## RFP ATTACHMENT 5

RFP S06-285

# Representations, Certifications and other Statements of Offerors

1\. FAR 52.203-2 Certification of Independent Price Determination

2\. FAR 52.203-11 Certification and Disclosure Regarding Payments to
Influence Certain Federal

> Transactions (DEVIATION)

3\. FAR 52.204-3 Taxpayer Identification

4\. FAR 52.204-5 Women-Owned Business (Other Than Small Business)

5\. FAR 52.209-5 Certification Regarding Debarment, Suspension, Proposed
Debarment and Other

> Responsibility Matters

6\. FAR 52.215-6 Place of Performance

7\. FAR 52.219-1 Small Business Program Representations

8\. FAR 52.219-19 Small Business Concern Representation for the Small
Business Competitiveness

> Demonstration Program

9\. FAR 52.219-21 Small Business Size Representation for Targeted
Industry Categories Under the

> Small Business Competitiveness Demonstration Program

10\. FAR 52.219-22 Small Disadvantaged Business Status

11\. FAR 52.222-18 Certification Regarding Knowledge of Child Labor for
Listed End Products

12\. FAR 52.222-22 Previous Contracts and Compliance Reports

13\. FAR 52.222-25 Affirmative Action Compliance

14\. FAR 52.222-38 Compliance with Veterans' Employment Reporting
Requirements

15\. FAR 52.222-48 Exemption From Application of Service Contract Act
Provisions

16\. FAR 52.223-4 Recovered Material Certification

17\. FAR 52.223-9 Estimate of Percentage of Recovered Material Content
for EPA -- Designated Products, Alternate I

18\. FAR 52.223-13 Certification of Toxic Chemical Release Reporting

19\. FAR 52.225-2 Buy American Act\--Balance of Payments Program
Certificate

20\. FAR 52.225-4 Buy American Act\--North American Free Trade
Agreement\--Israeli Trade Act---

> Balance of Payments Program Certificate

21\. FAR 52.225-6 Trade Agreements Certificate

22\. FAR 52.226-2 Historically Black College or University and Minority
Institution Representation

23\. FAR 52.227-6 Royalty Information

24\. Certification Regarding Environmental Tobacco Smoke

25\. FAR 52.227-15 Representation of Limited Rights Data and Restricted
Computer Software

[To Be Completed by the Offeror]{.underline}: **(The Representations and
Certifications must be executed by an individual authorized to bind the
offeror.)** The offeror makes the following Representations and
Certifications as part of its proposal **(check/complete all appropriate
boxes or blanks on the following pages**).

  --------------------------------------------- -- -----------------------
                                                   

  **(Name of Offeror)**                            **(RFP No.)**

                                                   

                                                   

  **(Signature of Authorized Individual)**         **(Date)**

                                                   

                                                   

  **Typed Name of Authorized Individual**          

                                                   
  --------------------------------------------- -- -----------------------

Note: The penalty for making false statements in offers is prescribed in
18 U.S.C 1001

**1. 52.203-2 [CERTIFICATE OF INDEPENDENT PRICE
DETERMINATION]{.underline} (APRIL 1985)**

> \[NOTE: This provision is applicable when a firm-fixed price or
> fixed-price with economic price adjustment contract is contemplated.\]

\(a\) The offeror certifies that -

> \(1\) The prices in this offer have been arrived at independently,
> without, for the purpose of restricting competition, any consultation,
> communication, or agreement with any other offeror or competitor
> relating to (i) those prices, (ii) the intention to submit an offer,
> or (iii) the methods or factors used to calculate the prices offered;

(2) The prices in this offer have not been and will not be knowingly
    disclosed by the offeror, directly or indirectly, to any other
    offeror or competitor before bid opening (in the case of a sealed
    bid solicitation) or contract award (in the case of a negotiated
    solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce
    any other concern to submit or not to submit an offer for the
    purpose of restricting competition.

> \(b\) Each signature on the offer is considered to be a certification
> by the signatory that the signatory\--

(1) Is the person in the offeror\'s organization responsible for
    determining the prices being offered in this bid or proposal, and
    that the signatory has not participated and will not participate in
    any action contrary to subparagraphs (a)(1) through (a)(3) above; or

(2) \(i\) Has been authorized in writing, to act as agent for the
    following principals in certifying that those principals have not
    participated, and will not participate any action contrary to
    subparagraphs (a)(1) through (a)(3) above

  -----------------------------------------------------------------------

  -----------------------------------------------------------------------

> **\[insert full name of person(s) in the offeror\'s organization
> responsible for determining the prices offered in this bid or
> proposal, and the title of his or her position in the offeror\'s
> organization\];**

(ii) As an authorized agent, does certify that the principals named in
     subdivision (b)(2)(i) above have not participated, and will not
     participate, in any action contrary to subparagraphs (a)(1) through
     (a)(3) above; and

(iii) As an agent, has not personally participated, and will not
      participate, in any action contrary to subparagraphs (a)(1)
      through (a)(3) above.

> \(c\) If the offeror deletes or modifies subparagraph (a)(2) above,
> the offeror must furnish with its offer a signed statement setting
> forth in detail the circumstances of the disclosure.

**2. 52.203-11 [CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS
TO]{.underline} [INFLUENCE CERTAIN FEDERAL TRANSACTIONS
(DEVIATION)]{.underline}**

> \(a\) The definitions and prohibitions contained in the clause, at FAR
> 52.203-12, Limitations on Payments to Influence Certain Federal
> Transactions, included in this solicitation, are hereby incorporated
> by reference in paragraph (b) of this certification.

