SOLICITATION NOTICE
R -- Informatics technical Advisor in Maputo, Mozambique. - contract sample
- Notice Date
- 8/10/2009
- Notice Type
- Cancellation
- NAICS
- 923120
— Administration of Public Health Programs
- Contracting Office
- Department of Health and Human Services, Centers for Disease Control and Prevention, Procurement and Grants Office (Atlanta), 2920 Brandywine Road, Room 3000, Atlanta, Georgia, 30341-4146
- ZIP Code
- 30341-4146
- Solicitation Number
- 2009-N-11510
- Archive Date
- 9/5/2009
- Point of Contact
- Sam Jamison, Phone: 7704884787, Rafael A. Aviles, Phone: 770-488-2805
- E-Mail Address
-
esw2@cdc.gov, raviles@cdc.gov
(esw2@cdc.gov, raviles@cdc.gov)
- Small Business Set-Aside
- N/A
- Description
- contract sample This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation: proposals are being requested and a written solicitation will not be issued. The solicitation number is 2009-N-11510 and this is a request for proposal. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-35. The position solicited is an Informatics Technical Advisor in Maputo, Mozambique. Area of Consideration Only United States citizens are eligible for this position. Citizens and permanent residents of the host country, and third country nationals, are not eligible under this solicitation. Security Clearance: OPM National Agency Check with Inquiries (NACI). Period of Performance The period of performance shall consist of one base period plus option periods for a total not to exceed 60 months. The solicitation, conditional offer, and clearance process takes about 6 months and the estimated start date is or on or about January 31, 2010. The actual period of performance will be identified at time of contract award, after the clearance process has concluded. The Effective Date will be coordinated in advance with the Contract Awardee and the funding program office before the contract is signed. Compensation and Reimbursement a. The Contractor shall be reimbursed on a bi-weekly basis for the period of performance. Reimbursement shall be based on a 40-hour work week to include leave and holidays. The salary range is $69,950 to $111,467 per year, dependent upon individual salary history, work experience, and education background. b. The Contractor is responsible for obtaining health insurance for the country of service (this is mandatory and up to 75% of premium cost is reimbursable) and life insurance (this is optional - up to 1/3 of the premium cost is reimbursable). c. The contract shall be a Personal Services Contract (PSC) under the authority of 42 USC 242l(b)(8). d. Post Cost of Living Allowance, Post Differential, and Danger Pay rates, if any, as provided for in this contract may fluctuate. By signing a contract, the Personal Service Contractor agrees to be compensated based upon the then-current rates of these overseas allowances and differential for all U.S. Government civilian employees assigned to your location of assignment, as approved by the U.S. Department of State's Office of Allowances. These overseas allowances and differential may increase, decrease, or even be eliminated altogether during the life of the contract. Description/Work Statement Purpose: The Informatics Technical Advisor (ITA) is responsible for coordinating and managing all health information systems activities funded through PEPFAR Mozambique, including the development of routine information systems for service delivery, national surveillance and reporting systems. The ITA is responsible for the expansion of hardware and connectivity infrastructure and software development activities. This position has the authority to develop, monitor, steer and prioritize informatics and applications development activities based on CDC and USG Mozambique team priorities and resources. This position is responsible for the development of scopes of work, functional specifications, and contracts, with clear deliverables for these activities. 40% Management of informatics projects, including applications development - Tracks and monitors the progress of all PEPFAR-supported informatics activities in MOH and key USG implementing partners, to ensure that these activities are well planned and continue to reach set milestones. Using experience in informatics and team leadership, incumbent meets routinely with informatics partners to assess plans, progress, and priorities. Responsible for basic project management and tracking and applications lifecycle planning and supervision. Uses technical expertise to provide technical assistance and consultation to partners in order to facilitate the progress of these activities. Reports routinely to the CDC Strategic Information (SI) Team Lead and technical working group (TWG) leads on progress of relevant activities. 20% Coordination of health information systems strengthening activities - Develops and monitors all informatics and health information systems strengthening activities. Provides updates to the CDC and, as appropriate, other USG technical leads, on progress of these activities, and assists in the planning of future resource needs and activities. Facilitates information sharing across projects by convening routine applications technical working groups (TWGs), both nationally and specific to the relevant program area. Participates on national technical working groups and standards bodies to assure the creation and implementation of national systems development standards. Provides guidance to the PEPFAR Mozambique technical teams related to capacity for informatics at the MOH and key USG implementing partners, prioritization of resources and partners, partner selection, and budgeting for upcoming fiscal years. 20% Systems analysis and design - Conducts analyses of information systems operations and information flow, focusing on USG-funded partners including Ministry of Health. Periodically conducts an inventory to assess the capability of information systems used at MOH and key implementing partners to manage programs supported by PEPFAR. Uses judgment in identification of potential but practical improvements in both paper and electronic health information systems. Provides guidance on strategies for developing and implementing communication standards across systems. 