W911KB-17-R-0042.pdf

SEE ADDENDUM

(No Collect Calls)

W911KB-17-R-0042 10-Apr-2017

b. TELEPHONE NUMBER

907-753-2547

8. OFFER DUE DATE/LOCAL TIME

02:00 PM 24 Apr 2017

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W911KB9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

ERNEST L WOODS III

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

WC1JUW70463355

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

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

WOMEN-OWNED SMALL

BUSINESS (WOSB)

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

U.S. ARMY ENGINEER DISTRICT, ALASKA

CEPOA-CT-SP

PO BOX 6898

JBER AK 99506-0898

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE 16. ADMINISTERED BY

SEE SCHEDULE

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL BUSINESS

(EDWOSB)

SIZE STANDARD:

1,000 EM

NAICS:

331210

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

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

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF44

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

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

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

W911KB-17-R-0042

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1

FY2017 RELIEF WELLS AND WEIR STEEL FOR

FFP

CHENA PROJECT --- PROJECT NO.: 404596

AS DETAILED IN THE ATTACHED BID SCHEDULE

FOB: Destination

MILSTRIP: WC1JUW70463355

PURCHASE REQUEST NUMBER: WC1JUW70463355

NET AMT

BID SCHEDULE

Well Steel Materials

Weir Modification Steel Materials

CHENA RIVER LAKES FLOOD CONTROL PROJECT

Relief Well Materials:

1. Casing & Riser Pipe

Item Unit Qty Unit Cost Total $ Pile Casing:

ASTM A 252,

24” diameter, 3/8” wall, 60 foot sections

Each 10 $__________ $__________

Riser Pipe:

ASTM A 53

Grade B, 12” diameter, 3/8” wall, 12 foot sections

Each 84 $__________ $__________

2. Well Screens

Stainless 12 inch diameter, 25 slot with a keystone wire-wrapped continuous slot strainer, 30 degree beveled weld ring top (.375 inch thickness), 45 foot lengths w/bottom caps

Each

3. Fabricated Well Heads

Well Heads Each 88 $__________ $__________

4. Well Screen Centralizers

Stainless 12 inch centralizer

Each 252 $__________ $__________

Relief Well Material Shipping to 3800 Laurance Rd North Pole, AK 99705 $__________

Weir Materials:

½” X 12” A36 Steel Plate (10’ Sections)

Each 13 $__________ $__________

½” X 6” A36 Steel Plate

FT 3 $__________ $__________

½” X 4” A36 Steel Plate

FT 100 $__________ $__________

½” Round Bar Stock

FT 100 $__________ $__________

¾” Round Bar Stock

FT 100 $__________ $__________

½” X 12” A36 Steel Plate – Beveled Edge (10’ Sections)

Each 8 $__________ $__________

L 4 X 4 X 3/8 Galvanized

FT 16 $__________ $__________

HILTI 1.2” X 4-

1/4” HAS

Anchors, Galvanized

Each 36 $__________ $__________

½” X 24” X 4’- 0” A36

Each 2 $__________ $__________

½” X 8” X 4’-0” A36

Each 6 $__________ $__________

½” X 36” X 4’- 0” A36

Each 7 $__________ $__________

½” X 10” X 4’- 0” A36

Each 2 $__________ $__________

½” X 32” X 4’- 0” A36

Each 2 $__________ $__________

½” X 48” X 8’- 0” A36

Each 2 $__________ $__________

24” X 71.5” Bar Grate Galvanized

Each 4 $__________ $__________

Weir Material Shipping to 3800 Laurance Rd North Pole, AK 99507 $__________

Total Cost $______________

DESCRIPTION / SPECIFICATIONS / MATERIALS LIST

Well Steel Materials

Weir Modification Steel Materials

CHENA RIVER LAKES FLOOD CONTROL PROJECT

1. RELIEF WELL MATERIALS

The Government plans to install relief wells at the Moose Creek Dam during the summer of 2017 – June 1 to September 1. The contract is for material procurement only. Installation of the wells is not required. See attached drawing for well head details.

