W912BU-16-T-0012.pdf

SEE ADDENDUM

(No Collect Calls)

W912BU-16-T-0012 29-Jan-2016

b. TELEPHONE NUMBER

215-656-6771

8. OFFER DUE DATE/LOCAL TIME

02:00 PM 18 Feb 2016

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA 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.

W912BU9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

BRUCE E HAYES

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

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

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

W25PHS51901111

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 ORX

SMALL BUSINESS

WOMEN-OWNED SMALL

BUSINESS (WOSB)

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

US ARMY ENGINEER DISTRICT, PHILADELPHIA

CONTRACTING DIVISION

WANAMAKER BUILDING

100 PENN SQUARE EAST

PHILADELPHIA PA 19107-3390

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 E5R0720 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

OPS PHYS SB-FT MIFF DISTRIB

FORT MIFFLIN DIST. CNTR U.S. ARMY RESERVATION

LIN

PHILADELPHIA PA 19153

TEL: FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL BUSINESS

(EDWOSB)

SIZE STANDARD:

1000 Employees

NAICS:

336611

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

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

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

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

24.22.21.19.

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF60

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.

W912BU-16-T-0012

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 2 Each

REPAIR DREDGE PUMP IMPELLORS

FFP

The Contractor will repair two large (10,000 lbs. each) alloy cast steel dredge pump impellers by welding, hard facing, and machining. All work shall be completed in accordance with the reference drawings and the specifications listed in the SOW.

FOB: Destination

MILSTRIP: W25PHS51901111

PURCHASE REQUEST NUMBER: W25PHS51901111

NET AMT

BID SHEET

SECTION B

SUPPLIES OR SERVICES AND PRICE/COSTS

Provide all necessary plant, labor, material, equipment and services to perform the specified work in accordance with these specifications, reference drawings and the terms and conditions of the solicitation.

CLIN DESCRIPTION QUANTITY U/M U/P Total AMOUNT

0001 REBUILD IMPELLERS 2 EA $__________ $__________

0002 PREPARE IMPELLER VANES 30 SF $__________ $__________

FOR HARDFACE BUILDUP

0003 HARDFACE IMPELLER VANES 30 SF $__________ $__________

0004 ADDITIONAL AREAS FOR 20 SF $__________ $__________

HARDFACE BUILDUP

0005 ADDITIONAL AREAS FOR 20 SF $__________ $__________

HARDFACING

0006 FABRICATE AND INSTALL 2 EA $__________ $__________

SLEEVES

0007 SHIPPING 1 LS $__________ $__________

CONTRACTING OFFICER AUTHORITY

"Only a warranted Contracting Officer (either a Procuring Contracting Officer (PCO), or an Administrative Contracting Officer (ACO)), acting within their delegated limits, has the authority to issue modifications or otherwise change the terms and conditions of this contract. If an individual other than the Contracting Officer attempts to make changes to the terms and conditions of this contract you shall not proceed with the change and shall immediately notify the Contracting Officer."

SYSTEM FOR AWARD MANAGEMENT REGISTRATION: All contractors are required to register in the System for Award Management (SAM) database before an award can be made.

Contractor’s can obtain information on registration and annual confirmation requirements by calling 866-606-8220 or via the Internet at https://www.sam.gov.

In accordance with FAR 52.204-10, “Reporting Executive Compensation and First-Tier Subcontract Awards,” contractors are required to report information on subcontract awards for all awards over $30,000.00. The contract shall follow the instructions and report the required information at http://www.fsrs.gov. The contractor is responsible for notifying its subcontractors that the required information will be made public.

Contractors who receive a federal contract in excess of $25,000.00 are required by legislation (FAR 22.1310(b)) to submit an annual VETS-100 Report on your employment of targeted veterans. Information on submitting your report may be obtained by calling 703-461-2460 or by accessing the following internet web site: http://www.dol.gov/vets/vets-100.html/.

STATEMENT OF WORK (SOW/PWS)

DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

Intent It is the intent of the Government to repair two large (10,000 lbs. each) alloy cast steel dredge pump impellers by welding, hard facing, and machining to prepare them for replacement for the ones currently in use on the Dredge McFARLAND. All work shall be completed in accordance with the reference drawings and these specifications.

The contractor shall provide all necessary labor, materials, services and equipment to perform and complete the work listed in this specification. The contractor is responsible for properly staging and coordinating the work listed herein to ensure it is completed within the time frame as specified below.

Upon completion of the repairs specified herein, the impellers shall be ready for installation without requiring further rework.

Contractor Requirements The specialized nature of the work described herein necessitates that award of this contract will be made only to a contractor who can demonstrate satisfactory completion of repairs to large steel impellers within the five-year period preceding RFQ closing date. Rebuilding of the impellers is a specialized task that can cause potential loss to the Government should the impellers become warped or cracked due to improper repairs.

Government-Furnished Equipment

Description Quantity Impellers (used) 2 each Plug Gage 1 Balancing Rig 1 Lifting Hook 1

Reference Drawings The Government shall furnish the following reference drawings:

Drawing Number Description MF-M6-12 Impellers MF-M6-18 Rig for Balancing Impellers Chemical Properties And Material Requirements The chemical characteristics of the impellers as originally specified are:

Carbon: Not to exceed 0.40% Chromium: 0.50% - 0.75% The chemical characteristics of the wearing sleeve: Centrifugally cast Stainless Steel Type 316L Material used for build-up of impellers shall be low carbon alloy steel with a deposited Brinell hardness of approximately 250. Material shall be Mackay C, BU-Cl, or approved substitute.

Hard facing wire shall be suitable for the intended service. It shall be a high carbon, chromium alloy steel. Hardness of second layer, as-deposited, shall be a nominal 41 Rockwell C. Material shall be Mackay Co. 244-0 or approved substitute.

The outer surface of sleeve shall be sprayed with a Nickel Chrome Boron fused powder coating. Prior to turning down of the sleeves, the contractor shall submit the technical and installation data on the proposed coating to the COR for review and approval.

The O.D. of each sleeve must have a finished coating thickness of 0.050” to 0.070”and a minimum hardness of 60 Rockwell C. Machine grind the O.D. surface to a 6-8 RMS finish.

NOTE: The contractor may elect to include a relief area at each end of the sleeve to aid in installation of the fused powder coating. This relief area shall be no more than 0.25” in length.

The I.D. of the sleeve shall have a normal surface finish of 125 RMS.

Final O.D. dimensions shall be in accordance with the reference drawing.

PreliminaryWork

a. Upon receipt, check impellers with plug gage to determine if distorted. Report all findings on a written Condition Report to the Contracting Officer’s Representative (COR).

b. The surface of each impeller shall be sandblasted to remove all dirt, rust, and other material. Impeller surfaces shall be made ready for acceptance of hard facing and wearing sleeves. All existing balance weights shall be removed.

c. Prior to any work on the impellers, check annular faces on each impeller for distortion and parallelism. Report all findings on a written Condition Report to the Contracting Officer’s Representative (COR). All checks for distortion and parallelism shall be witnessed by the COR.

d. Impellers have been rebuilt by welding before and have subsequently been used in service. All deteriorated hard facing and build-up material shall be removed to gain access to the base metal or existing build-up material that is satisfactory for overlay. Removal of hard facing and/or build-up material shall be by means of air-arc gouging followed by grinding for slag and carbon removal.

A one foot section of the top and bottom sides of the leading edges of all 5 vanes, of both impellers, shall have its hard facing completely renewed. All existing hard facing and build-up material shall be removed to gain access to the base metal in order to examine the base material and renew the hard facing.

Inspection of the remaining hard facing on the impeller may warrant additional hard facing renewal. After the inspection, a Condition Report shall be prepared and submitted to the COR detailing the extent of additional work.

A separate Contract line item has been established to fund this additional work.

e. The impeller shall be checked with the plug gage after all build-up material has been added, and again after hard-facing has been completed.

Weld Procedure

a. The contractor shall prepare and submit for approval a detailed weld repair procedure that includes, but is not limited to, the pre-heat and post-heat procedures for bringing the impeller up to temperature prior to and after all welding. This shall reflect both the application of replacement of base material build-up and subsequent hard facing.

b. Apply hard facing to the application area of the impeller to result in an approximate total hard-face thickness of 0.5625”. This shall be accomplished in no less than three passes.

c. Any sections of hard-facing on the suction and motor sides of the impellers that has pulled away from the impeller shall be repaired to the satisfaction of the COR at no additional cost to the Government. The contractor shall remove the hard-facing down to the base metal and reweld all layers in accordance with the specifications.

Machining and Repairs Upon completion of welding and cooling of the impellers, check for distortion as follows:

a. Using the plug gage and feeler gages, check both impeller faces for distortion. Impeller faces shall be checked for parallelism and verified by the COR. The contractor shall submit a written report of these findings to the Contracting Officer.

b. Hand grind or machine weld as necessary to fit gage. Both finished surfaces of the gage shall be given a coating of Cosmoline 1058. The rest of the gage shall be painted with a standard rust preventive primer and coat of machinery enamel. The plug gage shall then be substantially crated (in government furnished crate that gage was picked up in) for protection and shipped to Fort Mifflin Distribution Center, Philadelphia, Pennsylvania. Shipping costs shall be reflected in the bid price.

c. Any deteriorated threads shall be restored to contract drawing dimensions. Upon completion of this work, clean all threads, coat threads with grease, and protect threads from water intrusion by means of a plexiglass cover and silicone.

d. Remove existing wearing sleeves from hubs. Prepare sleeve landing area to ensure there are no surface imperfections that will allow new sleeve to bind during installation. Fabricate and install new centrifugally cast stainless steel type 316L wearing sleeves, with the coating system as described herein, using a hot-oil bath to evenly heat the sleeve.

e. After installation of the sleeve, each impeller shall be statically balanced on knife edges to within one pound at the periphery using Government furnished rig for balancing. Furnish and install balancing weights as necessary. Final balancing shall be witnessed by the COR.

f. All machined surfaces shall be machined in accordance with reference drawings.

