W911S618R0004.docx

W911S618R0004

Section SF 1449 - CONTINUATION SHEET

CCTS Service Agreement Base Period

FFP

Annual Preventive Maintenance (PM) and Support plan for eight 3D-Track/CCTS (Chemical Cloud Tracking System) units including all parts of the P&T (Pan & Tilt), CPK (Communication Power Kit), and all parts of the sensor head. Once the CCTS units have had PM completed the contractor shall maintain and repair any parts that break under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See Performance Work Statement (PWS) located below in full text. The Government will issue task orders for this line item.

For Gov't Use Only: HR # W30MX1. POC = TBD FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

SHIP VIA: Best Way ( Shippers Option)

PSC CD: J066

NET AMT

CryoCooler Service Agreement Base Period

Annual Preventive Maintenance (PM) and Support plan for the CryoCoolers of eight CCTS units. Under the PM plan and associated support, the vendor will refurbish the cryocoolers as required and replace any cryocooler that fails under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See PWS located below in full text. The Government will issue task orders for this line item.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

eCMRA - Personnel Reporting System

Base Period - Reporting of Contractor Manpower Data Elements in accordance with the Department of Army Personnel Reporting System. SEE PWS for Instructions RE eCMRA.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

CCTS Hardware Upgrades Base Period

This CLIN is associated with the Instruments and hardware for the CCTS. This is a line item for instrument and hardware upgrades to meet testing requirements. The upgrade is expected to be a one-time action and shall be accomplished via task order. See PWS located below in full text.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

CCTS Software Upgrades Base Period

Software upgrades to the CCTS to support testing requirements. This line item is for software upgrades to meet CCTS testing requirements.

No minimum quantities for software upgrades are guaranteed. The Government shall notify the Contractor when software upgrades for the CCTS are required. The Contractor shall submit a fixed-price quote to provide the required software upgrades. The Government will issue task orders for any software upgrades ordered under this line item. See PWS located below in full text. See pricing schedule for labor rates (for any installation or programming labor).

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for eight 3D-Track/CCTS (Chemical Cloud Tracking System) units including all parts of the P&T (Pan & Tilt), CPK (Communication Power Kit), and all parts of the sensor head. Once the CCTS units have had PM completed the contractor shall maintain and repair any parts that break under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See Performance Work Statement (PWS) located below in full text. The Government will issue task orders for this line item.

For Gov't Use Only: HR # W30MX1. POC = TBD FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for the CryoCoolers of eight CCTS units. Under the PM plan and associated support, the vendor will refurbish the cryocoolers as required and replace any cryocooler that fails under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See PWS located below in full text. The Government will issue task orders for this line item.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Reporting of Contractor Manpower Data Elements in accordance with the Department of Army Personnel Reporting System. SEE PWS for Instructions RE eCMRA.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

This CLIN is associated with the Instruments and hardware for the CCTS. This is a line item for instrument and hardware upgrades to meet testing requirements. The upgrade is expected to be a one-time action and shall be accomplished via task order. See PWS located below in full text.

NET AMT

FFP

Software upgrades to the CCTS to support testing requirements. This line item is for software upgrades to meet CCTS testing requirements.

No minimum quantities for software upgrades are guaranteed. The Government shall notify the Contractor when software upgrades for the CCTS are required. The Contractor shall submit a fixed-price quote to provide the required software upgrades. The Government will issue task orders for any software upgrades ordered under this line item. See PWS located below in full text. See pricing schedule for labor rates (for any installation or programming labor).

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for eight 3D-Track/CCTS (Chemical Cloud Tracking System) units including all parts of the P&T (Pan & Tilt), CPK (Communication Power Kit), and all parts of the sensor head. Once the CCTS units have had PM completed the contractor shall maintain and repair any parts that break under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See Performance Work Statement (PWS) located below in full text. The Government will issue task orders for this line item.

