Springfield NWS Lawncare.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE 17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

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

BELOW IS CHECKED

SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF.

DATED . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITON IS

UNRESTRICTED OR

NAICS:

SIZE STANDARD:

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

OFFER

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

EMERGING SMALL

BUSINESS

8(A)

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

ARE ARE NOT ATTACHED

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

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

RFQ IFB RFP

STANDARD FORM 1449 (REV. 3/2005) BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE

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

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE PARTIAL FINAL

SCHEDULE Continued

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

PAGE 3 OF 32 WC-133W-12-RQ-0177

QUOTES SHOULD BE SENT TO

SHELLEY.SMITH@NOAA.GOV, FAXED TO

816-274-6993, OR MAILED TO THE FOLLOWING

ADDRESS:

NOAA/AGO/ERAD

ATTN: SHELLEY SMITH

601 E 12TH STREET, ROOM 1756

KANSAS CITY MO 64106-2808

0001 BASE YEAR

PERIOD OF PERFORMANCE

4/1/2012 THROUGH 3/31/2013

PROVIDE TOOLS, EQUIPMENT, MATERIALS, LABOR,

AND SUPERVISION TO PROVIDE LAWN CARE AND

GROUNDS KEEPING SERVICES FOR THE NATIONAL

WEATHER SERVICE WEATHER FORECAST

OFFICE LOCATED AT 5805 WEST HIGHWAY EE,

SPRINGFIELD, MO 65802 IN ACCORDANCE WITH

THE STATEMENT OF WORK AND DEPARTMENT OF

LABOR WAGE DETERMINATION WD 05-2311 REV 12.

THE QUANTITIES LISTED BELOW ARE ESTIMATES

ONLY. CONTRACTOR WILL BE PAID FOR ACTUAL

WORK PERFORMED.

MOW GRASSY AREAS, TRIM AROUND BUILDING

AND STATIONARY OBJECTS, REMOVE WEEDS

FROM SHRUBBERY AND MULCH-COVERED AREAS,

EDGE SIDEWALKS, REMOVE CLIPPINGS AND

DEBRIS.

26 JOBS AT $__________ PER JOB

MOW FIELD AREAS, TRIM AROUND STATIONARY

OBJECTS, REMOVE CLIPPINGS AND DEBRIS.

5 JOBS AT $__________ PER JOB

PRUNE AND TRIM TREES AND SHRUBBERY IN

SPRING AND FALL

2 JOBS AT $__________ PER JOB

FERTILIZE WEEKLY MOW AREA IN SPRING,

SUMMER, AND FALL

3 JOBS AT $__________ PER JOB

HOURLY RATE FOR ADDITIONAL WORK OUTSIDE

OF THE STATEMENT OF WORK: $__________ PER

HOUR

Period of Performance: 04/01/2012 to 03/31/2013

1.00 LO

OPT

0002 OPTION YEAR 1

PERIOD OF PERFORMANCE

4/1/2013 THROUGH 3/31/2014

PROVIDE TOOLS, EQUIPMENT, MATERIALS, LABOR,

AND SUPERVISION TO PROVIDE LAWN CARE AND

GROUNDS KEEPING SERVICES FOR THE NATIONAL

WEATHER SERVICE WEATHER FORECAST

OFFICE LOCATED AT 5805 WEST HIGHWAY EE,

SPRINGFIELD, MO 65802 IN ACCORDANCE WITH

THE STATEMENT OF WORK AND THE APPLICABLE

DEPARTMENT OF LABOR WAGE DETERMINATION.

1.00 LO

PAGE 4 OF 32 WC-133W-12-RQ-0177

THE QUANTITIES LISTED BELOW ARE ESTIMATES

ONLY. CONTRACTOR WILL BE PAID FOR ACTUAL

WORK PERFORMED.

MOW GRASSY AREAS, TRIM AROUND BUILDING

AND STATIONARY OBJECTS, REMOVE WEEDS

FROM SHRUBBERY AND MULCH-COVERED AREAS,

EDGE SIDEWALKS, REMOVE CLIPPINGS AND

DEBRIS.

26 JOBS AT $__________ PER JOB

MOW FIELD AREAS, TRIM AROUND STATIONARY

OBJECTS, REMOVE CLIPPINGS AND DEBRIS.

