W911RQ-16-R-0008_Conformed_Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W911RQ-16-R-0008 17-Aug-2016

b. TELEPHONE NUMBER

903-334-2330

8. OFFER DUE DATE/LOCAL TIME

12:00 PM 18 Oct 2016

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.

W911RQ9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

LEOLA LIGGINS

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

SEE SCHEDULE

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

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

RED RIVER ARMY DEPOT

DIRECTORATE FOR CONTRACTING

100 JAMES CARLOW DRIVE BLDG 431

TEXARKANA TX 75507-5000

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

SIZE STANDARD:

$7,500,000

NAICS:

562991

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.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF55

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.

W911RQ-16-R-0008

Section SF 30 - BLOCK 14 CONTINUATION PAGE

NOTES

Added following provisions, clauses, & sections: 52.212-3 Alt 1, 52.203-6, 52.209-6, 52.219-14, 52.219-28, 52.222- 22, 52.222-17, 52.222-43, 52.222-55, 52.252-1, LS7015, 52.216-19, 52.216-18, 52.216-21, 252.216-7006, and changed verbiage in the following clauses: 52.212-2, 52. 222-42, 52.217-8, 52.217-9, and Instructions to Offerors.

The date and time set for reciept of the quotes has been changed from Monday 19 September 2016 at 10:00 am to Tuesday 18 October 2016 at 12 noon CST. There are no other changes. Offerors are reminded to ackowledge this and every amendment in writing. Failure to acknowledge an amendment in writing could result in an offer being rejected.

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES ESTIMATED

QUANTITY

UNIT UNIT PRICE ESTIMATED AMOUNT

0001 1 Lot

BASE YEAR PORTABLE CHEMICAL TOILET

FFP

MONTHLY PRICE PER PORTABLE CHEMICAL TOILET: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Portable Chemical Toilet.

Estimated 50 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

NSN: AASSVC533702NI

MILSTRIP: W45G18533702NI

PURCHASE REQUEST NUMBER: W45G18533702NI

ESTIMATED

NET AMT

UNIT UNIT PRICE ESTIMATED AMOUNT

0002 1 Lot

BASE YEAR PORTABLE HAND WASH STATION

FFP

MONTHLY PRICE PER HAND WASH STATION: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Hand Wash Station. Estimated 25 each per month. Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

NSN: AASSVC533702NJ

MILSTRIP: W45G18533702NJ

PURCHASE REQUEST NUMBER: W45G18533702NJ

UNIT UNIT PRICE ESTIMATED AMOUNT

0003 1 Lot

BASE YEAR SHORT TERM

FFP

PRICE PER SHORT TERM PORTABLE CHEMICAL TOILET:$______.

PRICE PER SHORT TERM HANDICAP PORTABLE CHEMICAL

TOILET:$______. PRICE PER SHORT TERM HAND WASH

STATION:$_____.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Short Term Portable Chemical Toliet, Short Term Handicap Portable Chemical Toilet, and Hand Wash Station. Estimated 18 Total Portable Chemical Toilets and 6 Total Hand Wash Stations per year at three seperate events. Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

PURCHASE REQUEST NUMBER: A3E000608500MA

UNIT UNIT PRICE ESTIMATED AMOUNT

0004 Each

BASE YEAR CDRL

FFP

CDRL Base Year

FFP

CDRLs in accordance with Exhibit 1, DD Form 1423 dated 14 Oct 2016.

Reference PWS. Base Year is the date of contract award through day 365.

Exhibit 1:

CDRL A01: Performance Check Sheet CDRL A02: Monthly Report CDRL A03: Safety Data Sheet (SDS)

PURCHASE REQUEST NUMBER: A3E000608500MB

UNIT UNIT PRICE ESTIMATED AMOUNT

0005 Each

BASE YEAR CMRA

FFP

CMR Base Year

FFP

Annual Contractor Manpower Reporting (CMR) Clause FAR 52.237-4000.

Base Year is the date of contract award through day 365.