\(b\) The offeror, by signing its offer, hereby certifies to the best of
his or her knowledge and belief that on or after December 23, 1989 --

(1) 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 awarding of a contract resulting from
    this solicitation.

(2) If any funds other than Federal appropriated funds (including profit
    or fee received under a covered Federal transaction) 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 this
    solicitation, the offeror shall complete and submit with its offer,
    OMB Standard Form-LLL, \"Disclosure of Lobbying Activities\", to the
    Contracting Officer, and

(3) He or she will include the language of this certification in all
    Subcontract awards at any tier and require that all recipients of
    Subcontract awards in excess of \$100,000 shall certify and disclose
    accordingly.

    c.  Submission of this certification and disclosure is a
        prerequisite for making or entering into this contract imposed
        by section 1352, Title 31, United States Code. Any person who
        makes an expenditure prohibited under this provision or who
        fails to file or amend the disclosure form to be filed or
        amended by this provision, shall be subject to a civil penalty
        of not less than \$10,000, and not more than \$100,000, for each
        such failure.

**3. 52.204-3 [TAXPAYER IDENTIFICATION (OCTOBER 1998)]{.underline}**

\(a\) Definitions.

> ***Common paren***t, as used in this provision, means that corporate
> entity that owns or controls an affiliated group of corporations that
> files its Federal income tax returns on a consolidated basis, and of
> which the offeror is a member.
>
> ***Taxpayer Identification Number (TIN***), as used in this provision,
> means the number required by the Internal Revenue Service (IRS) to be
> used by the offeror in reporting income tax and other returns. The TIN
> may be either a Social Security Number or an Employer Identification
> Number.

\(b\) All offerors must submit the information required in paragraphs
(d) through (f) 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 IRS. If the resulting contract is subject to the payment reporting
requirements described in Federal Acquisition Regulation (FAR) 4.904,
the failure or refusal by the offeror to furnish the information may
result in a 31 percent reduction of payments otherwise due under the
contract.

> \(c\) 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.

\(d\) 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.

\(e\) 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

\(f\) Common parent.

> \[ \] Offeror is not owned or controlled by a common parent as defined
> in paragraph (a) of this provision.
>
> \[ \] Name and TIN of common parent:
>
> Name\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> TIN\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**4. 52.204-5 [WOMEN-OWNED BUSINESS (Other Than Small Business) (MAY
1999)]{.underline}**

> \(a\) *Definitio*n. Women-owned business concern, as used in this
> provision, means a concern 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 its stock is owned by one or more women; and whose
> management and daily business operations are controlled by one or more
> women.

i.  *Representatio*n. *\[Complete only if the offeror is a women-owned
    business concern and has not represented itself as a small business
    concern in paragraph (b)(1) of FAR 52.219-1, Small Business Program
    Representations, of this solicitatio*n.\]

> The offeror represents that it **\[ \]** is a women-owned business
> concern.

**5.** **52.209-5 [CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
PROPOSED SUSPENSION, PROPOSED DEBARMENT AND OTHER RESPONSIBILITY MATTERS
(DECEMBER 2001) ]{.underline}**

**(NOTE: Applies to contracts expected to exceed \$100,000.)**

\(a\) (1) The Offeror certifies, to the best of its knowledge and
belief, that --

> \(i\) The Offeror and/or any of its Principals \--

A.  Are **\[** \], are not **\[ \]** presently debarred, suspended,
    proposed for debarment, or declared ineligible for the award of
    contracts by any Federal agency;

B.  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
    public (Federal, state or local) 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

C.  Are **\[ \]**, are not **\[ \]** presently indicted for, or
    otherwise criminally or civilly charged by a governmental entity
    with, commission of any of the offenses enumerated in subdivision
    (a)(1)(i)(B) of this provision.

D.  If the offeror has responded affirmatively, the offeror shall
    provide additional information if requested by the Contracting
    Officer; and

> \(ii\) The Offeror has **\[ \]**, has not **\[ \]**, within a
> three-year period preceding this offer, had one or more contracts
> terminated for default by any Federal agency.

\(2\) "Principals" for the purposes of this certification, means
offerors; directors; owners; partners; and, persons having primary
management or supervisory responsibilities within a business entity
(e.g., general manager, plant manager, head of a subsidiary, division,
or business segment, and similar positions).

> **THIS CERTIFICATION CONCERNS A MATTER WITHIN THE JURISDICTION OF AN
> AGENCY OF THE UNITED STATES AND THE MAKING OF A FALSE, FICTITIOUS, OR
> FRAUDULENT CERTIFICATION MAY RENDER THE MAKER SUBJECT TO PROSECUTION
> UNDER SECTION 1001, TITLE 18, UNITED STATES CODE.**

(b) The Offeror shall provide immediate written notice to the
    Contracting Officer if, at any time prior to contract award, the
    Offeror learns that its certification was erroneous when submitted
    or has become erroneous by reason of changed circumstances.

(c) A certification that any of the items in paragraph (a) of this
    provision exists will not necessarily result in withholding of an
    award under this solicitation. However, the certification will be
    considered in connection with a determination of the Offeror\'s
    responsibility. Failure of the Offeror to furnish a certification or
    provide such additional information as requested by the Contracting
    Officer may render the Offeror nonresponsible.

(d) Nothing contained in the foregoing shall be construed to require
    establishment of a system of records in order to render, in good
    faith, the certification required by paragraph (a) of this
    provision. The knowledge and information of an Offeror is not
    required to exceed that which is normally possessed by a prudent
    person in the ordinary course of business dealings.

