ATTACHMENT A SUPPLIER CERTIFICATIONS

Transcription

1 ATTACHMENT A SUPPLIER CERTIFICATIONS AMG RFQ #: SUPPLIER NAME: AMG PART#: 9 DIGIT ZIP CODE (Manufacturing Location): If manufactured outside of U.S., indicate % of non-u.s. manufacture and country: % Country: QUALITY SYSTEM REGISTRATION: DATED: (Provide copy of registration certificate (e.g. ISO9001:2008, ISO/TS 16949, etc.)) SAM.GOV REGISTRATION: YES: EXPIRATION DATE: NO: Completed attachments must be submitted (required as indicated) with Supplier s response to RFQ. Applicable for Commercial Items? Applicable for Non-Commercial Items? Comments Offeror s Assertion Of Commerciality (page 2) Specialty Metals Survey (DFARS ; -7009) (page 4) Executive Compensation Reporting (as required per FAR ) (page 5) FAR , , , , DDTC and DFARS Certifications (Pages 6-9) Diminishing Manufacturing Sources and Material Shortages (DMSMS) Data Forms (pages 10-13) FAR Cost Accounting Standards Notices and Certification (Oct 2015) (pages 14-16) FAR Offeror Representations and Certifications -- Commercial Items (April 2016)(pages 17-33) FAR Annual Representations and Certifications (April 2016) (pages 34-38) AND DFARS , Alternate A, Annual Representations and Certifications (Jan 2015) (pages 39-41) Yes Yes Complete and Sign Yes Yes Complete and Sign Yes Yes Complete if anticipated award is greater than $25,000 (and meet stated criteria). Yes Yes Complete and Sign Yes No Yes Yes Complete form specific to Mechanical Parts, Electronic Parts, COTS Software or Custom Software Required when award is anticipated to be greater than $750,000. Does not apply to small businesses or foreign governments. Yes No ** See Note Below No Yes ** See Note Below ** Note: AMG encourages all suppliers to register and complete representations and certifications online at on an annual basis. After reviewing the SAM database information, the supplier verifies by submission of the offer that the representations and certifications currently posted electronically have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code), as of the date of this offer and are incorporated in this offer by reference (see FAR ); except for the changes identified below [supplier to insert changes, identifying change by clause number, title, date]. 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. Online certification alleviates the necessity of completing portions of the attached FAR /DFARS (Non- Commercial Items) and FAR (Commercial Items). Should a supplier opt not to register and complete representations and certifications online, copies of fully completed FAR /DFARS (for Non-Commercial items) or FAR (for Commercial items) must be submitted with each quote.

2 2 OFFEROR S ASSERTION OF COMMERCIALITY AMG Part No(s) and Description(s) Supplier (Offeror): Offeror is not asserting commerciality. (Check and sign below) Offeror is asserting commerciality. (Check, complete the following sections and sign below.) Offeror, hereby asserts to AM General that the following item(s) meet the definition provided in FAR for a commercial item or service. (If more than one type of exception is included for multiple items or services, please indicate which item or service corresponds to each type of exception claimed): Offeror asserts that the above items/services (please check any that apply): A. Are items that are not real property, are of a type customarily used by the general public, or by nongovernmental entities for purposes other than governmental purposes, and (i) has been sold, leased or licensed to the general public; of (ii) has been offered for sale, lease or license to the general public. OR B. Are items that have evolved through advances in technology or performance, from an item which fits the definition in paragraph A, are not yet available in the commercial marketplace, but will be available in the commercial marketplace in time to satisfy the delivery requirements of this purchase order; Identify original item, advances in technology and when item will be available within commercial marketplace. OR C. Are items that would satisfy a criterion expressed in paragraphs (A) or (B) above but for (check 1 or 2): (1) Modifications of a type customarily available in the commercial marketplace; Identify modification and where available within commercial marketplace. Provide a technical description of the differences between the proposed item and the comparison item: or (2) Minor modifications of a type not customarily available in the commercial marketplace made to meet Federal Government requirements. Minor modifications means modifications that do not significantly alter the nongovernmental function or essential physical characteristics of an item or component, or change the purpose of a process. Factors to be considered in determining whether a modification is minor include the value and size of the modification and the comparative value and size of the final product. Dollar values and percentages may be used as guideposts, but are not conclusive evidence that a modification is minor; Identify modification(s) and why item still fits definition of commercial item. Provide a technical description of the differences between the proposed item and the comparison item:

3 3 OR D. Are combinations of items meeting the requirements of this definition that are of a type customarily combined and sold in combination to the general public. Explain. OR E. Are installation services, maintenance services, repair services, training services, and other services if (i) Such services are procured for support of an item referred to in paragraph (A), (B), (C), or (D) of this definition, regardless of whether such services are provided by the same source or at the same time as the item; and (ii) the source of such services provides similar services contemporaneously to the general public under terms and conditions similar to those offered to the Federal Government; Explain. OR F. Are services of a type offered and sold competitively in substantial quantities in the commercial marketplace based on established catalog or market prices for specific tasks performed or specific outcomes to be achieved and under standard commercial terms and conditions. For purposes of these services (i) Catalog price means a price included in a catalog, price list, schedule, or other form that is regularly maintained by the manufacturer or vendor, is either published or otherwise available for inspection by customers, and states prices at which sales are currently, or were last, made to a significant number of buyers constituting the general public; and (ii) Market prices means current prices that are established in the course of ordinary trade between buyers and sellers free to bargain and that can be substantiated through competition or from sources independent of the offerors. Explain. Offeror must attach evidence of prices at which the same or similar items or services have been sold to the commercial market. Offeror further agrees that Offeror has on file, and will make available to AM General or the Government, upon request, documentary support for the assertions set forth above that is adequate to support those assertions to the satisfaction of AM General and the Government. Offeror grants AM General or the Government the right to examine, at any time before award, books, records, documents or other directly pertinent records to verify any request for an exception under the FAR s commercial item/services provision, and the reasonableness of price. Access does not extend to cost or profit information or other data relevant solely to the offeror s determination of the prices to be offered in the catalog or marketplace. This information will be provided in a format that is mutually acceptable to Offeror and AM General. Signature Date Printed Name Title

4 4 SPECIALTY METALS RESTRICTIONS DFARS (MAR 2013) and DFARS (OCT 2014) set forth requirements pertaining to the acquisition of specialty metals, and items containing specialty metals. Specifically, any specialty metals purchased or incorporated into items delivered under this contract must be melted or produced in the United States, its outlying areas, or a qualifying country (defined in DFARS ). The definition of specialty metals and additional information (including any exceptions) are indicated within DFARS and DFARS In order to ensure AM General satisfies its prime contract requirements regarding specialty metals, suppliers are required to complete and submit the following survey, prior to any subcontract/purchase order award. Specialty Metals Survey Part No. Questions No Yes 1. Does the manufactured part (indicated above) contain "specialty metals"? a. if no, your survey is completed (sign, date and return) b. if yes, answer question #2 2. Is the "specialty metal" melted or produced in the United States? a. If yes, your survey is completed (sign, date and return) b. if no, answer question #3 3. Does the manufactured article qualify for an exception identified within DFARS ? a. If yes, please detail below. Your survey is completed (sign, date and return) b. if no, answer question #4 4. Indicate whether a domestic source is known to be available. Signature Printed Name and Title Company Name Date Contact Contact Telephone Number

5 5 REPORTING OF EXECUTIVE COMPENSATION (IN ACCORDANCE WITH FAR ) FAR requires prime contractors to obtain and report executive compensation information from subcontractors. Specifically, the name and total compensation for a subcontractor s five most highly compensated executives must be reported within one month of subcontract award, and annually thereafter. This requirement pertains to subcontracts valued at $30,000 or more if (i) In the subcontractor s preceding fiscal year, the subcontractor received (A) 80 percent or more of its annual gross revenues from Federal contracts (and subcontracts), loans, grants (and subgrants) and cooperative agreements; and (B) $25,000,000 or more in annual gross revenues from Federal contracts (and subcontracts), loans, grants (and subgrants) and cooperative agreements; and (ii) The public does not have access to information about the compensation of the executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of (To determine if the public has access to the compensation information, see the U.S. Security and Exchange Commission total compensation filings at In order for AM General to comply with FAR , the following must be completed and submitted upon subcontract award, and annually thereafter. The subcontractor is indicating an exemption. (Check and identify relevant paragraph (i) or (ii) above.) If no exemption is indicated, complete the following table. Executive Name Total Compensation (for the subcontractor s preceding fiscal year). Total Compensation is calculated as indicated within FAR Prepared by: Name Date