Cleaning After all work is completed and inspected, the impellers shall be cleaned of all loose weld slag, paint, dirt and other debris.

PACKAGING AND MARKING

Special Marking Each impeller in this contract shall be stenciled in at least two locations with the following information:

• Spares Designation No. Port: MD-01-01-05 or Stbd: MD-01-01-06

• Weight: To be weighed by the Contractor

• Contract No.: W912BU-16-P-XXXX

Stencil markings shall in fade-resistant paint, 2" high and legible.

In order to aid in identifying the repaired impellers at a later date, the impellers shall be marked by "weld writing" with an electric arch electrode in a single pass. The writing shall be on the motor side face of each impeller, 1-2" high and state the following information:

• Serial Number of Impeller

• Repaired Date

• Name of Company

• Finished Weight of Impeller

• Port or Starboard All “weld writing” and stencil markings from previous repairs shall be removed. The motor side of the impellor is the side with the sleeve.

Preservation And Shipment Requirements

a. Preservation – In accordance with Requirements listed above.

b. Shipment – The contractor shall ship the impellers lying flat by truck to and from the destinations listed below and is responsible for all shipping costs. The contractor is responsible for obtaining all necessary permits and insurance ensuring that the casings are packaged to insure carrier acceptance and safe delivery to destination in a manner complying with the rules and regulations applicable to the mode of transportation.

The plug gage and balancing rig shall be returned in the same government furnished crate that was used to deliver them and will be substantially packaged for protection as specified.

INSPECTION AND ACCEPTANCE

Pre-Award Inspection It is recommended that potential vendors inspect the impellers since failure to do so will not relieve the contractor of the responsibility for performing the repairs necessary to restore the impellers to the satisfaction of the Contracting Officer's Representative (COR). Impellers are presently located at Fort Mifflin Distribution Center in Philadelphia, Pennsylvania.

Inspection of Repairs Inspection of the impeller repairs may be made by the COR during any stage of the repairs, including, but not limited to, inspection of prepared surfaces prior to and after weld repair.

However, these inspections shall not in any manner or form preclude the contractor from establishing a quality assurance program or inspection procedure to ensure complete and strict conformance to the specifications. Final inspection will be made by the COR at the repair facility prior to shipment. Any repairs not in exact accordance with the specifications will result in rejection of the repairs. The contractor shall notify the COR of the date on which the impellers will be ready for final inspection, a minimum of ten working days prior to the date.

The contractor shall provide all labor necessary to assist the COR with his inspections and shall give the COR a minimum of five working days advance notice of any inspection requiring his/her presence.

Preliminary And Final Acceptances Preliminary acceptance will occur at the contractor’s facility after the final inspection. Satisfactory preliminary acceptance means the impellers are ready for preservation, packaging and shipment to destination.

Final acceptance will not be made until the impellers have been delivered to the final destination and have been inspected to determine if the hardfacing has been damaged. Repairs to the hardfacing due to damage while in transit will be the responsibility of the contractor and shall be repaired at no additional cost to the Government.

DELIVERY AND PERFORMANCE

Shipment Destination

Pick up and Delivery shall be made by the contractor at the following destination:

Fort Mifflin Distribution Center U.S. Army Corps of Engineers Reservation 6400 Hog Island Road Philadelphia, PA 19153 P.O.C.: Mr. Richard Burns, Superintendent (215) 365-5095, FAX (215) 365-0808

The Government will provide crane/forklift services and rigging support to assist in loading and off- loading of the dredge pump impellers at the location listed above.

The contractor shall inform the Superintendent and Contracting Officer’s Representative of the pick-up and delivery dates of the impellers no less than five working days prior to pick-up and delivery. Both impellers shall be delivered as one shipment. No deliveries will be accepted on Saturdays and Sundays. Pick-up and delivery of the impellers shall be closely coordinated with the POC referenced above.

The contractor shall bear the cost of shipping the impellers to and from Fort Mifflin Distribution Center from their facility. The Government will be responsible for assisting the contractor with loading, after contract award and notice-to-proceed has been granted.