(e) The certification in paragraph (a) of this provision is a material
    representation of fact upon which reliance was placed when making an
    award. If it is later determined that the Offeror knowingly rendered
    an erroneous certification, in addition to other remedies available
    to the Government, the Contracting Officer may terminate the
    contract resulting from this solicitation for default.

**6. 52.215-6 [PLACE OF PERFORMANCE (OCTOBER 1997)]{.underline}**

(a) The offeror or respondent, in the performance of any contract
    resulting from this solicitation, **\[ \]** intends, **\[ \]** does
    not intend **(check applicable block)** to use one or more plants or
    facilities located at a different address from the address of the
    offeror or respondent as indicated in this proposal or response to
    request for information.

(b) If the offeror or respondent checks \"intends\" in paragraph (a) of
    this provision, it shall insert in the following spaces the required
    information:

  --------------------------------- -- -----------------------------------
  **Place of Performance** (Street     **Name and Address of Owner and
  Address, City, State, County, Zip    Operator of the Plant or Facility
  Code)                                if Other than Offeror or
                                       Respondent**

                                       

                                       

                                       

                                       
  --------------------------------- -- -----------------------------------

**7.** **52.219-1 [SMALL BUSINESS PROGRAM REPRESENTATIONS (MAY
2001)]{.underline}**

> (Note: This provision applies to solicitations exceeding the
> micro-purchase threshold when the contract is to be performed in the
> United States, its territories or possessions, Puerto Rico, the Trust
> Territory of the Pacific Islands, or the District of Columbia.)
>
> \(a\) (1) The North American Industry Classification System (NAICS)
> code for this acquisition is [\[INSERT NAICS CODE\]]{.underline}
>
> \(2\) The small business size standard is \[INSERT SIZE STANDARD\]
>
> \(3\) The small business size standard for a concern which submits an
> offer in its own name, other than on a construction or service
> contract, but which proposes to furnish a product which it did not
> itself manufacture, is 500 employees.

(b) **Representation**s.

    1.  The offeror represents as part of its offer that it **\[ \]**
        is, **\[ \]** is not a small business concern.

> \(2\) **(Complete only if the offeror represented itself as a small
> business concern in paragraph (b)(1) of this provision.)** The offeror
> represents, for general statistical purposes, that it **\[ \]** is,
> **\[ \]** is not a small disadvantaged business concern as defined in
> 13 CFR 124.1002.
>
> \(3\) **Complete only if the offeror represented itself as a small
> business concern in paragraph (b)(1) of this provision.)** The offeror
> represents as part of its offer that it **\[ \]** is, **\[ \]** is not
> a women-owned small business concern.
>
> \(4\) **(Complete only if the offeror represented itself as a small
> business concern in paragraph (b)(1) of this provision.)** The offeror
> represents as part of its offer that it **\[ \]** is, **\[ \]** is not
> a veteran-owned small business concern.
>
> \(5\) **(Complete only if the offeror represented itself as a
> veteran-owned small business concern in paragraph (b)(4) of this
> provision.)** The offeror represents as part of its offer that it **\[
> \]** is, **\[ \]** is not a service-disabled veteran-owned small
> business concern.

6.  **(Complete only if the offeror represented itself as a small
    business concern in paragraph (b)(1) of the provision.)** The
    offeror represents, as a part of its offeror, that \--

> \(i\) It \[ \] is, \[ \] is not a HUBZone small business concern
> listed, on the date of this representation, on the List of Qualified
> HUBZone Small Business Concerns maintained by the Small Business
> 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 \[ \] is, \[ \] is not a joint venture that complies with
> the requirements of 13 CFR part 126, and the representation in
> paragraph (b)(6)(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.

\(c\) **Definition**s. As used in this provision\--

> **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 or which is owned by
> one or more service-disabled veterans; and

(ii) The Management and daily business operation of which are controlled
     by one or more service-disabled veterans or, in the case of a
     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 the size standard in paragraph (a) of this provision.
>
> **Women-owned small business concer**n, means a small business
> concern-
>
> \(1\) That is at least 51 percent owned by one or more women; or, in
> the case of any publicly owned business, at least 51 percent of the
> stock of which is owned by one or more women; and
>
> \(2\) Whose management and daily business operations are controlled by
> one or more women.
>
> **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.

\(d\) **Notice.**

> \(1\) If this solicitation is for supplies and has been set aside, in
> whole or in part, for small business concerns, then the clause in this
> solicitation providing notice of the set-aside contains restrictions
> on the source of the end items to be furnished.
>
> \(2\) Under 15 U.S.C. 645(d), any person who misrepresents a firm\'s
> status as a small, HUBZone small, small disadvantaged, or women-owned
> small business concern in order to obtain a contract to be awarded
> under the preference programs established pursuant to section 8(a),
> 8(d), 9, or 15 of the Small Business Act or any other provision of
> Federal law that specifically references section 8(d) for a definition
> of program eligibility, shall---
>
> \(i\) Be punished by imposition of fine, imprisonment, or both;
>
> \(ii\) Be subject to administrative remedies, including suspension and
> debarment; and
>
> \(iii\) Be ineligible for participation in programs conducted under
> the authority of the Act.

**8. 52.219-19 [SMALL BUSINESS CONCERN REPRESENTATION FOR THE SMALL
BUSINESS COMPETITIVENESS DEMONSTRATION PROGRAM (OCTOBER
2000)]{.underline}**

> (This representation must be completed if the acquisition is for one
> of the four designated industry groups of the Small Representations
> and Certifications - Negotiated DECEMBER 27, 2001 8 Business
> Competitiveness Demonstration Program specified in FAR
> 19.1005(a)\[includes Construction Contracts under NAICS codes that
> comprise Industry Subsectors 233, 234 and 235\].)