PURCHASE REQUEST NUMBER: A3E000608500MC

UNIT UNIT PRICE ESTIMATED AMOUNT

1001 Lot

OPTION OPT YEAR 1 PORTABLE CHEMICAIL TOILETS

FFP

MONTHLY PRICE PER PORTABLE CHEMICAL TOILET: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Portable Chemical Toilet.

Estimated 50 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NK

PURCHASE REQUEST NUMBER: A3E000608500NK

UNIT UNIT PRICE ESTIMATED AMOUNT

1002 1 Lot

OPTION OPT YEAR 1 HAND WASH STATIONS

FFP

MONTHLY PRICE PER HAND WASH STATION: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Hand Wash Station. Estimated 25 each per month. Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NL

PURCHASE REQUEST NUMBER: A3E000608500NL

UNIT UNIT PRICE ESTIMATED AMOUNT

1003 Lot

OPTION OPT YEAR 1 SHORT TERM

FFP

PRICE PER SHORT TERM PORTABLE CHEMICAL TOILET: $______.

PRICE PER SHORT TERM HANDICAP PORTABLE CHEMICAL TOILET:

$______. PRICE PER SHORT TERM HAND WASH STATION: $_____.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Short Term Portable Chemical Toliet, Short Term Handicap Portable Chemical Toilet, and Hand Wash Station. Estimated 18 Total Portable Chemical Toilets and 6 Total Hand Wash Stations per year at three seperate events. Funding cited per delivery order. Quantities specified per delivery order.

PURCHASE REQUEST NUMBER: A3E000608500MD

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 1 CDRL

FFP

CDRL Option Year One

FFP

CDRLs in accordance with Exhibit 1, DD Form 1423 dated 14 Oct 2016.

Reference PWS. Option Year One is day 366 through day 730.

Exhibit 1:

CDRL A01: Performance Check Sheet CDRL A02: Monthly Report CDRL A03: Safety Data Sheet (SDS)

PURCHASE REQUEST NUMBER: A3E000608500ME

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 1 CMRA

FFP

CMR Option Year One

FFP

Annual Contractor Manpower Reporting (CMR) Clause FAR 52.237-4000.

Option Year One is day 366 through day 730.

PURCHASE REQUEST NUMBER: A3E000608500MF

UNIT UNIT PRICE ESTIMATED AMOUNT

2001 1 Lot

OPTION OPT YEAR 2 PORTABLE CHEMICAL TOILETS

FFP

MONTHLY PRICE PER PORTABLE CHEMICAL TOILET: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Portable Chemical Toilet.

Estimated 50 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NM

PURCHASE REQUEST NUMBER: A3E000608500NM

UNIT UNIT PRICE ESTIMATED AMOUNT

2002 1 Lot

OPTION OPT YEAR 2 PORTABLE HAND WASH STATIONS

FFP

MONTHLY PRICE PER HAND WASH STATION: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Hand Wash Station.

Estimated 25 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NN

PURCHASE REQUEST NUMBER: A3E000608500NN

UNIT UNIT PRICE ESTIMATED AMOUNT

2003 Lot

OPTION OPT YEAR 2 SHORT TERM

FFP

PRICE PER SHORT TERM PORTABLE CHEMICAL TOILET:$______.

PRICE PER SHORT TERM HANDICAP PORTABLE CHEMICAL

TOILET:$______. PRICE PER SHORT TERM HAND WASH STATION:

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Short Term Portable Chemical Toliet, Short Term Handicap Portable Chemical Toilet, and Hand Wash Station.

Estimated 18 Total Portable Chemical Toilets and 6 Total Hand Wash Stations per year at three seperate events. Funding cited per delivery order. Quantities specified per delivery order.

PURCHASE REQUEST NUMBER: A3E000608500MG

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 2 CDRL

FFP

CDRL Option Year Two

FFP

CDRLs in accordance with Exhibit 1, DD Form 1423 dated 14 Oct 2016.

Reference PWS. Option Year Two is day 731 through day 1095.

