DATA INCIDENT NOTIFICATION

The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual
representations and certification electronically in the System for Award Management (SAM) accessed
through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications
electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.
(a) Definitions. As used in this provision-
Covered telecommunications equipment or services has the meaning provided in the clause 52.204-25,
Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.
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, and the concern is certified by
SBA or an approved third-party certifier in accordance with 13 CFR 127.300. It automatically qualifies as a
women-owned small business eligible under the WOSB Program.
Forced or indentured child labor means all work or service-
(1) Exacted from any person under the age of 18 under the menace of any penalty for its
nonperformance and for which the worker does not offer himself voluntarily; or
(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which
can be accomplished by process or penalties.
Highest-level owner means the entity that owns or controls an immediate owner of the offeror, or that owns
or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises
control of the highest level owner.
Immediate owner means an entity, other than the offeror, that has direct control of the offeror. Indicators of
control include, but are not limited to, one or more of the following: ownership or interlocking management,
identity of interests among family members, shared facilities and equipment, and the common use of
employees.
Inverted domestic corporation, means a foreign incorporated entity that meets the definition of an inverted
domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C.
395(c).
Manufactured end product means any end product in product and service codes (PSCs) 1000-9999, except-
(1) PSC 5510, Lumber and Related Basic Wood Materials;
(2) Product or Service Group (PSG) 87, Agricultural Supplies;
(3) PSG 88, Live Animals;
(4) PSG 89, Subsistence;
(5) PSC 9410, Crude Grades of Plant Materials;
(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;
(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;
(8) PSC 9610, Ores;
(9) PSC 9620, Minerals, Natural and Synthetic; and
(10) PSC 9630, Additive Metal Materials.
Place of manufacture means the place where an end product is assembled out of components, or otherwise
made or processed from raw materials into the finished product that is to be provided to the Government. If a
product is disassembled and reassembled, the place of reassembly is not the place of manufacture.
Predecessor means an entity that is replaced by a successor and includes any predecessors of the
predecessor.
Reasonable inquiry has the meaning provided in the clause 52.204-25, Prohibition on Contracting for Certain
Telecommunications and Video Surveillance Services or Equipment.
Restricted business operations means business operations in Sudan that include power production activities,
mineral extraction activities, oil-related activities, or the production of military equipment, as those terms are
defined in the Sudan Accountability and Divestment Act of 2007 (Pub. L.110-174). Restricted business
operations do not include business operations that the person (as that term is defined in Section 2 of the Sudan
Accountability and Divestment Act of 2007) conducting the business can demonstrate-
(1) Are conducted under contract directly and exclusively with the regional government of southern Sudan;
(2) Are conducted pursuant to specific authorization from the Office of Foreign Assets Control in
the Department of the Treasury, or are expressly exempted under Federal law from the requirement
to be conducted under such authorization;
(3) Consist of providing goods or services to marginalized populations of Sudan;
(4) Consist of providing goods or services to an internationally recognized peacekeeping force or
humanitarian organization;
(5) Consist of providing goods or services that are used only to promote health or education; or
(6) Have been voluntarily suspended. “Sensitive technology”— Sensitive technology—
(1) Means hardware, software, telecommunications equipment, or any other technology
that is to be used specifically-
(i) To restrict the free flow of unbiased information in Iran; or
(ii) To disrupt, monitor, or otherwise restrict speech of the people of Iran; and
(2) Does not include information or informational materials the export of which the
President does not have the authority to regulate or prohibit pursuant to section
203(b)(3)of the International Emergency Economic Powers Act (50 U.S.C. 1702(b)(3)).
Service-disabled veteran-owned small business (SDVOSB) concern means a small business concern—
(1)
(i) Not less than 51 percent of which is owned and controlled 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; or

