to Governmcnt-Contracts-or-Grants.aspx

6. Contracting officers, grants officers, and ordering officers may also want to consider inclusion of a similar clause as in paragraph 1 above in contracts, grants and orders that use non-appropriated funds.

Additional Information: Questions about this AB may be directed to Suspension and Debarment at TreasuryS&DCCV,treasurv.gov or call (202) 622-5666

AB 1052.203-99 Prohibition on Contracting with Entities that Require Certain Internal

Confidentiality Agreements. (Mar 2015)(DEVIATION 2015-00003)

(a) The Contractor shall not require employees or subcontractors seeking to report fraud, waste, or abuse to sign or comply with internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(b) The contractor shall notify employees that the prohibitions and restrictions of any internal confidentiality agreements covered by this clause are no longer in effect.

(c) The prohibition in paragraph (a) of this clause does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

(d)(1) In accordance with section 743 of Division E, Title VII, of the Consolidated and Further Continuing Resolution Appropriations Act, 2015 (Pub. L. 113-235), use of funds appropriated (or otherwise made available) under that or any other Act may be prohibited, if the Government determines that the Contractor is not in compliance with the provisions of this clause.

(2) The Government may seek any available remedies in the event the contractor fails to comply with the provisions of this clause.

(End of clause)

AB 1052.203-98 Prohibition on Contracting with Entities that Require Certain Internal

Confidentiality Agreements- Representation. (DEVIATION 2015-00003)

(a) In accordance with section 743 ofDivision E, Title VII, of the Consolidated and Further Continuing Resolution Appropriations Act, 2015 (Pub. L. 113-235), Government agencies are not permitted to use funds appropriated (or otherwise made available) under that or any other Act for contracts with an entity that requires employees or subcontractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(b) The prohibition in paragraph (a) of this provision does not contravene requirements applicable to Standard Form 312, Form 4414, or any other form issued by a Federal department or agency governing the nondisclosure of classified information.

(c) Representation. By submission of its offer, the Offeror represents that it does not require employees or subcontractors of such entity seeking to report fraud, waste, or abuse to sign internal confidentiality agreements or statements prohibiting or otherwise restricting such employees or subcontractors from lawfully reporting such waste, fraud, or abuse to a designated investigative or law enforcement representative of a Federal department or agency authorized to receive such information.

(End of provision)

DT1052.232-7033 Electronic Submission of Payment Requests (Apr 2015)

(a) Definitions. As used in this clause-

(1) "Payment request" means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements identified in FAR 32.905(b), "Content of Invoices" and the applicable Payment clause included in this contract.

(b) Except as provided in paragraph (c) of this clause, the Contractor shall submit payment requests electronically using the Invoice Processing Platform (IPP).

Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.

(c) The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing in accordance with Treasury procedures.

(d) If alternate payment procedures are authorized, the Contractor shall include a copy of the Contracting Officer's written authorization with each payment request.

(End of clause)

1052.224-9008 SAFEGUARDS AGAINST UNAUTHORIZED DISCLOSURE OF SENSITIVE

BUT UNCLASSIFIED INFORMATION (NOV 2015)

Treasury Directive Publication 15-71 (TD P 15-71), Chapter III - Information Security, Section 24 - Sensitive But Unclassified Information defines SBU information as `any information, the loss, misuse, or unauthorized access to or modification of which could adversely affect the national interest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 552a of Title 5, United States Code (USC) (the Privacy Act) but which has not been specifically authorized under criteria established by an executive order or an act of Congress to be kept secret in the interest of national defense or foreign policy.`" As further described in IRM 10.8.1 - Information Technology (IT) Security, Policy and Guidance, SBU may be categorized in one or more of the following groups-o Returns and Return Information o Sensitive Law Enforcement Information o Employee Information o Personally Identifiable Information o Other Protected Information

Confidentiality requirements for tax returns and return information are established by Section 6103 of the Internal Revenue Code (26 U.S.C. 6103), and the penalties for unauthorized access and disclosure of returns and return information are found in Sections 7213, 7213A and 7431 of the Internal Revenue Code (26 U.S.C. 7213, 7213A and 7431).

Contractors who perform work at contractor managed sites using contractor managed IT resources shall adhere to the general guidance and specific security control standards or requirements contained in Publication 4812, Contractor Security Controls. Typically all contracts that require contractor (and its employees) to handle, manage, or process Sensitive but Unclassified (SBU) information shall be protected at the moderate risk level. The Publication 4812 provides a comprehensive list of all security controls and guidance and guidance.

