FILE | R | USPSC Program Officer - Sudan (Multiple Positions) - OF612 Form

FBO DAILY ISSUE OF JULY 31, 2008 FBO #2439
DOCUMENT

R -- USPSC Program Officer - Sudan (Multiple Positions) - OF612 Form

Notice Date: 7/29/2008
Notice Type: OF612 Form
NAICS: 921190 — Other General Government Support
Contracting Office: Agency for International Development, Washington D.C., USAID/Washington, 1300 Pennsylvania Avenue, NW, Room 7.10-006, Washington, District of Columbia, 20523
ZIP Code: 20523
Solicitation Number: M-OAA-DCHA-DOFDA-08-1573
Archive Date: 9/13/2008
Point of Contact: Kelly Tobin,, Phone: 202-661-9381, Jaimee F. Braun, Phone: 202-661-9377
E-Mail Address: ktobin@usaid.gov, jbraun@ofda.gov
Small Business Set-Aside: N/A
Description: SOLICITATION NUMBER: M/OAA/DCHA/DOFDA-08-1573 ISSUANCE DATE: July 29, 2008 CLOSING DATE: August 29, 2008, 5:00 p.m. EDT SUBJECT: Solicitation for U.S. Personal Service Contractor for a Program Officer (Multiple Positions) in Sudan Ladies/Gentlemen: The United States Government, represented by the U.S. Agency for International Development (USAID), is seeking applications (Optional Form 612 only) from qualified U.S. citizens to provide personal services as a Program Officer - Sudan under a personal services contract, as described in the attached solicitation. Submittals shall be in accordance with the attached information at the place and time specified. Applicants interested in applying for this position MUST submit the following materials: •Complete and hand-signed federal form OF-612 (including OF-612 continuation sheets as needed). NOTE: Submission of a resume alone IS NOT a complete application. This position requires the completion of additional forms and/or supplemental materials as described in the "Applying" section. Please carefully review the complete job announcement and the "Applying" instructions. Failure to provide the required information and/or materials will result in your not being considered for employment. •Supplemental document specifically addressing the five (5) Quality Ranking Factors (QRFs) shown in the solicitation. Incomplete or unsigned applications shall not be considered. These signed forms must be mailed, delivered, faxed, or emailed (email applications must be signed) to: GlobalCorps 529 14th Street, NW, Suite 700 Washington, DC 20045 E-Mail Address: posudan@globalcorps.com Facsímile: (202) 315-3803 or (240) 465-0244 Applicants should retain for their records copies of all enclosures which accompany their applications. Any questions on this solicitation may be directed to: Kelly Tobin or Jaimee Braun Telephone Number: (202) 661-9381 or (202) 661-9377 E-Mail Address: posudan@globalcorps.com Website: www.globalcorps.com Facsímile: (202) 315-3803 or (240) 465-0244 Sincerely, Angela Fortune Contracting Officer Solicitation for U.S. Personal Service Contractor (PSC) Program Officer - Sudan (Multiple Positions) 1. SOLICITATION NO.: M/OAA/DCHA/DOFDA-08-1573 2. ISSUANCE DATE: July 29, 2008 3. CLOSING DATE/TIME FOR RECEIPT OF APPLICATIONS: August 29, 2008 5:00 pm EDT 4. POSITION TITLE: Program Officer - Sudan 5. MARKET VALUE: GS-13 ($68,625 - $89,217 - not eligible for locality pay). Final compensation will be negotiated within the listed market value based upon the candidate’s past salary, work history and educational background. 6. PERIOD OF PERFORMANCE: Two years, renewable up to five years 7. PLACE OF PERFORMANCE: Sudan 8. STATEMENT OF WORK POSITION DESCRIPTION BACKGROUND The Office of U.S. Foreign Disaster Assistance (OFDA) is the office within USAID that is responsible for providing non-food humanitarian assistance in response to international crises and disasters. OFDA is part of the Bureau for Democracy, Conflict, and Humanitarian Assistance (DCHA) and is organized into three divisions under the management of the Office of the Director (OD). The Program Support Division (PS) provides programmatic and administrative support including budget/financial services, procurement planning, contracts and grants administration, and communication support for OFDA’s Washington and field offices. The Disaster Response and Mitigation Division (DRM) is responsible for coordinating with other organizations for the provision of relief supplies and humanitarian assistance. DRM also devises, coordinates, and implements program strategies for a variety of natural and human caused disaster situations. DRM hires sector specialists to provide technical expertise in assessing the quality of disaster response. The Operations Division (OPS) develops and manages logistical, operational, and technical support for disaster responses and administrative support to all offices and operations. OPS maintains readiness to respond to emergencies through several mechanisms, including managing Search and Rescue Teams (SAR), Disaster Assistance Response Teams (DARTs), and Washington-based Response Management Teams (RMTs). INTRODUCTION On January 9, 2005, the Government of Sudan (GOS) and the Sudan People’s Liberation Movement/Army (SPLM/A) signed the Comprehensive Peace Agreement (CPA) officially ending Africa’s longest running civil war. Over the course of the 21-year conflict, fighting, famine, and disease killed more than 2 million people, forced an estimated 628,000 people to seek refuge in neighboring countries, and displaced more than 4 million people within Sudan—the largest internally displaced person (IDP) population in the world. In April 2003, a separate conflict began in Darfur, Western Sudan, when the locally based Sudanese Liberation Movement/Army (SLM/A) attacked GOS security forces in the city of El Fasher. The resulting humanitarian emergency in Darfur affects an estimated 2.6 million people, approximately 40 percent of the population, including 1.9 million IDPs and 220,000 refugees in eastern Chad. The concurrent emergencies have exacerbated already fragile humanitarian conditions, and challenged local capacity to provide for the population. DCHA staff in Sudan work as part of the USAID Mission in Sudan. DCHA staff in Khartoum includes representatives from OFDA, the Office of Food for Peace (FFP) and the Office of Transition Initiatives (OTI). OFDA requires two Program Officers, who may be assigned to Khartoum, Juba, other parts of Sudan, or the region, depending on needs. He/she will report to the OFDA Country Representative for Sudan and coordinate regularly with OFDA colleagues in Sudan and the OFDA Sudan team in Washington, D.C. This includes sharing project ideas, strategies, and soliciting advice and guidance. He/she will work with a small team of experienced Foreign Service Nationals (FSNs) specializing in the areas of food security, health, gender, and livelihoods. Each FSN staff member is also responsible for a specific geographic area and specific grants. OBJECTIVE OFDA must recruit Program Officers for Northern and Southern Sudan in order to meet its program objectives. The incumbent will serve as a point of contact for OFDA in the field and is responsible for contributing to the development of strategies and plans, reviewing proposals, monitoring grants, liaising with grantees and other members of the humanitarian community, and reporting on the humanitarian situation. 9. CORE FUNCTIONAL AREAS OF RESPONSIBILITY DUTIES AND RESPONSIBILITIES The Program Officer will provide full time in-country coordination of the humanitarian response for Southern Sudan or northern Sudan (including eastern Sudan and the Three Areas of Abyei, Nuba and Southern Blue Nile). The Program Officer may assist in humanitarian assistance activities in all parts of Sudan as needed. The Program Officer must be prepared to function effectively in a challenging and restrictive work environment and be willing to strictly abide to U.S. Embassy security guidelines. The incumbent may be required to serve as a critical component of a U.S. government disaster assessment team, DART, RMT, or to backfill other staff members in the overseas office. The Program Officer's responsibilities will include the following: •Serve as a primary Point of Contact (POC) and technical expert on humanitarian issues and programs in the Area of Responsibility (AOR). •Coordinate closely with the Sudan team in Washington, work with relevant national program staff and maintain regular contact with development assistance colleagues in the USAID mission (especially on issues regarding the South and the Three Areas). •Assess a broad spectrum of emergency conditions to provide recommendations, implementation strategy, monitoring, and evaluation of OFDA response programs. •Coordinate closely with the OFDA Team in Khartoum and other field offices, and maintain a daily liaison with United Nations (UN) agencies, International Organizations (IOs), Non-governmental Organizations (NGOs), and other organizations conducting humanitarian activities in the AOR. •Provide guidance to potential grant applicants based on “OFDA’s Guidelines for Proposals and Reporting;” review concept papers and proposals, providing recommendations/comments to OFDA for funding determination. •Work in close consultation with the OFDA Country Representative for Sudan to ensure that FSN staff competencies are used in the most efficient way to enhance the overall U.S. Government response in the South and in the Three Areas, northern and eastern Sudan. •Travel frequently (security permitting) to assess, evaluate and monitor conditions at OFDA project sites in Sudan, and make strategic recommendations for interventions. Report to OFDA on the quality of the grantee's work, noting deficiencies, attributes and evolving operational