W911SA-16-T-0046_Solicitation.docx

W911SA-16-T-0046

Section SF 1449 - CONTINUATION SHEET

Rubber Mulch Year 1

FFP

Contractor shall manufacture and deliver 3/8" to 3/4" Uncoated Black Rubber Mulch in accordance with the terms and conditions of the solicitation and resultant contract. The minimum volume the rubber mulch shall be packaged as, is 1 ton. Year 1 POP : February 28, 2016 - February 27, 2017 FOB: Destination

PURCHASE REQUEST NUMBER: 0010779825-0001

NET AMT

Rubber Mulch Year 2

Contractor shall manufacture and deliver 3/8" to 3/4" Uncoated Black Rubber Mulch in accordance with the terms and conditions of the solicitation and resultant contract. The minimum volume the rubber mulch shall be packaged as, is 1 ton. Year 1 POP : February 28, 2017 - February 27, 2018

NET AMT

Rubber Mulch Year 3

Contractor shall manufacture and deliver 3/8" to 3/4" Uncoated Black Rubber Mulch in accordance with the terms and conditions of the solicitation and resultant contract. The minimum volume the rubber mulch shall be packaged as, is 1 ton. Year 1 POP : February 28, 2018 - February 27, 2019

NET AMT

SUPPLEMENTAL INFORMATION

1. Request for Quote (RFQ) for the manufacture and delivery of rubber mulch to Fort McCoy, WI. The resultant contract will be a Firm-Fixed Price, multiple year, Indefinite Delivery Indefinite Quantity contract. The period of performance is 28 February 2016 (or subsequent date) through 27 February 2019 and a six month option to extend.

2. Place of Delivery: Fort McCoy, WI, with delivery locations within Fort McCoy boundaries. Exact locations to be determined with each delivery order. Government will offload the materials at a designated site.

3. This procurement is Set-Aside for Small Business under the NAICS Code 326299 with a size standard of 500 Employees.

4. All discourse concerning this solicitation and its requirement shall be directed to the Fort McCoy Contracting Office. Any remarks, explanations, or answers provided by any other Government Representative shall not change or qualify any of the terms or conditions of the solicitation. The solicitation shall only be changed by a written amendment issued by the Fort McCoy Contracting Office.

5. An award for this requirement will be made pursuant to FAR Part 13.5, Simplified Procedures for Certain Commercial Items and FAR Part 12, Acquisition of Commercial Items.

6. The contractor shall accept payment via credit card for projects authorized by the ordering officers and that have followed the required policies and procedures within this solicitation and resultant contract.

7. This will be a single award Indefinite Delivery/Indefinite Quantity (IDIQ) type contract.

The minimum guarantee for the first year is 61 tons.

There is no minimum guarantee beyond the first year.

In accordance with FAR 52.216-22, “Indefinite Quantity”, the quantities specified in the CLINs are estimates only and are not purchased by this contract.

The Government pays only for the actual quantities ordered and received by contract delivery order. The Government reserves the right to order the maximum quantities and is obligated to order only the minimum guarantee.

8. Anticipated contract ordering periods are as follows:

Year 1: 28 February 2016 - 27 February 2017 Year 2: 28 February 2017 - 27 February 2018 Year 3: 28 February 2018 - 27 February 2019

9. In accordance with Clause 252.216-7006, Ordering, :

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the contract schedule. Such orders may be issued prior to the expiration of the contract.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c)(1) If issued electronically, the order is considered “issued” when a copy has been posted to the Electronic Document Access system, and notice has been sent to the Contractor.

(2) If mailed or transmitted by facsimile, a delivery order or task order is considered “issued” when the Government deposits the order in the mail or transmits by facsimile. Mailing includes transmittal by U.S. mail or private delivery services.

(3) Orders may be issued orally only if authorized in the schedule.

10. Ordering Officer: Work required under this contract shall be ordered by issuance of delivery orders by designated Government activities. The activity shown in block 9 of the SF 1449 is authorized to issue delivery orders.

ORDERING OFFICIAL/OFFICER

There will be a designated Ordering Official under this contract, authorized to make purchases up to their designated authority of $25,000, per single known requirement, against this IDIQ contract.

Orders under this threshold will not be issued on an individual Delivery Order FORM 1449, however, all requirements of the contract award, and all policies and procedures will be applicable to orders by the designated official.