20% Requirements gathering - Develops clear and methodical requirements documentation for each informatics project. Works closely with technical staff from the partner team and relevant program areas to ensure that each informatics project has a clearly defined set of requirements, timeline, and deliverables. Provides technical assistance to the partners in work plan development, with clear deliverables and program activity monitoring. Note: Post-entry training will be focused primarily on PEPFAR- and HHS/CDC-established policies, procedures and regulations that govern specific activity management, including monitoring and program assessment/evaluation, and procurement systems. Necessary post-entry training will be provided on-site or at Regional or Atlanta-based facilities. Selection Factors: The applicant that represents the best value to the Government will be considered for award. To determine best value, the following factors will be considered: 1. The extent an applicant meets the minimum and desired qualifications based on information obtained through the application package and interviews, if conducted. Note that interviews may or may not be conducted; therefore, the application package should clearly identify how well the applicant meets the minimum and desired qualifications of this position. Interviews, if conducted, may be either in-person or via telephone. 2. Information collected from reference checks. References will only be verified for those applicants determined to have a reasonable chance of being selected for award. 3. Results of a cost assessment. The cost assessment will determine the total cost (salary plus benefits and allowances) of the applicant for the complete term of the contract (base period plus any option years). Basis for Award In determining best value, paramount consideration shall be given to technical merit (applicant qualifications and reference checks) rather than to cost. In cases where applicants are determined to be essentially equal, then cost may become the determining factor. Submission of Application: All applications must be legible and submitted in the English language. The solicitation number must be included on all documents submitted with the application package, as well as any other correspondence regarding this solicitation. A complete application package must be received at the following location no later than the closing date and time above: Centers for Disease Control and Prevention Procurement and Grants Office Mailstop K75, Branch 7 Attn: Sam Jamison, Contract Specialist Solicitation 2009-N-11510 Moz 2920 Brandywine Road Atlanta, GA 30341-5539 A complete application package may be emailed to the attention of Sam Jamison at esw2@cdc.gov. Facsimile copies will not be accepted. For information purposes, please advise as to where you first learned about this contract position. Applications received after the closing date and time will not be accepted. Refer to Federal Acquisition Regulation 15.208 regarding submission of late proposals: (http://www.acqnet.gov/far/current/html/Subpart%2015_2.html#wp1125227). A. A complete application shall consist of: 1) a completed Optional Form 612 (Optional Application for Federal Employment) or resume or curriculum vitae that provides the same information required in a OF 612. Form OF 612, Optional Application for Federal Employment, can be located at: http://www.opm.gov/Forms/html/of.asp]. 2) References (see below). 3) Salary documentation current (or highest recent) (see below). 4) You must also complete and return the following: a) Benefit Eligibility For PSC Candidate and b) International Tax Certification, and c) FAR 52.212-3 Offeror Representations and Certifications [NOTE: Most applicants will need to complete (d), (h), and (l) 3, 4, and 5]. B. Knowledge, Skills, and Abilities Applicant's resume must provide the extent of their qualifications: 1) Minimum/Essential Qualifications: a) Knowledge: Knowledge of organizational and operational concepts and practices applied by public, private, or non-profit agencies and organizations engaged in health-related endeavors, especially as it relates to public health prevention programming. Broad perspective and thorough knowledge of the principles of public health programs and practice. b) Education: BA/BS degree in computer science, software engineering, statistics, biostatistics, mathematics or related field and five years of work experience, or three years of experience with a Masters degree in computer science or software engineering. c) Training: Incumbent is expected to possess the necessary technical training and skills required to perform the duties and responsibilities required of the position. d) Experience: Five years of progressively responsible experience with BA/BS degree in computer science, software engineering, statistics, biostatistics, mathematics or related field or three years of progressively responsible experience with a Masters degree in computer science or software engineering. At least two years of the above must include supervision and management experience with responsibility for interacting with supervisors, subordinates and professional staff from other institutes or organizations. Must have experience with the HIV/AIDS response in Sub Saharan Africa and knowledge of the related institutional environment. Must have experience working on Health Management Information Systems (HMIS) in Southern Africa or similar settings. Must have experience in the setting of computer software development standards, specifications, and guidelines as well as experience working within already set standards to implement IT solutions. e) Language skills: a fluent language skill in English, writing and conversing is required. The ability to develop skills in speaking, reading, writing and understanding Portuguese will be required. f) Skills: Ability to readily analyze, understand, and discuss new program design, management, and implementation approaches. Demonstrated ability to identify priority actions, and to generate and complete work plans within short time frames. Ability to prioritize and handle multiple tasks under tight deadlines. Ability to establish effective working relationships with individuals and official representatives of public health organizations, particularly those representing the MOH and other international organizations. Strong computer literacy and aptitude to rapidly acquire and apply additional skills. Strong oral and written skills and ability to clearly communicate new program and technical concepts to technical and non-technical counterparts. Strong interpersonal communication and negotiation skills in achieving results with a wide range of program partners. 