Exhibit 1:

CDRL A01: Performance Check Sheet CDRL A02: Monthly Report CDRL A03: Safety Data Sheet (SDS)

PURCHASE REQUEST NUMBER: A3E000608500MH

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION Opt Year 2 CMRA

FFP

CMR Option Year Two

FFP

Annual Contractor Manpower Reporting (CMR) Clause FAR 52.237-4000.

Option Year Two is day 731 through day 1095.

PURCHASE REQUEST NUMBER: A3E000608500MI

UNIT UNIT PRICE ESTIMATED AMOUNT

3001 1 Lot

OPTION OPT YEAR 3 PORTABLE CHEMICAL TOILETS

FFP

MONTHLY PRICE PER PORTABLE CHEMICAL TOILET: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Portable Chemical Toilet.

Estimated 50 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NO

PURCHASE REQUEST NUMBER: A3E000608500NO

UNIT UNIT PRICE ESTIMATED AMOUNT

3002 1 Lot

OPTION OPT YEAR 3 PORTABLE HAND WASH STATIONS

FFP

MONTHLY PRICE PER HAND WASH STATION: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Hand Wash Station.

Estimated 25 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NP

PURCHASE REQUEST NUMBER: A3E000608500NP

UNIT UNIT PRICE ESTIMATED AMOUNT

3003 Lot

OPTION OPT YEAR 3 SHORT TERM

FFP

PRICE PER SHORT TERM PORTABLE CHEMICAL TOILET:$______.

PRICE PER SHORT TERM HANDICAP PORTABLE CHEMICAL

TOILET:$______. PRICE PER SHORT TERM HAND WASH

STATION:$_____.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Short Term Portable Chemical Toliet, Short Term Handicap Portable Chemical Toilet, and Hand Wash Station.

Estimated 18 Total Portable Chemical Toilets and 6 Total Hand Wash Stations per year at three seperate events. Funding cited per delivery order. Quantities specified per delivery order.

PURCHASE REQUEST NUMBER: A3E000608500MJ

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 3 CDRL

FFP

CDRL Option Year Three

FFP

CDRLs in accordance with Exhibit 1, DD Form 1423 dated 14 Oct 2016.

Reference PWS. Option Year Three is 1096 through day 1460.

Exhibit 1:

CDRL A01: Performance Check Sheet CDRL A02: Monthly Report CDRL A03: Safety Data Sheet (SDS)

PURCHASE REQUEST NUMBER: A3E000608500MK

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 3 CMRA

FFP

CMR Option Year Three

FFP

Annual Contractor Manpower Reporting (CMR) Clause FAR 52.237-4000.

Option Year Three is day 1096 through day 1460.

PURCHASE REQUEST NUMBER: A3E000608500ML

UNIT UNIT PRICE ESTIMATED AMOUNT

4001 1 Lot

OPTION OPT YEAR 4 PORTABLE CHEMICAL TOILETS

FFP

MONTHLY PRICE PER PORTABLE CHEMICAL TOILET: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Portable Chemical Toilet.

Estimated 50 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NQ

PURCHASE REQUEST NUMBER: A3E000608500NQ

UNIT UNIT PRICE ESTIMATED AMOUNT

4002 1 Lot

OPTION OPT YEAR 4 PORTABLE HAND WASH STATIONS

FFP

MONTHLY PRICE PER HAND WASH STATION: $_____________.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Hand Wash Station.

Estimated 25 each per month.

Funding cited per delivery order. Quantities specified per delivery order.

FOB: Destination

MILSTRIP: A3E000608500NR

PURCHASE REQUEST NUMBER: A3E000608500NR

UNIT UNIT PRICE ESTIMATED AMOUNT

4003 Lot

OPTION OPT YEAR 4 SHORT TERM

FFP

PRICE PER SHORT TERM PORTABLE CHEMICAL TOILET:$______.

PRICE PER SHORT TERM HANDICAP PORTABLE CHEMICAL

TOILET:$______. PRICE PER SHORT TERM HAND WASH

STATION:$_____.

Pricing shall be based on the delivery and servicing, IAW the Performance Work Statement, of a single Short Term Portable Chemical Toliet, Short Term Handicap Portable Chemical Toilet, and Hand Wash Station.