\(a\) **Definition**

> \"Emerging small business\" as used in this solicitation, means a
> small business concern whose size is no greater than 50 percent of the
> numerical size standard applicable to the North American Industry
> Classification System (NAICS) code assigned to a contracting
> opportunity.
>
> \(b\) **(Complete only if offeror has represented itself under the
> provision at FAR 52.219-1 as a small business concern under the size
> standards of this solicitation.)**
>
> The Offeror **\[ \]** is, **\[ \]** is not an emerging small business.
>
> \(c\) **(Complete only if the Offeror is a small business or an
> emerging small business, indicating its size range.)**
>
> Offeror\'s number of employees for the past twelve months **(check
> this column if size standard stated in solicitation is expressed in
> terms of number of employees)** or Offeror\'s average annual gross
> revenue for the last 3 fiscal years **(Check this column if size
> standard stated in solicitation is expressed in terms of annual
> receipts). (Check one of the following.)**

  ----------- -- ---------------------------- --- ---------- ------------------------------
  Number of                                       Average    
  Employees                                       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. 52.219-21 [SMALL BUSINESS SIZE REPRESENTATION FOR TARGETED INDUSTRY
CATEGORIES UNDER THE SMALL BUSINESS COMPETITIVENESS DEMONSTRATION
PROGRAM (MAY 1999)]{.underline}**

> **(Complete only if the Offeror has represented itself under the
> provision 52.219-1 as a small business concern under the size
> standards of this solicitation.)**
>
> **(NOTE: This representation must be completed if this solicitation
> covers one of the ten targeted industry categories under the Small
> Business Competitiveness Demonstration Program and if the offeror has
> certified itself under the clause at FAR 52.219-1 to be a small
> business concern under the size standards of this solicitation).**
>
> Offeror\'s number of employees for the past twelve months **(check
> this column if size standard stated in solicitation is expressed in
> terms of number of employees)** or Offeror\'s average annual gross
> revenue for the last three fiscal years **(check this column if size
> standard stated in solicitation is expressed in terms of annual
> receipts). (Check one of the following.)**

  ----------- -- ---------------------------- --- ---------- ------------------------------
  Number of                                       Average    
  Employees                                       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
  ----------- -- ---------------------------- --- ---------- ------------------------------

The ten targeted industries are as follows:

  ---------------- -- --------------- -- -----------------------------------
  Product Service     SIC Code           Description
  Code                                   

  G004                8742               Counseling/Training/Social
                                         Rehabilitation Services

  J099                7699               Maintenance, Repair and Rebuilding
                                         of Equipment (Office Machines, Text
                                         Processing Systems & Visible Record
                                         Equipment)

  K099                7699               Modification of Equipment (Misc.)

  Q210                8099, 8742         General Health Care Services

  R406                8742               Policy Review/Development Services

  R497                7299               Personal Services

  6505                2833, 2834,        Drugs and Biologics
                      2835, 2836         

  7045                3572, 3695,        ADP Supplies
                      5065               

  7110                5021               Office Furniture

  7510                5112               Office Supplies
  ---------------- -- --------------- -- -----------------------------------

**10. 52.219-22 [SMALL DISADVANTAGED BUSINESS STATUS (OCTOBER
1999)]{.underline}**

> **(Note: This applies to competitive solicitations over \$500,000.)**
>
> \(a\) **General.** This provision is used to assess an offeror\'s
> small disadvantaged business status for the purpose of obtaining a
> benefit on this solicitation. Status as a small business and status as
> a small disadvantaged business for general statistical purposes is
> covered by the provision at FAR 52.219-1, Small Business Program
> Representation.

\(b\) **Representations.**

(1) **General.** The offeror represents, as part of its offer, that it
    is a small business under the size standard applicable to this
    acquisition; and either\--

> **\[ \]** (i) It has received certification by the Small Business
> Administration as a small disadvantaged business concern consistent
> with 13 CFR 124, Subpart B; and
>
> \(A\) No material change in disadvantaged ownership and control has
> occurred since its certification;
>
> \(B\) Where the concern is owned by one or more disadvantaged
> individuals, 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);
> and
>
> \(C\) It is identified, on the date of its representation, as a
> certified small disadvantaged business concern in the database
> maintained by the Small Business Administration (PRO-Net); or
>
> **\[ \]** (ii) It has 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.
>
> \(2\) **\[ \] For Joint Ventures**. The offeror represents, as part of
> its offer, that it is a joint venture that complies with the
> requirements at 13 CFR 124.1002(f) and that the representation in
> paragraph (b)(1) of this provision is accurate for the small
> disadvantaged business concern that is participating in the joint
> venture. *\[The offeror shall enter the name of the small
> disadvantaged business concern that is participating in the joint
> venture: \_\_\_\_\_\_\_\_\_\_\_\_.\]*
>
> \(c\) **Penalties and Remedie**s. Anyone who misrepresents any aspects
> of the disadvantaged status of a concern for the purposes of securing
> a contract or Subcontract shall:
>
> \(1\) Be punished by imposition of a fine, imprisonment, or both;
>
> \(2\) Be subject to administrative remedies, including suspension and
> debarment; and
>
> \(3\) Be ineligible for participation in programs conducted under the
> authority of the Small Business Act.

