American Embassy Kiev

Date: 9/08/2006

# To: Prospective Quoters

Subject: Request for Quotations number **SOUP300-06-Q-0007**

Enclosed is a Request for Quotations (RFQ) for **completing Retail
Pricing Survey.** If you would like to submit a quotation complete the
required portions of the attached document (SF-1449, Continuation to
SF-1449, and Section 3), and submit it to the address shown on the
Standard Form 1449 that follows this letter.

The U.S. Government intends to award a contract/purchase order to the
responsible company submitting an acceptable quotation at the lowest
price. We intend to award a contract/purchase order based on initial
quotations, without holding discussions, although we may hold
discussions with companies in the competitive range if there is a need
to do so.

Quotations are due **by 17:00 on Friday, September 15, 2006.**

Sincerely,

Eric Mendenhall,

Contracting Officer

Enclosure

#### TABLE OF CONTENTS

**Section 1 - The Schedule**

-   SF 1449 cover sheet

-   Continuation To SF-1449, RFQ Number **SOUP300-06-Q-0007,** Prices,
    Block 23

-   Continuation To SF-1449, RFQ Number **SOUP300-06-Q-0007,** Schedule
    Of Supplies/Services, Block 20 Description/Specifications/Work
    Statement

-   Attachment 1 to Description/Specifications/Statement of Work,
    DSP-23Y Report - Forms DS-2020 through DS-2027:

1.  Full Cost of Living Survey (Form DS-2020 through DS-2025)

2.  Hotel and Restaurant Report (Form DS-2026)

3.  Embassy Store Report (Form DS-2027)

### Section 2 -- Contract Clauses

**Section 3** -- **Offeror Representations and Certifications**

#### SECTION 1 - THE SCHEDULE

**CONTINUATION TO SF-1449, RFQ NUMBER SOUP300-06-Q-0007 PRICES, BLOCK
23**

##### [SCOPE OF SERVICES]{.underline}

The contractor shall complete all work, including furnishing all labor,
material, transportation, equipment and services, required under this
contract for cost-of-living survey services within the time specified.
The price listed below shall include all labor, materials, overhead, and
profit. In consideration of satisfactory performance of all scheduled
services required under this contract, the Government will pay the
contractor a firm-fixed-price for performing the following survey(s):

[Line Item]{.underline} [Description]{.underline} [Price]{.underline}

1 Full cost of living survey (Form DS-2020 through DS-2025)\
\_\_\_\_\_\_\_\_\_

2 Hotel and Restaurant Report (Form DS-2026) \_\_\_\_\_\_\_\_\_

3 Embassy Store Report (Form DS-2027) \_\_\_\_\_\_\_\_\_

Total: \_\_\_\_\_\_\_\_\_

(local currency)

**CONTINUATION TO SF-1449, RFQ NUMBER *SOUP300-06-Q-0007* SCHEDULE OF
SUPPLIES/SERVICES, BLOCK 20 DESCRIPTION/SPECIFICATIONS/WORK STATEMENT**

The contractor shall perform the following survey(s). The contractor
shall be familiar with the local market, American norms, and be able to
read English well enough to follow the instructions provided below and
the forms required to complete the work.

\(1\) [IMPORTANCE OF RETAIL PRICE SURVEY (DS-2020 through
DS-2025)]{.underline}

The full Retail Price Schedule used to measure living cost differences
between locations abroad and Washington, D.C., serves as the basis for
determining:

-   Any \"post\" (cost-of-living) allowance for Federal civilian
    employees;

-   The U.S. Department of Defense cost-of-living allowances (COLA) for
    members of the Uniformed Services; and

-   Cost-of-living comparisons for American business firms and other
    organizations who maintain allowances for private Americans abroad.

[The Hotel and Restaurant Report (Form DS-2026)]{.underline}

The Hotel and Restaurant Report are used to maintain appropriate travel
per diem allowances for U.S. Government personnel (civilian and
uniformed services).

[The Embassy or Consulate Store Report (Form Ds-2027)]{.underline}

The Embassy or Consulate Store Report is used to report prices at
Embassy and Consulate Commissaries or Employee Association Stores. In
locations with such facilities, these prices are an integral part of
determining the cost-of-living.

\(3\) [PREPARATION FOR RETAIL PRICE SURVEY]{.underline}

This survey must accurately reflect foreign living costs for the average
American family. The index numbers computed from the survey are designed
to reflect costs for the average Washington, DC family living in the
foreign area. The contractor must be familiar with the retail outlets
and types of goods and services generally used by an average family.