5 JOBS AT $__________ PER JOB

PRUNE AND TRIM TREES AND SHRUBBERY IN

SPRING AND FALL

2 JOBS AT $__________ PER JOB

FERTILIZE WEEKLY MOW AREA IN SPRING,

SUMMER, AND FALL

3 JOBS AT $__________ PER JOB

HOURLY RATE FOR ADDITIONAL WORK OUTSIDE

OF THE STATEMENT OF WORK: $__________ PER

HOUR

Period of Performance: 04/01/2013 to 03/31/2014

OPT

0003 OPTION YEAR 2

PERIOD OF PERFORMANCE

4/1/2014 THROUGH 3/31/2015

PROVIDE TOOLS, EQUIPMENT, MATERIALS, LABOR,

AND SUPERVISION TO PROVIDE LAWN CARE AND

GROUNDS KEEPING SERVICES FOR THE NATIONAL

WEATHER SERVICE WEATHER FORECAST

OFFICE LOCATED AT 5805 WEST HIGHWAY EE,

SPRINGFIELD, MO 65802 IN ACCORDANCE WITH

THE STATEMENT OF WORK AND THE APPLICABLE

DEPARTMENT OF LABOR WAGE DETERMINATION.

THE QUANTITIES LISTED BELOW ARE ESTIMATES

ONLY. CONTRACTOR WILL BE PAID FOR ACTUAL

WORK PERFORMED.

MOW GRASSY AREAS, TRIM AROUND BUILDING

AND STATIONARY OBJECTS, REMOVE WEEDS

FROM SHRUBBERY AND MULCH-COVERED AREAS,

EDGE SIDEWALKS, REMOVE CLIPPINGS AND

DEBRIS.

26 JOBS AT $__________ PER JOB

MOW FIELD AREAS, TRIM AROUND STATIONARY

OBJECTS, REMOVE CLIPPINGS AND DEBRIS.

5 JOBS AT $__________ PER JOB

PRUNE AND TRIM TREES AND SHRUBBERY IN

SPRING AND FALL

2 JOBS AT $__________ PER JOB

FERTILIZE WEEKLY MOW AREA IN SPRING,

SUMMER, AND FALL

PAGE 5 OF 32 WC-133W-12-RQ-0177

3 JOBS AT $__________ PER JOB

HOURLY RATE FOR ADDITIONAL WORK OUTSIDE

OF THE STATEMENT OF WORK: $__________ PER

HOUR

Period of Performance: 04/01/2014 to 03/31/2015

OPT

0004 OPTION YEAR 3

PERIOD OF PERFORMANCE

4/1/2015 THROUGH 3/31/2016

PROVIDE TOOLS, EQUIPMENT, MATERIALS, LABOR,

AND SUPERVISION TO PROVIDE LAWN CARE AND

GROUNDS KEEPING SERVICES FOR THE NATIONAL

WEATHER SERVICE WEATHER FORECAST

OFFICE LOCATED AT 5805 WEST HIGHWAY EE,

SPRINGFIELD, MO 65802 IN ACCORDANCE WITH

THE STATEMENT OF WORK AND THE APPLICABLE

DEPARTMENT OF LABOR WAGE DETERMINATION.

THE QUANTITIES LISTED BELOW ARE ESTIMATES

ONLY. CONTRACTOR WILL BE PAID FOR ACTUAL

WORK PERFORMED.

MOW GRASSY AREAS, TRIM AROUND BUILDING

AND STATIONARY OBJECTS, REMOVE WEEDS

FROM SHRUBBERY AND MULCH-COVERED AREAS,

EDGE SIDEWALKS, REMOVE CLIPPINGS AND

DEBRIS.

26 JOBS AT $__________ PER JOB

MOW FIELD AREAS, TRIM AROUND STATIONARY

OBJECTS, REMOVE CLIPPINGS AND DEBRIS.

5 JOBS AT $__________ PER JOB

PRUNE AND TRIM TREES AND SHRUBBERY IN

SPRING AND FALL

2 JOBS AT $__________ PER JOB

FERTILIZE WEEKLY MOW AREA IN SPRING,

SUMMER, AND FALL

3 JOBS AT $__________ PER JOB

HOURLY RATE FOR ADDITIONAL WORK OUTSIDE

OF THE STATEMENT OF WORK: $__________ PER

HOUR

Period of Performance: 04/01/2015 to 03/31/2016

1.00 LO

OPT

0005 OPTION YEAR 4

PERIOD OF PERFORMANCE

4/1/2016 THROUGH 3/31/2017

PROVIDE TOOLS, EQUIPMENT, MATERIALS, LABOR,

AND SUPERVISION TO PROVIDE LAWN CARE AND

GROUNDS KEEPING SERVICES FOR THE NATIONAL

WEATHER SERVICE WEATHER FORECAST

OFFICE LOCATED AT 5805 WEST HIGHWAY EE,

SPRINGFIELD, MO 65802 IN ACCORDANCE WITH

THE STATEMENT OF WORK AND THE APPLICABLE

DEPARTMENT OF LABOR WAGE DETERMINATION.