6 6 REPRESENTATION REGARDING DEBARMENT, SUSPENSION, PROPOSED DEBARMENT OR DECLARED INELIGIBLE STATUS (Reference FAR ) 1. The Offeror represents that the Offeror and/or any of its Principals are not presently debarred, suspended, proposed for debarment by the Federal Government or declared ineligible for award of Government contracts or subcontracts; 2. The Offeror shall provide immediate written notice to the Buyer if the Offeror learns that its certification was erroneous when submitted or if the Offeror and/or any of its Principals hereafter becomes debarred, suspended, proposed for debarment by the Federal Government or declared ineligible for award of Government contracts or subcontracts. CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (Reference FAR ) (a) Definitions. As used in this provision Lobbying contact has the meaning provided at 2 U.S.C. 1602(8). The terms agency, influencing or attempting to influence, officer or employee of an agency, person, reasonable compensation, and regularly employed are defined in the FAR clause of this solicitation entitled Limitation on Payments to Influence Certain Federal Transactions ( ). (b) Prohibition. The prohibition and exceptions contained in the FAR clause of this solicitation entitled Limitation on Payments to Influence Certain Federal Transactions ( ) are hereby incorporated by reference in this provision. (c) Certification. The Offeror, by signing its offer, hereby 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 its behalf in connection with the awarding of this contract. (d) Disclosure. 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. (e) Penalty. Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by 31 U.S.C Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure required to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure. (f) Should the Offeror s circumstances change during the life of any resulting subcontract with respect to the above, the Offeror will notify Buyer immediately. CERTIFICATION REGARDING COMBATING TRAFFICKING IN PERSONS (REFERENCE FAR ) The Offeror/Subcontractor represents that it has read, understands and will comply with AM General s Anti Human Trafficking Policy as well as AM General s Subcontract Anti Human Trafficking Procedure (located at and chain/military.php respectively. Additionally, the Offeror/Subcontractor represents that it will also certify that it has implemented a human trafficking compliance plan and conducted due diligence as required by FAR (h) and (i), if the subcontract meets the threshold requirements set out in FAR (h) and (i).

7 7 The Offeror represents that it PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (Reference FAR ) 1. has participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation, the clause originally contained in Section 310 of Executive Order or the clause contained in Section 201 of Executive Order and has filed all required compliance reports; or 2. has participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation, the clause originally contained in Section 310 of Executive Order or the clause contained in Section 201 of Executive Order but has not filed all required compliance reports; or 3. has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation, the clause originally contained in Section 310 of Executive order or the clause contained in Section 201 of Executive Order and therefore no compliance reports have been required. 1. The Offeror represents that it: AFFIRMATIVE ACTION COMPLIANCE (Reference FAR ) a. has developed will maintain and has on file, or b. has not developed and does not have on file, at each establishment, a written affirmative action program required by the rules and regulations of the Secretary of Labor FR 60 1, 60 2 or 60 4). c. has not previously had contracts subject to the written affirmative action program requirement of the rules and regulations of the Secretary of Labor. 2. If 1.b is marked, then the Offeror represents that it will develop, maintain, update annually and have on file, at each establishment, a written affirmative action compliance program within 120 days from the commencement of any contract in excess of $50,000 it receives from the Buyer. PROVISIONS I THROUGH J OF THESE REPRESENTATIONS AND CERTIFICATIONS ARE NOT APPLICABLE WITH RESPECT TO WORK PERFORMED OUTSIDE OF THE UNITED STATES AND ITS OUTLYING AREAS. CERTIFICATION OF REGISTRATION WITH THE DIRECTORATE OF DEFENSE TRADE CONTROLS (DDTC) The Offeror certifies that it: is, or is not required to be registered to manufacture or export defense articles, or furnish defense services as required by the International Traffic in Arms Regulations (22 C.F.R. Part 122). If required to be registered, the Offeror certifies that it is currently registered with DDTC. CERTIFICATION (SIGNATURE) IS REQUIRED BY AN AUTHORIZED OFFICIAL VERIFYING THE INFORMATION CONTAINED IN THIS PACKAGE IS TRUE. (VOID UNLESS SIGNED)