conditions. •Participate in and report on joint donor humanitarian evaluations and UN-led assessments, and participate actively in the international community response structures. •Provide regular reporting, through official cables and other means, on issues related to the humanitarian situation in Sudan. Provide overviews of patterns and trends in the humanitarian situation and keep the OFDA Country Representative for Sudan and the Sudan Team in Washington current on response issues. •Prepare agendas and briefings for official U.S. Government visitors interested in humanitarian issues. •Under the guidance of the Administrative Officer, provide day-to-day supervision for locally engaged staff, administrative oversight at the field office level, and coordinate travel itineraries for very important persons. •As requested, assist U.S. Embassy staff with humanitarian assistance matters. •Operate OFDA communications and data processing equipment, including satellite telephones, cellular type mobile phones, and hand held radios. •Become certified and serve as a Cognizant Technical Officer (CTO) for grants and cooperative agreements under portfolio of responsibility. SUPERVISORY RELATIONSHIP: The Program Officer will report directly to the OFDA Country Representative for Sudan. SUPERVISORY CONTROLS: Supervisory controls will be minimal. The supervisor provides administrative direction in terms of broadly defined missions or functions. The incumbent is expected to take initiative, act independently, and perform with minimal direction in responding to humanitarian emergencies. 10. PHYSICAL DEMANDS The work is generally sedentary and does not pose undue physical demands. During deployment on DARTs (if required), and during site visits, there may be some additional physical exertion including long periods of standing, walking over rough terrain, or carrying of moderately heavy items (less than 50 pounds). 11. WORK ENVIRONMENT Work is primarily performed in an office setting. During deployment on DARTs (if required), and during site visits, the work may involve special safety and/or security precautions, wearing of protective equipment, and exposure to severe weather conditions. 12. START DATE: Immediately, once necessary clearances are obtained. 13. POINT OF CONTACT: See Cover Letter. EDUCATION/EXPERIENCE REQUIRED FOR THIS POSITION (Determines basic eligibility for the position. Applicants who do not meet all of education and experience factors are considered NOT qualified for the position.) Bachelor’s degree with significant study in or pertinent to the specialized field (including, but not limited to, international relations, economics, food policy or a related field) and a minimum of seven (7) years of progressively responsible work experience in development, emergency relief or humanitarian assistance, which must include field experience in a developing country working on one or more of the following: emergency relief operations; monitoring and evaluating humanitarian programs; or needs assessments and/or analysis. OR Master’s degree with significant study in or pertinent to the specialized field (including, but not limited to, international relations, economics, food policy or a related field) and a minimum of five (5) years of progressively responsible work experience in development, emergency relief or humanitarian assistance, which must include field experience in a developing country working on one or more of the following: emergency relief operations, monitoring and evaluating humanitarian programs; or needs assessments and/or analysis. SELECTION FACTORS (Determines basic eligibility for the position. Applicants who do not meet all of the selection factors are considered NOT qualified for the position.) •Applicant is a U.S. Citizen; •Complete and hand-signed federal form OF-612 and OF-612 continuation sheets submitted; •All applicants must submit complete dates (months/years) and hours per week for all positions listed on the OF-612 to allow for adequate evaluation of your related and direct experience. Experience that cannot be quantified will not be counted towards meeting the experience requirements. •Supplemental document specifically addressing the Quality Ranking Factors (QRFs) submitted; •Ability to obtain a SECRET level security clearance as provided by USAID; •Ability to obtain a Department of State medical clearance; •Satisfactory verification of academic credentials. QUALITY RANKING FACTORS (QRFs) (Used to determine the competitive ranking of qualified applicants in comparison to other applicants. The factors are listed in priority order from highest to least.) QRF #1Describe, in detail, your professional experience providing technical advice on humanitarian needs and existing program activities, and recommending appropriate