PAGE 6 OF 32 WC-133W-12-RQ-0177

THE QUANTITIES LISTED BELOW ARE ESTIMATES

ONLY. CONTRACTOR WILL BE PAID FOR ACTUAL

WORK PERFORMED.

MOW GRASSY AREAS, TRIM AROUND BUILDING

AND STATIONARY OBJECTS, REMOVE WEEDS

FROM SHRUBBERY AND MULCH-COVERED AREAS,

EDGE SIDEWALKS, REMOVE CLIPPINGS AND

DEBRIS.

26 JOBS AT $__________ PER JOB

MOW FIELD AREAS, TRIM AROUND STATIONARY

OBJECTS, REMOVE CLIPPINGS AND DEBRIS.

5 JOBS AT $__________ PER JOB

PRUNE AND TRIM TREES AND SHRUBBERY IN

SPRING AND FALL

2 JOBS AT $__________ PER JOB

FERTILIZE WEEKLY MOW AREA IN SPRING,

SUMMER, AND FALL

3 JOBS AT $__________ PER JOB

HOURLY RATE FOR ADDITIONAL WORK OUTSIDE

OF THE STATEMENT OF WORK: $__________ PER

HOUR

INSTRUCTIONS TO QUOTERS:

QUOTERS MUST SUBMIT ALL QUESTIONS

CONCERNING THIS SOLICITATION BY E-MAIL OR

FAX WITHIN 5 DAYS OF THE ISSUANCE OF THIS

SOLICITATION.

THE GOVERNMENT INTENDS TO MAKE AN

AWARD TO THE RESPONSIVE RESPONSIBLE

QUOTER(S) PROVIDING THE BEST VALUE TO THE

GOVERNMENT, PRICE AND NON-PRICE FACTORS

CONSIDERED. "BEST VALUE" MEANS THE

EXPECTED OUTCOME OF AN ACQUISITION THAT,

IN THE GOVERNMENT'S ESTIMATION, PROVIDES

THE GREATEST OVERALL BENEFIT IN RESPONSE

TO THE REQUIREMENT.

THE GOVERNMENT RESERVES THE RIGHT TO

MAKE A COMPARATIVE EVALUATION OF QUOTES

IN DETERMINING BEST VALUE IN ACCORDANCE

WITH FAR 13.106-2(B)(3).

A SITE VISIT IS STRONGLY ENCOURAGED.

QUOTERS ARE STRONGLY ENCOURAGED TO

INSPECT THE SITE WHERE SERVICES ARE TO BE

PERFORMED AND TO SATISFY THEMSELVES AS TO

ALL GENERAL AND LOCAL CONDITIONS THAT MAY

AFFECT THE COST OF THE PERFORMANCE OF THE

CONTRACT, TO THE EXTENT SUCH INFORMATION

IS REASONABLY OBTAINABLE. IN NO EVENT WILL

A FAILURE TO INSPECT THE SITE CONSTITUTE

GROUNDS FOR A CLAIM AFTER AWARD OF THE

CONTRACT.

THE FOLLOWING INFORMATION IS TO BE

RETURNED:

PAGE 7 OF 32 WC-133W-12-RQ-0177

1) PAGE 1 (COMPLETE BLOCKS 17A, 30A, 30B, AND

30C).

2) PAGE 3-6 (FILL IN YOUR QUOTE/PRICES).

3) YOUR DUN & BRADSTREET (D&B) D-U-N-

S NUMBER. IF YOU DO NOT HAVE A DUNS

NUMBER, YOU MAY REQUEST ONE AT HTTP://

FEDGOV.DNB.WEBFORM.

4) VERIFICATION OF REGISTRATION IN THE

CENTRAL CONTRACTING REGISTRY DATABASE.