The contractor shall furnish the following well steel materials:

Casing & Riser:

o Pile Casing: ASTM A 252*, 24” diameter, 1/2” wall, 1 foot of one end of the casing shall be 1” wall, 60 foot sections (10 each) o Riser Pipe: ASTM A 53 Grade B, 12” diameter, 3/8” wall, 12 foot sections (84 each)

Pre-fabricated Well Head:

o Well heads shall be fabricated per attached drawing (88 each)

Well Screens: 70 Each o Stainless Steel ASTM A 312/A 312M, Type 304-L o 12 inch diameter, 25 slot with a keystone wire-wrapped continuous slot strainer, 30 degree beveled weld ring top (.375 inch thickness), 45 foot lengths o Each length shall have a bottom cap (.375 inch thickness)

Screen Centralizers: 252 Each o Stainless 12 inch centralizer

QA INSPECTION: Upon completion of the first length of well screen, the contractor shall allow the Government to inspect the product prior to the completion of remaining screen sections. This requirement will apply to the fabricated heads as well.

Shipping Address: 3800 Laurence Rd, North Pole, AK 99705 *steel alternatives of comparable grade may be accepted

2. WEIR MODIFICATION MATERIALS

The Government plans to modify the South Seepage Collector Channel Weir at the Chena River Flood Control Project. The Objective of this project is to provide a sharp crested weir at a constant elevation for the purpose of measuring seepage discharge. This contract is for material procurement only. See attached drawings for weir details.

The contractor shall furnish the following materials:

Item Length/Quantity Use Notes

1 ½” X 12” A36 Steel Plate 130 FT Base Plate 10’ Sections 2 ½” X 6” A36 Steel Plate 3 FT Base Plate 3 ½” X 4” A36 Steel Plate 100 FT Filler Plate 4 ½” Round Bar Stock 100 FT Filler Rod 5 ¾” Round Bar Stock 100 FT Filler Rod 6 ½” X 12” A36 Steel Plate – Beveled Edge 80 FT Weir Plate 10’ Sections 7 L 4 X 4 X 3/8 Galvanized 16 FT Bar Grate

Ledge

8 HILTI 1.2” X 4-1/4” HAS Anchors, Galvanized

36 EA

9 ½” X 24” X 4’-0” A36 2 EA Dam Plate 10 ½” X 8” X 4’-0” A36 6 EA Dam Plate 11 ½” X 36” X 4’-0” A36 7 EA Dam Plate 12 ½” X 10” X 4’-0” A36 2 EA Dam Plate 13 ½” X 32” X 4’-0” A36 2 EA Dam Plate 14 ½” X 48” X 8’-0” A36 2 EA Dam Plate 15 24” X 71.5” Bar Grate Galvanized 4 EA Metal Deck

See attached drawing for further material and project details.

Shipping address: 3800 Laurance Road, North Pole, Alaska 99705

3. SHIPMENT PRIORITY & LEAD TIME REQUIREMENTS

The contractor shall prioritize relief well materials for shipment scheduling. The following relief well material items shall be delivered to the project site prior to the scheduled work start date of 1 June:

Casing & Riser Well Screen Screen Centralizer

The contractor shall provide the lead time for delivery of the relief well materials as well as subsequent shipment scheduling for weir material items.

4. BASIS FOR AWARD

This contract will be awarded to the offeror with the lowest price who submits a technically acceptable proposal. The Contractor’s proposal shall include the following items:

For relief well materials listed in Section 1:

a. Well material items meeting the specification requirements.

b. Lead time for FOB shipping 3800 Laurance Rd, North Pole, AK 99705

For weir materials listed in Section 2:

a. Weir material items meeting the specification requirements.

b. Lead time for FOB shipping 3800 Laurance Rd, North Pole, AK 99705

Proposals will be rated as either “acceptable” or “not acceptable” based on required material specifications and lead time requirements. The Government requires delivery not later than 20 May 2017.