For Gov't Use Only: HR # W30MX1. POC = TBD FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for the CryoCoolers of eight CCTS units. Under the PM plan and associated support, the vendor will refurbish the cryocoolers as required and replace any cryocooler that fails under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See PWS located below in full text. The Government will issue task orders for this line item.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Reporting of Contractor Manpower Data Elements in accordance with the Department of Army Personnel Reporting System. SEE PWS for Instructions RE eCMRA.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

This CLIN is associated with the Instruments and hardware for the CCTS. This is a line item for instrument and hardware upgrades to meet testing requirements. The upgrade is expected to be a one-time action and shall be accomplished via task order. See PWS located below in full text.

NET AMT

FFP

Software upgrades to the CCTS to support testing requirements. This line item is for software upgrades to meet CCTS testing requirements.

No minimum quantities for software upgrades are guaranteed. The Government shall notify the Contractor when software upgrades for the CCTS are required. The Contractor shall submit a fixed-price quote to provide the required software upgrades. The Government will issue task orders for any software upgrades ordered under this line item. See PWS located below in full text. See pricing schedule for labor rates (for any installation or programming labor).

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for eight 3D-Track/CCTS (Chemical Cloud Tracking System) units including all parts of the P&T (Pan & Tilt), CPK (Communication Power Kit), and all parts of the sensor head. Once the CCTS units have had PM completed the contractor shall maintain and repair any parts that break under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See Performance Work Statement (PWS) located below in full text. The Government will issue task orders for this line item.

For Gov't Use Only: HR # W30MX1. POC = TBD FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for the CryoCoolers of eight CCTS units. Under the PM plan and associated support, the vendor will refurbish the cryocoolers as required and replace any cryocooler that fails under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See PWS located below in full text. The Government will issue task orders for this line item.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Reporting of Contractor Manpower Data Elements in accordance with the Department of Army Personnel Reporting System. SEE PWS for Instructions RE eCMRA.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

This CLIN is associated with the Instruments and hardware for the CCTS. This is a line item for instrument and hardware upgrades to meet testing requirements. The upgrade is expected to be a one-time action and shall be accomplished via task order. See PWS located below in full text.

NET AMT

FFP

Software upgrades to the CCTS to support testing requirements. This line item is for software upgrades to meet CCTS testing requirements.

No minimum quantities for software upgrades are guaranteed. The Government shall notify the Contractor when software upgrades for the CCTS are required. The Contractor shall submit a fixed-price quote to provide the required software upgrades. The Government will issue task orders for any software upgrades ordered under this line item. See PWS located below in full text. See pricing schedule for labor rates (for any installation or programming labor).

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for eight 3D-Track/CCTS (Chemical Cloud Tracking System) units including all parts of the P&T (Pan & Tilt), CPK (Communication Power Kit), and all parts of the sensor head. Once the CCTS units have had PM completed the contractor shall maintain and repair any parts that break under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See Performance Work Statement (PWS) located below in full text. The Government will issue task orders for this line item.

For Gov't Use Only: HR # W30MX1. POC = TBD FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Annual Preventive Maintenance (PM) and Support plan for the CryoCoolers of eight CCTS units. Under the PM plan and associated support, the vendor will refurbish the cryocoolers as required and replace any cryocooler that fails under normal wear during the period of performance. Repairs and maintenance may be performed at Dugway or the vendor's location. Dugway will pay for shipping the items to the vendor. The vendor will pay for shipping the items back to Dugway. See PWS located below in full text. The Government will issue task orders for this line item.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

FFP

Reporting of Contractor Manpower Data Elements in accordance with the Department of Army Personnel Reporting System. SEE PWS for Instructions RE eCMRA.

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

This CLIN is associated with the Instruments and hardware for the CCTS. This is a line item for instrument and hardware upgrades to meet testing requirements. The upgrade is expected to be a one-time action and shall be accomplished via task order. See PWS located below in full text.

NET AMT

FFP

Software upgrades to the CCTS to support testing requirements. This line item is for software upgrades to meet CCTS testing requirements.

No minimum quantities for software upgrades are guaranteed. The Government shall notify the Contractor when software upgrades for the CCTS are required. The Contractor shall submit a fixed-price quote to provide the required software upgrades. The Government will issue task orders for any software upgrades ordered under this line item. See PWS located below in full text. See pricing schedule for labor rates (for any installation or programming labor).