Estimated 18 Total Portable Chemical Toilets and 6 Total Hand Wash Stations per year at three seperate events. Funding cited per delivery order. Quantities specified per delivery order.

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 4 CDRL

FFP

CDRL Option Year Four

FFP

CDRLs in accordance with Exhibit 1, DD Form 1423 dated 14 Oct 2016.

Reference PWS. Option Year Four is day 1461 through day 1825.

Exhibit 1:

CDRL A01: Performance Check Sheet CDRL A02: Monthly Report CDRL A03: Safety Data Sheet (SDS)

PURCHASE REQUEST NUMBER: A3E000608500MM

UNIT UNIT PRICE ESTIMATED AMOUNT

OPTION OPT YEAR 4 CMRA

FFP

CMR Option Year Four

FFP

Annual Contractor Manpower Reporting (CMR) Clause FAR 52.237-4000.

Option Year Four is day 1461 through day 1825.

PURCHASE REQUEST NUMBER: A3E000608500MO

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 1001 Destination Government Destination Government 1002 Destination Government Destination Government 1003 Destination Government Destination Government 1004 Destination Government Destination Government 1005 Destination Government Destination Government 2001 Destination Government Destination Government 2002 Destination Government Destination Government 2003 Destination Government Destination Government 2004 Destination Government Destination Government 2005 Destination Government Destination Government 3001 Destination Government Destination Government 3002 Destination Government Destination Government 3003 Destination Government Destination Government 3004 Destination Government Destination Government 3005 Destination Government Destination Government 4001 Destination Government Destination Government 4002 Destination Government Destination Government 4003 Destination Government Destination Government 4004 Destination Government Destination Government 4005 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

0001 12 mths. ADC 1 RED RIVER ARMY DEPOT

HESS, TERRY (DPW)

100 JAMES CARLOW DRIVE

TEXARKANA TX 75507-5000

903-334-4024

W911RQ

0002 12 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

0003 12 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

0004 12 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

0005 12 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

1001 24 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

1002 24 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

1003 24 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

1004 24 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

1005 24 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

2001 36 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

2002 36 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

2003 36 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

2004 36 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

2005 36 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

3001 48 mths. ADC 1 RED RIVER ARMY DEPOT

HUGHES, RICHARD A (DRM)

100 JAMES CARLOW DRIVE

TEXARKANA TX 75507-5000

903-334-2738

3002 48 mths. ADC 1 RED RIVER ARMY DEPOT

HESS, TERRY (DPW)

100 JAMES CARLOW DRIVE

TEXARKANA TX 75507-5000

903-334-4024

3003 48 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

3004 48 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

3005 48 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

4001 60 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

4002 60 mths. ADC 1 (SAME AS PREVIOUS LOCATION)

4003 60 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

4004 60 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

4005 60 mths. ADC 0 (SAME AS PREVIOUS LOCATION)

PERFORMANCE WORK STATEMENT

Performance Work Statement

PWS

This Performance Work Statement describes Red River Army Depot’s (RRAD) requirement for the supplying and servicing of Portable Chemical Toilets and Hand Wash Stations at various fixed locations as well as on a short term basis. This contract will be a requirements type contract with a base and four options. There is no minimum or maximum quantities.

1. Definitions: For the purpose of this contract, the following definitions will apply-

1.1 CONTRACT ADMINISTRATOR: The official Government representative delegated authority by the Contracting officer to administer a contract. This individual, normally working in an appropriate contracting field, advises on all contractual matters.

1.2 CONTRACTING OFFICER (KO): A person duly appointed with the authority to enter into and administer contracts on behalf of the Government.

1.3 CONTRACTING OFFICER’S REPRESENTATIVE (COR): An individual designated in writing by the contracting officer to act as an authorized representative of the contracting officer to perform specific duties within the scope and limitations as defined by the contracting officer.

1.4 CONTRACTOR: The Contractor, its subsidiaries and affiliates, joint ventures involving the contractor, or any entity with which the contractor may have merged or any individual or entity that assisted or advised the contractor in the preparation of a quote/offer under this solicitation.

1.5 GOVERNMENT: RRAD, hereinafter referred to as the Government, the KO, or the COR as applicable.

1.6 SDS: Safety Data Sheet Form containing health hazard information about chemical products.

1.7 UNIT(s): Used when referring to both Portable Chemical Toilet(s) and Hand Wash Station(s) collectively.

2. General

2.1 Contractor shall, per delivery order, supply and service Portable Chemical Toilets and Hand Wash Stations to fixed locations throughout the installation of RRAD IAW (in accordance with) the requirements and schedules set forth in this PWS.

2.2 Contractor shall, per delivery order, supply and service Portable Chemical Toilets, Portable Handicap Chemical Portable Toilets, and Hand Wash Stations to Short Term locations in designated areas on the installation of RRAD IAW the requirements and schedules set forth in this PWS.

3. Fixed Location

3.1 Portable Chemical Toilets and Hand Wash Stations shall be delivered to predetermined locations on RRAD IAW locations provided within the delivery order. Each Portable Chemical Toilet and Hand Wash Station shall be serviced IAW Section 6- Performance Requirements.

3.2 Delivery of Fixed Location Portable Chemical Toilets and Hand Wash Stations shall be complete within 5 business days after issuance of the initial delivery order of the base year. Delivery orders following the initial delivery order for the remainder of the base year and any option years shall be delivered within, but not exceeding 2 business days.

3.3 A number of the fixed locations are located in areas accessible only by way of unimproved roads and/or muddy terrain.

4. Short Term

4.1 Portable Chemical Toilets, Portable Handicap Chemical Portable Toilets, and Hand Wash Stations shall be delivered to predetermined locations on RRAD IAW locations provided within the delivery order.

4.2 Delivery of Short Term Portable Chemical Toilets, Portable Handicap Chemical Toilets, and Hand Wash Stations shall be completed IAW special instructions and Period of Performance requirements set forth in the delivery order. Each Portable Chemical Toilet, Portable Handicap Chemical Portable Toilet, and Hand Wash Station shall be delivered in fully functional state that meets requirements located in Section 5- Unit Specifications.

5. Unit Specifications

5.1 All units shall be skid mounted and shall be either one-piece shell construction or high grade recycled plastic and shall be stabilized to prevent blowing over in RRAD’s commonly occurring strong winds.

5.2 All units shall be delivered clean and free of any physical defects and graffiti.

5.3 All units shall be marked to identify MALE or FEMALE, and have identification numbers painted or as decals on the front and back that are readable from 20 feet.

5.4 Units shall be equipped with the following:

5.4.1 Portable Chemical Toilet

Toilet Paper Toilet Paper Holders Clean unbroken toilet seats Adequate screen vents Operational interior locking mechanisms Spring-loaded doors providing for automatic closure Performance Check Sheet (Exhibit 1: CDRL A001)

5.4.2 Portable Handicap Chemical Toilet

Same as Portable Chemical Toilet

5.4.3 Hand Wash Station

Paper Towels Anti- Bacterial Hand Soap Filled with Potable Water Performance Check Sheet (Exhibit 1: CDRL A001)

6. Performance Requirements

6.1 Fixed Location units shall be serviced every Tuesday and Friday. In the case of a holiday falling on either the Tuesday or Friday of a particular week, the COR will notify the contractor with an alternate service schedule two weeks in advance of the effected week. All other weeks not effected will remain on the regular service schedule of Tuesday and Friday.

6.2 Servicing on units shall consist of the following:

6.2.1 Portable Chemical Toilets

Pump out storage tank.

Replace chemicals and water, maintaining a chemical to water ratio IAW manufacturer’s recommendations.

Clean and disinfect all interior surfaces.

Replenish toilet paper to provide for a one-week supply in each unit.

Provide maintenance, repair, or replacement of units as needed.

Fill in Performance Check Sheet (Exhibit 1: CDRL A001) after completion of each service.

6.2.2 Hand Wash Stations

Pump out fresh water and gray water tanks completely.