P 1/2" X 48" DAM PLATE

1'-6"

EL. 491.15'

EL. 492.00'

EL. 492.19'

1/2" Ø x 4 1/4" EMBED

EPOXY ANCHOR

3/8

3/8

DAM PLATE

SCALE: 1-1/2" = 1'-0"

B

S-101 S-101

EXISTING WEIR FILL

NOTE:

APPLY 4 CONTINUOUS BEADS OF 100%

SILICONE CAULK TO BOTTOM OF BASE

PLATES BEFORE MOUNTING TO

CONCRETE

L

P 1/2" X 12" BASE PLATE

L

GENERAL NOTE:

THE OBJECTIVE OF THIS PROJECT IS TO PROVIDE A SHARP CRESTED WEIR AT A CONSTANT ELEVATION FOR THE PURPOSE OF

MEASURING SEEPAGE DISCHARGE THROUGH THE SOUTH SEEPAGE COLLECTOR CHANNEL. METHODS EMPLOYED TO CONSTRUCT

THIS WEIR MODIFICATION SHALL BE AIMED AT PROVIDING A CONSTANT WEIR CREST ELEVATION WITHIN THE TOLERANCE SHOWN.

ATTACHING THE BASE PLATE TO EXISTING SHEET PILE AT A CONSTANT ELEVATION IS CRITICAL TO THE SUCCESS OF THIS PROJECT.

CHENA RIVER

SOUTH SEEPAGE

COLLECTOR CHANNEL

1-1/2" x 3/16" 13/16" C-C

BEARING BARS 13-W-4

SERRATED BAR GRATE,

GALVANIZED,

24" MIN. GRATE PANEL

WIDTH, BANDED ENDS

EXISTING CATWALK

BASE PLATE

P 1/2" X 12" X 9' - 0"

6" 2'-0" 2'-0" 2'-0" 2'-0" 6"

1'-6" 2'-0" 2'-0" 2'-0" 1'-6"

5/8"Ø HOLE, TYP

P 1/2" X 6" X 1' - 6"

P 1/2" X 12" X 6' - 8"

6'-0"

2'-0" 40'-0" APPROX 6'

DAM PLATE WEIR PLATE DAM PLATE

P 1/2" X 24" X 4'-0"

DAM PLATE SCHEDULE

MARK DIMENSIONS QUANTITY

L

P 1/2" X 36" X 4'-0"

L

P 1/2" X 8" X 4'-0"

L

P 1/2" X 10" X 4'-0"

L

P 1/2 X 32" X 4'-0"

L

P 1/2 X 48" X 8'-0"

L

(2)

(7)

(6)

(2)

(2)

(2)

L

L

L

CUT CATWALK DIAGONAL

BRACING AS NEEDED TO

ACCOMMODATE DAM

PLATE, WELD BRACING

TO DAM PLATE WITH

CONTINUOUS WELDS

AROUND ALL SPLICES.

CUT TO FIT

2"

A

S

S

B

S-101 S-101

C

S-101 S-102

2'-0"40'-0"APPROX 6'

DAM PLATEWEIR PLATEDAM PLATE

CUT TO FIT

TIE DAM PLATE INTO EXISTING

SHEET PILE STRUCTURE AT

BOTH ENDS OF THE WEIR

MODIFICATIONS. FILL GAPS

BETWEEN PLATES AND SHEET

PILE AS NECESSARY TO

PROVIDE A WATER TIGHT

CONNECTION .

ALASKA DISTRICT

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REFERENCE

NUMBER:

SHEET OF

US ARMY CORPS

OF ENGINEERS

A

B

C

D

E

F

G

H

1 2 3 4 5 6 7 8 9 10 11 12

D r a w i n g

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W e i r

D e s i g n

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K d w g l a s t s a v e d o n

A

M w a s p l o t t e d b y

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L e w i s

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FINAL

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S K

VERIFY SCALES: IF THIS LINE 0 2"

DOES NOT MEASURE 2", ADJUST SCALE ACCORDINGLY.

S-101

D A

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3/16"5/16"

BEVEL DETAIL

SCALE: 1" = 1"