(2) A small business concern eligible under the SDVOSB Program in accordance with 13
CFR part 128 (see subpart 19.14).
(3) Service-disabled veteran, as used in this definition, 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),
and who is registered in the Beneficiary Identification and Records Locator Subsystem, or
successor system that is maintained by the Department of Veterans Affairs’ Veterans
Benefits Administration, as a service-disabled veteran.
Service-disabled veteran-owned small business (SDVOSB) concern eligible under the SDVOSB Program
means an SDVOSB concern that-
(1) Effective January 1, 2024, is designated in the System for Award Management (SAM) as
certified by the Small Business Administration (SBA) in accordance with 13 CFR 128.300; or
(2) Has represented that it is an SDVOSB concern in SAM and submitted a complete
application for certification to SBA on or before December 31, 2023.
Service-disabled veteran-owned small business (SDVOSB) Program means a program that authorizes
contracting officers to limit competition, including award on a sole-source basis, to SDVOSB concerns
eligible under the SDVOSB Program.
Small business concern-
(1) Means a concern, including its affiliates, that is independently owned and operated, not
dominant in its field of operation, and qualified as a small business under the criteria in 13 CFR part
121 and size standards in this solicitation.
(2) Affiliates, as used in this definition, means business concerns, one of whom directly or
indirectly controls or has the power to control the others, or a third party or parties control or have
the power to control the others. In determining whether affiliation exists, consideration is given to
all appropriate factors including common ownership, common management, and contractual
relationships. SBA determines affiliation based on the factors set forth at 13 CFR 121.103.
Small disadvantaged business concern, consistent with 13 CFR 124.1001, means a small business concern
under the size standard applicable to the acquisition, that—
(1) Is at least 51 percent unconditionally and directly owned (as defined at 13 CFR 124.105) by—
(i) One or more socially disadvantaged (as defined at13 CFR 124.103) and
economically disadvantaged (as defined at 13 CFR 124.104) individuals who
are citizens of the United States; and
(ii) Each individual claiming economic disadvantage has a net worth not
exceeding the threshold at 13 CFR 124.104(c)(2) after taking into account the
applicable exclusions set forth at 13 CFR124.104(c)(2); and
(2) The management and daily business operations of which are controlled (as defined at
13.CFR 124.106) by individuals, who meet the criteria in paragraphs (1)(i) and (ii) of this
definition.
Subsidiary means an entity in which more than 50 percent of the entity is owned-
(1) Directly by a parent corporation; or
(2) Through another subsidiary of a parent corporation
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. 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 and controlled 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 least51 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, and the concern is certified by SBA or an approved third-party certifier in
accordance with 13 CFR 127.300.
(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 in SAM.
(2) The offeror has completed the annual representations and certifications electronically
in SAM accessed through http://www.sam.gov. After reviewing SAM 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 Products and Commercial Services, have been entered or
updated in the last 12 months, are current, accurate, complete, and applicable to this
solicitation (including the business size standard(s) applicable to the NAICS code(s)
referenced for this solicitation), at the time this offer is submitted and are incorporated in
this offer by reference (see FAR 4.1201), except for paragraphs .
[Offeror to identify the applicable paragraphs at (c) through (v) of this provision that the offeror has
completed for the purposes of this solicitation only, if any.
These amended representation(s) and/or certification(s) are also incorporated in this offer and are current,
accurate, and complete as of the date of this offer.
Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to
the representations and certifications posted electronically on SAM.]
(c) Offerors must complete the following representations when the resulting contract is for supplies
to be delivered or services to be performed in the United States or its outlying areas, or when the
contracting officer has applied part 19 in accordance with 19.000(b)(1)(ii). Check all that apply.
(1) Small business concern. The offeror represents as part of its offer that-
(i) It # is, # is not a small business concern; or
(ii) It # is, # is not a small business joint venture that complies with the requirements of
13 CFR 121.103(h) and 13 CFR 125.8(a) and (b). [ The offeror shall enter the name and
unique entity identifier of each party to the joint venture: ___________ .]
(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) SDVOSB 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 that it # is, # is not an
SDVOSB concern.
(4) SDVOSB concern joint venture eligible under the SDVOSB Program. The offeror represents
that it # is, # is not an SDVOSB joint venture eligible under the SDVOSB Program that complies
with the requirements of 13 CFR 128.402. [Complete only if the offeror represented itself as an
SDVOSB concern in paragraph (c)(3) of this provision.] [The offeror shall enter the name and