Refill Fresh Water tank with potable water Only.

Disinfect exterior surfaces.

Refill anti-bacterial hand soap.

Refill paper towels.

Fill in Performance Check Sheet (Exhibit 1: CDRL A001) after completion of each service.

6.3 Check sheets for Portable Toilets shall be placed on the inside of the door, between the middle and top of the door, and stored inside a clear protective sleeve. Check sheets for Hand Wash Stations shall be stored in the nearest Portable Chemical Toilet, below the toilet check sheet, and in the same state. Check sheets shall be numbered to identify which unit it belongs to.

Check sheets shall be initialed, by the servicing personnel, for all applicable duties accomplished. An “N/A” shall be placed in any block that is not applicable. The Performance Check Sheet (Exhibit 1: CDRL A001) will be the only check sheet format used during the performance of this contract.

6.4 Upon request of COR, relocation of existing toilets to an alternate location shall be accomplished within 5 business days when requested by the COR.

6.5 Unscheduled servicing of units, IAW COR request, shall be completed within an 8 hour period of request.

6.6 Pumping Equipment shall meet the following requirements:

Equipment shall be self-propelled or trailer mounted.

Gasoline or diesel powered and shall be self – contained.

Outfitted with an on-board pump, hoses and storage tank.

Some travel may be required on hilly terrain and unimproved roads, and the proposed pumping equipment, whether trailer mounted or not, shall be capable of travel on this type of terrain.

All equipment shall be watertight to prevent spillage of liquids during transit between collection points and the disposal site.

Exterior of all equipment shall be clean and free of any residual materials or debris.

6.7 DISPOSAL of ALL contents collected from units shall be done at an approved site outside of RRAD.

6.8 Contractor shall provide for the safety and wellbeing of personnel employed in the administration of this contract. Contractor personnel shall be made aware, by the Contractor, of any hazards involved in the use of chemical products and/or toxic materials necessary to the execution of this contract, and instructed in their safe usage, handling, and disposal. The Government will be held blameless for any action on the Contractor's part or that of Contractor's employees or subcontractors which may result in illness, injury or death.

6.9 SDS (Exhibit 1: CDRL A001) shall be maintained on file and present where any hazardous materials may be stored, transported, or used in the execution of contract requirements. Copies of each SDS shall also be furnished by email to the COR 24 hours PRIOR to starting work on a delivery order.

6.10 Excess chemicals and/or toxic materials used in execution of Contract requirements are considered Hazardous Waste. They shall be removed from the installation and disposed of in accordance with all applicable local, state and federal regulations.

6.11 The Contractor or representative shall immediately report any employee accidents, injuries or occupational illnesses, regardless of the severity, to RRAD Safety, Security Office, and the COR. Records shall be maintained of any accident resulting in traumatic injury or death, or resulting in damage to Government property, supplies and equipment.

6.12 A representative appointed by the Contractor should be present at RRAD during Contractor’s working hours or be available by phone. The name and phone number for this representative shall be provided to the KO and COR within three calendar days following the award of the contract. An alternate may be required if the Contractor has numerous employees.

7. Reporting & Inspection/Acceptance

7.1 Reporting will be accomplished through the use of Performance Check Sheets and Monthly Invoicing Report.

7.1.1 Exhibit 1: CDRL A001- Performance Check Sheets shall be completed IAW stated instructions located in Section 6.3. Performance Check Sheets shall be submitted with Exhibit 2: Monthly Invoice Report

7.1.2 Exhibit 1: CDRL A001- Monthly Invoice Report shall be completed and electronically submitted to the COR within 5 business days of invoice submission to Wide Area Work Flow (WAWF).

7.2 Inspection/Acceptance of monthly services will be accomplished by the COR’s verification that each unit was serviced IAW criteria set forth in Section 6- Performance Requirements.

