Solicitation_W9124M18Q0032.pdf

SEE ADDENDUM

(No Collect Calls)

W9124M18Q0032 24-Aug-2018

b. TELEPHONE NUMBER

912-767-5467

8. OFFER DUE DATE/LOCAL TIME

02:00 PM 28 Sep 2018

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.

W9124M9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JAMES E. SHUMAN

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

0011199057

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

MICC - FORT STEWART

976 WILLIAM H. WILSON AVE SUITE 100

FORT STEWART GA 31314

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: (912)767-8420 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 OF90

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.

W9124M18Q0032

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 240 Each Monthly Rental of PCLs

FFP

Monthly Rental of Portable Chemical Latrines (PCL) IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

PURCHASE REQUEST NUMBER: 0011199057

PSC CD: W045

NET AMT

0002 2,160 Each Service of Monthly Rented PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

0003 240 Each Daily Rental of PCLs

FFP

Daily Rental of Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

0004 240 Each Service of Daily Rented PCLs

FFP

Individual Service Performed IAW the PWS Paragraph 5.4 FOB: Destination

0005 24 Each Monthly Rental of HC PCLs

FFP

Monthly Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 2 Latrines x 12 Months) FOB: Destination

0006 216 Each Service of Monthly Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

0007 48 Each Daily Rental of HC PCLs

FFP

Daily Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 4 Latrines x 12 Months)

FOB: Destination

0008 48 Each Service of Daily Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

0009 36 Each Monthly Rental of HW Stations

FFP

Monthly Rental of Hand Wash (HW) Station IAW PWS Paragraph 5 (Approximately 3 Hand Wash Stations x 12 Months)

FOB: Destination

0010 324 Each Service of Monthly Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

0011 84 Each Daily Rental of HW Stations

FFP

Daily Rental of Hand Wash Station IAW PWS Paragraph 5 (Approximately 7 Hand Wash Stations x 12 Months)

FOB: Destination

0012 84 Each Service of Daily Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

0013 12 Each Relocation of Units

FFP

Relocation of PCLs and Hand Wash Stations IAW PWS Paragraph 5.5 FOB: Destination

0014 12 Each Unplanned Order Fee

FFP

Fee for Unplanned Orders in addition to the cost of rental. IAW PWS Paragraph 5.8 FOB: Destination

0015 1 Each Contract Manpower Reporting (CMR)

FFP

Cost of complying with CMR required in PWS Paragraph 5.9. There is no fee to register on the CMR website. This Contract Line Item Number (CLIN) provides a means for capturing the administrative expense of complying with this requirement. If this cost is accounted for in the other CLINs and will not be invoiced separately, enter a cost of “0” on this line.

FOB: Destination

1001 240 Each OPTION Monthly Rental of PCLs

FFP

Monthly Rental of Portable Chemical Latrines (PCL) IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

1002 2,160 Each OPTION Service of Monthly Rented PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

1003 240 Each OPTION Daily Rental of PCLs

FFP

Daily Rental of Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

1004 240 Each OPTION Service of Daily Rented PCLs

FFP

Individual Service Performed IAW the PWS Paragraph 5.4 FOB: Destination

1005 24 Each OPTION Monthly Rental of HC PCLs

FFP

Monthly Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 2 Latrines x 12 Months) FOB: Destination

1006 216 Each OPTION Service of Monthly Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

1007 48 Each OPTION Daily Rental of HC PCLs

FFP

Daily Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 4 Latrines x 12 Months)

FOB: Destination

1008 48 Each OPTION Service of Daily Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

1009 36 Each OPTION Monthly Rental of HW Stations

FFP

Monthly Rental of Hand Wash (HW) Station IAW PWS Paragraph 5 (Approximately 3 Hand Wash Stations x 12 Months)

FOB: Destination

1010 324 Each OPTION Service of Monthly Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

1011 84 Each OPTION Daily Rental of HW Stations

FFP

Daily Rental of Hand Wash Station IAW PWS Paragraph 5 (Approximately 7 Hand Wash Stations x 12 Months)