unique entity identifier of each party to the joint venture: ___________ .]
(5) Small disadvantaged business concern. [Complete only if the offeror represented itself as a
small business concern in paragraph (c)(1) of this provision.] The offeror represents that it # is, # is
not a small disadvantaged business concern as defined in 13 CFR 124.1001.
(6) 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.
(7) WOSB joint venture eligible under the WOSB Program. The offeror represents that it # is, # is
not a joint venture that complies with the requirements of 13 CFR 127.506(a) through (c). [ The
offeror shall enter the name and unique entity identifier of each party to the joint venture:
___________ .]
(8) Economically disadvantaged women-owned small business (EDWOSB) joint venture. The
offeror represents that it # is, # is not a joint venture that complies with the requirements of 13 CFR
127.506(a) through (c). [The offeror shall enter the name and unique entity identifier of each party
to the joint venture: _____________ .]
Note to paragraphs (c)(9) and (10): Complete paragraphs (c)(9) and (10) only if this solicitation is
expected to exceed the simplified acquisition threshold.
(9) Women-owned business concern (other than small business concern). [Complete only if the
offeror is a women-owned business concern and did not represent itself as a small business concern
in paragraph (c)(1) of this provision.] The offeror represents that it # is a women-owned business
concern.
(10) 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: _______________ .
(11) HUBZone small business concern. [Complete only if the offeror represented itself as a small
business concern in paragraph (c)(1) of this provision.] The offeror represents, as part of its offer,
that–
(i) It # is, # is not a HUBZone small business concern listed, on the date of this
representation, as having been certified by SBA as a HUBZone small business concern in
the Dynamic Small Business Search and SAM, and will attempt to maintain an
employment rate of HUBZone residents of 35 percent of its employees during
performance of a HUBZone contract (see 13 CFR 126.200(e)(1)); and
(ii) It # is, # is not a HUBZone joint venture that complies with the requirements of 13
CFR 126.616(a) through (c). [The offeror shall enter the name and unique entity identifier
of each party to the joint venture: _____________ .] Each HUBZone small business
concern participating in the HUBZone joint venture shall provide representation of its
HUBZone status.
(d) [Reserved]
(e) Certification Regarding Payments to Influence Federal Transactions (31
http://uscode.house.gov/ U.S.C. 1352). (Applies only if the contract is expected to exceed
$150,000.) By submission of its offer, the offeror certifies to the best of its knowledge and belief
that no Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
employee of Congress or an employee of a Member of Congress on his or her behalf in connection
with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of
1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror
shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying
Activities, to provide the name of the registrants. The offeror need not report regularly employed
officers or employees of the offeror to whom payments of reasonable compensation were made.
(f) Buy American Certificate. (Applies only if the clause at Federal Acquisition Regulation (FAR)
52.225-1, Buy American-Supplies, is included in this solicitation.)
(1)
(i) The Offeror certifies that each end product, except those listed in paragraph (f)(2) of
this provision, is a domestic end product and that each domestic end product listed in
paragraph (f)(3) of this provision contains a critical component.
(ii) The Offeror shall list as foreign end products those end products manufactured in the
United States that do not qualify as domestic end products. For those foreign end products
that do not consist wholly or predominantly of iron or steel or a combination of both, the
Offeror shall also indicate whether these foreign end products exceed 55 percent domestic
content, except for those that are COTS items. If the percentage of the domestic content is
unknown, select “no”.
(iii) The Offeror shall separately list the line item numbers of domestic end products that
contain a critical component (see FAR 25.105).
(iv) The terms “commercially available off-the-shelf (COTS) item,” “critical 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 Exceeds 55% domestic content (yes/no)
———————- ———————– —————————
———————- ———————– —————————
———————- ———————– —————————
[List as necessary]
(3) Domestic end products containing a critical
component: Line Item No.
[List as necessary]
(4) The Government will evaluate offers in accordance with the policies and procedures of FAR part 25.
(g)
(1) Buy American-Free Trade Agreements-Israeli Trade Act Certificate. (Applies only if
the clause at FAR 52.225-3, Buy American-Free Trade Agreements-Israeli Trade Act, is
included in this solicitation.)
(i)
(A) The Offeror certifies that each end product, except those listed in paragraph (g)(1)(ii) or
(iii) of this provision, is a domestic end product and that each domestic end product listed
in paragraph (g)(1)(iv) of this provision contains a critical component.
(B) The terms “Bahraini, Moroccan, Omani, Panamanian, or Peruvian end product,”
“commercially available off-the-shelf (COTS) item,” “critical component,” “domestic end
product,” “end product,” “foreign end product,” “Free Trade Agreement country,” “Free