interventions in a complex emergency response. Such experience is to include identifying and assessing the full spectrum of humanitarian needs of vulnerable populations, ensuring quality programming and demonstrating an understanding of appropriate humanitarian response options. QRF #2Proven skill in verbal and written communication as demonstrated through the frequent preparation and presentation of various information products, such as humanitarian reports, briefing material, analyses, field assessments, data collection and program evaluations. QRF #3Describe your experience working and/or liaising with a diverse group of officials, authorities and organizations engaged in disaster response/preparedness and humanitarian assistance initiatives, including relevant USG foreign affairs agencies (such as the State Department, Department of Defense, and USAID Missions), UN and other International Organizations, and non-governmental organizations. QRF #4Describe your professional experience in providing guidance to humanitarian organizations who are developing proposals and promoting organizational and program compliance with USG donor funding and program regulations. QRF #5Describe your demonstrated experience in administrative aspects of field work and organizing schedules, travel, logistics and briefings for high-level representation for your organization(s). BASIS OF RATING: Applicants who meet the Education/Experience requirements and Selection Factors will be further evaluated based on scoring of the Quality Ranking Factor (QRF) responses. Those applicants determined to be competitively ranked may also be evaluated on interview performance and satisfactory professional reference checks. Applicants are required to address each of the QRFs on a separate sheet describing specifically and accurately what experience, training, education and/or awards they have received that are relevant to each factor. Be sure to include your name and the announcement number at the top of each additional page. Failure to address the selection and/or Quality Ranking Factors may result in your not receiving credit for all of your pertinent experience, education, training and/or awards. The Applicant Rating System is as Follows: QRFs have been assigned the following points: QRF #1 – 15 points QRF #2 – 10 points QRF #3 – 10 points QRF #4 – 10 points QRF #5 – 5 points Interview Performance – 30 points Satisfactory Professional Reference Checks – 20 points Total Possible Points: 100 APPLYING: Applications must be received by the closing date and time at the address specified in the cover letter. Qualified individuals are required to submit: 1.A complete U.S. Government OF-612 form with hand-written signature (including OF-612 continuation sheets as needed) (downloadable forms are available on the USAID website, http://www.usaid.gov/procurement_bus_opp/procurement/forms, internet http://www.gsa.gov/Portal/gsa/ep/formslibrary.do, at Federal offices, or at www.globalcorps.com). NOTE: Submission of a resume alone IS NOT a complete application. This position requires the completion of additional forms and/or supplemental materials as described in this section. Failure to provide the required information and/or materials will result in your not being considered for employment. 2.A supplemental document specifically addressing the five (5) Quality Ranking Factors (QRFs) shown in the solicitation. To ensure consideration of applications for the intended position, please reference the solicitation number on your application, and as the subject line in any cover letter. DOCUMENT SUBMITTALS Via mail: GlobalCorps, 529 14th Street, NW, Suite 700, Washington, DC 20045 Via facsímile: (202) 315-3803 or (240) 465-0244 Via email: posudan@globalcorps.com The most qualified candidates may be interviewed and required to provide a writing sample. OFDA will not pay for any expenses associated with the interviews. Professional references and academic credentials will be evaluated for applicants being considered for selection. NOTE: If a Secret security clearance is not obtained within nine months after offer acceptance, the offer may be rescinded. NOTE: If a Department of State medical clearance is not obtained within six months after offer acceptance, the offer may be rescinded. NOTE REGARDING GOVERNMENT OBLIGATIONS FOR THIS SOLICITATION This solicitation in no way obligates USAID to award a PSC contract, nor does it commit USAID to pay any cost incurred in the preparation and submission of the application. NOTE REGARDING DATA UNIVERSAL NUMBERING SYSTEM (DUNS) NUMBERS All individuals contracted as US PSCs are required to have a DUNS Number. USAID will provide a generic DUNS Number and PSCs are not required to register with CCR. For general information about DUNS Numbers, please refer to FAR Clause 52.204-6, Data Universal Numbering System (DUNS) Number (10/2003) http://acquisition.gov/comp/far/current/html/52_200_206.html#wp1137568 LIST OF REQUIRED FORMS FOR PSCs Forms outlined below can found at: http://www.usaid.gov/forms/ or at http://www.forms.gov/bgfPortal/citizen.portal 1. Optional Form 612. 