YOU MAY REGISTER AT WWW.CCR.GOV. A DUNS

NUMBER IS REQUIRED.

5) VENDOR REPRESENTATIONS AND

CERTIFICATIONS (COMPLETE FAR CLAUSE

52.212-3, OR CERTIFY COMPLETION IN ORCA AT

HTTPS://ORCA.BPN.GOV/).

6) AS REQUESTED IN 1352.213-70, PROVIDE

YOUR RESPONSE TO THE FACTORS USED TO

EVALUATE QUOTES. CONTRACTORS WHO DO NOT

RESPOND TO EACH EVALUATION FACTOR MAY BE

CONSIDERED NON-RESPONSIVE.

7) AS REQUESTED IN 1352.237-75, PROVIDE

THE NAME AND PHONE NUMBER OF THE LOCAL

CONTACT FOR THE VENDOR.

8) AN E-MAIL ADDRESS AND/OR FAX NUMBER

WHERE YOU CAN BE REACHED FOR FUTURE

CORRESPONDENCE.

Period of Performance: 04/01/2016 to 03/31/2017

Table of Contents

PAGE 8 OF 32 WC-133W-12-RQ-0177

SECTION

. 1 Clauses

PAGE 9 OF 32 WC-133W-12-RQ-0177

SECTION

. 1 Clauses

1. 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

2. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

3. 52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (FEB 2012)

4. 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (FEB 2012)

5. 52.212-4 CONTRACT TERMS AND CONDITIONS--COMMERCIAL ITEMS (FEB 2012)

6. 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR

EXECUTIVE ORDERS--COMMERCIAL ITEMS (MAR 2012)

7. 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

8. 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

9. 52.223-1 BIOBASED PRODUCT CERTIFICATION (DEC 2007)

10. 52.223-2 AFFIRMATIVE PROCUREMENT OF BIOBASED PRODUCTS UNDER SERVICE AND

CONSTRUCTION CONTRACTS (DEC 2007)

11. 52.223-10, WASTE REDUCTION PROGRAM (AUG 2000)

12. 52.223-11 OZONE-DEPLETING SUBSTANCES (MAR 2001)

13. 52.225-25 PROHIBITION ON ENGAGING IN SANCTIONED ACTIVITIES RELATING TO IRAN-

CERTIFICATION (SEP 2010)

14. Add 52.233-17, AFFIRMATIVE PROCUREMENT OF EPA-DESIGNATED ITEMS IN SERVICE AND

CONSTRUCTION CONTRACTS (MAY 2008)

15. 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

16. 52.237-2 PROTECTION OF GOVERNMENT BUILDINGS, EQUIPMENT, AND VEGETATION (APR 1984) . 26

17. 52.237-3 CONTINUITY OF SERVICES (JAN 1991)

18. 1352.201-70 CONTRACTING OFFICER'S AUTHORITY (APR 2010)

19. 1352.209-73 COMPLIANCE WITH THE LAWS (APR 2010)

20. 1352.209-74 ORGANIZATIONAL CONFLICT OF INTEREST (APR 2010)

21. 1352.213-70 EVALUATION UTILIZING SIMPLIFIED ACQUISITION PROCEDURES (APR 2010)

22. 1352.215-72 INQUIRIES (APR 2010)

23. 1352.228-70 INSURANCE COVERAGE (APR 2010)

24. 1352.228-72 DEDUCTIBLES UNDER REQUIRED INSURANCE COVERAGE- FIXED PRICE (APR 2010) .. 28

25. 1352.233-70 AGENCY PROTESTS (APR 2010)

26. 1352.233-71 GAO AND COURT OF FEDERAL CLAIMS PROTESTS (APR 2010)

27. 1352.237-75, KEY PERSONNEL (APRIL 2010)

28. 1352.246-70 PLACE OF ACCEPTANCE (APR 2010)

29. 1352.270-70 PERIOD OF PERFORMANCE (APR 2010)

30. IT SECURITY INFORMATION

31. STATEMENT OF WORK

1. 1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

PAGE 10 OF 32 WC-133W-12-RQ-0177

This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es):

https://www.acquisition.gov/FAR/

(End of Provision)

2. 2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): https://www.acquisition.gov/FAR/

(End of Clause)

3. 9 52.212-1 INSTRUCTIONS TO OFFERORS--COMMERCIAL ITEMS (FEB 2012)

(Reference 12.301)

4. 1

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (FEB

2012)

An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically via https://www.acquisition.gov. If an offeror has not completed the annual representations and certifications electronically at the ORCA website, the offeror shall complete only paragraphs (c) through (o) 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.