Trade Agreement country end product,” “Israeli end product,” and “United States” are
defined in the clause of this solicitation entitled “Buy American-Free Trade
Agreements-Israeli Trade Act.”
(ii) The Offeror certifies that the following supplies are Free Trade Agreement country
end products (other than Bahraini, Moroccan, Omani, Panamanian, or Peruvian end
products) or Israeli end products as defined in the clause of this solicitation entitled “Buy
American-Free Trade Agreements- Israeli Trade Act.”
Free Trade Agreement Country End Products (Other than Bahraini, Moroccan, Omani,
Panamanian, or Peruvian End Products) or Israeli End Products:
Line Item No. Country of Origin
———————- ———————–
———————- ———————–
———————- ———————–
[List as necessary]
(iii) The Offeror shall list those supplies that are foreign end products (other than those
listed in paragraph (g)(1)(ii) of this provision) as defined in the clause of this solicitation
entitled “Buy American-Free Trade Agreements-Israeli Trade Act.” The Offeror shall list
as other foreign end products those end products manufactured in the United States that
do not qualify as domestic end products. For those foreign end products that do not
consist wholly or predominantly of iron or steel or a combination of both, the Offeror
shall also indicate whether these foreign end products exceed 55 percent domestic
content, except for those that are COTS items. If the percentage of the domestic content is
unknown, select “no”.
Other Foreign End Products:
Line Item No. Country of Origin Exceeds 55% domestic content (yes/no)
———————- ———————– —————————
———————- ———————– —————————
———————- ———————– —————————
[List as necessary]
(iv) The Offeror shall list the line item numbers of domestic end products that contain a critical
component (see FAR 25.105).
Line Item No.
[List as necessary]
(v) The Government will evaluate offers in accordance with the policies and procedures of FAR part 25.
(2) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate 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 Israeli end products as defined in the
clause of this solicitation entitled “Buy American—Free Trade Agreements—Israeli Trade Act”:
Israeli End Products:
Line Item No.
———————-
———————-
———————-
[List as necessary]
(3) Buy American-Free Trade Agreements-Israeli Trade Act Certificate, Alternate III. If Alternate
III to the clause at 52.225-3 is included in this solicitation, substitute the following paragraphs
(g)(1)(i)(B) and (g)(1)(ii) for paragraphs (g)(1)(i)(B) and (g)(1)(ii) of the basic provision:
(g)(1)(i)(B) The terms “Korean end product”, “commercially available off-the-shelf (COTS) item,”
“critical component,” “domestic end product,” “end product,” “foreign end product,” “Free Trade
Agreement country,” “Free Trade Agreement country end product,” “Israeli end product,” and
“United States” are defined in the clause of this solicitation entitled “Buy American-Free Trade
Agreements-Israeli Trade Act.”
(g)(1)(ii) The Offeror certifies that the following supplies are Korean end products or Israeli end
products as defined in the clause of this solicitation entitled “Buy American—Free Trade
Agreements—Israeli Trade Act”:
Korean End Products 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 statute. The
Government will consider for award only offers of U.S.-made or designated country end products
unless the Contracting Officer determines that there are no offers for such products or that the
offers for such products are insufficient to fulfill the requirements of the solicitation.
(h) Certification Regarding Responsibility Matters (Executive Order 12689). (Applies only if the
contract value is expected to exceed the simplified acquisition threshold.) The offeror certifies, to
the best of its knowledge and belief, that the offeror and/or any of its principals–
(1) # Are, # are not presently debarred, suspended, proposed for debarment, or declared ineligible
for the award of contracts by any Federal agency;
(2) # Have, # have not, within a three-year period preceding this offer, been convicted of or had a
civil judgment rendered against them for: commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a Federal, state or local government contract or
subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making
false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property;
(3) # Are, # are not presently indicted for, or otherwise criminally or civilly charged by a
Government entity with, commission of any of these offenses enumerated in paragraph (h)(2) of
this clause; and
(4) # Have, # have not, within a three-year period preceding this offer, been notified of any
delinquent Federal taxes in an amount that exceeds the threshold at 9.104-5(a)(2) 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) In the United States (Check this box if the total anticipated price of offered end products
manufactured in the United States exceeds the total anticipated price of offered end products
manufactured outside the United States); or
(2) Outside the United States.
(k) Certificates regarding exemptions from the application of the Service Contract Labor Standards
(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.]
X (1) Maintenance, calibration, or repair of certain equipment as described in FAR 22.1003-4(c)(1). The
offeror # does # does not certify that–
(i) The items of equipment to be serviced under this contract are used regularly for other
than Governmental purposes and are sold or traded by the offeror (or subcontractor in the