2. Medical History and Examination Form (DS-1843). ** 3. Questionnaire for Sensitive Positions (for National Security) (SF-86), or ** 4. Questionnaire for Non-Sensitive Positions (SF-85). ** 5. Finger Print Card (FD-258). ** 6. Employment Eligibility Verification (I-9 Form). ** ** Forms 2 through 6 shall be completed ONLY upon the advice of the Contracting Officer that an applicant is the successful candidate for the job. CONTRACT INFORMATION BULLETINS (CIBs) and ACQUISITION & ASSISTANCE POLICY DIRECTIVES (AAPDs) PERTAINING TO PSCs CIBs and AAPDs contain changes to USAID policy and General Provisions in USAID regulations and contracts. Please refer to http://www.usaid.gov/business/business_opportunities/cib/subject.html#psc to determine which CIBs and AAPDs apply to this contract. AAPD 06-10 – PSC MEDICAL PAYMENT RESPONSIBILITY AAPD No. 06-10 is hereby incorporated as Attachment 1 to the solicitation. BENEFITS/ALLOWANCES: As a matter of policy, and as appropriate, a PSC is normally authorized the following benefits and allowances: BENEFITS: Employer's FICA Contribution Contribution toward Health & Life Insurance Pay Comparability Adjustment Annual Increase Eligibility for Worker's Compensation Annual & Sick Leave ALLOWANCES (if Applicable).* (A) Temporary Lodging Allowance (Section 120). (B) Living Quarters Allowance (Section 130). (C) Post Allowance (Section 220). (D) Supplemental Post Allowance (Section 230). (E) Separate Maintenance Allowance (Section 260). (F) Education Allowance (Section 270). (G) Education Travel (Section 280). (H) Post Differential (Chapter 500). (I) Payments during Evacuation/Authorized Departure (Section 600), and (J) Danger Pay (Section 650). * Standardized Regulations (Government Civilians Foreign Areas). FEDERAL TAXES: USPSCs are required to pay Federal Income Taxes, FICA, and Medicare ALL QUALIFIED APPLICANTS WILL BE CONSIDERED REGARDLESS OF AGE, RACE, COLOR, SEX, CREED, NATIONAL ORIGIN, LAWFUL POLITICAL AFFILIATION, NON-DISQUALIFYING HANDICAP, MARITAL STATUS, SEXUAL ORIENTATION, AFFILIATION WITH AN EMPLOYEE ORGANIZATION, OR OTHER NON-MERIT FACTOR. ATTACHMENT 1 ACQUISITION & ASSISTANCE POLICY DIRECTIVE (AAPD) NO. 06-10 PSC MEDICAL EXPENSE PAYMENT RESPONSIBILITY General Provision 22, MEDICAL EXPENSE PAYMENT RESPONSIBILITY (OCTOBER 2006) (a) Definitions. Terms used in this General Provision are defined in 16 FAM 116 available at http://www.foia.state.gov/REGS/fams.asp?level=2&id=59&fam=0. Note: personal services contractors are not eligible to participate in the Federal Employees Health Programs. (b) The regulations in the Foreign Affairs Manual, Volume 16, Chapter 520 (16 FAM 520), Responsibility for Payment of Medical Expenses, apply to this contract, except as stated below. The contractor and each eligible family member are strongly encouraged to obtain health insurance that covers this assignment. Nothing in this provision supersedes or contradicts any other term or provision in this contract that pertains to insurance or medical costs, except that section (e) supplements General Provision 25. “MEDICAL EVACUATION (MEDEVAC) SERVICES.” (c) When the contractor or eligible family member is covered by health insurance, that insurance is the primary payer for medical services provided to that contractor or eligible family member(s) both in the United States and abroad. The primary insurer’s liability is determined by the terms, conditions, limitations, and exclusions of the insurance policy. When the contractor or eligible family member is not covered by health insurance, the contractor is the primary payer for the total amount of medical costs incurred and the U.S. Government has no payment obligation (see paragraph (f) of this provision). (d) USAID serves as a secondary payer for medical expenses of the contractor and eligible family members who are covered by health insurance, where the following conditions are met: (1) The illness, injury, or medical condition giving rise to the expense is incurred, caused, or materially aggravated while the eligible individual is stationed or assigned abroad; (2) The illness, injury, or medical condition giving rise to the expense required or requires hospitalization and the expense is directly related to the treatment of such illness, injury, or medical condition, including obstetrical care; and (3) The Office of Medical Services (M/MED) or a Foreign Service medical provider (FSMP) determines that the treatment is appropriate for, and directly related to, the