D

S-102 S-102

ITEM LENGTH USE NOTES

1/2" X 12" A36 STEEL PLATE 125 FT BASE PLATE BASE PLATE ACROSS SHEET PILE AND

CONCRETE GATE STRUCTURE. SPECIFIC PLATE

LENGTHS AND HOLE PLACEMENT OVER THE

CONCRETE STRUCTURE ARE SHOWN ON S-101

1/2" X 6" A36 STEEL PLATE 3 FT BASE PLATE BASE PLATE ON CONCRETE

STRUCTURE AT CATWALK LEGS

1/2" X 4" A36 STEEL PLATE 100 FT FILLER PLATE SHORT SEGMENTS TO FILL GAPS

1/2" Ø ROUND BAR STOCK 100 FT FILLER ROD SHORT SEGMENTS TO FILL GAPS

3/4" Ø ROUND BAR STOCK 100 FT FILLER ROD SHORT SEGMENTS TO FILL GAPS

1/2" X 12" A36 STEEL PLATE 80 FT WEIR PLATE BEVELED EDGE

L 4 X 4 X 3/8, GALVANIZED 16 FT. BAR GRATE TWO 8 FOOT LENGTHS, FOUR 5/8" HOLES

LEDGE @ 24" OC ON ONE LEG OF EACH

HILTI 1.2" Ø X 4-1/4" HAS 36 33 NEEDED FOR PROJECT

ANCHORS, GALVANIZED

P 1/2" X 24" X 4'-0" 2 DAM PLATE

P 1/2" X 8" X 4'-0" 6 DAM PLATE

P 1/2" X 36" X 4'-0" 7 DAM PLATE

P 1/2" X 10" X 4'-0" 2 DAM PLATE

P 1/2" X 32" X 4'-0" 2 DAM PLATE

P 1/2" X 48" X 8'-0" 2 DAM PLATE

24" X 71.5" BAR GRATE 4 METAL DECK AMICO 1-1/2" X 3/16" 13/16" C-C 13-W-4

GALVANIZED SERRATED BAR GRATE W/ BANDED ENDS

PURCHASE HARDWARE TO ATTACH TO

STEEL MEMBERS

L

L

L

L

L

L

WEIR MODIFICATION MATERIALS

P 1/2" X 12" WEIR PLATE,

BEVELED EDGE, SEE DETAIL

ORIENT WEIR PLATE SUCH

THAT BEVELED EDGE FACES

THE SEEPAGE COLLECTOR

CHANNEL

1'-0"

CHENA RIVERSOUTH SEEPAGE

COLLECTOR CHANNEL

EXISTING DECKING

1/2"

EXISTING WEIR FILL

EL. 491.15'

EL. 492.19' ± 0.02'

3/8

3/8

3/8

WEIR PLATE

SCALE: 3" = 1'-0"

A

S-101 S-102

EXISTING SHEET PILE

D

S-102 S-102

3/8

P 1/2" X 4", SEE NOTES

L

SUPPORT CUT END OF DECKING

WITH PRESSURE TREATED LUMBER.

L

NOTES:

1. THE CONSISTENCY OF THE TOP ELEVATION OF THE

EXISTING SHEET PILE IS NOT KNOWN. SURVEY THE

TOP ELEVATION OF EXISTING SHEET PILE AND

DETERMINE SHIM OR SPACER HEIGHTS AS REQUIRED

ACROSS THEW STRUCTURE PRIOR TO WELDING.

2. WELD BASE PLATE TO TOP OF EXISTING SHEET PILE.

WELDS SHALL BE CONTINUOUS AND WATER TIGHT.

3. WHERE GAPS OCCUR BETWEEN THE BASE PLATE AND

THE TOP OF SHEET PILE, FILL THE GAP WITH ROUND

BAR STOCK OR PLATE STEEL AS SHOWN.

P 1/2" X 12" BASE PLATE

L

WEIR CREST ELEVATION

EXISTING ELEVATION, SEE NOTE 1

GENERAL NOTE:

THE OBJECTIVE OF THIS PROJECT IS TO PROVIDE A SHARP CRESTED WEIR AT A CONSTANT ELEVATION FOR THE PURPOSE

OF MEASURING SEEPAGE DISCHARGE THROUGH THE SOUTH SEEPAGE COLLECTOR CHANNEL. METHODS EMPLOYED TO

CONSTRUCT THIS WEIR MODIFICATION SHALL BE AIMED AT PROVIDING A CONSTANT WEIR CREST ELEVATION WITHIN THE

TOLERANCE SHOWN. ATTACHING THE BASE PLATE TO EXISTING SHEET PILE AT A CONSTANT ELEVATION IS CRITICAL TO

THE SUCCESS OF THIS PROJECT.