case of an exempt subcontract) in substantial quantities to the general public in the course
of normal business operations;
(ii) The services will be furnished at prices which are, or are based on, established catalog
or market prices (see FAR 22.1003-4(c)(2)(ii)) for the maintenance, calibration, or repair
of such equipment; and
(iii) The compensation (wage and fringe benefits) plan for all service employees
performing work under the contract will be the same as that used for these employees and
equivalent employees servicing the same equipment of commercial customers.
X (2) Certain services as described in FAR 22.1003-4(d)(1). The offeror # does # does not certify that-
(i) The services under the contract are offered and sold regularly to non-Governmental customers,
and are provided by the offeror (or subcontractor in the case of an exempt subcontract) to the
general public in substantial 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 Labor Standards 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 the SAM to be eligible for award.)
(1) All offerors must submit the information required in paragraphs (l)(3) through (l)(5) of this
provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting
requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the
Internal Revenue Service (IRS).
(2) The TIN may be used by the Government to collect and report on any delinquent amounts
arising out of the offeror’s relationship with the Government (31 U.S.C. 7701(c)(3)). If the resulting
contract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided
hereunder may be matched with IRS records to verify the accuracy of the offeror’s TIN.
(3) Taxpayer Identification Number (TIN).
TIN: ________________ .
TIN has been applied for.
TIN is not required because:
Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income
effectively connected with the conduct of a trade or business in the United States and does not have
an office or place of business or a fiscal paying agent in the United States;
Offeror is an agency or instrumentality of a foreign government;
Offeror is an agency or instrumentality of the Federal Government.
(4) Type of organization.
Sole proprietorship;
Partnership;
Corporate entity (not tax-exempt);
Corporate entity (tax-exempt);
Government entity (Federal, State, or local);
Foreign government;
International organization per 26 CFR1.6049-4;
Other .
(5) Common parent.
Offeror is not owned or controlled by a common parent;
Name and TIN of common parent:
Name: ___________________
TIN: ____________________ .
(m) Restricted business operations in Sudan. By submission of its offer, the offeror certifies that the
offeror does not conduct any restricted business operations in Sudan.
(n) Prohibition on Contracting with Inverted Domestic Corporations.
(1) Government agencies are not permitted to use appropriated (or otherwise made available) funds
for contracts with either an inverted domestic corporation, or a subsidiary of an inverted domestic
corporation, unless the exception at 9.108-2(b) applies or the requirement is waived in accordance
with the procedures at 9.108-4.
(2) Representation. The Offeror represents that–
(i) It # is, # is not an inverted domestic corporation; and
(ii) It # is, # is not a subsidiary of an inverted domestic corporation.
(o) Prohibition on contracting with entities engaging in certain activities or transactions relating to Iran.
(1) The offeror shall e-mail questions concerning sensitive technology to the Department of State at
[email protected].
(2) Representation and Certifications. Unless a waiver is granted or an exception applies as
provided in paragraph (o)(3) of this provision, by submission of its offer, the offeror-
(i) Represents, to the best of its knowledge and belief, that the offeror does not export any sensitive
technology to the government of Iran or any entities or individuals owned or controlled by, or
acting on behalf or at the direction of, the government of Iran;
(ii) Certifies that the offeror, or any person owned or controlled by the offeror, does not engage in
any activities for which sanctions may be imposed under section 5 of the Iran Sanctions Act; and
(iii) Certifies that the offeror, and any person owned or controlled by the offeror, does not
knowingly engage in any transaction that exceeds the threshold at FAR 25.703-2(a)(2) with Iran’s
Revolutionary Guard Corps or any of its officials, agents, or affiliates, the property and interests in
property of which are blocked pursuant to the International Emergency Economic Powers Act (et
seq.) (see OFAC’s Specially Designated Nationals and Blocked Persons List at
https://www.treasury.gov/resource-center/sanctions/SDN-List/Pages/default.aspx).
(3) The representation and certification requirements of paragraph (o)(2) of this provision do not apply if-
(i) This solicitation includes a trade agreements certification (e.g., 52.212-3(g) or a comparable
agency provision); and
(ii) The offeror has certified that all the offered products to be supplied are designated country end products.
(p) Ownership or Control of Offeror. (Applies in all solicitations when there is a requirement to be
registered in SAM or a requirement to have a unique entity identifier in the solicitation).
(1) The Offeror represents that it # has or # does not have an immediate owner. If the Offeror has
more than one immediate owner (such as a joint venture), then the Offeror shall respond to
paragraph (2) and if applicable, paragraph (3) of this provision for each participant in the joint
venture.
(2) If the Offeror indicates “has” in paragraph (p)(1) of this provision, enter the following information:
Immediate owner CAGE code: _________________ .
Immediate owner legal name: _________________ .
(Do not use a “doing business as” name)
Is the immediate owner owned or controlled by another entity: # Yes or # No.
(3) If the Offeror indicates “yes” in paragraph (p)(2) of this provision, indicating that the immediate
owner is owned or controlled by another entity, then enter the following information:
Highest-level owner CAGE code: _______________ .
Highest-level owner legal name: _______________ .
(Do not use a “doing business as” name)
(q) Representation by Corporations Regarding Delinquent Tax Liability or a Felony Conviction under any
Federal Law.
(1) As required by sections 744 and 745 of Division E of the Consolidated and Further Continuing
Appropriations Act, 2015 (Pub. L. 113-235), and similar provisions, if contained in subsequent
appropriations acts, The Government will not enter into a contract with any corporation that–
(i) Has any unpaid Federal tax liability that has been assessed, for which all judicial and
administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely
manner pursuant to an agreement with the authority responsible for collecting the tax liability,
where the awarding agency is aware of the unpaid tax liability, unless an agency has considered
suspension or debarment of the corporation and made a determination that suspension or debarment
is not necessary to protect the interests of the Government; or
(ii) Was convicted of a felony criminal violation under any Federal law within the preceding 24
months, where the awarding agency is aware of the conviction, unless an agency has considered
suspension or debarment of the corporation and made a determination that this action is not
necessary to protect the interests of the Government.
(2) The Offeror represents that-
(i) It is # is not # a corporation that has any unpaid Federal tax liability that has been assessed, for
which all judicial and administrative remedies have been exhausted or have lapsed, and that is not
being paid in a timely manner pursuant to an agreement with the authority responsible for collecting
the tax liability; and
(ii) It is # is not # a corporation that was convicted of a felony criminal violation under a Federal
law within the preceding 24 months.
(r) Predecessor of Offeror. (Applies in all solicitations that include the provision at 52.204-16,
Commercial and Government Entity Code Reporting.)
(1) The Offeror represents that it # is or # is not a successor to a predecessor that held a Federal
contract or grant within the last three years.
(2) If the Offeror has indicated “is” in paragraph (r)(1) of this provision, enter the following
information for all predecessors that held a Federal contract or grant within the last three years (if
more than one predecessor, list in reverse chronological order):
Predecessor CAGE code: (or mark “Unknown”).
Predecessor legal name: ________________
(Do not use a “doing business as” name).
(s) Reserved.
(t) Reserved.
(u)
(1) In accordance with section 743 of Division E, Title VII, of the Consolidated and
Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor
provisions in subsequent appropriations acts (and as extended in continuing resolutions),
Government agencies are not permitted to use appropriated (or otherwise made available)
funds for contracts with an entity that requires employees or subcontractors of such entity
seeking to report waste, fraud, or abuse to sign internal confidentiality agreements or
statements prohibiting or otherwise restricting such employees or subcontractors from
lawfully reporting such waste, fraud, or abuse to a designated investigative or law
enforcement representative of a Federal department or agency authorized to receive such
information.
(2) The prohibition in paragraph (u)(1) of this provision does not contravene requirements
applicable to Standard Form 312 (Classified Information Nondisclosure Agreement),
Form 4414 (Sensitive Compartmented Information Nondisclosure Agreement), or any
other form issued by a Federal department or agency governing the nondisclosure of
classified information.
(3) Representation. By submission of its offer, the Offeror represents that it will not
require its employees or subcontractors to sign or comply with internal confidentiality
agreements or statements prohibiting or otherwise restricting such employees or
subcontractors from lawfully reporting waste, fraud, or abuse related to the performance
of a Government contract to a designated investigative or law enforcement representative
of a Federal department or agency authorized to receive such information (e.g., agency
Office of the Inspector General).
(v) Covered Telecommunications Equipment or Services-Representation. Section
889(a)(1)(A) and section 889 (a)(1)(B) of Public Law 115-232.
(1) The Offeror shall review the list of excluded parties in the System for Award
Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal
awards for “covered telecommunications equipment or services”.
(i) The Offeror represents that- It # does, # does not provide covered
telecommunications equipment or services as a part of its offered products or
services to the Government in the performance of any contract, subcontract, or
other contractual instrument.
(ii) After conducting a reasonable inquiry for purposes of this representation,
that it # does, # does not use covered telecommunications equipment or
services, or any equipment, system, or service that uses covered
telecommunications equipment or services.