Prices and Salient Features for the project will still require agreement/approval by the ordering official.

The ordering officials will administer and be the main POC for all orders placed under their authority.

The names and contact information for these individuals will be included in the resultant contract.

The following describes the procedures to be used for ordering items under this contract by using the Federal Government-wide purchase card. This option to order by use of the Government-wide purchase card is strictly an alternative method of ordering by the Government and may be used in place of ordering by other order forms that comply with FAR 12.204. The Government reserves the right to unilaterally terminate the use of the credit card at any time.

All ordering officers may use the Government-wide purchase card, commonly referred to as the Government "credit card," as an alternative method of ordering and paying for purchases made under this contract. Purchase card orders are subject to all terms and conditions of this contract, unless otherwise stated in this provision or another provision or clause in this contract.

The purchase card is specifically designed for use by the Federal Government. The purchase card is like a typical commercial credit card. However, the authorization limitations of the purchase card are more specific, i.e., only for a particular contract, monthly limitations, certain categories of products or services, etc. The purchase card will be exclusively used for official Government purchases in accordance with the prices, terms, and conditions of this contract. The purchase card order limitation shall be $25,000. With respect to ordering authority, only designated Ordering Officers may use the purchase card as a means of purchasing items on this contract.

Credit limits for the purchase card for ordering officers is $25,000. These credit limits for the purchase card are the responsibility of the credit card holder and the approving office.

The contractor shall accept payment via credit card for projects authorized by the ordering officers and that have followed the required policies and procedures within this solicitation and resultant contract.

Invoices for orders placed by the ordering officer will be submitted directly to the ordering officer. However, use of WAWF to create and accept receiving reports is mandatory when the GPC is used as a method of payment against a contract. In order to ensure proper routing of contract transactions paid with the GPC, use the code "CRCARD" in the Pay Official/DoDAAC field. The contractor is required to generate a receiving report in WAWF, and the Government acceptor is required to accept the receiving report in WAWF. The Cardholder is required to verify that acceptance has occurred in WAWF prior to submitting the invoice to the Certifying Official for certification.

11. Quotes can be submitted in the following way:

Email: eve.k.day.civ@mail.mil

12. PERIOD FOR ACCEPTANCE OF QUOTES. The offeror agrees to hold the prices in its quote firm for 90 calendar days from the date specified for receipt of quotes.

13. Written questions must be furnished to the Government no later than 11 January 2016 at 04:00 PM (Central Time) in order to ensure a timely response is provided by the quote closing date. All questions are to be submitted in writing by the time indicated in the solicitation or they may not be addressed before solicitation closing date; therefore, Offerors are advised to submit questions as soon as possible. Please provide your company name, telephone number, point of contact, email address, and solicitation number on all questions. The Government will respond to all questions via the issuance of an amendment which incorporates the question and the Government’s response.

14. Functional POC: To be determined at the time of award (TBD)

15. Ordering Officer: TBD at time of Award.

16. Contract Administrator: TBD at time of award. If you have questions pertaining to this contract after contract award (i.e. questions regarding delivery, invoice procedures, etc.), please request assistance from the Contract Administrator. Be sure to include the contract number in your request for assistance. Requesting contract administration assistance from any other individual could result in a delayed response.

17. Contracting Officer: TBD at time of award.

18. Post award Conference: In the event the Contracting Officer decides to conduct a Post Award Conference in accordance with DFARS 242.5, the successful offeror will be notified and will be required to attend. The Contracting Officer’s notification will include specific details regarding the date, time, and location of the conference, any need for attendance by subcontractors, and information regarding the items to be discussed.

19. A DUNS number is required for SAM registration. If your company does not have a DUNS#, obtain one by calling 800-333-0505.

20. DUNS NUMBER ______________________________.

21. TAXPAYER ID #______________________________.

22. SYSTEM for AWARD MANAGEMENT (SAM) REGISTRATION: SAM Registration is required of all Department of Defense contractors. SAM registration enables electronic funds transfer of contract payments. If your company is not already registered, please register in the SAM database at www.sam.gov.

a. A DUNS number is required for SAM registration. If your company does not have DUNS #, obtain one by calling 800-333-0505.

b. Whether your company is a current or new registrant in the SAM database, your registration must indicate that you are a provider of NAICS 326299 under the Goods – Services section of the registration to be eligible to receive a contract for this solicitation.

c. If the prospective awardee for this request for quotes is not registered in the SAM database by close of solicitation, including NAICS 326299 under the Goods – Services section, depending on mission requirements, the government reserves the right to proceed to award to the next otherwise successful registered offeror.