illness, injury, or medical condition. (e) The Mission Director may, on the advice of M/MED or an FSMP at post, authorize medical travel for the contractor or an eligible family member in accordance with the General Provision 10, Travel and Transportation Expenses (July 1993), section (i) entitled “Emergency and Irregular Travel and Transportation.” In the event of a medical emergency, when time does not permit consultation, the Mission Director may issue a Travel Authorization Form or Medical Services Authorization Form DS-3067, provided that the FSMP or Post Medical Advisor (PMA) is notified as soon as possible following such an issuance. The contractor must promptly file a claim with his or her medevac insurance provider and repay to USAID any amount the medevac insurer pays for medical travel, up to the amount USAID paid under this section. The contractor must repay USAID for medical costs paid by the medevac insurer in accordance with sections (f) and (g) below. In order for medical travel to be an allowable cost under General Provision 10, the contractor must provide USAID written evidence that medevac insurance does not cover these medical travel costs. (f) If the contractor or eligible family member is not covered by primary health insurance, the contractor is the primary payer for the total amount of medical costs incurred. In the event of a medical emergency, the Medical and Health Program may authorize issuance of Form DS-3067, Authorization for Medical Services for Employees and/or Dependents, to secure admission to a hospital located abroad for the uninsured contractor or eligible family member. In that case, the contractor will be required to reimburse USAID in full for funds advanced by USAID pursuant to the issuance of the authorization. The contractor may reimburse USAID directly or USAID may offset the cost from the contractor’s invoice payments under this contract, any other contract the individual has with the U.S. Government, or through any other available debt collection mechanism. (g) When USAID pays medical expenses (e.g., pursuant to Form DS-3067, Authorization for Medical Services for Employees and/or Dependents), repayment must be made to USAID either by insurance payment or directly by the contractor, except for the amount of such expenses USAID is obligated to pay under this provision. The Contracting Officer will determine the repayment amount in accordance with the terms of this provision and the policies and procedures for employees contained in 16 FAM 521. When USAID pays the medical expenses, including medical travel costs (see section (e) above), of an individual (either the contractor or an eligible family member) who is covered by insurance, that individual promptly must claim his or her benefits under any applicable insurance policy or policies. As soon as the individual receives the insurance payment, the contractor must reimburse USAID for the full amount that USAID paid on the individual’s behalf or the repayment amount determined by the Contracting Officer in accordance with this paragraph, whichever is less. If an individual is not covered by insurance, the contractor must reimburse USAID for the entire amount of all medical expenses and any travel costs the contractor receives from his/her medevac provider. (h) In the event that the contractor or eligible family member fails to recover insurance payments or transfer the amount of such payments to USAID within 90 days, USAID will take appropriate action to collect the payments due, unless such failure is for reasons beyond the control of the USPSC/dependent. (i) Before departing post or terminating the contract, the contractor must settle all medical expense and medical travel costs. If the contractor is insured, he or she must provide proof to the Contracting Officer that those insurance claims have been submitted to the insurance carrier(s) and sign a repayment agreement to repay to USAID any amounts paid by the insurance carrier(s).
Web Link: FedBizOpps Complete View
(https://www.fbo.gov/?s=opportunity&mode=form&id=bf1a83104aadeb10af2faff3ec794e2b&tab=core&_cview=1)
Document(s): OF612 Form; File Name: OF-612 Form (OF612 Form.doc); Link: https://www.fbo.gov//utils/view?id=d792bb91df7b5c2b8d32464e1495795a; Bytes: 200.00 Kb; File Name: OF-612 Continuation Sheet (OF612cont2.doc); Link: https://www.fbo.gov//utils/view?id=b1db16dca6503ccd1eb5dbd56e8c5587; Bytes: 423.00 Kb; Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
Record: SN01626193-W 20080731/080729230307-bf1a83104aadeb10af2faff3ec794e2b (fbodaily.com)
Source: FedBizOpps Link to This Notice
(may not be valid after Archive Date)

| FSG Index | This Issue's Index | Today's FBO Daily Index Page |

Loren Data's SAM Daily™

R -- USPSC Program Officer - Sudan (Multiple Positions) - OF612 Form