(a)This representation shall be completed if the Offeror received $7.5 million or more in Federal contract awards in the prior Federal fiscal year. The representation is optional if the Offeror received less than $7.5 million in Federal contract awards in the prior Federal fiscal year.

(b)Representation. [Offeror is to check applicable blocks in paragraphs (1) and (2).]

(1)The Offeror (itself or through its immediate owner or highest-level owner) □ does, □ does not publicly disclose greenhouse gas emissions, i.e., make available on a publicly accessible website the results of a greenhouse gas inventory, performed in accordance with an accounting standard with publicly available and consistently applied criteria, such as the Greenhouse Gas Protocol Corporate Standard.

(2)The Offeror (itself or through its immediate owner or highest-level owner) □ does, □ does not publicly disclose a quantitative greenhouse gas emissions reduction goal, i.e., make available on a publicly available website a target to reduce absolute emissions or emissions intensity by a specific quantity or percentage.

(3)A publicly accessible website includes the Offeror’s own website or a recognized, third-party greenhouse gas emissions reporting program.

(c)If the Offeror checked “does” in paragraphs (b)(1) or (b)(2) of this provision, respectively, the Offeror shall provide the publicly accessible website(s) where greenhouse gas emissions and/or reduction goals are reported:________________.

The Contractor’s work under this contract shall conform with all operational controls identified in the applicable agency or facility Environmental Management Systems and provide monitoring and measurement information necessary for the Government to address environmental performance relative to the goals of the Environmental Management Systems.

(a)Definitions. As used in this clause-

Gender identity has the meaning given by the Department of Labor’s Office of Federal Contract Compliance Programs, and is found at http://www.dol.gov/ofccp/LGBT/LGBT_FAQs.html.

Sexual orientation has the meaning given by the Department of Labor’s Office of Federal Contract Compliance Programs, and is found at http://www.dol.gov/ofccp/LGBT/LGBT_FAQs.html.

(b)Requirement to notify.

(1)It is a violation of Executive Order 11246 for a Contractor to refuse to employ any applicant or not to assign any person hired in the United States, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, or Wake Island, on the basis that the individual’s race, color, religion, sex, sexual orientation, gender identity, or national origin is not compatible with the policies of the country where or for whom the work will be performed (41 CFR 60-1.10).

(2)The Contractor shall notify the U.S. Department of State, Assistant Secretary, Bureau of Political-Military Affairs (PM), 2201 C Street NW, Room 6212, Washington, DC 20520, and the U.S. Department of Labor, Deputy Assistant Secretary for Federal Contract Compliance, when it has knowledge of any employee or potential employee being denied an entry visa to a country where this contract will be performed, and it believes the denial is attributable to the race, color, religion, sex, sexual orientation, gender identity, or national origin of the employee or potential employee.

(a)Definition. As used in this clause.

Compensation means any payments made to, or on behalf of, an employee or offered to an applicant as remuneration for employment, including but not limited to salary, wages, overtime pay, shift differentials, bonuses, commissions, vacation and holiday pay, allowances, insurance and other benefits, stock options and awards, profit sharing, and retirement.

Compensation information means the amount and type of compensation provided to employees or offered to applicants, including, but not limited to, the desire of the Contractor to attract and retain a particular employee for the value the employee is perceived to add to the Contractor’s profit or productivity; the availability of employees with like skills in the marketplace; market research about the worth of similar jobs in the relevant marketplace; job analysis, descriptions, and evaluations; salary and pay structures; salary surveys; labor union agreements; and Contractor decisions, statements and policies related to setting or altering employee compensation.

Essential job functions means the fundamental job duties of the employment position an individual holds. A job function may be considered essential if-

(1)The access to compensation information is necessary in order to perform that function or another routinely assigned business task; or

(2)The function or duties of the position include protecting and maintaining the privacy of employee personnel records, including compensation information.

Gender identity has the meaning given by the Department of Labor’s Office of Federal Contract Compliance Programs, and is found at http://www.dol.gov/ofccp/LGBT/LGBT_FAQs.html.

Sexual orientation has the meaning given by the Department of Labor’s Office of Federal Contract Compliance Programs, and is found at http://www.dol.gov/ofccp/LGBT/LGBT_FAQs.html.

United States, means the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. Virgin Islands, and Wake Island.