―Inverted domestic corporation‖, as used in this section, means a foreign incorporated entity which is treated as an inverted domestic corporation under 6 U.S.C. 395(b), i.e., a corporation that used to be incorporated in the

United States, or used to be a partnership in the United States, but now is incorporated in a foreign country, or is a subsidiary whose parent corporation is incorporated in a foreign country, that meets the criteria specified in 6

U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c). An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the

Internal Revenue Code at 26 U.S.C. 7874.

―Manufactured end product‖ means any end product in Federal Supply Classes (FSC) 1000-9999, except—

(1) FSC 5510, Lumber and Related Basic Wood Materials;

(2) Federal Supply Group (FSG) 87, Agricultural Supplies;

(3) FSG 88, Live Animals;

(4) FSG 89, Food and Related Consumables;

(5) FSC 9410, Crude Grades of Plant Materials;

PAGE 11 OF 32 WC-133W-12-RQ-0177

(6) FSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) FSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) FSC 9610, Ores;

(9) FSC 9620, Minerals, Natural and Synthetic; and

(10) FSC 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.

―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—

PAGE 12 OF 32 WC-133W-12-RQ-0177

(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 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 Online

Representations and Certifications Application (ORCA) website.

(2) The offeror has completed the annual representations and certifications electronically via the ORCA website accessed through https://www.acquisition.gov. After reviewing the ORCA database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ______________.

[Offeror to identify the applicable paragraphs at (c) through (o) 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 ORCA.]

(c) Offerors must complete the following representations when the resulting contract will be performed in the

United States or its outlying areas. Check all that apply.

(1) Small business concern. The offeror represents as part of its offer that it____is,____is not a small business concern.

(2) Veteran-owned small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents as part of its offer that it____is,____is not a veteran-owned small business concern.

(3) Service-disabled veteran-owned small business concern. [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (c)(2) of this provision.] The offeror represents as part of its offer that it____is,____is not a service-disabled veteran-owned small business concern.

(4) Small disadvantaged business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, for general statistical purposes, 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-

PAGE 13 OF 32 WC-133W-12-RQ-0177

owned small business concern.

(6) WOSB concern eligible under the WOSB Program. [Complete only if the offeror represented itself as a women-owned small business concern in paragraph (c)(5) of this provision.] The offeror represents that—

(i) It ___ is,____ is not a WOSB concern eligible under the WOSB Program, has provided all the required documents to the WOSB Repository, and no change in circumstances or adverse decisions have been issued that affects its eligibility; and

(ii) It ___ is,____ is not a joint venture that complies with the requirements of 13 CFR part 127, and the representation in paragraph (c)(6)(i) of this provision is accurate in reference to the WOSB concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the WOSB concern or concerns that are participating in the joint venture: __________.] Each WOSB concern 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 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)(7)(i) of this provision is accurate in reference to the EDWOSB concern or concerns that are participating in the joint venture. The offeror shall enter the name or names of the EDWOSB concern or concerns that are participating in the joint venture: __________. Each EDWOSB concern participating in the joint venture shall submit a separate signed copy of the EDWOSB representation.

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

(8) Women-owned business concern (other than small business concern). [Complete only if the offeror is a women-owned business concern and did not represent itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents that it____is a women-owned business concern.

(9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price:____________________________________

(10) [Complete only if the solicitation contains the clause at FAR 52.219-23, Notice of Price Evaluation

Adjustment for Small Disadvantaged Business Concerns, or FAR 52.219-25, Small Disadvantaged Business

Participation Program—Disadvantaged Status and Reporting, and the offeror desires a benefit based on its disadvantaged status.]

(i) General. The offeror represents that either—

(A) It ___ is,____ is not certified by the Small Business Administration as a small disadvantaged business concern and identified, on the date of this representation, as a certified small disadvantaged business concern in the CCR Dynamic Small Business Search database maintained by the Small Business Administration, and that no material change in disadvantaged ownership and control has occurred since its certification, and, where the concern is owned by one or more individuals claiming disadvantaged status, the net worth of each individual upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); or

(B) It ____ has, ____ has not submitted a completed application to the Small Business Administration or a Private Certifier to be certified as a small disadvantaged business concern in accordance with 13 CFR 124, Subpart B, and a decision on that application is pending, and that no material change in disadvantaged ownership and control has occurred since its application was submitted.