Time Of Delivery

The Government requires delivery to be made according to the following schedule:

DESCRIPTION

QUANTITY TIME

(Within the number of days stated below Impellers (Repaired) 2 No Later than 90 days after award

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A Government N/A Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 90 dys. ADC 2 OPS PHYS SB-FT MIFF DISTRIB

FORT MIFFLIN DIST. CNTR U.S. ARMY

RESERVATION

LIN

PHILADELPHIA PA 19153

FOB: Destination

E5R0720

CLAUSES INCORPORATED BY REFERENCE

52.203-17 Contractor Employee Whistleblower Rights and Requirement

To Inform Employees of Whistleblower Rights

APR 2014

52.204-7 System for Award Management JUL 2013 52.204-10 Reporting Executive Compensation and First-Tier

Subcontract Awards

OCT 2015

52.204-13 System for Award Management Maintenance JUL 2013 52.204-16 Commercial and Government Entity Code Reporting JUL 2015 52.204-17 Ownership or Control of Offeror NOV 2014 52.204-18 Commercial and Government Entity Code Maintenance JUL 2015 52.209-2 Prohibition on Contracting with Inverted Domestic

Corporations--Representation

NOV 2015

52.209-6 Protecting the Government's Interest When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment

OCT 2015

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

52.212-1 Instructions to Offerors--Commercial Items OCT 2015 52.212-2 Evaluation - Commercial Items OCT 2014 52.214-34 Submission Of Offers In The English Language APR 1991 52.214-35 Submission Of Offers In U.S. Currency APR 1991 52.222-3 Convict Labor JUN 2003 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity APR 2015 52.222-35 Equal Opportunity for Veterans OCT 2015 52.222-36 Equal Opportunity for Workers with Disabilities JUL 2014 52.222-41 Service Contract Labor Standards MAY 2014 52.222-50 Combating Trafficking in Persons MAR 2015 52.222-55 Minimum Wages Under Executive Order 13658 DEC 2014

52.223-18 Encouraging Contractor Policies To Ban Text Messaging While Driving

AUG 2011

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.225-20 Prohibition on Conducting Restricted Business Operations in

Sudan--Certification

AUG 2009

52.232-23 Alt I Assignment of Claims (May 2014) - Alternate I APR 1984 52.232-33 Payment by Electronic Funds Transfer--System for Award

Management

JUL 2013

52.232-40 Providing Accelerated Payments to Small Business Subcontractors

DEC 2013

52.233-1 Alt I Disputes (May 2014) - Alternate I DEC 1991 52.233-3 Protest After Award AUG 1996 52.237-3 Continuity Of Services JAN 1991 52.242-15 Stop-Work Order AUG 1989 52.253-1 Computer Generated Forms 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 252.204-7011 Alternative Line Item Structure SEP 2011 252.225-7001 Buy American And Balance Of Payments Program-- Basic

(Nov 2014)

NOV 2014

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2012 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991

CLAUSES INCORPORATED BY FULL TEXT

52.204-3 TAXPAYER IDENTIFICATION (OCT 1998)

(a) Definitions.

Common parent, as used in this provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.

Taxpayer Identification Number (TIN), as used in this provision, means the number required by the Internal Revenue Service (IRS) to be used by the offeror in reporting income tax and other returns. The TIN may be either a Social Security Number or an Employer Identification Number.

(b) All offerors must submit the information required in paragraphs (d) through (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the IRS. If the resulting contract is subject to the payment reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract.

(c) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN.

(d) Taxpayer Identification Number (TIN).

___ TIN:.--------------------------------------------------------

___ TIN has been applied for.

___ TIN is not required because:

___ Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;

___ Offeror is an agency or instrumentality of a foreign government;

___ Offeror is an agency or instrumentality of the Federal Government.

(e) Type of organization.

___ Sole proprietorship;

___ Partnership;

___ Corporate entity (not tax-exempt);

___ Corporate entity (tax-exempt);

___ Government entity (Federal, State, or local);

___ Foreign government;

___ International organization per 26 CFR 1.6049-4;

___ Other--------------------------------------------------------

(f) Common parent.

___ Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision.

___ Name and TIN of common parent:

Name-------------------------------------------------------------------

TIN--------------------------------------------------------------------

(End of provision)

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS (DEC

2014)

The Contractor's representations and certifications, including those completed electronically via the System for Award Management (SAM), are incorporated by reference into the contract.

(End of clause)

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:

LINE ITEM NO. COUNTRY OF ORIGIN

[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:

LINE ITEM NO. COUNTRY OF ORIGIN

[List as necessary]

(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:

LINE ITEM NO. COUNTRY OF ORIGIN

[List as necessary]

(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:

Line Item No.: Country of Origin:

[List as necessary]

(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:

Line Item No.: Country of Origin:

[List as necessary]

(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

Line Item No.: Country of Origin:

[List as necessary]

(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).