FOB: Destination

1012 84 Each OPTION Service of Daily Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

1013 12 Each OPTION Relocation of Units

FFP

Relocation of PCLs and Hand Wash Stations IAW PWS Paragraph 5.5 FOB: Destination

1014 12 Each OPTION Unplanned Order Fee

FFP

Fee for Unplanned Orders in addition to the cost of rental. IAW PWS Paragraph 5.8 FOB: Destination

1015 1 Each OPTION Contract Manpower Reporting (CMR)

FFP

Cost of complying with CMR required in PWS Paragraph 5.9. There is no fee to register on the CMR website. This Contract Line Item Number (CLIN) provides a means for capturing the administrative expense of complying with this requirement. If this cost is accounted for in the other CLINs and will not be invoiced separately, enter a cost of “0” on this line.

2001 240 Each OPTION Monthly Rental of PCLs

FFP

Monthly Rental of Portable Chemical Latrines (PCL) IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

2002 2,160 Each OPTION Service of Monthly Rented PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

2003 240 Each OPTION Daily Rental of PCLs

FFP

Daily Rental of Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

2004 240 Each OPTION Service of Daily Rented PCLs

FFP

Individual Service Performed IAW the PWS Paragraph 5.4 FOB: Destination

2005 24 Each OPTION Monthly Rental of HC PCLs

FFP

Monthly Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 2 Latrines x 12 Months) FOB: Destination

2006 216 Each OPTION Service of Monthly Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

2007 48 Each OPTION Daily Rental of HC PCLs

FFP

Daily Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 4 Latrines x 12 Months)

FOB: Destination

2008 48 Each OPTION Service of Daily Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

2009 36 Each OPTION Monthly Rental of HW Stations

FFP

Monthly Rental of Hand Wash (HW) Station IAW PWS Paragraph 5 (Approximately 3 Hand Wash Stations x 12 Months)

FOB: Destination

2010 324 Each OPTION Service of Monthly Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

2011 84 Each OPTION Daily Rental of HW Stations

FFP

Daily Rental of Hand Wash Station IAW PWS Paragraph 5 (Approximately 7 Hand Wash Stations x 12 Months)

FOB: Destination

2012 84 Each OPTION Service of Daily Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

2013 12 Each OPTION Relocation of Units

FFP

Relocation of PCLs and Hand Wash Stations IAW PWS Paragraph 5.5 FOB: Destination

2014 12 Each OPTION Unplanned Order Fee

FFP

Fee for Unplanned Orders in addition to the cost of rental. IAW PWS Paragraph 5.8 FOB: Destination

2015 1 Each OPTION Contract Manpower Reporting (CMR)

FFP

Cost of complying with CMR required in PWS Paragraph 5.9. There is no fee to register on the CMR website. This Contract Line Item Number (CLIN) provides a means for capturing the administrative expense of complying with this requirement. If this cost is accounted for in the other CLINs and will not be invoiced separately, enter a cost of “0” on this line.

3001 240 Each OPTION Monthly Rental of PCLs

FFP

Monthly Rental of Portable Chemical Latrines (PCL) IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

3002 2,160 Each OPTION Service of Monthly Rented PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

3003 240 Each OPTION Daily Rental of PCLs

FFP

Daily Rental of Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

3004 240 Each OPTION Service of Daily Rented PCLs

FFP

Individual Service Performed IAW the PWS Paragraph 5.4 FOB: Destination

3005 24 Each OPTION Monthly Rental of HC PCLs

FFP

Monthly Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 2 Latrines x 12 Months) FOB: Destination

3006 216 Each OPTION Service of Monthly Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

3007 48 Each OPTION Daily Rental of HC PCLs

FFP

Daily Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 4 Latrines x 12 Months)

FOB: Destination

3008 48 Each OPTION Service of Daily Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