2. Desired Qualifications: a) Knowledge of the Organization: Have, or be able to acquire, a thorough knowledge of the Mozambican health system. Have good knowledge of existing clinical information systems found in settings such as Mozambique and have worked collaboratively with Non-Government Organizations, government and/or donors in job-related efforts. Ability to understand how information systems operate at multiple levels (central, provincial, and clinic levels). b) Education: PhD degree in computer science or software engineering. c) Language skills: Portuguese fluency at Level 4 C. References: Each applicant shall submit three Professional references other than family members. Two references shall be from a current and previous supervisor. The following information is required: Name, Address, Telephone Number, Title, and Email Address. D. Current (or Highest Recent) Salary Documentation: Each applicant shall submit supporting documentation that reflects their current or highest recent salary. Examples of such supporting documentation are the most recent earning statement, an official letter from current employer signed by the applicant's current supervisor or Human Resources Representative, or the applicant's most recent U.S. Federal tax return (if applicable). Each applicant shall also include a letter indicating the minimum salary in U.S. dollars the applicant would accept for the position. E. Benefit Eligibility for PSC Candidate: Name:________________________________________ REQUIREMENT PROVIDE ADDITIONAL INFORMATION OR DOCUMENTATION: A. City and State (or Country, if not in U.S.), Where Currently Domiciled. B. 1. Country in Which You are Permanently Resident. B. 2. Do You Currently Pay Income Taxes to That Country? B.3. Do You Currently Pay Social Security Contributions to That Country? C. In What Country Were You Born? D. 1. If Already Present in Mozambique Reason for Current Presence There. D. 2 Also If Already Present in Mozambique, How Long Have You Continuously Resided There, Excluding Short Periods of Absence for Vacation, Conferences/Symposia, etc. N/A/ or reason for current presence in country, e.g., brought there by previous employer [provide name of employer, your status and job title, and whether housing and repatriation was included in employment package]; dependent of someone brought there by employer [provide name of employer and whether housing and repatriation is included in employment package], etc. E. Attach Copy of Current Visa for Mozambique, If Any. F. 1 Do You or Any Immediate Relative (Spouse, Parent, Child, Sibling) Permanently Reside in Mozambique ? F.2 Do You or Any Immediate Relative Own Any Property and/or Any Business in Mozambique ? If so, please describe. G. Home City and State (or City and Country, if not in U.S.). Home or place of original recruitment. Used as basis for Relief Travel and Repatriation destination. H. Please List All Countries in Which You Presently Hold Citizenship or Nationality and Attach Copy of Complete Front Page of Most Recent Passport(s). I. Family Members Accompanying You to Mozambique : Spouse: Children Under Age 18 at Time of Arrival - How Many?: Please list name and date of birth of each J. Annual Education Travel for Children Up to Age 21 at Time of Your Arrival at Location of Contract Performance Who Are Attending a Recognized Post-Secondary Educational Institution on a Full-Time Basis NOTE: Children are eligible until the end of the school year in which they turn age 21. Children Before 21st Birthday at Time of Arrival Attending a Recognized Post-Secondary Educational Institution on a Full-Time Basis - How Many?: Please list name and date of birth and city and state (or country, if not in U.S.) of location of educational institution for each: F. ADDENDUM TO FAR 52.212-3 International Tax Certification A. ( )Have never worked or resided in Mozambique. (If you check this, skip to C(1) and (2)). B(1) ( )Have - ( )Have Not: filed all required federal, state and local income tax returns in Mozambique, or have obtained a valid extension or exemption for such filings. B(2) ( )Have - ( )Have not: paid income taxes when due in Mozambique. C(1) ( )Have - ( )Have Not: filed all required federal, state and local income tax returns in country of citizenship or residency (home country) or have obtained a valid extension or exemption for such filings. C(2) ( )Have - ( )Have not: paid income taxes when due in home country Printed Name: ___________________________ Signature: _____________________________ Date: ______________________ The Contracting Officer may request documentary evidence of tax compliance in situations where he/she has reason to believe that a Certification may be inaccurate or invalid. The specific documentation requested could vary depending upon country of assignment but examples could include a copy of the tax forms filed, a letter of tax exemption, a tax certification memorandum, etc. Noncompliance with tax law in the country of assignment could result in termination of the contract in accordance with FAR Clause 52.249-12 Termination (Personal Services). This certification will be required on an annual basis prior to the exercise of each contract option period. (End of Certification Page) Applicant Name: _________________________ G. FAR 52.212-3 Offeror Representations and Certifications-Commercial Items (June 2009) An offeror shall complete only paragraph (b) of this provision if the offeror has completed the annual representations and certifications electronically at http://orca.bpn.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 (m) of this provision. (a) Definitions. As used in this provision- "Emerging small business" means a small business concern whose size is no greater than 50 percent of the numerical size standard for the NAICS code designated. "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" 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). "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; (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 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 "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. "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 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 (1) Whose management and daily business operations are controlled by one or more women. (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 at http://orca.bpn.