**Alternate I (OCTOBER 1998)**

> **(Note: Not applicable in accordance with CAAC Letter 2004-05, dated
> December 27, 2004, entitled, "Expired Program Authority for the Price
> Evaluation Adjustment for Small Disadvantaged Business Program.")**

As prescribed in 19.306(b), add the following paragraph (b)(3) to the
basic provision:

> \(3\) Address. The offeror represents that its address\_\_\_\_\_\_is,
> \_\_\_\_\_\_is not in a region for which a small disadvantaged
> business procurement mechanism is authorized and its address has not
> changed since its certification as a small disadvantaged business
> concern or submission of its application for certification. The list
> of authorized small disadvantaged business procurement mechanisms and
> regions is posted at
> http://www.arnet.gov/References/sdbadjustments.htm. The offeror shall
> use the list in effect on the date of this solicitation. "Address," as
> used in this provision, means the address of the offeror as listed on
> the Small Business Administration's register of small disadvantaged
> business concerns or the address on the completed application that the
> concern has submitted to the Small Business Administration or a
> Private Certifier in accordance with 13 CFR part 124, subpart B. For
> joint ventures, "address" refers to the address of the small
> disadvantaged business concern that is participating in the joint
> venture.

**11. 52.222-18 [CERTIFICATION REGARDING KNOWLEDGE OF CHILD LABOR FOR
LISTED END PRODUCTS (FEBRUARY 2001)]{.underline}**

*(Applies to all contracts for supplies over \$2,500. See FAR 22.1503
for more information)*

a.  *Definitio*n.

> *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.
>
> b\. *Listed end products.* The following end product(s) being acquired
> under this solicitation is (are) included in the List of Products
> Requiring Contractor Certification as to Forced or Indentured Child
> Labor, identified by their country of origin. There is a reasonable
> basis to believe that listed end products from the listed countries of
> origin may have been mined, produced, or manufactured by forced or
> indentured child labor.

  -----------------------------------------------------------------------
  Listed End Product

  -----------------------------------------------------------------------

  -----------------------------------------------------------------------
  Listed Countries of Origin

  -----------------------------------------------------------------------

> c\. *Certificatio*n. The Government will not make award to an offeror
> unless the offeror, by checking the appropriate block, certifies to
> either paragraph (c)(1) or paragraph (c)(2) of this provision.
>
> **\[ \]** (1) The offeror will not supply any end product listed in
> paragraph (b) of this provision that was mined, produced, or
> manufactured in a corresponding country as listed for that end
> product.
>
> **\[ \]** (2) The offeror may supply an end product listed in
> paragraph (b) 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 such end product. On the basis of those
> efforts, the offeror certifies that it is not aware of any such use of
> child labor.

**12. 52.222-22 [PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEBRUARY
1999)]{.underline}**

The offeror represents that --

> \(a\) It **\[ \]** has, **\[ \]** has not participated in a previous
> contract or Subcontract subject to the Equal Opportunity clause of
> this solicitation;

\(b\) It **\[ \]** has, **\[ \]** has not, filed all required compliance
reports; and

> \(c\) Representations indicating submission of required compliance
> reports, signed by proposed Subcontractors, will be obtained before
> Subcontract awards.

**13.** **52.222-25 [AFFIRMATIVE ACTION COMPLIANCE (APRIL
1984)]{.underline}**

> The offeror represents that (a) it **\[ \]** has developed and has on
> file, **\[ \]** has not developed and does not have on file, at each
> establishment, affirmative action programs required by the rules and
> regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or (b)
> it **\[ \]** has not previously had contracts subject to the written
> affirmative action programs requirement of the rules and regulations
> of the Secretary of Labor.

**14.** **52.222-38 [COMPLIANCE WITH VETERANS' EMPLOYMENT REPORTING
REQUIREMENTS (DECEMBER 2001)]{.underline}**

> By submission of its offer, the offeror represents that, if it is
> subject to the reporting requirements of 38 U.S.C. 4212(d) (i.e., if
> it has any contract containing Federal Acquisition Regulation clause
> 52.222-37, Employment Reports on Special Disabled Veterans, Veterans
> of the Vietnam Era, and Other Eligible Veterans), it has submitted the
> most recent VETS-100 Report required by that clause.

**15. 52.222-48 [EXEMPTION FROM APPLICATION OF SERVICE CONTRACT ACT
PROVISIONS FOR CONTRACTS FOR MAINTENANCE, CALIBRATION, AND/OR REPAIR OF
CERTAIN INFORMATION TECHNOLOGY, SCIENTIFIC AND MEDICAL AND/OR OFFICE AND
BUSINESS EQUIPMENT---CONTRACTOR CERTIFICATION (AUGUST
1996)]{.underline}**

> **(NOTE: This clause is applicable to all solicitations and resultant
> contracts calling for maintenance, calibration, and/or repair of
> information technology, scientific and medical, and office and
> business equipment if the contracting officer determines that the
> resultant contract may be exempt from Service Contract Act
> coverage).**

\(a\) The following certification shall be checked:

**CERTIFICATION**

> The offeror certifies **\[** \], does not certify **\[ \]** that: (1)
> The items of equipment to be serviced under this contract are
> commercial items which are used regularly for other than Government
> purposes, and are sold or traded by the Contractor in substantial
> quantities to the general public in the course of normal business
> operations; (2) The contract services are furnished at prices which
> are, or are based on, established catalog or market prices for the
> maintenance, calibration, and/or repair of certain information
> technology, scientific and medical, and/or office and business
> equipment. An \"established catalog price\" is a price (including
> discount price) recorded in a catalog, price list schedule, or other
> verifiable and established record that is regularly maintained by the
> manufacturer or the Contractor and is either published or otherwise
> available for inspection by customers. An \"established market price\"
> is a current price, established in the usual course of ordinary and
> usual trade between buyers and sellers free to bargain, which can be
> substantiated by data from sources independent of the manufacturer or
> Contractor; and (3) The Contractor utilizes the same compensation
> (wage and fringe benefits) plan for all service employees performing
> work under the contract as the Contractor uses for equivalent
> employees servicing the same equipment of commercial customers.