1'-6"

SECTION

SCALE: 1-1/2" = 1'-0"

C

S-101 S-102

EXISTING WEIR FILL

1'-6"

1/2" Ø x 4 1/4" EMBED

EPOXY ANCHOR,

24" SPACING

EXISTING WEIR FILL

1-1/2" x 3/16" 13/16" C-C BEARING BARS 13-W-4

SERRATED BAR GRATE, GALVANIZED,

24" MIN. GRATE PANEL WIDTH, BANDED ENDS

L 4 x 4 x 3/8, GALVANIZED

CONCRETE ANCHORS:

USE HILTI HIT HY 150/HIT-ICE INJECTION ADHESIVE

AND HILTI HAS STANDARD A36 RODS, GALVANIZED.

EXISTING CONCRETE,

TYPICAL

ALASKA DISTRICT

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REFERENCE

NUMBER:

SHEET OF

US ARMY CORPS

OF ENGINEERS

A

B

C

D

E

F

G

H

1 2 3 4 5 6 7 8 9 10 11 12

D r a w i n g

O

E

N P r i v a t e C

W H

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H E

N A

P r o j e c t s

W e i r

D e s i g n

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H L

S

K d w g l a s t s a v e d o n

A

M w a s p l o t t e d b y

E p p s

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VERIFY SCALES: IF THIS LINE 0 2"

DOES NOT MEASURE 2", ADJUST SCALE ACCORDINGLY.

S-102

W E

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REFERENCE

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SHEET OF

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P r o j e c t s b y

L o c a t i o n C h e n a i v e r L a k e s

P r o j e c t C h e n r o j e c t

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ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

(VG) Very Good Performance meets contractual requirements and exceeds some to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner.

There should have been no significant weaknesses identified.

(S) Satisfactory Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner.

(U) Unsatisfactory

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

(N) Not Applicable

No information or did not apply to your contract

Rating will be neither positive nor negative.

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Offeror Information Firm Being Evaluated: CAGE Code:

Address: DUNs Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain) Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work High Med Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

TO BE COMPLETED BY CLIENT

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

Contract Title:

Contract Location:

CLIENT INFORMATION (Client to complete following blocks) Client Information Name:

Title:

Phone Number:

Email Address:

Describe the client’s role in the project:

Date Questionnaire was completed (mm/dd/yy):

Client’s Signature:

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

a) Quality of technical data/report preparation efforts E VG S M U N

b) Ability to meet quality standards specified for technical performance E VG S M U N

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance

E VG S M U N

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below)

E VG S M U N

b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract

E VG S M U N

3. CUSTOMER SATISFACTION:

a) To what extent were the end users satisfied with the project? E VG S M U N

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes;

responsiveness to administrative reports, businesslike and communication)

E VG S M U N

c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer?

E VG S M U N

d) Overall customer satisfaction E VG S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

E VG S M U N

b) Ability to hire, apply, and retain a qualified workforce to this effort E VG S M U N

c) Government Property Control E VG S M U N

d) Knowledge/expertise demonstrated by contractor personnel E VG S M U N

e) Utilization of Small Business concerns E VG S M U N

f) Ability to simultaneously manage multiple projects with multiple disciplines

E VG S M U N

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E VG S M U N

h) Effectiveness of overall management (including ability to effectively lead, manage and control the program)

E VG S M U N

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractually agreed price(s)?

E VG S M U N

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E VG S M U N

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

E VG S M U N

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

Yes No

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

Yes No

f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes No

6. SAFETY/SECURITY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E VG S M U N

b) Contractor complied with all security requirements for the project and personnel security requirements.

E VG S M U N

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

E VG S M U N

b) Compliance with contractual terms/provisions (explain if specific issues)

E VG S M U N

c) Would you hire or work with this firm again? (If no, please explain below)

Yes No

d) In summary, provide an overall rating for the work performed by this contractor.

E VG S M U N

Please provide responses to the questions above (if applicable) and/or additional remarks.

Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

END OF QUESTIONNAIRE

NOTE: USACE REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE

AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE

COMPLETED QUESTIONNAIRE TO USACE WITH THEIR PROPOSAL, AND MAY

DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON USACE

SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES

DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED

DIRECTLY TO USACE. PLEASE CONTACT THE OFFEROR FOR USACE POC

INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL

INFORMATION ON THIS FORM.