\(4\) [BASIC SURVEY TECHNIQUES]{.underline}

The contractor shall personally visit the retail outlets covered in the
survey. In addition to personally inspecting the items and their prices,
it is important that the contractor meets the store or department
manager and obtains their cooperation, which is essential for a good
survey. Contractors shall identify themselves as working under contract
to the U.S. Mission and explain the reasons for the survey and its
importance to the American community. The contractor shall ask to
collect the information on his or her own. In a large store, the
contractor shall request the names of the managers of the various
departments.

The contractor shall gather specific information from each retail
source. The forms provide instructions for each section. In order to
accurately compare overseas costs with those in Washington, D.C., it is
important that the contractor follow these specifications as closely as
local conditions permit.

The contractor shall view the actual items rather than relying on an
inventory list from the store manager in order to judge the suitability
of individual items for American employees.

Sometimes it is necessary for contractors to pledge confidentiality or
to place other restrictions on the use of data they collect from a
specific retail establishment. Any such restrictions must be clearly
noted in an attachment to the survey report. This specific proprietary
information will not be subject to disclosure under the Freedom of
Information Act. This is an important point, as the ability of the
program to obtain objective and reliable price data hinges upon the
goodwill and cooperation of the retail merchants participating in the
survey.

\(5\) [SELECTION OF OUTLETS]{.underline}

The Embassy shall provide a copy of the previous survey with a list of
the two most frequently used local retail establishments at post for the
various categories of retails products (such as, beef, seafood, men's
clothes). The contractor shall visit these retail establishments to
collect information on the corresponding goods and services. If an
establishment no longer carries a particular product, a substitute
outlet that also is popular among U.S. government and private personnel
shall be chosen and the information collected. The retail establishment
must be available to Government, military, and private personnel. Use
the comments section of the appropriate pages to fully explain why the
substitution was necessary.

\(6\) [SELECTION OF PRICES]{.underline}

The **Retail Price Schedule** lists the names of specific items and
sometimes, specific sizes and requests [The Typical Retail
Price]{.underline} for those items (such as, steak, apples, canned
vegetables (15-17 oz.)).

-   The items priced shall be as close as possible in quality to those
    found in the U.S.

-   If a survey item is available at more than one price and no size is
    specified on the package, report the price for the one that appears
    to be the closest to that requested in the DS-2020 through DS-2025.

-   If a requested size is not available, the closest equivalent size
    shall be selected.

-   If a requested item is not available at the retail outlet, a
    comparable item may be substituted but this substitution must be
    explained in the comments section of the appropriate page of the
    DS-2020 through DS-2025.

-   Embassy commissary prices shall be reported only on DS-2027.

For most survey items, the report also asks for substitute and economy
price items.

-   **The Substitute Price Item** represents the item most often
    purchased as the consumer\'s **second choice** when the typical item
    is unavailable. This item may be more or less expensive than the
    typically priced item. In some cases, it may be an identical price
    but represent a different brand or item variation.

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-   **The Economy Price Item** represents the **least expensive** item
    suitable for use by the American family at the foreign location.

If either the \"typical\" or the \"substitute\" item is also the lowest
price item, it shall be repeated as the economy item. The contractor
shall use its judgment, based upon an average American family's
selection of items and normal budget constraints, to select items which
would represent substitute and economy items.

> The reporting of three price levels where appropriate is important. If
> an item is temporarily out of stock, the price last charged shall be
> listed in the report. Anticipated price changes shall be given
> separately. Every effort shall be made to provide the full price range
> requested for a particular outlet. If either the first or second most
> frequently used outlets do not carry the item requested, the
> contractor shall visit another retail outlet (preferably, the third
> most used outlet as determined by the LPQs) to collect the price data.

All prices in the report shall be those actually paid by Americans. If a
survey item is on sale, the regular price, the special sale price, and
the duration of the sale must be reported. If the reported prices do not
include local retail sales taxes, the amount of tax added to each item
by the merchant (at the time of purchase) shall be clearly reported at
the top of the appropriate pages of the Retail Price Schedule. Special
cash discounts and delivery charges shall be reported in the
"description" or "comments" areas.

If prices are significantly lower when purchased with U.S. dollars or
other forms of currency, this shall be reported.

**Note**[:]{.underline} the price information reported on pages 2
through 38 of the retail price schedule must be local retail prices
available to all American residents. These prices are used to develop
and publish living cost comparisons for use by the public.