3009 36 Each OPTION Monthly Rental of HW Stations

FFP

Monthly Rental of Hand Wash (HW) Station IAW PWS Paragraph 5 (Approximately 3 Hand Wash Stations x 12 Months)

FOB: Destination

3010 324 Each OPTION Service of Monthly Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

3011 84 Each OPTION Daily Rental of HW Stations

FFP

Daily Rental of Hand Wash Station IAW PWS Paragraph 5 (Approximately 7 Hand Wash Stations x 12 Months)

FOB: Destination

3012 84 Each OPTION Service of Daily Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

3013 12 Each OPTION Relocation of Units

FFP

Relocation of PCLs and Hand Wash Stations IAW PWS Paragraph 5.5 FOB: Destination

3014 12 Each OPTION Unplanned Order Fee

FFP

Fee for Unplanned Orders in addition to the cost of rental. IAW PWS Paragraph 5.8 FOB: Destination

3015 1 Each OPTION Contract Manpower Reporting (CMR)

FFP

Cost of complying with CMR required in PWS Paragraph 5.9. There is no fee to register on the CMR website. This Contract Line Item Number (CLIN) provides a means for capturing the administrative expense of complying with this requirement. If this cost is accounted for in the other CLINs and will not be invoiced separately, enter a cost of “0” on this line.

4001 240 Each OPTION Monthly Rental of PCLs

FFP

Monthly Rental of Portable Chemical Latrines (PCL) IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

4002 2,160 Each OPTION Service of Monthly Rented PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

4003 240 Each OPTION Daily Rental of PCLs

FFP

Daily Rental of Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 20 Latrines x 12 Months)

FOB: Destination

4004 240 Each OPTION Service of Daily Rented PCLs

FFP

Individual Service Performed IAW the PWS Paragraph 5.4 FOB: Destination

4005 24 Each OPTION Monthly Rental of HC PCLs

FFP

Monthly Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 2 Latrines x 12 Months) FOB: Destination

4006 216 Each OPTION Service of Monthly Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

4007 48 Each OPTION Daily Rental of HC PCLs

FFP

Daily Rental of Handicap Accessible Portable Chemical Latrines IAW PWS Paragraph 5 (Approximately 4 Latrines x 12 Months)

FOB: Destination

4008 48 Each OPTION Service of Daily Rented HC PCLs

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

4009 36 Each OPTION Monthly Rental of HW Stations

FFP

Monthly Rental of Hand Wash (HW) Station IAW PWS Paragraph 5 (Approximately 3 Hand Wash Stations x 12 Months)

FOB: Destination

4010 324 Each OPTION Service of Monthly Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

4011 84 Each OPTION Daily Rental of HW Stations

FFP

Daily Rental of Hand Wash Station IAW PWS Paragraph 5 (Approximately 7 Hand Wash Stations x 12 Months)

FOB: Destination

4012 84 Each OPTION Service of Daily Rented HW Stations

FFP

Individual Service Performed IAW PWS Paragraph 5.4 FOB: Destination

4013 12 Each OPTION Relocation of Units

FFP

Relocation of PCLs and Hand Wash Stations IAW PWS Paragraph 5.5 FOB: Destination

4014 12 Each OPTION Unplanned Order Fee

FFP

Fee for Unplanned Orders in addition to the cost of rental. IAW PWS Paragraph 5.8 FOB: Destination

4015 1 Each OPTION Contract Manpower Reporting (CMR)

FFP

Cost of complying with CMR required in PWS Paragraph 5.9. There is no fee to register on the CMR website. This Contract Line Item Number (CLIN) provides a means for capturing the administrative expense of complying with this requirement. If this cost is accounted for in the other CLINs and will not be invoiced separately, enter a cost of “0” on this line.