(b)

(1)If, during any 12-month period (including the 12 months preceding the award of this contract), the Contractor has been or is awarded nonexempt Federal contracts and/or subcontracts that have an aggregate value in excess of $10,000, the Contractor shall comply with this clause, except for work performed outside the United States by employees who were not recruited within the United States. Upon request, the Contractor shall provide information necessary to determine the applicability of this clause.

(2)If the Contractor is a religious corporation, association, educational institution, or society, the requirements of this clause do not apply with respect to the employment of individuals of a particular religion to perform work connected with the carrying on of the Contractor’s activities (41 CFR 60-1.5).

(c)

(1)The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. However, it shall not be a violation of this clause for the Contractor to extend a publicly announced preference in employment to Indians living on or near an Indian reservation, in connection with employment opportunities on or near an Indian reservation, as permitted by 41 CFR 60-1.5.

(2)The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. This shall include, but not be limited to-

(i)Employment;

(ii)Upgrading;

(iii)Demotion;

(iv)Transfer;

(v)Recruitment or recruitment advertising;

(vi)Layoff or termination;

(vii)Rates of pay or other forms of compensation; and

(viii)Selection for training, including apprenticeship.

(3)The Contractor shall post in conspicuous places available to employees and applicants for employment the notices to be provided by the Contracting Officer that explain this clause.

(4)The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.

(5)

(i)The Contractor shall not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This prohibition against discrimination does not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee’s essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the Contractor’s legal duty to furnish information.

(ii)The Contractor shall disseminate the prohibition on discrimination in paragraph (c)(5)(i) of this clause, using language prescribed by the Director of the Office of Federal Contract Compliance Programs (OFCCP), to employees and applicants by-

(A)Incorporation into existing employee manuals or handbooks; and

(B)Electronic posting or by posting a copy of the provision in conspicuous places available to employees and applicants for employment.

(6)The Contractor shall send, to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, the notice to be provided by the Contracting Officer advising the labor union or workers’ representative of the Contractor’s commitments under this clause, and post copies of the notice in conspicuous places available to employees and applicants for employment.

(7)The Contractor shall comply with Executive Order11246, as amended, and the rules, regulations, and orders of the Secretary of Labor.

(8)The Contractor shall furnish to the contracting agency all information required by Executive Order11246, as amended, and by the rules, regulations, and orders of the Secretary of Labor. The Contractor shall also file Standard Form100 (EEO-1), or any successor form, as prescribed in 41 CFR Part 60-1. Unless the Contractor has filed within the 12 months preceding the date of contract award, the Contractor shall, within 30 days after contract award, apply to either the regional Office of Federal Contract Compliance Programs (OFCCP) or the local office of the Equal Employment Opportunity Commission for the necessary forms.

(9)The Contractor shall permit access to its premises, during normal business hours, by the contracting agency or the OFCCP for the purpose of conducting on-site compliance evaluations and complaint investigations. The Contractor shall permit the Government to inspect and copy any books, accounts, records (including computerized records), and other material that may be relevant to the matter under investigation and pertinent to compliance with Executive Order11246, as amended, and rules and regulations that implement the Executive Order.

(10)If the OFCCP determines that the Contractor is not in compliance with this clause or any rule, regulation, or order of the Secretary of Labor, this contract may be canceled, terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts, under the procedures authorized in Executive Order11246, as amended. In addition, sanctions may be imposed and remedies invoked against the Contractor as provided in Executive Order11246, as amended; in the rules, regulations, and orders of the Secretary of Labor; or as otherwise provided by law.

(11)The Contractor shall include the terms and conditions of this clause in every subcontract or purchase order that is not exempted by the rules, regulations, or orders of the Secretary of Labor issued under Executive Order11246, as amended, so that these terms and conditions will be binding upon each subcontractor or vendor.

(12)The Contractor shall take such action with respect to any subcontract or purchase order as the Director of OFCCP may direct as a means of enforcing these terms and conditions, including sanctions for noncompliance, provided, that if the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of any direction, the Contractor may request the United States to enter into the litigation to protect the interests of the United States.

(d)Notwithstanding any other clause in this contract, disputes relative to this clause will be governed by the procedures in 41 CFR 60-1.

(End of clause)

If a contract in the amount of $10 million or more will result from this solicitation, the prospective Contractor and its known first-tier subcontractors with anticipated subcontracts of $10 million or more shall be subject to a preaward compliance evaluation by the Office of Federal Contract Compliance Programs (OFCCP), unless, within the preceding 24 months, OFCCP has conducted an evaluation and found the prospective Contractor and subcontractors to be in compliance with Executive Order11246.