As directed by the Contracting Officer, the contractor will be required to input data into Archer or a similar system to describe the security controls being used to protect information.

a. Eligibility, Fitness and Suitability. Contractor personnel hired for work within the United States or its territories and possessions and who require access, wherever the location, to IRS owned or controlled facilities or work on contracts that involve the design, operation, repair, or maintenance of information systems, and/or require access to SBU information, must meet the eligibility requirements under IRM 10.23.2, Contractor Investigations, and shall be subject to security screening and investigative processing, commensurate with the position sensitivity level, and in accordance with IRM 10.23.2, and TD P 15-71. Contractor employees must be favorably adjudicated prior to starting work on the contract or before being granted staff-like access (or interim staff-like access, if approved by Personnel Security) to IRS information systems or SBU information.

b. General Conditions for Allowed Disclosure. Any SBU information, in any format, made available to contractor personnel shall be treated as confidential information and shall be used only for the purposes of carrying out the requirements of this contract.

Inspection by or disclosure to anyone other than a duly authorized officer or employee of the contractor shall require prior written approval of the IRS. Requests to make such inspections or disclosures shall be addressed to the Contracting Officer (CO).

c. Non-Disclosure Agreement (NDA). Consistent with TD P 15-71, Chapter II, Section 2, and IRM 10.23.2, each contractor employee who requires access to SBU information shall complete, sign and submit to Personnel Security -through the CO (or COR, if assigned)- an approved NDA.

d. Encryption. All SBU information must be protected at rest, in transit, and in exchanges (i.e., internal and external communications). The contractor shall employ encryption methods and tools to ensure the confidentiality, integrity, and availability of SBU information.

e. Incident and Situation Reporting. Within the first hour it becomes known, the contractor shall report any incident/situation to the COR (e.g., inspected or disclosed without authorization or disclosed to an unauthorized party, loss or stolen, misdirected, intercepted, hacked, or other situation has taken place that violates computer security policies). Concurrent with its reporting it to the COR, the contractor shall report incidents/situations (24x7x365) to Situation Awareness Management Center (SAMC) through any of the following methods:

Telephone: (202) 283-4809 (local) or toll free hotline at (866) 216-4809

Fax: (202) 283-0345

E-mail: samc@cirsc.irs.gov

f. In addition, if the SBU information is or involves returns or return information, or threatens the safety or security of personnel or information systems, the contractor shall report the incident/situation to the Treasury Inspector General for Tax Administration (TIGTA) hotline at (800) 366-4484.

g. Disposition of SBU Information. All SBU information processed during the performance of this contract, or to which the contractor was given access (as well as all related output, deliverables, or secondary or incidental by-products, information or data generated by the contractor or others directly or indirectly from the source material), regardless of form or format, shall be completely purged from all data storage components of the contractor`s facility(s) and computer systems, and no SBU information will be retained by the contractor either-

When it has served its useful, contractual purpose, and is no longer needed to meet the contractor`s other, continuing contractual obligations to the IRS or

When the contract expires, or is terminated by the IRS (for convenience, default, or cause).

h. The contractor shall completely purge from its systems and Electronic Information Technology, and/or return all SBU information (originals, copies, and derivative works) within 30 days of the point at which it has served its useful contractual purpose, or the contract expires or is terminated by the IRS (unless, the CO determines, and establishes, in writing, a longer period to complete the disposition of SBU information).

i. Subcontractors. Subcontractors of the contractor are held to the same provisions, investigative requirements, and standards of conduct for handling and protecting SBU information as employees of the prime contractor.

j. Other Safeguards. [Insert any additional disclosure safeguards provided by the Program Office/COR or that the Contracting Officer determines are necessary and in the best interest of the Government and not addressed elsewhere in the contract.]

[End of Clause]

IR1052.232-7003 Electronic Invoicing and Payment Requirements for the Invoice

Processing Platform (IPP) (Aug 2012)

(a) Definitions:

"Short payment" as used in this clause means an invoice that includes the cost or price for supplies or services delivered or performed, as well as the cost or price for supplies or services not yet tendered to the Government in accordance with the terms of the contract, order or agreement.

Short payment example: The contract requires the delivery of a set number of items, with the price, delivery location, and delivery due date also specified. The vendor delivers 50% of the items as specified but invoices for 100% of the items. Before implementation of the IPP, the IRS would have paid the vendor for the items delivered and instructed the vendor to re-invoice the IRS when the balances of the items were delivered. In other words, the IRS would "short pay" the invoice since the IRS did not remit payment for the full invoice amount. With implementation of the IPP, the IRS can no longer do this because the IRS cannot accept an electronic invoice that includes items not yet received. The IRS will reject the invoice. The vendor needs to submit an invoice for only the items received by the IRS (in this case, 50%), and, assuming that these items meet all other contract terms and conditions, the IRS will pay the invoiced amount. The vendor submits subsequent invoice(s) for items as they are delivered and accepted.

(b) The Invoice Processing Platform (IPP) is a secure Web-based electronic invoicing and payment information service available to all Federal agencies and their suppliers.