23. REPRESENTATIONS AND CERTIFICATIONS REQUIREMENT: Prospective contractors must also complete electronic annual representations and certifications (FAR 52.212-3 Alternative 1 Offeror Representations and Certifications - Commercial Items) to include the DFARS Representations and Certifications at www.sam.gov in conjunction with required registration in the System for Award Management, www.sam.gov database by the request for quote closing date to be eligible to receive an award for this request for quote.

24. The “Equal Employment Opportunity Is The Law” notice (poster) referenced in FAR Clause 52.222-26(b)(3), Equal Opportunity, is located at http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf

25. Under Executive Order 11701 and the Contracts Clause entitled “Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era and Other eligible Veterans” (September 2006)(FAR 52.222-35), all Federal contractors with contracts of $100,000 or more must list job openings with the appropriate State Employment Service Office. If you have any questions about Executive Order 11701 or the Affirmative Action Program to encourage the hiring of veterans, please call the State Employment Office and ask for a Veteran’s Representative.

26. INFORMATION FOR EVALUATION

This section supplements clause 52.212-1 which is included elsewhere in this request for quote. The Government will award a contract resulting from this request for quote to the responsible offeror whose quote, conforming to the request for quote, will be most advantageous to the Government, price and other factors considered. The Government intends to evaluate quotes and award a contract without discussions with Offerors. Therefore, the offeror’s initial quote should contain the offeror’s best terms from a price and technical standpoint. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all quotes if such action is in the public interest; accept other than the lowest priced quotes; and waive informalities and minor irregularities in quotes received.

In case of discrepancy between a unit price and an extended price listed in the Item number, the unit price will be presumed to be correct, subject, however, to correction to the same extent and in the same manner as any other mistake.

This solicitation shall be evaluated by awarding to the quote that is technically acceptable and the lowest price.

TECHNICAL FACTOR:

In response to the solicitation/request for quote for this requirement, Offerors shall submit supporting documentation explicitly showing how the Salient Features and contract terms and conditions will be met.

Evaluation –Each item in Technical Requirements Table will receive one of the adjectival ratings defined below. Any criterion that receives “U” rating will result in an overall unacceptable rating for the factor and are not eligible for award.

The offeror meets the minimum salient features of all items being procured.

PRICE FACTOR:

Submission Instructions – Offerors shall submit a fully completed SF 1449, Pricing Schedule, or acceptable alternative as identified in 52.212-1 or elsewhere in the RFQ.

This solicitation shall be evaluated based on prices and specifications listed in each CLIN of the Solicitation.

Price will not be assigned an adjectival rating; and will be evaluated to determine if the Offeror's quoted price is fair, reasonable, and balanced. The Government may determine that a quote is unacceptable if prices are significantly unbalanced. Price shall be evaluated at estimated quantities multiplied times their respective unit price. In accordance with FAR 52.217-6 Option for Increased Quantity, 30% of the total contract quantity will also be evaluated. Offerors shall not submit a price for the potential 30% increase in quantity.

The government will not evaluate its option to extend services (see FAR Clause 52.217-8) as part of price evaluation. This option is only intended to extend the ordering period for any quantities not used, not add additional quantity. Offerors are required only to price the CLINs listed for years 1 through 3. Offerors shall not submit a price for the potential six month extension of services period (see FAR Clause 52.217-8) The Government may choose to exercise the Extension of Services at the end of any performance period, utilizing the rates of that performance period.

Unrealistically Low Prices: Unrealistically low quoted prices, initially or subsequently, may be grounds for eliminating a quote from competition.

Unbalanced Pricing: Offerors are cautioned against submitting a quote that contains unbalanced pricing. Unbalanced pricing exists when, despite an acceptable total evaluated price, the price of one or more contract line items is significantly over or understated as indicated by the application of cost or price analysis techniques. The Government shall analyze quotes to determine whether they are unbalanced with respect to separately priced line items or subline items. Quotes that are determined to be unbalanced may be rejected if the contracting officer determines that the lack of balance poses an unacceptable risk to the Government.