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 01-NOV-2018 TO

31-OCT-2019

N/A DPW FORT STEWART

CHRISTIAN ROBERTS

399 STEPHEN DOUGLAS ST

HUNTER ARMY AIRFIELD GA 31409-4627

(912) 315-5828

W33Q9Y

0002 POP 01-NOV-2018 TO

31-OCT-2019

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0004 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0005 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0006 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0007 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0008 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0009 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0010 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0011 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0012 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0013 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0014 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

0015 POP 01-NOV-2018 TO

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 01-NOV-2019 TO

31-OCT-2020

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1004 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1005 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1006 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1007 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1008 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1009 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1010 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1011 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1012 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1013 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1014 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

1015 POP 01-NOV-2019 TO

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 01-NOV-2020 TO

31-OCT-2021

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2004 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2005 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2006 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2007 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2008 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2009 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2010 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2011 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2012 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2013 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2014 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

2015 POP 01-NOV-2020 TO

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 01-NOV-2021 TO

31-OCT-2022

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3003 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3004 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3005 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3006 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3007 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3008 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3009 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3010 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3011 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3012 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3013 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3014 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

3015 POP 01-NOV-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 01-NOV-2022 TO

31-OCT-2023

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4004 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4005 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4006 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4007 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4008 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4009 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4010 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4011 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4012 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4013 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4014 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

4015 POP 01-NOV-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.203-12 Limitation On Payments To Influence Certain Federal

Transactions

OCT 2010

52.204-7 System for Award Management OCT 2016 52.204-9 Personal Identity Verification of Contractor Personnel JAN 2011 52.204-13 System for Award Management Maintenance OCT 2016 52.204-16 Commercial and Government Entity Code Reporting JUL 2016 52.204-18 Commercial and Government Entity Code Maintenance JUL 2016 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.212-1 Instructions to Offerors--Commercial Items JAN 2017 52.212-2 Evaluation - Commercial Items OCT 2014 52.212-4 Contract Terms and Conditions--Commercial Items JAN 2017 52.217-5 Evaluation Of Options JUL 1990 52.223-3 Hazardous Material Identification And Material Safety Data JAN 1997 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2011 52.228-5 Insurance - Work On A Government Installation JAN 1997 52.232-18 Availability Of Funds APR 1984 52.232-37 Multiple Payment Arrangements MAY 1999 52.232-39 Unenforceability of Unauthorized Obligations JUN 2013 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-1 Disputes MAY 2014 52.237-1 Site Visit APR 1984 52.237-2 Protection Of Government Buildings, Equipment, And

Vegetation

APR 1984

52.237-3 Continuity Of Services JAN 1991 252.201-7000 Contracting Officer's Representative DEC 1991 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights SEP 2013 252.203-7005 Representation Relating to Compensation of Former DoD

Officials

NOV 2011

252.204-7003 Control Of Government Personnel Work Product APR 1992 252.209-7004 Subcontracting With Firms That Are Owned or Controlled By

The Government of a Country that is a State Sponsor of Terrorism

OCT 2015

252.223-7006 Prohibition On Storage, Treatment, and Disposal of Toxic or Hazardous Materials

SEP 2014

252.243-7001 Pricing Of Contract Modifications DEC 1991

ADDENDUM TO 52.212.1

Solicitation provision 52.212-1, Instruction to Offerors – Commercial Items, is tailored as follows:

Paragraph (b)(11), in Submission of offers, is deleted.

Paragraph (c), Period for acceptance of offers, 30 calendar days is changed to 90 calendar days.

Paragraph (d), Product samples, is deleted.

Paragraph (g), Contract award, add the following: If discussion are held, a competitive range will be determined and offerors notified. The Contracting Officer may limit the competitive range for purposes of efficiency IAW FAR Part

15.306 (c)(2).

Paragraph (h), Multiple awards, is deleted.

Paragraph (i), Availability of requirements documents cited in the solicitation, is deleted.

The following paragraphs are added to provide specific instructions.

(m) Offer submittal and inquiries.

(1) Offers must review Provision 52.212-2, Evaluation - Commercial Items. Offerors are responsible for providing the information required by this provision.

(2) Offers may be submitted via mail, email, or hand delivered (email is preferred) to both of the Points of Contact listed below. Submission must be received no later than the date and time in Block 8 of the SF 1449.