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(ii)____Joint Ventures under the Price Evaluation Adjustment for Small Disadvantaged Business

Concerns. The offeror represents, as part of its offer, that it is a joint venture that complies with the requirements in 13 CFR 124.1002(f) and that the representation in paragraph (c)(10)(i) of this provision is accurate for the small disadvantaged business concern that is participating in the joint venture. [The offeror shall enter the name of the small disadvantaged business concern that is participating in the joint venture: ________________.]

(11) 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)(11)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture: __________.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation.

(d) 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 Act Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act—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

PAGE 15 OF 32 WC-133W-12-RQ-0177

solicitation entitled ―Buy American Act—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 Act—Free Trade Agreements—Israeli Trade Act Certificate. (Applies only if the clause at

FAR 52.225-3, Buy American Act—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, 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 Act—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, or Peruvian end products) or Israeli end products as defined in the clause of this solicitation entitled ―Buy American Act—Free Trade Agreements—Israeli Trade Act‖:

Free Trade Agreement Country End Products (Other than Bahrainian, Moroccan, Omani, 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) of this provision) as defined in the clause of this solicitation entitled ―Buy American Act—

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

PAGE 16 OF 32 WC-133W-12-RQ-0177

[List as necessary]

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

(2) Buy American Act—Free Trade Agreements—Israeli Trade Act Certificate, Alternate I. 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 Act—Free Trade Agreements—Israeli Trade Act‖:

Canadian End Products:

Line Item No.

[List as necessary]

(3) Buy American Act—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 Act—Free Trade Agreements—

Israeli Trade Act‖:

Canadian or Israeli End Products:

Line Item

No.

Country of

Origin

[List as necessary]

(4) 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)(4)(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

PAGE 17 OF 32 WC-133W-12-RQ-0177

[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 Act. The Government will consider for award only offers of U.S.-made or designated country end products unless the Contracting Officer determines that there are no offers for such products or that the offers for such products are insufficient to fulfill the requirements of the solicitation.

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

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

(2) ____ Have, ____ have not, within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a Federal, state or local government contract or subcontract; violation of

Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property;

(3) ____ Are, ____ are not presently indicted for, or otherwise criminally or civilly charged by a

Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of this clause; and

(4) ____ Have, ____ have not, within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

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

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

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

(ii) Examples.

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

(B) The IRS has filed a notice of Federal tax lien with respect to an assessed tax liability, and the taxpayer has been issued a notice under I.R.C. §6320 entitling the taxpayer to request a hearing with the IRS

Office of Appeals contesting the lien filing, and to further appeal to the Tax Court if the IRS determines to sustain the lien filing. In the course of the hearing, the taxpayer is entitled to contest the underlying tax liability because the taxpayer has had no prior opportunity to contest the liability. This is not a delinquent tax because it is not a final tax liability. Should the taxpayer seek tax court review, this will not be a final tax liability until the taxpayer has exercised all judicial appeal rights.

(C) The taxpayer has entered into an installment agreement pursuant to I.R.C. §6159. The taxpayer is making timely payments and is in full compliance with the agreement terms. The taxpayer is not delinquent because the taxpayer is not currently required to make full payment.

PAGE 18 OF 32 WC-133W-12-RQ-0177

(D) The taxpayer has filed for bankruptcy protection. The taxpayer is not delinquent because enforced collection action is stayed under 11 U.S.C. §362 (the Bankruptcy Code).

(i) Certification Regarding Knowledge of Child Labor for Listed End Products (Executive Order 13126). [The

Contracting Officer must list in paragraph (i)(1) any end products being acquired under this solicitation that are included in the List of Products Requiring Contractor Certification as to Forced or Indentured Child Labor, unless excluded at 22.1503(b).]

(1) Listed end products.

Listed End

Product

Listed Countries of

Origin

(2) Certification. [If the Contracting Officer has identified end products and countries of origin in paragraph (i)(1) of this provision, then the offeror must certify to either (i)(2)(i) or (i)(2)(ii) by checking the appropriate block.]

[ ] (i) The offeror will not supply any end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product.

[ ] (ii) The offeror may supply an end product listed in paragraph (i)(1) of this provision that was mined, produced, or manufactured in the corresponding country as listed for that product. The offeror certifies that it has made a good faith effort to determine whether forced or indentured child labor was used to mine, produce, or manufacture any such end product furnished under this contract. On the basis of those efforts, the offeror certifies that it is not aware of any such use of child labor.