\(b\) If a negative certification is made and a Service Contract Act
wage determination is not attached to the solicitation, the Contractor
shall notify the Contracting Officer as soon as possible.

> \(c\) Failure to execute the certification in paragraph (a) of this
> clause or to contact the Contracting Officer as required in paragraph
> (b) of this clause may render the bid or offer non-responsive.

**16. 52.223-4 [RECOVERED MATERIAL CERTIFICATION (OCTOBER
1997)]{.underline}**

**(This certification is applicable in solicitations that are for, or
specify the use, of recovered materials.)**

> As required by the Resource Conservation and Recovery Act of 1976 (42
> U.S.C. 6962(c)(3)(A)(i)), the offeror certifies, by signing this
> offer, that the percentage of recovered materials to be used in the
> performance of the contract will be at least the amount required by
> the applicable contract specifications.

**17. 52.223-9 ALTERNATE I (AUGUST 2000) ESTIMATE OF PERCENTAGE OF
RECOVERED MATERIAL CONTENT FOR EPA-DESIGNATED PRODUCTS**

**(This certification is applicable in solicitations that are for, or
specify the use, of EPA designated products containing recovered
materials.)**

The Contractor shall execute the following certification required by the
Resource Conservation and Recovery Act of 1976 (42 U.S.C.
6962(i)(2)(C)):

CERTIFICATION

> I, \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_(name of
> certifier), am an officer or employee responsible for the performance
> of this contract and hereby certify that the percentage of recovered
> material content for EPA-designated products met the applicable
> contract specifications.

  -----------------------------------------------------------------------

  *\[Signature of the Officer or Employee\]*

  *\[Typed Name of the Officer or Employee\]*

  *\[Title\]*

  *\[Name of Company, Firm, or Organization\]*

  *\[Date\]*
  -----------------------------------------------------------------------

**18.** **52.223-13 [CERTIFICATION OF TOXIC CHEMICAL RELEASE REPORTING
(AUGUST 2003)]{.underline}**

> **[\[]{.underline}Note: This certification is applicable for all
> solicitations for competitive contracts expected to exceed \$100,000
> and competitive 8(a) contracts. It is not applicable to acquisitions
> of commercial items, or to contracts where the contractor\'s
> facilities are located outside the United States and its outlying
> areas.\]**
>
> \(a\) Executive Order 13148, of April 21, 2000, Greening the
> Government through Leadership in Environmental Management, requires
> submission of this certification as a prerequisite for contract award.

\(b\) By signing this offer, the offeror certifies that--

> \(1\) As the owner or operator of facilities that will be used in the
> performance of this contract that are subject to the filing and
> reporting requirements described in section 313 of the Emergency
> Planning and Community Right-to-Know Act of 1986 (EPCRA) (42 U.S.C.
> 11023) and section 6607 of the Pollution Prevention Act of 1990 (PPA)
> (42 U.S.C. 13106), the offeror will file and continue to file for such
> facilities for the life of the contract the Toxic Chemical Release
> Inventory Form (Form R) as described in sections 313(a) and (g) of
> EPCRA and section 6607 of PPA; or
>
> \(2\) None of its owned or operated facilities to be used in the
> performance of this contract is subject to the Form R filing and
> reporting requirements because each such facility is exempt for at
> least one of the following reasons: (Check each block that is
> applicable.)
>
> **\[ \]** (i) The facility does not manufacture, process, or otherwise
> use any toxic chemicals listed under section 313(c) of EPCRA, 42
> U.S.C. 11023(c);
>
> **\[ \]** (ii) The facility does not have 10 or more full-time
> employees as specified in section 313(b)(1)(A) of EPCRA, 42 U.S.C.
> 11023(b)(1)(A);
>
> **\[ \]** (iii) The facility does not meet the reporting thresholds of
> toxic chemicals established under section 313(f) of EPCRA, 42 U.S.C.
> 11023(f) (including the alternate thresholds at 40 CFR 372.27,
> provided an appropriate certification form has been filed with EPA);
>
> **\[ \]** (iv) The facility does not fall within Standard Industrial
> Classification Code (SIC) major groups 20 through 39 or their
> corresponding North American Industry Classification System (NAICS)
> sectors 31 through 33; or
>
> **\[ \]** (v) The facility is not located within any State of the
> United States, the District of Columbia, the Commonwealth of Puerto
> Rico, Guam, American Samoa, the United States Virgin Islands, the
> Northern Mariana Islands, or any other territory or possession over
> which the United States has jurisdiction.

**19. 52.225-2 [BUY AMERICAN ACT CERTIFICATE (JUNE 2003)]{.underline}**

> **\[Note: This provision is applicable for all requirements EXCEPT
> for 1) foreign contracts or 2) when one of the following two
> provisions (52.225-4, Buy American Act\--North American Free Trade
> Agreement\--Israeli Trade Act\--Balance of Payments Program
> Certificate, or 52.225-6, Trade Agreements Certificate) apply.**
>
> \(a\) The offeror certifies that each end product, except those listed
> in paragraph (b) 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 o this solicitation entitled "Buy American Act --
> Supplies."
>
> \(b\) Foreign End Products:

  ------------------- -- -------------------------------------------------
  Line Item No:          

  Country of Origin:     

  (List as necessary)    
  ------------------- -- -------------------------------------------------

> \(c\) The Government will evaluate offers in accordance with the
> policies and procedures of Part 25 of the Federal Acquisition
> Regulation.