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 (n) 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 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 o is, o 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 o is, o 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 o is, o 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 o is, o 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 o is, o is not a women-owned small business concern. Note: Complete paragraphs (c)(6) and (c)(7) only if this solicitation is expected to exceed the simplified acquisition threshold. (6) 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 o is a women-owned business concern. (7) 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:____________________________________ (8) Small Business Size for the Small Business Competitiveness Demonstration Program and for the Targeted Industry Categories under the Small Business Competitiveness Demonstration Program. [Complete only if the offeror has represented itself to be a small business concern under the size standards for this solicitation.] (i) [Complete only for solicitations indicated in an addendum as being set-aside for emerging small businesses in one of the designated industry groups (DIGs).] The offeror represents as part of its offer that it o is, o is not an emerging small business. (ii) [Complete only for solicitations indicated in an addendum as being for one of the targeted industry categories (TICs) or designated industry groups (DIGs).] Offeror represents as follows: (A) Offeror's number of employees for the past 12 months (check the Employees column if size standard stated in the solicitation is expressed in terms of number of employees); or (B) Offeror's average annual gross revenue for the last 3 fiscal years (check the Average Annual Gross Number of Revenues column if size standard stated in the solicitation is expressed in terms of annual receipts). (Check one of the following): Number of Employees Average Annual Gross Revenues __ 50 or fewer __ $1 million or less __ 51-100 __ $1,000,001-$2 million __ 101-250 __ $2,000,001-$3.5 million __ 251-500 __ $3,500,001-$5 million __ 501-750 __ $5,000,001-$10 million __ 751-1,000 __ $10,000,001-$17 million __ Over 1,000 __ Over $17 million (9) [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 o is, o 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 database maintained by the Small Business Administration (PRO-Net), 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 o has, o 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. (ii) o 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)(9)(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: ________________.] (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 o is, o 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 change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR Part 126; and (ii) It o is, o is not a 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 the HUBZone small business concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture: __________.] Each HUBZone small business concern participating in the 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 o has, o has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and (ii) It o has, o has not filed all required compliance reports. (2) Affirmative Action Compliance. The offeror represents that- (i) It o has developed and has on file, o 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 o 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 $100,000.) 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 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. The terms "component," "domestic end product," "end product," "foreign end product," and "United States" are defined in the clause of this 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 the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The terms "Bahrainian or Moroccan end product," "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 or Moroccan 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 or Moroccan 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. Other Foreign End Products: Line Item No. Country of Origin ______________ _________________ ______________ _________________ ______________ _________________ [List as necessary] (iv) The Government will evaluate offers in accordance with the policies and procedures of FAR Part 25. (2) Buy American 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 ______________ _________________ ______________ _________________ ______________ _________________ [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) o Are, o are not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; (2) o Have, o 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) o Are, o 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) o Have, o 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. (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) o 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) o 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 o does o 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 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 o does o 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 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). o TIN: ________________________________. o TIN has been applied for. o TIN is not required because: o 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; o Offeror is an agency or instrumentality of a foreign government; o Offeror is an agency or instrumentality of the Federal Government. (4) Type of organization. o Sole proprietorship; o Partnership; o Corporate entity (not tax-exempt); o Corporate entity (tax-exempt); o Government entity (Federal, State, or local); o Foreign government; o International organization per 26 CFR 1.6049-4; o Other ________________________________. (5) Common parent. o Offeror is not owned or controlled by a common parent; o Name and TIN of common parent: Name ________________________________. TIN _________________________________. (m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that it does not conduct any restricted business operations in Sudan. n) Prohibition on Contracting with Inverted Domestic Corporations. (1) Relation to Internal Revenue Code. A foreign entity that is treated as an inverted domestic corporation for purposes of the Internal Revenue Code at 26 U.S.C. 7874 (or would be except that the inversion transactions were completed on or before March 4, 2003), is also an inverted domestic corporation for purposes of 6 U.S.C. 395 and for this solicitation provision (see FAR 9.108). (2) Representation. By submission of its offer, the offeror represents that it is not an inverted domestic corporation and is not a subsidiary of one. (End of provision)
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