\(7\) [SUMMARY OF SURVEY PREPARATION GUIDELINES]{.underline}

a\. The contractor shall submit the completed survey to the Contracting
Officer's Representative, who will coordinate the survey with all other
U.S. Government agencies at the post, the senior officer of the
uniformed services, and the American private community.

b\. The contractor shall complete the 2003 version of the Retail Price
Schedule (form DS-2020 through DS-2027).

(1) reserved

d\. If there has been a previous survey, it must be used as a guide in
preparing the new survey report. To the extent possible, report the
prices of the same type, brand, or model of individual items from survey
to survey. Avoid item substitution beyond that required by the item
specifications or changes in local availability.

e\. The survey shall reflect living costs for the average Washington
family, 3 to 4 persons, living in the foreign location with a base
salary of about \$41,000 (GS-11, Step 5) per year in 1998. The
contractor shall avoid premium or luxury goods this family cannot
afford, even if it can.

f\. Report prices in the currency charged by the individual outlet.
Explain all usage of non-local currency. [The contractor shall not
convert local currency prices into U.S. dollars]{.underline}.

g\. Report local weights and measures for each individual item. [The
contractor shall not convert local weight measures (such as kilos) into
pounds and ounces]{.underline}.

h\. All prices reported on pages 2 through 38 of the DSP-23Y report
shall be local retail prices available to all American residents,
including uniformed military and private U.S. citizens.

i\. Report prices of goods available at Embassy Commissary on pages 44
-51 of the survey form. These prices are reported
[separately]{.underline} and [in addition]{.underline} [to]{.underline}
the prices at the two most frequently used local retail outlets.

j\. The finished report shall be submitted to the COR for review for
completeness and accuracy, and then coordinated with the heads of all
civilian agencies at the post and the senior officer of the uniformed
services before submission (see pages 43-44).

\(8\) Due Dates for Deliverables

The contractor shall deliver to the Contracting Officer's Representative
the following report(s) by the date(s) indicated:

[Item]{.underline} [Description]{.underline} [Due Date]{.underline}

1 Full Cost of Living Survey (Form DS-2020 through DS-2025)\
10/13/2006

2 Hotel and Restaurant Report (Form DS-2026) 10/13/2006

3 Embassy Store Report (Form DS-2027) 10/13/2006

\(9\) [REVIEW BEFORE SUBMISSION]{.underline}

######  OMISSIONS

When completed, the contractor shall review the report to ensure that
all the information requested is furnished. While all the items may not
necessarily be used by U.S. Government employees, each represents a
broad class of other goods and services important to Americans. The
omission of any price quotation eliminates the type of expenditure it
represents. In those cases where goods and services are available to
Government employees through special facilities, some local items are
important to living-cost comparisons made for private Americans residing
at the post. In addition, should there be a sudden change in the
availability of special facilities for Federal employees, this local
price information shall enable the Department to make allowance
adjustments without a time-consuming survey of the missing items.

[INCONSISTENCIES WITH PREVIOUS SURVEY]{.underline}

The contractor shall compare all current prices and weights with the
previous survey. If the prices or weights are substantially different,
provide explanations or comments so that it will not be assumed there is
an error in the current report. If errors are discovered in the previous
survey, this shall be reported so that a valid comparison between the
reports can be made.

**Attachment 1**

DSP-23Y Report :

1\) Form DS-2020 through DS-2025, Retail Price Schedule

2\) Form DS-2026, Hotel and Restaurant Report

3\) Form DS-2027, Embassy Store Report

**SECTION 2 -- CONTRACT CLAUSES**

[652.232-70 PAYMENT SCHEDULE AND INVOICE SUBMISSION (FIXED-PRICE) (AUG
1999)]{.underline}

\(a\) General. The Government shall pay the contractor as full
compensation for all work required, performed, and accepted under this
contract the firm fixed-price stated in this contract.

\(b\) Invoice Submission. The contractor shall submit invoices in an
original to the office identified in Block 18b of the SF-1449. To
constitute a proper invoice, the invoice shall include all the items
required by FAR 32.905(e).

The contractor shall show Value Added Tax (VAT) as a separate item on
invoices submitted for payment.