It is the contractor’s responsibility to confirm receipt of correspondence. Email submittals should include the solicitation number in the subject of the email. Emails shall be kept to a file size of less than 10 megabytes, or separated into multiple emails with the number of emails identified in the subject line (1 of __, 2 of __, etc). It is the responsibility of the offeror to verify that the emailed offer has been received timely. Fax submittals will not be accepted.

(3) Site Visit: A site visit will only be conducted if requested. Request must be received no later than 8:00 AM on 10 SEP 2018.

(4) Any questions regarding this solicitation must be submitted in writing no later than 14 SEP 2018.

Submit all questions to both of the Points of Contact below.

(5) Points of Contact:

Michelle Spence Jim Shuman Phone: 912-767-2448 Phone: 912-767-5467 michelle.a.spence2.civ@mail.mil james.e.shuman.civ@mail.mil

(6) Mailing Address:

MICC Fort Stewart Michelle Spence / Jim Shuman

ATTN: W9124M-18-Q-0032

976 William H Wilson AVE, Suite 100 Fort Stewart, GA. 31314

(n) Proposal content.

(1) Request for Proposal Documents: Offerors are required to submit a completed Standard Form (SF) 1449.

Failure to follow the below contract proposal preparation instructions may cause your proposal to be deemed unacceptable by the Government.

(i) SF 1449: This form must be fully completed and signed in block 20. The contractor shall acknowledge any amendments to the RFQ in accordance with the instructions on the SF 1449 (page 1of the SF30 amendment must be signed and return).

(ii) Price Schedule: The Price Schedule shall be submitted fully completed and error free. Prices should show each unit price and total amount for each line item. The offeror shall ensure the units prices are represented in two decimal positions only (example: $0.27, not 0.27458).

(iii) Representations and Certifications: The offeror shall ensure that provisions 5212-3 Offeror Representations and Certifications – Commercial Items; and 52.219-1, Small Business Program Representations ALT I are completed and submitted with all blocks in each certification/representation completed truthfully and completely. Offerors are not required to complete this provision if they have completed Online Representations and Certifications in the System for Award Management and no changes are necessary.

(2) Technical Submission: The offer must at a minimum demonstrate the following:

- The company and project manager have 3 years of PCL experience performing service of a similar magnitude and complexity.

- The company possesses or has access to the required equipment including: pump trucks, hand wash stations, standard PCLs, and handicap PCLs.

- A plan for meeting the 12 hour emergency response time in PWS paragraph 5.7.

(3) Past Performance: The offeror shall describe their record of past performance with services similar in nature, size, and complexity. Offerors shall submit a list of relevant contracts performed within the past 3 years including current work. Past performance information shall be presented in the following format. Data that is not current or references that can no longer be reached will be discarded and not considered.

- Customer Name

- Contract number, contract value, and period of performance

- Description of the work and how it is relevant to this solicitation

- Points of contact with telephone numbers and e-mail addresses

(End of Addendum)

ADDENDUM TO 52.212-2

Solicitation provision 52.212-2, Evaluation – Commercial Items, is tailored as follows:

Paragraph (a), (b), and (c) are deleted and hereby replaced as follows:

(a) Basis for Contract Award: This is a best value source selection conducted in accordance with Federal Acquisition Regulation (FAR) 15.3, Source Selection, as supplemented by the Defense Federal Acquisition Regulation Supplement (DFARS), and the Army Federal Acquisition Regulation Supplement (AFARS). Award will be made to a single offeror who is deemed responsible in accordance with the FAR; whose offer conforms to the solicitation requirements; and is judged by an overall assessment to be the Lowest Priced Technically Acceptable offer. Trade-offs between cost/price and non-cost/price factors are not permitted.

(b) Evaluation Criteria: each proposals will be evaluated under three evaluation factors: Technical Acceptability, Past Performance, and Price.