Effective October 1, 2012, invoicing for payment through the IPP will be mandatory for all new contract awards. Additional information regarding the IPP may be found at the IPP website address https://www.ipp.gov. Contractors must complete the contractor point of contact information below, and submit it with their proposal submissions.

Contractors may contact the IPP Helpdesk for assistance via e-mail at ippgroup@bos.frb.org or via phone at (866) 973-3131. Once a contract award has been made, the contractor will be contacted by the IPP via e-mail to set-up an account.

It will be necessary for contractors to login to their IPP accounts every 90 days to keep their IPP accounts active.

(c) Contractor Point of Contact Information

Contractor Name:

Contractor IPP Point of Contact Name:

Contractor Phone Number:

Contractor E-mail Address:

(d) Electronic Invoicing and Payment Requirements

Vendor invoices submitted electronically through the IPP should be in the proper format and contain the information required for payment processing. In order to be approved for payment, a proper invoice must list the items specified in FAR 52.232-25 (a)(3)(i) through (a)(3)(x), or in the case of a Commercial Item Contract, the items included in 52.212-4(g)(1)(i) through (g)(1)(x).

Under this contract, the following documents are required to be submitted as an attachment to the invoice (Contracting Officer fills in additional documentation that must be furnished by the contractor (e.g. timesheet)):

Contracting Officer other required documentation to be furnished by contractor

(e) Payment and Invoice Questions

For payment and invoice questions, contact the Beckley Finance Center at (304) 254-3372 or via e-mail at cfo.bfc.ipp.customer.support@irs.gov.

(f) Waiver

If the Contractor is unable to use the IPP for submitting payment requests starting on October 1, 2012, then a waiver form must be completed and submitted with the contractors proposal submission for review and approval by the Contracting Officer based on one of the conditions listed in the waiver form included as Attachment 1 to this clause. The vendor will be notified prior to award as to whether their request for waiver has been approved or denied. If the waiver is granted, then a copy of the waiver must be submitted with each paper invoice that the vendor submits to the payment office or the invoice will be returned.

(g) Short Payment

Short payment on vendor submitted invoices will no longer be processed or paid. If any portion of the invoice does not meet the requirements for a proper invoice, the entire invoice shall be rejected and returned to the vendor unpaid.

(End of Clause)

IR1052.232-7003 W Internal Revenue Service (IRS) Invoice Processing Platform(IPP)

Waiver Form

The IRS invoicing and payment requirements clause (IR1052.232-7003) requires that all invoices under awards made (or effective) on or after October 1, 2012, be submitted electronically via the IPP unless a waiver is requested and granted. If the Contractor is unable to submit its invoice through the IPP, the Contractor shall complete this waiver form indicating the reason for the waiver request by selecting the appropriate box below and providing a narrative summarizing in detail the circumstances requiring a waiver. For a solicitation, submit the waiver form with the proposal submission. For a modification that incorporates the IPP clause into an existing contract, submit the form with the modification. The CO will notify the vendor via e-mail or another appropriate means of communication prior to award as to whether their waiver has been approved or denied. If the waiver is granted, then a copy of the approved waiver must be submitted with each invoice that the vendor submits to the payment office or the invoice will be returned.

Reason for requesting a waiver of the requirement to submit an electronic invoice via the IPP:

1. Submission of invoices through IPP would impose a hardship on an individual (includes employees and sole proprietors) due to: either a physical or mental disability; a geographic, language, or literacy barrier; or an undue financial burden. The requirement to submit invoices through the IPP is automatically waived for all individuals who do not have payment capability using ACH with a U.S. financial institution.

2. The political, financial or communications infrastructure where the place of business is located does not support access to the IPP for submitting invoices electronically.

3. The contractor is located within an area designated by the President of the United States or an authorized agency administration as a disaster area.

(Please identify area/location.)

4. The submission of invoices electronically may pose a threat to national security, the life or physical safety of an individual may be endangered, or a law enforcement action may be compromised.

5. The agency does not expect to receive more than one invoice from the same contractor within a one-year period. i.e., the invoice submission is non-recurring.

6. The contractor customarily submits a high volume of invoices on a regular basis via file format, not currently supported by the IPP (i.e., uses a file format other than XML or CSV) and the high volume of invoices would cause a significant burden to the contractor if submitted through the IPP individually. If utilizing this exception, please identify the file formats supported by your invoicing system so that the IPP may consider implementing the requested file format at a later date. File format(s) used: .

7. Other - Please explain

Attach a separate sheet of paper with a summary narrative substantiating the circumstances for the waiver exception selected from above (1 through 7).

Attachment 1

Waiver Submitted By:

Contractor Name

Name of Person Submitting Request for Waiver Title

Signature of Person Submitting Request for Waiver (electronic signature not acceptable)

E-mail Address Phone No.

Contract/Order No. Date Submitted

Waiver Approved By:

Contracting Officers Name Printed

Contracting Officers Signature Date (electronic signature is not acceptable)