27. ALTERNATE DISPUTES RESOLUTION: In furtherance of Federal policy and the Administrative Dispute Resolution Act of 1990 (ADR Act), Public Law 101-552 and FAR Clause 52.233-1, Subparagraph (d) (2) (1) (B) (2), the Contracting Officer will try to resolve all post award acquisition issues in controversy by mutual agreement of both parties. Interested parties are encouraged to use alternative dispute resolution procedures to the maximum.

28. LEGAL COMPLIANCE: The Contractor shall comply with all Federal, State, and Local Laws, codes and regulations applicable to his performance under this contract, and shall be solely responsible for all costs associated with said compliance.

29. Security Requirements: The contractor and all associated subcontractors’ employees shall provide all information required for background checks to meet installation access requirements to be accomplished by Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. The contractor and all associated subcontractors’ employees shall also comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification Index (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes. The Government may require monthly participation in the Installation Random Antiterrorism Program.

30. RAPID GATE

Fort McCoy is offering an Installation Access Control Solution called the RAPIDGate Program. This program is available, with installation approval, to new and existing vendors, contractors, subcontractors and service providers who require routine access to Fort McCoy and desire streamlined entry into the Installation. This program is available at a registration cost to the company, with an additional fee per employee.

Through two integrated processes - Access Privilege Management and Enrollment/Registration - the RAPIDGate Program enables electronic verification of identity and access privileges at Fort McCoy's access control points (ACPs).

Companies choosing to participate in the RAPIDGate Program will have streamlined access onto the installation. Participants will have access through all gates that size permits (Main Gate and Gate 20) and will be subject to RANDOM vehicle inspections. At the Main Gate RAPIDGate participants will be able to use either lane, enabling fast access onto the installation through that gate.

Non-RAPIDGate participants and companies that choose not to participate in the RAPIDGate Program will be required to access the installation through Gate 20, whereby a Temporary day pass will be issued for each person. Contracts with a duration period of 30 days or less will be required to apply for a pass under an exception to policy. The maximum pass period AS an exception to policy is 30 days with approval by the DES Physical Security Branch. To apply for a 30 day pass, the company is required to provide Physical Security a copy of the contract award, along with identification.

Companies that service Fort McCoy may enroll in the RAPIDGate Program by calling 1-877-RAPIDGate (1-877-727-4342). The Program will confirm with the installation Physical Security Branch that the company has legitimate business on the installation. Once the company has enrolled, its employees can register at the self-service KIOSK Registration Stations located at the Fort McCoy Visitor Control Center (VCC) in building 35.

The RAPIDGate Program confirms the individual's employment status with the company, and then performs identity authentication and background screening. Employees who qualify are issued a personalized RAPIDGate ID Credential Badge. The Program performs background screening on a regular basis to verify continued eligibility in the Program.

Questions about the Fort McCoy RAPIDGate Program should be addressed to info@rapidgate.com with the subject line RE: RAPIDGate Program, or to the Physical Security Branch, Directorate of Emergency Services at 608-388-8445 or mark.a.reaves.civ@mail.mil.

31. ATTACHMENTS:

TITLE

Attachment 1 AT OPSEC

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

DELIVERY INFORMATION

27-FEB-2017

BARRY SCHROEDER

2786 W 14TH AVE

FORT MCCOY, WI WI 54656

W5CP3D

27-FEB-2018

W5CP3D

27-FEB-2019

W5CP3D

CLAUSES INCORPORATED BY REFERENCE

CLAUSES INCORPORATED BY FULL TEXT

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (NOV 2015) 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 accessed through http://www.acquisition.gov . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) 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 (p) 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. The offeror represents that --

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

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

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

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

(1) 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:

(iii) The offeror shall list those supplies that are foreign end products (other than those listed in paragraph (g)(1)(ii) or 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—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. If Alternate I to the clause at FAR 52.225-3 is included in this solicitation, substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the basic provision:

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

Canadian End Products:

Line Item No.:

[List as necessary]

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

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

Canadian or Israeli End Products:

(4) Buy American—Free Trade Agreements—Israeli Trade Act Certificate, Alternate III. If Alternate III to the clause at 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…