(j) Place of manufacture. (Does not apply unless the solicitation is predominantly for the acquisition of manufactured end products.) For statistical purposes only, the offeror shall indicate whether the place of manufacture of the end products it expects to provide in response to this solicitation is predominantly—

(1) ____ In the United States (Check this box if the total anticipated price of offered end products manufactured in the United States exceeds the total anticipated price of offered end products manufactured outside the United States); or

(2) ____ Outside the United States.

(k) Certificates regarding exemptions from the application of the Service Contract Act. (Certification by the offeror as to its compliance with respect to the contract also constitutes its certification as to compliance by its subcontractor if it subcontracts out the exempt services.) [The contracting officer is to check a box to indicate if paragraph (k)(1) or (k)(2) applies.]

[ ] (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The offeror ____ does ____ does not certify that—

(i) The items of equipment to be serviced under this contract are used regularly for other than

Governmental purposes and are sold or traded by the offeror (or subcontractor in the case of an exempt subcontract) in substantial quantities to the general public in the course of normal business operations;

(ii) The services will be furnished at prices which are, or are based on, established catalog or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair of such equipment; and

(iii) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract will be the same as that used for these employees and equivalent employees servicing the same equipment of commercial customers.

[ ] (2) Certain services as described in FAR 22.1003-4(d)(1). The offeror ____ does ____ does not certify that—

(i) The services under the contract are offered and sold regularly to non-Governmental customers, and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the general public in substantial

PAGE 19 OF 32 WC-133W-12-RQ-0177

quantities in the course of normal business operations;

(ii) The contract services will be furnished at prices that are, or are based on, established catalog or market prices (see FAR 22.1003-4(d)(2)(iii));

(iii) Each service employee who will perform the services under the contract will spend only a small portion of his or her time (a monthly average of less than 20 percent of the available hours on an annualized basis, or less than 20 percent of available hours during the contract period if the contract period is less than a month) servicing the Government contract; and

(iv) The compensation (wage and fringe benefits) plan for all service employees performing work under the contract is the same as that used for these employees and equivalent employees servicing commercial customers.

(3) If paragraph (k)(1) or (k)(2) of this clause applies—

(i) If the offeror does not certify to the conditions in paragraph (k)(1) or (k)(2) and the Contracting Officer did not attach a Service Contract Act wage determination to the solicitation, the offeror shall notify the Contracting

Officer as soon as possible; and

(ii) The Contracting Officer may not make an award to the offeror if the offeror fails to execute the certification in paragraph (k)(1) or (k)(2) of this clause or to contact the Contracting Officer as required in paragraph (k)(3)(i) of this clause.

(l) Taxpayer Identification Number (TIN) (26 U.S.C. 6109, 31 U.S.C. 7701). (Not applicable if the offeror is required to provide this information to a central contractor registration database to be eligible for award.)

(1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) 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 Internal Revenue Service (IRS).

(2) 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.

(3) 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.

(4) 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 ________________________________.

(5) Common parent.

____ Offeror is not owned or controlled by a common parent;

____ Name and TIN of common parent:

PAGE 20 OF 32 WC-133W-12-RQ-0177

Name ________________________________.

TIN _________________________________.

(m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the offeror does not conduct any restricted business operations in Sudan.

(n) Prohibition on Contracting with Inverted Domestic Corporations.

(1) Relation to Internal Revenue Code. An inverted domestic corporation as herein defined does not meet the definition of an inverted domestic corporation as defined by the Internal Revenue Code 25 U.S.C. 7874.

(2) Representation. By submission of its offer, the offeror represents that—

(i) It is not an inverted domestic corporation; and

(ii) It is not a subsidiary of an inverted domestic corporation.

(o) Sanctioned activities relating to Iran.

(1) The offeror shall e-mail questions concerning sensitive technology to the Department of State at

CISADA106@state.gov.

(2) Representation and Certification. Unless a waiver is granted or an exception applies as provided in paragraph (o)(3) of this provision, by submission of its offer, the offeror—

(i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive technology to the government of Iran or any entities or individuals owned or controlled by, or acting on behalf or at the direction of, the government of Iran; and

(ii) Certifies that the offeror, or any person owned or controlled by the…