\(c\) Contractor Remittance Address. The Government will make payment to
the contractor's address stated on the cover page of this contract,
unless a separate remittance address is shown below:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[52.232-34 \-- Payment by Electronic Funds Transfer\--Other Than Central
Contractor Registration (May 1999)]{.underline}

\(a\) *Method of payment.*

> \(1\) All payments by the Government under this contract shall be made
> by electronic funds transfer (EFT), except as provided in paragraph
> (a)(2) of this clause. As used in this clause, the term "EFT" refers
> to the funds transfer and may also include the payment information
> transfer.
>
> \(2\) In the event the Government is unable to release one or more
> payments by EFT, the Contractor agrees to either\--
>
> \(i\) Accept payment by check or some other mutually agreeable method
> of payment; or
>
> \(ii\) Request the Government to extend payment due dates until such
> time as the Government makes payment by EFT (but see paragraph (d) of
> this clause).

\(b\) *Mandatory submission of Contractor\'s EFT information*.

> \(1\) The Contractor is required to provide the Government with the
> information required to make payment by EFT (see paragraph (j) of this
> clause). The Contractor shall provide this information directly to the
> office designated in this contract to receive that information
> (hereafter: \`\`designated office\'\') by
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \[*the Contracting Officer
> shall insert date, days after award, days before first request, the
> date specified for receipt of offers if the provision at 52.232-38 is
> utilized, or \`\`concurrent with first request\'\' as prescribed by
> the head of the agency; if not prescribed, insert \`\`no later than 15
> days prior to submission of the first request for payment\'\'*\]. If
> not otherwise specified in this contract, the payment office is the
> designated office for receipt of the Contractor\'s EFT information. If
> more than one designated office is named for the contract, the
> Contractor shall provide a separate notice to each office. In the
> event that the EFT information changes, the Contractor shall be
> responsible for providing the updated information to the designated
> office(s).
>
> \(2\) If the Contractor provides EFT information applicable to
> multiple contracts, the Contractor shall specifically state the
> applicability of this EFT information in terms acceptable to the
> designated office. However, EFT information supplied to a designated
> office shall be applicable only to contracts that identify that
> designated office as the office to receive EFT information for that
> contract.

\(c\) *Mechanisms for EFT payment*. The Government may make payment by
EFT through either the Automated Clearing House (ACH) network, subject
to the rules of the National Automated Clearing House Association, or
the Fedwire Transfer System. The rules governing Federal payments
through the ACH are contained in 31 CFR part 210.

\(d\) *Suspension of payment*. (1) The Government is not required to
make any payment under this contract until after receipt, by the
designated office, of the correct EFT payment information from the
Contractor. Until receipt of the correct EFT information, any invoice or
contract financing request shall be deemed not to be a proper invoice
for the purpose of prompt payment under this contract. The prompt
payment terms of the contract regarding notice of an improper invoice
and delays in accrual of interest penalties apply.

> \(2\) If the EFT information changes after submission of correct EFT
> information, the Government shall begin using the changed EFT
> information no later than 30 days after its receipt by the designated
> office to the extent payment is made by EFT. However, the Contractor
> may request that no further payments be made until the updated EFT
> information is implemented by the payment office. If such suspension
> would result in a late payment under the prompt payment terms of this
> contract, the Contractor\'s request for suspension shall extend the
> due date for payment by the number of days of the suspension.

\(e\) *Liability for uncompleted or erroneous transfers*.

> \(1\) If an uncompleted or erroneous transfer occurs because the
> Government used the Contractor\'s EFT information incorrectly, the
> Government remains responsible for\--
>
> \(i\) Making a correct payment;
>
> \(ii\) Paying any prompt payment penalty due; and
>
> \(iii\) Recovering any erroneously directed funds.
>
> \(2\) If an uncompleted or erroneous transfer occurs because the
> Contractor\'s EFT information was incorrect, or was revised within 30
> days of Government release of the EFT payment transaction instruction
> to the Federal Reserve System, and\--
>
> \(i\) If the funds are no longer under the control of the payment
> office, the Government is deemed to have made payment and the
> Contractor is responsible for recovery of any erroneously directed
> funds; or
>
> \(ii\) If the funds remain under the control of the payment office,
> the Government shall not make payment and the provisions of paragraph
> (d) shall apply.

\(f\) *EFT and prompt payment*. A payment shall be deemed to have been
made in a timely manner in accordance with the prompt payment terms of
this contract if, in the EFT payment transaction instruction released to
the Federal Reserve System, the date specified for settlement of the
payment is on or before the prompt payment due date, provided the
specified payment date is a valid date under the rules of the Federal
Reserve System.