8. Invoicing

8.1 Invoicing will be completed by submitting a single, monthly invoice to Wide

Area Work Flow (WAWF) portal. Contractor shall be responsible for registering and creating an account through https://wawf.eb.mil/xhtml/unauth/help/helpvendors.xhtml

INSTRUCTION TO OFFERS

INSTRUCTIONS TO OFFERORS

INSTRUCTIONS TO OFFERORS

Offerors are required to complete the following items. Failure to complete these items could result in rejection of your offer.

FOB: __________________________ (Destination Preferred) All unit cost must contain freight charges.

Proposed Delivery: ________________________Days Clearly state whether all line items meets the required delivery!

Price quoted from, Published Price List, Give Date: _________________________

Origin of manufacturer: U.S. _______________ Other ___________________ Minimum order or dollar amount: ____________________________ Did you package multiple line items? If so, which ones? N/A Payment Terms: ____________________________ Federal Tax Identification Number: ________________________ Dun & Bradstreet Number: ___________________________ Cage Code Number: ___________________________ Fax Number: _________________________ E-Mail Address: ________________________________ Submittals: All quotes shall include descriptive materials that demonstrate the capabilities of the item or items proposed. If proposing an "or equal" product, the submittals must clearly reflect conformity to each of the salient characteristics listed in the specifications. The Government reserves the right to make an award based on initial quote submissions. Failure to submit descriptive material which clearly reflects conformance with the specifications may result in your quote being rendered nonresponsiveand being rejected. If submitting a quote on the exact brand name and part number specified no descriptive material is required.

Offers shall be submitted in FBO or by email to christopher.l.johnston20.civ@mail.mil

CLAUSES INCORPORATED BY REFERENCE

52.203-3 Gratuities APR 1984 52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber

Content Paper

MAY 2011

52.212-1 Instructions to Offerors--Commercial Items OCT 2015 52.212-4 Contract Terms and Conditions--Commercial Items MAY 2015 52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran-- Representation and Certifications.

OCT 2015

52.237-2 Protection Of Government Buildings, Equipment, And Vegetation

APR 1984

252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.204-7012 Safeguarding Covered Defense Information and Cyber Incident Reporting.

DEC 2015

252.232-7003 Electronic Submission of Payment Requests and Receiving Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006

CLAUSES INCORPORATED BY FULL TEXT

52.209-4020 ANTI-TERRORISM (AT) LEVEL I TRAINING REQUIREMENT (JUN 2012) (TACOM)

All contractor employees, including subcontractor employees, requiring access to Army installations, facilities, or controlled access areas shall complete AT Level I awareness training within 60 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever applies. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee to the COR (or to the contracting officer, if a COR is not assigned) within 60 calendar days after completion of training by all employees and subcontractor personnel. AT Level I awareness training is available at https://atlevel1.dtic.mil/at.

52.209-4022 iWATCH TRAINING (JUN 2012) (TACOM)

The contractor and all associated subcontractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity Anti-Terrorism Officer (ATO)). This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 60 calendar days of contract award and within 60 calendar days of new employees’ commencing performance, with the results reported to the COR no later than 60 calendar days after contract award.

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:

Evaluation on will be based on FAR Part 12- Commercial Items. Award will be made to the lowest response offer.

(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 (JUL 2016)

ALTERNATE I (OCT 2014)

The offeror shall complete only paragraphs (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 (r) of this provision.

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

“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.

“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.

“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.

“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 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.

(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 on the SAMwebsite.

(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 representation 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 (q) 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 to 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: 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 certified in accordance with 13 CFR part 126; and

(ii) It [ ___ ] is, [ ___ ] is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: ___ .] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(11) (Complete if the offeror has represented itself as disadvantaged in paragraph (c)(4) of this provision.)

[The offeror shall check the category in which its ownership falls]:

___ Black American.

___ Hispanic American.

___ Native American (American Indians, Eskimos, Aleuts, or Native Hawaiians).

___ Asian-Pacific American (persons with origins from Burma, Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China, Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines, Republic of Palau, Republic of the Marshall Islands, Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).

___ Subcontinent Asian (Asian-Indian) American (persons with origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the Maldives Islands, or Nepal).

___ Individual/concern, other than one of the preceding.

(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.