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 31-MAY-2017 1 N/A

FOB: Destination

CLAUSES INCORPORATED BY REFERENCE

52.204-7 System for Award Management JUL 2013 52.212-1 Instructions to Offerors--Commercial Items OCT 2016 52.212-4 Contract Terms and Conditions--Commercial Items MAY 2015 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7005 Representation Relating to Compensation of Former DoD Officials

NOV 2011

252.204-7004 Alt A System for Award Management Alternate A FEB 2014 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.244-7000 Subcontracts for Commercial Items JUN 2013

CLAUSES INCORPORATED BY FULL TEXT

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) 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:

Offers will be technically evaluated in accordance with the requirements set forth in the Scope of Work / Description / Specifications. Award will be made to the lowest-priced technically acceptable offeror. The Government reserves the right to make award on the initial offer received without discussions.

Offers will be evaluated in accordance with the following factors:

(i) price;

(ii) technical capability of the item offered to meet the Government requirement

(iii) past performance.

Technical and past performance, when combined, are approximately equal, when combined, when compared to price.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (DEC 2016)

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

(a) Definitions. As used in this provision --

“Administrative merits determination” means certain notices or findings of labor law violations issued by an enforcement agency following an investigation. An administrative merits determination may be final or be subject to appeal or further review. To determine whether a particular notice or finding is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Arbitral award or decision” means an arbitrator or arbitral panel determination that a labor law violation occurred, or that enjoined or restrained a violation of labor law. It includes an award or decision that is not final or is subject to being confirmed, modified, or vacated by a court, and includes an award or decision resulting from private or confidential proceedings. To determine whether a particular award or decision is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Civil judgment” means—

(1) In paragraph (h) of this provision: A judgment or finding of a civil offense by any court of competent jurisdiction.

(2) In paragraph (s) of this provision: Any judgment or order entered by any Federal or State court in which the court determined that a labor law violation occurred, or enjoined or restrained a violation of labor law. It includes a judgment or order that is not final or is subject to appeal. To determine whether a particular judgment or order is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“DOL Guidance” means the Department of Labor (DOL) Guidance entitled: ``Guidance for Executive Order 13673, `Fair Pay and Safe Workplaces' ''. The DOL Guidance, dated August 25, 2016, can be obtained from www.dol.gov/fairpayandsafeworkplaces.

“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. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“Enforcement agency” means any agency granted authority to enforce the Federal labor laws. It includes the enforcement components of DOL (Wage and Hour Division, Office of Federal Contract Compliance Programs, and Occupational Safety and Health Administration), the Equal Employment Opportunity Commission, the Occupational Safety and Health Review Commission, and the National Labor Relations Board. It also means a State agency designated to administer an OSHA-approved State Plan, but only to the extent that the State agency is acting in its capacity as administrator of such plan. It does not include other Federal agencies which, in their capacity as contracting agencies, conduct investigations of potential labor law violations. The enforcement agencies associated with each labor law under E.O. 13673 are--

(1) Department of Labor Wage and Hour Division (WHD) for--

(i) The Fair Labor Standards Act;

(ii) The Migrant and Seasonal Agricultural Worker Protection Act;

(iii) 40 U.S.C. chapter 31, subchapter IV, formerly known as the Davis-Bacon Act;

(iv) 41 U.S.C. chapter 67, formerly known as the Service Contract Act;

(v) The Family and Medical Leave Act; and

(vi) E.O. 13658 of February 12, 2014 (Establishing a Minimum Wage for Contractors);

(2) Department of Labor Occupational Safety and Health Administration (OSHA) for--

(i) The Occupational Safety and Health Act of 1970; and

(ii) OSHA-approved State Plans;

(3) Department of Labor Office of Federal Contract Compliance Programs (OFCCP) for--

(i) Section 503 of the Rehabilitation Act of 1973;

(ii) The Vietnam Era Veterans' Readjustment Assistance Act of 1972 and the Vietnam Era Veterans' Readjustment Assistance Act of 1974; and

(iii) E.O. 11246 of September 24, 1965 (Equal Employment Opportunity);

(4) National Labor Relations Board (NLRB) for the National Labor Relations Act; and

(5) Equal Employment Opportunity Commission (EEOC) for--

(i) Title VII of the Civil Rights Act of 1964;

(ii) The Americans with Disabilities Act of 1990;

(iii) The Age Discrimination in Employment Act of 1967; and

(iv) Section 6(d) of the Fair Labor Standards Act (Equal Pay Act).