\(g\) *EFT and assignment of claims*. If the Contractor assigns the
proceeds of this contract as provided for in the assignment of claims
terms of this contract, the Contractor shall require as a condition of
any such assignment, that the assignee shall provide the EFT information
required by paragraph (j) of this clause to the designated office, and
shall be paid by EFT in accordance with the terms of this clause. In all
respects, the requirements of this clause shall apply to the assignee as
if it were the Contractor. EFT information that shows the ultimate
recipient of the transfer to be other than the Contractor, in the
absence of a proper assignment of claims acceptable to the Government,
is incorrect EFT information within the meaning of paragraph (d) of this
clause.

\(h\) *Liability for change of EFT information by financial agent*. The
Government is not liable for errors resulting from changes to EFT
information provided by the Contractor\'s financial agent.

\(i\) *Payment information*. The payment or disbursing office shall
forward to the Contractor available payment information that is suitable
for transmission as of the date of release of the EFT instruction to the
Federal Reserve System. The Government may request the Contractor to
designate a desired format and method(s) for delivery of payment
information from a list of formats and methods the payment office is
capable of executing. However, the Government does not guarantee that
any particular format or method of delivery is available at any
particular payment office and retains the latitude to use the format and
delivery method most convenient to the Government. If the Government
makes payment by check in accordance with paragraph (a) of this clause,
the Government shall mail the payment information to the remittance
address in the contract.

\(j\) *EFT information*. The Contractor shall provide the following
information to the designated office. The Contractor may supply this
data for this or multiple contracts (see paragraph (b) of this clause).
The Contractor shall designate a single financial agent per contract
capable of receiving and processing the EFT information using the EFT
methods described in paragraph (c) of this clause.

> \(1\) The contract number (or other procurement identification
> number).
>
> \(2\) The Contractor\'s name and remittance address, as stated in the
> contract(s).
>
> \(3\) The signature (manual or electronic, as appropriate), title, and
> telephone number of the Contractor official authorized to provide this
> information.
>
> \(4\) The name, address, and 9-digit Routing Transit Number of the
> Contractor\'s financial agent.
>
> \(5\) The Contractor\'s account number and the type of account
> (checking, saving, or lockbox).
>
> \(6\) If applicable, the Fedwire Transfer System telegraphic
> abbreviation of the Contractor\'s financial agent.
>
> \(7\) If applicable, the Contractor shall also provide the name,
> address, telegraphic abbreviation, and 9-digit Routing Transit Number
> of the correspondent financial institution receiving the wire transfer
> payment if the Contractor\'s financial agent is not directly on-line
> to the Fedwire Transfer System; and, therefore, not the receiver of
> the wire transfer payment.

**SECTION 3** -- OFFEROR REPRESENTATIONS AND CERTIFICATIONS

[52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS -- COMMERCIAL ITEMS
(JUNE 2006)]{.underline}

An offeror shall complete only paragraph (j) 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 (b) through (i) of
this provision.

\(a\) \[Reserved\]

\(b\) 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
> (b)(3) through (b)(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 (3l 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 U.S. and does not have an office
> or place of business or a fiscal paying agent in the United States;

\_\_\_ Offeror is an agency or instrumentality of a foreign government;

\_\_\_ Offeror is an agency or instrumentality of the Federal
Government.

> \(4\) Type of Organization.

\_\_ Sole Proprietorship;

\_\_ Partnership:

\_\_ Corporate Entity (not tax-exempt);

\_\_ Corporate Entity (tax-exempt);

\_\_ Government entity (Federal, State, or local);

\_\_ Foreign government;

\_\_ International organization per 26 CFR 1.6049-4;

\_\_ Other
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

> \(5\) Common Parent.
>
> \_\_\_ Offeror is not owned or controlled by a common parent;

\_\_\_ Name and TIN of common parent;

Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

TIN
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

\(c\) -- (d) \[Reserved\]

­­­­

\(e\) 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.

\(f\) --(g) Reserved

\(h\) Certification Regarding Debarment, Suspension or Ineligibility for
Award (Executive Order 12549). (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; and

\(2\) \[ \] 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, or receiving stolen
property; and

\(3\) \[ \] Are, \[ \] are not presently indicted for, or otherwise
criminally or civilly charged by a Government entity with, commission of
any of these offenses.

\(i\) 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)(1) *Annual Representations and Certifications.* Any changes provided
by the offeror in paragraph (j) 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
[h*ttp://orca.bpn.gov*](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 (b) through (i) 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.\]*