**20. 52.225-4 [BUY AMERICAN ACT NORTH AMERICAN FREE TRADE
AGREEMENT---ISRAELI TRADE ACT]{.underline}**

> **\[Note: This provision is applicable for requirements for supplies
> or services involving the furnishing of supplies with a cost exceeding
> \$25,000 but less than \$175,000, [EXCEPT]{.underline}, for small
> businesses or any other exemption cited at FAR 25.401.\]**

\(a\) The offeror certifies that each end product, except those listed
in paragraph (b) or (c) 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 "component," "domestic end product," "end product," "end product
of Australia, Canada, Chile, Mexico, or Singapore," "foreign end
product," and "United States" are defined in the clause of this
solicitation entitled, "Buy American Act -- Free Trade Agreements --
Israeli Trade Act."

> \(b\) The offeror certifies that the following supplies are NAFTA
> country end products or Israeli end products as defined in the clause
> of this solicitation entitled, "Buy American Act---North American Free
> Trade Agreement\--Israeli Trade Act\--Balance of Payments Program":

**END PRODUCTS OF AUSTRALIA, CANADA, CHILE, MEXICO, SINGAPORE, OR
ISRAEL**

  ------------------- -- -------------------------------------------------
  Line Item No:          

  Country of Origin:     

  (List as necessary)    
  ------------------- -- -------------------------------------------------

\(c\) The offeror shall list those supplies that are foreign end
products (other than those listed in paragraph (b) of this provision) as
defined in the clause of this solicitation entitled, "Buy American
Act\--North American Free Trade Agreement\--Israeli Trade Act\--Balance
of Payments Program." 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)    
  ------------------- -- -------------------------------------------------

> \(d\) The Government will evaluate offers in accordance with the
> policies and procedures of Part 25 of the Federal Acquisition
> Regulation.
>
> **ALTERNATE I (JANUARY 2004)** As prescribed in 25.1101(b)(2)(ii),
> substitute the following paragraph (b) for paragraph (b) of the basic
> provision:

**\[Note: Applies when the acquisition value exceeds \$25,000 but is
less than \$50,000.\]**

> \(b\) The offeror certifies that the following supplies are Canadian
> end products as defined in the clause of this solicitation entitled
> "Buy American Act\--North American Free Trade Agreement\--Israeli
> Trade Act."

**CANADIAN END PRODUCTS**

  ------------------- -- -------------------------------------------------
  Line Item No:          

  Country of Origin:     

  (List as necessary)    
  ------------------- -- -------------------------------------------------

> **ALTERNATE II (JANUARY 2004)** As prescribed in 25.1101(b)(2)(iii),
> substitute the following paragraph (b) for paragraph (b) of the basic
> provision:

**\[Note: Applies when the acquisition value is \$50,000 or more, but is
less than \$53,150.\]**

> \(b\) 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\--North American Free Trade
> Agreement\--Israeli Trade Act."

**CANADIAN OR ISRAELI END PRODUCTS**

  ------------------- -- -------------------------------------------------
  Line Item No:          

  Country of Origin:     

  (List as necessary)    
  ------------------- -- -------------------------------------------------

**21. 52.225-6 [TRADE AGREEMENTS CERTIFICATE - (JANUARY
2005)]{.underline}**

> **\[Note: This provision is applicable for acquisitions valued at
> \$186,000 or more, if the Trade Agreement Act applies. (See FAR 25.401
> and 25.403).\]**
>
> \(a\) The offeror certifies that each end product, except those listed
> in paragraph (b) of this provision, is a U.S.-made, designated
> country, Caribbean Basin country, or NAFTA country end product, as
> defined in the clause of this solicitation entitled "Trade
> Agreements."
>
> \(b\) The offeror shall list as other end products those supplies that
> are not U.S.-made, designated country, Caribbean Basin country, or
> NAFTA country end products.
>
> **OTHER END PRODUCTS**

  ------------------- -- -------------------------------------------------
  Line Item No:          

  Country of Origin:     

  (List as necessary)    
  ------------------- -- -------------------------------------------------

> \(c\) The Government will evaluate offers in accordance with the
> policies and procedures of Part 25 of the Federal Acquisition
> Regulation. For line items subject to the Trade Agreements Act, the
> Government will evaluate offers of U.S.-made, designated country,
> Caribbean Basin country, or NAFTA country end products without regard
> to the restrictions of the Buy American Act or the Balance of Payments
> Program. The Government will consider for award only offers of
> U.S.-made, designated country, Caribbean Basin country, or NAFTA
> 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 this
> solicitation.

**22. 52.226-2 [HISTORICALLY BLACK COLLEGE OR UNIVERSITY AND MINORITY
INSTITUTION REPRESENTATION - (MAY 2001)]{.underline}**

\(a\) Definitions. As used in this provision\--

> *Historically Black College or University* means an institution
> determined by the Secretary of Education to meet the requirements of
> 34 CFR 608.2. For the Department of Defense, the National Aeronautics
> and Space Administration, and the Coast Guard, the term also includes
> any nonprofit research institution that was an integral part of such a
> college or university before November 14, 1986.
>
> *Minority Institution* means an institution of higher education
> meeting the requirements of Section 1046(3) of the Higher Education
> Act of 1965 (20 U.S.C. 1067k, including a Hispanic-serving institution
> of higher education, as defined in Section 316(b)(1) of the Act (20
> U.S.C. 1101a.)).