"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).

“Labor compliance agreement” means an agreement entered into between a contractor or subcontractor and an enforcement agency to address appropriate remedial measures, compliance assistance, steps to resolve issues to increase compliance with the labor laws, or other related matters.

“Labor laws” means the following labor laws and E.O.s:

(1) The Fair Labor Standards Act.

(2) The Occupational Safety and Health Act (OSHA) of 1970.

(3) The Migrant and Seasonal Agricultural Worker Protection Act.

(4) The National Labor Relations Act.

(5) 40 U.S.C. chapter 31, subchapter IV, formerly known as the Davis-Bacon Act.

(6) 41 U.S.C. chapter 67, formerly known as the Service Contract Act.

(7) E.O. 11246 of September 24, 1965 (Equal Employment Opportunity).

(8) Section 503 of the Rehabilitation Act of 1973.

(9) The Vietnam Era Veterans' Readjustment Assistance Act of 1972 and the Vietnam Era Veterans' Readjustment Assistance Act of 1974.

(10) The Family and Medical Leave Act.

(11) Title VII of the Civil Rights Act of 1964.

(12) The Americans with Disabilities Act of 1990.

(13) The Age Discrimination in Employment Act of 1967.

(14) E.O. 13658 of February 12, 2014 (Establishing a Minimum Wage for Contractors).

(15) Equivalent State laws as defined in the DOL Guidance. (The only equivalent State laws implemented in the FAR are OSHA-approved State Plans, which can be found at www.osha.gov/dcsp/osp/approved_state_plans.html).

“Labor law decision” means an administrative merits determination, arbitral award or decision, or civil judgment, which resulted from a violation of one or more of the laws listed in the definition of ``labor laws''.

“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.

“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" means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and size standards in this solicitation.

“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 the stock of which 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 its stock is owned by one or more women; or

(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.

Note to paragraph (a): By a court order issued on October 24, 2016, the following definitions in this paragraph (a) are enjoined indefinitely as of the date of the order: ``Administrative merits determination'', ``Arbitral award or decision'', paragraph (2) of ``Civil judgment'', ``DOL Guidance'', ``Enforcement agency'', ``Labor compliance agreement'', ``Labor laws'', and ``Labor law decision''. The enjoined definitions will become effective immediately if the court terminates the injunction. At that time, DoD, GSA, and NASA will publish a document in the Federal Register advising the public of the termination of the injunction.

(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 posted electronically on the SAM website.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website accessed through https://www.acquisition.gov. After reviewing the SAM database 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 Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ___ .

[Offeror to identify the applicable paragraphs at (c) through (t) 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 ORCA.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it ( ___ ) is, ( ___ ) is not a small business concern.

(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 it ( ___ ) is, ( ___ ) is not a service-disabled veteran-owned small business concern.

(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.

Note to paragraphs (c)(8) and (9): Complete paragraphs (c)(8) and (c)(9) only if this solicitation is expected to exceed the simplified acquisition threshold.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that--

(i) It [ ___ ] is, [ ___ ] is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate for each WOSB concern eligible under the WOSB Program participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern eligible under the WOSB Program and other small businesses that are participating in the joint venture: ___ .] Each WOSB concern eligible under the WOSB Program participating in the joint venture shall submit a separate signed copy of the WOSB representation.

(7) Economically disadvantaged women-owned small business (EDWOSB) concern. [Complete only if the offeror represented itself as a WOSB concern eligible under the WOSB Program in (c)(6) of this provision.] The offeror represents that--

(i) It [ ___ ] is, [ ___ ] is not an EDWOSB concern, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It [ ___ ] is, [ ___ ] is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(7)(i) of this provision is accurate for each EDWOSB concern participating in the joint venture. [The offeror shall enter the name or names of the EDWOSB concern and other small businesses that are participating in the joint venture: ___ -.] Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

(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, 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…