8 8 DFARS BUY AMERICAN BALANCE OF PAYMENTS PROGRAM CERTIFICATE (Basic NOV 2014) (a) Definitions. Commercially available off the shelf (COTS) item, component, domestic end product, foreign end product, qualifying country, qualifying country end product, and United States as used in this provision, have the meanings given in the Buy American and Balance of Payments Program clause of this solicitation. (b) Evaluation. The Government (1) Will evaluate offers in accordance with the policies and procedures of Part 225 of the Defense Federal Acquisition Regulation Supplement; and (2) Will evaluate offers of qualifying country end products without regard to the restrictions of the Buy American statute or the Balance of Payments Program. (c) Certifications and identification of country of origin. (1) For all line items subject to the Buy American and Balance of Payments Program clause of this solicitation, the offeror certifies that (i) Each end product, except those listed in paragraphs (c)(2) or (3) of this provision, is a domestic end product; and (ii) For end products other than COTS items, components of unknown origin are considered to have been mined, produced, or manufactured outside the United States or a qualifying country. (2) The offeror certifies that the following end products are qualifying country end products: Line Item Number Country of Origin (3) The following end products are other foreign end products, including 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 (ii) of the definition of domestic end product : Line Item Number Country of Origin (If known) (End of provision)

9 9 OFFEROR S EXECUTION Offeror s signature below applies to all provisions (pages 5 8) above. Company: Date: Address: Offeror s Place of Performance (City/State/Country:) Name: Phone: Fax: Title: Signature

10 10 DMSMS DATA FORM Mechanical Parts Part Number: Vendor Name: Vendor Address: Part Description: Name of Preparer: Date of Survey: Vendor Representative: Vendor Phone Number: Vendor Cage Code: Data Provided by: Vendor DMSMS Plan Available? Yes / No 1. Is the part an active product? Yes / No 2. Is this part provided to any other customer? How many? 3. Are there different versions of this part being supplied to other customers? How many? 4. Do you manufacture this part or are you a distributor? Manufacturer Distributor As a manufacturer or a distributor, please answer the following questions. If you are a distributor, the following questions should be answered based on the OEM. 5. Is the part slated for obsolescence for any reason? Yes / No Reason? 6. What is the anticipated period of part production (start to finish)? Start Year Finish Year 7. What is the anticipated period of part warranty/service? Warranty Service 8. Are upgrades/newer versions of the part anticipated to be developed/provided? Yes / No Description of Upgrade: 9. If so, what is the anticipated time period(s) of introduction? Date: 10. Are you anticipating ceasing production of the original part once an update/new version is issued? Yes / No 11. Are any aspects of the part proved to you as a sole source or from an out-of-us supplier? List. 12. Are any of the aspects of the part covered by existing DMSMS or obsolescence notices? Provide description. 13. Additional Notes:

11 11 DMSMS DATA FORM Electronic Parts Part Number: Vendor Name: Vendor Address: Part Description: Name of Preparer: Date of Survey: Vendor Representative: Vendor Phone Number: Vendor Cage Code: Data Provided by: Vendor DMSMS Plan Available? Yes / No 1. Is the part an active product? Yes / No 2. Is this part provided to any other customer? How many? 3. Are there different versions of this part being supplied to other customers? How many? 4. Do you manufacture this part or are you a distributor? Manufacturer Distributor As a manufacturer or a distributor, please answer the following questions. If you are a distributor, the following questions should be answered based on the OEM. 5. Is the part slated for obsolescence for any reason? Yes / No Reason? 6. What is the anticipated period of part production (start to finish)? Start Year Finish Year 7. What is the anticipated period of part warranty/service? Warranty Service 8. Are upgrades/newer versions of the part anticipated to be developed/provided? Yes / No Description of Upgrade: 9. If so, what is the anticipated time period(s) of introduction? Date: 10. Are you anticipating ceasing production of the original part once an update/new version is issued? Yes / No 11. Are any aspects of the part proved to you as a sole source or from an out-of-us supplier? List. 12. Are any of the aspects of the part covered by existing DMSMS or obsolescence notices? Provide description. 13. Additional Notes:

12 12 DMSMS DATA FORM COTS Software Part Number: Vendor Name: Vendor Address: Part Description: Name of Preparer: Date of Survey: Vendor Representative: Vendor Phone Number: Vendor Cage Code: Data Provided by: Do you accomplish DMSMS analyses for your product line? Yes / No Vendor DMSMS Plan available? Part Questions 1. What is the current version/revision level of the software? 2. What is the basis for changing version/revision levels? 3. When was this product first available for sale? 4. Has this product ever been discontinued? 5. How long will license agreements for this product be obtainable? 6. How long will support for this product be obtainable? 7. Is there any anticipation to develop/allow third-party support after that? 8a. Are any upgrades/revisions currently planned? 8b. What is the time period for any revision/upgrade? 9. Will the planned revision/upgrade be backward compatible? 10. What are the different technical characteristics between the current and the planned revision/upgrade? 11. Will the planned revision/upgrade operate in the current hardware with the current software products (i.e., current operating system?) or are additional hardware/other applications anticipated/required? 12. Additional Notes:

13 13 DMSMS DATA FORM Custom Software Part Number: Vendor Name: Vendor Address: Part Description: Name of Preparer: Date of Survey: Vendor Representative: Vendor Phone Number: Vendor Cage Code: Data Provided by: Do you accomplish DMSMS analyses for your product line? Yes / No Vendor DMSMS Plan available? Part Questions 1. What is the current version/revision level of the software product? 2. Do you still have the ability to modify the software product? 3. Is the source code repository maintained? 4. Are the development tools maintained? 5. Are there any third-party components? 6. Are you able to compile those third-party components? 7. What is the planned product end of life? 8. What is the planned product end of support? 9. Will third-party support be available after that? If so, for how long? 10. Is there a planned replacement product? 11. Is the planned replacement product backwards compatible? 12. What development and testing hardware and software infrastructure are needed to maintain the software product? 13. Additional Notes:

14 Cost Accounting Standards Notices and Certification. (Oct 2015) Note: This notice does not apply to small businesses or foreign governments. This notice is in three parts, identified by Roman numerals I through III. Offerors shall examine each part and provide the requested information in order to determine Cost Accounting Standards (CAS) requirements applicable to any resultant contract. If the offeror is an educational institution, Part II does not apply unless the contemplated contract will be subject to full or modified CAS coverage pursuant to 48 CFR (c)(5) or (c)(6), respectively. I. Disclosure Statement -- Cost Accounting Practices and Certification (a) Any contract in excess of $750,000 resulting from this solicitation will be subject to the requirements of the Cost Accounting Standards Board (48 CFR Chapter 99), except for those contracts which are exempt as specified in 48 CFR (b) Any offeror submitting a proposal which, if accepted, will result in a contract subject to the requirements of 48 CFR Chapter 99 must, as a condition of contracting, submit a Disclosure Statement as required by 48 CFR When required, the Disclosure Statement must be submitted as a part of the offeror s proposal under this solicitation unless the offeror has already submitted a Disclosure Statement disclosing the practices used in connection with the pricing of this proposal. If an applicable Disclosure Statement has already been submitted, the offeror may satisfy the requirement for submission by providing the information requested in paragraph (c) of Part I of this provision. Caution: In the absence of specific regulations or agreement, a practice disclosed in a Disclosure Statement shall not, by virtue of such disclosure, be deemed to be a proper, approved, or agreed-to practice for pricing proposals or accumulating and reporting contract performance cost data. (c) Check the appropriate box below: * (1) Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows: (i) Original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and (ii) One copy to the cognizant Federal auditor. (Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable. Forms may be obtained from the cognizant ACO or Federal official and/or from the loose-leaf version of the Federal Acquisition Regulation.)