\(b\) *Representatio*n. The offeror represents that it\--

> **\[ \]** is **\[ \]** is not a Historically Black College or
> University;
>
> **\[ \]** is **\[ \]** is not a Minority Institution.

**23. 52.227-6 [ROYALTY INFORMATION - (APRIL 1984)]{.underline}**

> \(a\) **Cost or charges for royalties.** When the response to this
> solicitation contains costs or charges for royalties totaling more
> than \$250, the following information shall be included in the
> response relating to each separate item of royalty or license fee:

(1) Name and address of licensor.

(2) Date of license agreement.

(3) Patent numbers, patent application serial numbers or other basis on
    which the royalty is payable.

(4) Brief description, including any part or model numbers of each
    contract item or component on which the royalty is payable.

(5) Percentage or dollar rate of royalty per unit.

(6) Unit price of contract item.

(7) Number of units.

(8) Total dollar amount of royalties.

> \(b\) **Copies of current license**s. In addition, if specifically
> requested by the Contracting Officer before execution of the contract,
> the offeror shall furnish a copy of the current license agreement and
> an identification of applicable claims of specific patents.

**[(NOTE: Alternate I, below, is applicable for communication services
and facilities by a common carrier.)]{.underline}**

**ALTERNATE I (APRIL 1984), 52.227-6 [ROYALTY INFORMATION]{.underline}
(APRIL 1984)**

> Substitute the following for the introductory portion of paragraph (a)
> of the basic clause: When the response to this solicitation covers
> charges for special construction or special assembly that contain
> costs or charges for royalties totaling more than \$250, the following
> information shall be included in the response relating to each
> separate item of royalty or license fee:

**24. [CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE (DECEMBER
1994)]{.underline}**

> **(Note: This certification applies only to those contracts which
> contain provisions for children\'s services. The offeror\'s signature
> on the face page of these Representations and Certifications
> constitutes certification by the submitting organization of its
> compliance with the Act.)**
>
> Public Law 103-227, also known as the Pro-Children Act of 1994 (Act),
> requires that smoking not be permitted in any portion of any indoor
> facility owned or leased or contracted for by an entity and used
> routinely or regularly for the provision of health, day care, early
> childhood development services, education or library services to
> children under the age of 18, if the services are funded by Federal
> programs either directly or through State or local governments, by
> Federal grant, contract, loan, or loan guarantee. The law also applies
> to children\'s services that are provided in indoor facilities that
> are constructed, operated, or maintained with such federal funds. The
> law does not apply to children\'s services provided in private
> residences; portions of facilities used for inpatient drug or alcohol
> treatment; service providers whose sole source of applicable federal
> funds is Medicare or Medicaid; or facilities where WIC coupons are
> redeemed. Failure to comply with the provisions of the law may result
> in the imposition of a civil monetary penalty of up to \$1,000 for
> each violation and/or the imposition of an administrative compliance
> order on the responsible entity.
>
> By signing this certification, the offeror/contractor (for
> acquisitions) or applicant/grantee (for grants) certifies that the
> submitting organization will comply with the requirements of the Act
> and will not allow smoking within any portion of any indoor facility
> used for the provision of services for children as defined by the Act.
>
> The submitting organization agrees that it will require that the
> language of this certification be included in any subawards which
> contain provisions for children\'s services and that all subrecipients
> shall certify accordingly.

**25. 52.227-15 [REPRESENTATION OF LIMITED RIGHTS DATA AND RESTRICTED
COMPUTER SOFTWARE (MAY 1999)]{.underline}**

\(a\) This solicitation sets forth the work to be performed if a
contract award results, and the Government's known delivery requirements
for data (as defined in FAR 27.401). Any resulting contract may also
provide the Government the option to order additional data under the
Additional Data Requirements clause at 52.227-16 of the FAR, if included
in the contract. Any data delivered under the resulting contract will be
subject to the Rights in Data-General clause at 52.227-14 that is to be
included in this contract. Under the latter clause, a Contractor may
withhold from delivery data that qualify as limited rights data or
restricted computer software, and deliver form, fit, and function data
in lieu thereof. The latter clause also may be used with its Alternates
II and/or III to obtain delivery of limited rights data or restricted
computer software, marked with limited rights or restricted rights
notices, as appropriate. In addition, use of Alternate V with this
latter clause provides the Government the right to inspect such data at
the Contractor's facility.

\(b\) As an aid in determining the Government's need to include
Alternate II or Alternate III in the clause at 52.227-14, Rights in Data
-- General, the offeror shall complete paragraph (c) of this provision
to either state that none of the data qualify as limited rights data or
restricted computer software, or identify, to the extent feasible, which
of the data qualifies as limited rights data or restricted computer
software. Any identification of limited rights data or restricted
computer software in the offeror's response is not determinative of the
status of such data should a contract be awarded to the offeror.

\(c\) The offeror has reviewed the requirements for the delivery of data
or software and states \[*offeror check appropriate block*\] -

\[ \] None of the data proposed for fulfilling such requirements
qualifies as limited rights data or restricted computer software.

\[ \] Data proposed for fulfilling such requirements qualify as limited
rights data or restricted computer software and are identified as
follows:

  -----------------------------------------------------------------------

  -----------------------------------------------------------------------

NOTE: "Limited Rights Data" and "Restricted Computer Software" are
defined in the contract clause entitled "Rights in Data-General."