(1) Technical Expertise: In evaluating this element, the assessment will concentrate on the offeror’s experience as it relates to performing this requirement. The offeror’s proposal must demonstrate technical expertise associated with the requirement. Failure to provide technical expertise similar to the requirement may result in a determination that offeror’s proposal is unacceptable. The proposal is acceptable when the offeror’s proposal demonstrates experience in meeting or exceeding the PWS requirements without introducing unacceptable risk to the project.

The Technical Factor will receive one of the ratings defined below:

Rating Description

Acceptable Proposal clearly meets the minimum requirements of the solicitation.

Unacceptable Proposal does not clearly meet the minimum requirements of the solicitation.

(2) Past Performance: The Past Performance evaluation will assess the offeror’s probability of meeting the solicitation’s requirements as indicated by that offeror’s record of past performance. Past Performance is assessed at the factor level after evaluating aspects of the offeror’s recent past performance and focusing on performance that is relevant to the services being procured under this solicitation. Offerors should be aware that in conducting the performance risk assessment, the Government may use data provided in the offeror’s proposal and data obtained from other sources, such as the Past Performance Information Retrieval System (PPIRS) or similar systems. Past performance areas of evaluation include: Quality of Service, Business Relations, Cost Control, and Customer Satisfaction. Each factor above will be assessed on:

(i) Recency: An assessment of the past performance information will be made to determine if it is recent.

To be recent, the effort must be ongoing or must have been performed during the past 3 years from the date of issuance of this solicitation. Past performance information that fails this condition will not be evaluated.

(ii) Relevancy Assessment: The Government will conduct an evaluation of all recent performance information obtained to determine if it is the same or similar in nature, size, and complexity to the services/products being procured under this solicitation. A relevancy determination of the offeror’s past performance will be made. In determining relevancy for individual contracts, consideration will be given to the effort, or portion of the effort, being proposed by the offeror or subcontractor whose contract is being reviewed and evaluated. The past performance information provided in the proposal and information obtained from other sources will be used to establish the degree of relevancy of past performance.

Offerors without a record of relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned, the offeror may not be evaluated favorably or unfavorably on past performance. Therefore, the offeror shall be determined to have unknown past performance. In the context of acceptability/unacceptability, “unknown” shall be considered “acceptable.” The Past Performance Factor will be assigned one of the ratings defined below:

Rating Description

Acceptable Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown.

Unacceptable Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

(3) Price: Offers will be evaluated to determine if they are unreasonably high or unrealistically low in relation to other offers. Proposed prices will also be evaluated against the market value for other services currently being performed and the Independent Government Estimate (IGE). Offers with prices that are unreasonably high, unrealistically low, unbalanced (IAW FAR 15.404-1(g)), or do not support the technical solution may be eliminated from competition on the basis that the offeror does not understand the requirement or the offer represents too great a risk.

(c) 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. Evaluation of options shall not obligate the Government to exercise the option(s). As part of price evaluation, the Government will evaluate its option to extend services (see FAR Clause 52.217-8) by adding one-half of the offeror's final option period price to the offeror's total price. Thus, the offeror's total price for the purpose of evaluation will include the base period, all options, and 1/2 of the last option. Offerors are not required to enter a price for the six-month period.

(d) 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)

ADDENDUM TO 52.212-4

Contract Clause 52.212-4, Contract Terms and Conditions – Commercial Items, is tailored as follows:

The following paragraphs have been added:

(w) Required Insurance

In accordance with FAR clause 52.228-5 entitled, “Insurance--Work on a Government Installation” the following minimum amounts of insurance are required.

Workmen’s Compensation As required by Federal and State laws Employer’s Liability Insurance $100,000

General Liability Insurance Bodily Injury Liability $500,000 per occurrence Auto Liability Insurance $200,000 per person Bodily Injury $500,000 per occurrence Property Damage $300,000 per occurrence

(End of Addendum)

CLAUSES INCORPORATED BY FULL TEXT

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

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 (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.

“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 (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 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…