15 15 Date of Disclosure Statement: Name and Address of Cognizant ACO or Federal Official Where Filed: The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement. * (2) Certificate of Previously Submitted Disclosure Statement. The offeror hereby certifies that the required Disclosure Statement was filed as follows: Date of Disclosure Statement: Name and Address of Cognizant ACO or Federal Official Where Filed: The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement. * (3) Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately. * (4) Certificate of Interim Exemption. The offeror hereby certifies that (i) the offeror first exceeded the monetary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR , the offeror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a revised certificate to the Contracting Officer, in the form specified under subparagraph (c)(1) or (c)(2) of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement. Caution: Offerors currently required to disclose because they were awarded a CAScovered prime contract or subcontract of $50 million or more in the current cost accounting period may not claim this exemption (4). Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded. II. Cost Accounting Standards -- Eligibility for Modified Contract Coverage

16 16 If the offeror is eligible to use the modified provisions of 48 CFR (b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause. * The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR (b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAScovered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately. Caution: An offeror may not claim the above eligibility for modified contract coverage if this proposal is expected to result in the award of a CAS-covered contract of $50 million or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more. III. Additional Cost Accounting Standards Applicable to Existing Contracts The offeror shall indicate below whether award of the contemplated contract would, in accordance with subparagraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts. * yes * no (End of Provision)

17 Offeror Representations and Certifications -- Commercial Items (Apr 2016) 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 If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (r) 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) , 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;

18 18 (6) PSC 9430, Miscellaneous Crude Animal Products, Inedible; (7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products; (8) PSC 9610, Ores; (9) PSC 9620, Minerals, Natural and Synthetic; and (10) PSC 9630, Additive Metal Materials. Place of manufacture means the place where an end product is assembled out of components, or otherwise made or processed from raw materials into the finished product that is to be provided to the Government. If a product is disassembled and reassembled, the place of reassembly is not the place of manufacture. Predecessor means an entity that is replaced by a successor and includes any predecessors of the predecessor. Restricted business operations means business operations in Sudan that include power production activities, mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L ). 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

19 19 (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 , 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 ) by-- (i) One or more socially disadvantaged (as defined at 13 CFR ) and economically disadvantaged (as defined at 13 CFR ) 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 (c)(2); and (2) The management and daily business operations of which are controlled (as defined at 13.CFR ) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this definition. Subsidiary means an entity in which more than 50 percent of the entity is owned (1) Directly by a parent corporation; or (2) Through another subsidiary of a parent corporation. Successor means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term successor does not include new offices/divisions of the same company or a company that only changes its name.

20 20 The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances. Veteran-owned small business concern means a small business concern (1) Not less than 51 percent of which is owned by one or more veterans(as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and (2) The management and daily business operations of which are controlled by one or more veterans. Women-owned business concern means a concern which is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the 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 After reviewing the SAM database information, the offeror verifies by submission of this offer that the representation and certifications currently posted electronically at FAR , 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 ), except for paragraphs. [Offeror to identify the applicable paragraphs at (c) through (r) 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.]

21 21 (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 (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

22 22 (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 womenowned business concern. (9) Tie bid priority for labor surplus area concerns. If this is an invitation for bid, small business offerors may identify the labor surplus areas in which costs to be incurred on account of manufacturing or production (by offeror or first-tier subcontractors) amount to more than 50 percent of the contract price: (10) HUBZone small business concern. [Complete only if the offeror represented itself as a small business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer, that-- (i) It [_] is, [_] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material changes in ownership and control, principal office, or HUBZone employee percentage have occurred since it was certified in accordance with 13 CFR part 126; and (ii) It [_] is, [_] is not a HUBZone joint venture that complies with the requirements of 13 CFR part 126, and the representation in paragraph (c)(10)(i) of this provision is accurate for each HUBZone small business concern participating in the HUBZone joint venture. [The offeror shall enter the names of each of the HUBZone small business concerns participating in the HUBZone joint venture:.] Each HUBZone small business concern participating in the HUBZone joint venture shall submit a separate signed copy of the HUBZone representation. (d) Representations required to implement provisions of Executive Order (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 --

23 23 (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) , 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 , Buy American -- Free Trade Agreements -- Israeli Trade Act, is included in this solicitation.)