FOB: Destination

ADDITIONAL MARKINGS: MARK ALL DOCUMENTS W911S6-18-P-XXXX

NET AMT

CLIN MINIMUM/MAXIMUM QUANTITY AND CLIN VALUE

The minimum quantity(s) and CLIN value(s) for all orders issued against the CLIN(s) on this contract shall not be less than the minimum quantity(s) and CLIN value(s) stated in the following table. The maximum quantity(s) and CLIN value(s) for all orders issued against the CLIN(s) on this contract shall not exceed the maximum quantity(s) and CLIN value(s) stated in the following table.

CLIN

MINIMUM

QUANTITY

MINIMUM

AMOUNT

MAXIMUM

QUANTITY

MAXIMUM

AMOUNT

CLIN DELIVERY/TASK ORDER MINIMUM/MAXIMUM QUANTITY AND CLIN ORDER VALUE

The minimum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not be less than the minimum quantity and order value stated in the following table. The maximum quantity and order value for the given Delivery/Task Order issued for this CLIN shall not exceed the maximum quantity and order value stated in the following table.

CLIN

MINIMUM

QUANTITY

MINIMUM

AMOUNT

MAXIMUM

QUANTITY

MAXIMUM

AMOUNT

$25,000.00

1.00

$160,000.00

$2,500.00

5.00

$160,000.00

$100.00

1.00

$600.00

$25,000.00

1.00

$160,000.00

$25,000.00

1.00

$160,000.00

$25,000.00

1.00

$160,000.00

$25,000.00

1.00

$160,000.00

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

18-JUL-2019

RECEIVING OFFICE

ACCOUNTABLE PROPERTY OFFICER

5464 DOOLITTLE AVENUE

DUGWAY UT 84022-5001

W909NB

18-JUL-2019

W909NB

18-JUL-2019

W909NB

W909NB

W909NB

18-JUL-2020

W909NB

18-JUL-2020

W909NB

18-JUL-2020

W909NB

18-JUL-2020

W909NB

18-JUL-2020

W909NB

18-JUL-2021

W909NB

18-JUL-2021

W909NB

18-JUL-2021

W909NB

18-JUL-2021

W909NB

18-JUL-2021

W909NB

18-JUL-2022

W909NB

18-JUL-2022

W909NB

18-JUL-2022

W909NB

18-JUL-2022

W909NB

18-JUL-2022

W909NB

18-JUL-2023

W909NB

18-JUL-2023

W909NB

18-JUL-2023

W909NB

18-JUL-2023

W909NB

18-JUL-2023

W909NB

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2017)

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 (u) 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.

“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.

(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 (u) 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 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.

(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.

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

(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.

(d) Certifications and 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 either to the Equal Opportunity clause of this solicitation, the and

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

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

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

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

(e) Certification Regarding Payments to Influence Federal Transactions (31 U.S.C. 1352). (Applies only if the contract is expected to exceed $150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

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

(1) The offeror certifies that each end product, except those listed in paragraph (f)(2) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American--Supplies.”

(2) Foreign End Products:

(List as necessary)

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

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

(i) The offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms ``Bahrainian, Moroccan, Omani, Panamanian, or Peruvian end product,'' ``commercially available off-the-shelf (COTS) item,'' ``component,'' ``domestic end product,'' ``end product,'' ``foreign end product,'' ``Free Trade Agreement country,'' ``Free Trade Agreement country end product,'' ``Israeli end product,'' and ``United States'' are defined in the clause of this solicitation entitled ``Buy American--Free Trade Agreements--Israeli Trade Act.''

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

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

[List as necessary]

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation entitled "Buy American-Free Trade Agreements-Israeli Trade Act." The offeror shall list as other foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.”

Other Foreign End Products:

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

(2) Buy American Act-Free Trade Agreements-Israeli Trade Act Certificate, Alternate I (Jan 2004). If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

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

Canadian End Products:

Line Item No.

(3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate II (Jan 2004). If Alternate II to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

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

Canadian or Israeli End Products:

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

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

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

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

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

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

Other End Products:

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

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

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

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

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

(4) [ ___ ] Have, [ ___ ] have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,500 for which the liability remains unsatisfied.

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

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

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

(ii) Examples.

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

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS Office of Appeals Contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability.