###### CONTRACT ADMINISTRATION DATA

(continuation from Standard Form 1449, block 18A.)

1\. Contract Administration: All contract administration matters will be
handled by the following individuals:

a\. CONTRACTOR:

b\. GOVERNMENT: Faye Dillard, Contracting Officer (90C)

VA Medical Center

100 Emancipation Drive

Hampton, VA 23667

2\. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the
contractor should be mailed to the following address:

3\. INVOICES: Invoices shall be submitted: Monthly:

4\. GOVERNMENT INVOICE ADDRESS: All invoices from the contractor shall

be mailed to the following address:

[Send Invoices To]{.underline}: **Fee Basis (136F)**

**VA Medical Center**

**1201 Broad Rock Blvd.**

**Richmond, Virginia 23249**

5\. Please enter your Dun and Bradstreet number below:

DUNS# \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (9
digits)

**OFFERORS MUST COMPLETE AND RETURN ALL INFORMATION DESIGNATED IN
52.212-1, INSTRUCTIONS TO OFFERORS - COMMERCIAL ITEMS, PARAGRAPH B,
PRIOR TO THE TIME SPECIFIED IN BLOCK 8 OF SF 1449 IN ORDER TO BE
CONSIDERED FOR AWARD.**

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of
amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

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Sealed offers for furnishing the supplies or services in the Schedule
will be received at the address specified in Block 9 of SF 1449, or if
hand carried, To the address shown in block 15, until the date and time
specified in Block 8. CAUTION - LATE Submissions, Modifications, and
Withdrawals: See provision 52.212-1. All offers are subject to all terms
and conditions of this solicitation.

This solicitation adheres to the format defined in FAR 12.303 for the
acquisition of commercial services and is issued and conducted under the
authority at FAR 13.6 using Simplified Acquisition Procedures.

**SCHEDULE OF SUPPLIES/SERVICE**

**(continuation from Standard Form 1449, block 20)**

1\. This is a Basic Ordering Agreement (BOA) for a period of one year
from date of award with an option to renew this agreement for two
additional years upon mutual agreement. In accordance with FAR 16.7, a
basic agreement is not a contract. A basic ordering agreement is a
written instrument of understanding, negotiated between an agency or
contracting activity and a contractor (see FAR clause 52.216-1, Type of
Contract). A contract is formed, in accordance with the terms and
conditions of this agreement, when VA agrees to place a patient in the
home hospice and the home hospice agrees to accept the patient. Upon
acceptance by the contractor of beneficiaries of Department of Veterans
Affairs (VA), all terms and conditions of this agreement shall apply
during such time as a VA patient remains in that home hospice at the
expense of VA.

2\. Upon acceptance of a VA patient by the home hospice, if and when
requested by the Contracting Officer or authorized representative, the
contractor shall furnish all supplies and services herein described, at
the rates specified herein. VA is obligated only to the extent
authorized placements of patients are made under this agreement.

3\. SERVICES

\(a\) Furnish Home Hospice Care Services to beneficiaries of the Hunter
Holmes McGuire, Department of Veterans Affairs Medical Center (VAMC),
Richmond, Virginia, in accordance with all terms, conditions and
provisions of this contract. Contract will be for a period of one year
from date of award with an option to renew for three additional years
upon.

\(b\) The VAMC intends to issue multiple award, firm fixed-price
contracts which provide service area coverage for the Primary Service
Area described in the solicitation (***see Attachment No.1***). The
Government reserves the right to make a single award for counties/cities
in the Service Area or separate awards within the Service Area,
whichever is deemed to be most advantageous to the Government.

\(c\) **[Offers will be submitted designating the offeror\'s area of
coverage (See Attachment No. 1 - Page 46)]{.underline}**. If an offeror
cannot provide coverage for the [ENTIRE]{.underline} service area, the
offeror must list the counties it intends to cover (See page 8).
Offerors must provide all the Health Care Services required in the area
of coverage. Offeror shall be a full service agency capable of providing
all the services required by the contract. **[CONTRACT AGENCY SHALL NOT
SUB-CONTRACT SERVICES TO ANOTHER HOSPICE AGENCY.]{.underline}**

\(d\) The estimated quantity for each offeror will vary based on the
number of clients residing in those areas who are eligible for the
services covered by the Department of Veterans Affairs.

\(e\) It is the intent of the VAMC that the Contracted Agency shall
receive referrals and provide all skilled and non-skilled care, (except
in cases where a third party payer and the payer requires and/or the
patient requests a specific agency) as authorized by VAMC to VAMC
patients in their homes.

-   Estimated Number of Referrals per FY is 15-20.

*(Note: The number of referrals cited above are for
statistical/historical purposes only. These are fee basis patients only
in the McGuire VAMC Primary Service Area. The government is not
promising a minimum or maximum number of referrals for this agreement).*

-   Approximately 15% of the total referrals are VA FEE BASIS eligible
    patients; in these cases the VA will be the payer. The majority of
    the referrals are Medicare pay, with a small number of other (HMO,
    Medicaid, etc.) third party payers.

\(f\) It is impossible to determine the exact or estimated amount that
will be expended under this contract. **No obligation will be incurred
by VAMC under this agreement until authorizations are issued for home
hospice care of specific beneficiaries.** VAMC agrees to make payment on
a timely basis for services rendered in accordance with such
authorizations upon receipt of billings submitted at the completion of
each month's services.

(h) The contractor shall provide a per diem rate to include all hospice
    services.

**CONTINUATION OF STANDARD FORM 1449 BLOCKS 19 through 24**

**PRICE SCHEDULE**

##### Home Hospice Services

**[BASE YEAR]{.underline}**

Description of Services

**Estimated Cost Per**

**[Visits]{.underline} [Visit]{.underline}**

**1. PERDIEM -**

**All Inclusive**

**Home Hospice**

**Care Services 210 \$\_\_\_\_\_\_**

**TOTAL ESTIMATED BASE YEAR COST \$\_\_\_\_\_\_\_**

**[OPTION YEAR 1]{.underline}**

Description of Services:

**Estimated Cost Per**

**[Visits]{.underline} [Visit]{.underline}**

**1. PERDIEM -**

**All Inclusive**

**Home Hospice**

**Care Services 210 \$\_\_\_\_\_\_**

**TOTAL ESTIMATED OPTION YEAR I COST \$\_\_\_\_\_\_\_**

**[OPTION YEAR II]{.underline}**

Description of Services:

**Estimated Cost Per**

**[Visits]{.underline} [Visit]{.underline}**

**1. PERDIEM -**

**All Inclusive**

**Home Hospice**

**Care Services 210 \$\_\_\_\_\_\_**

**TOTAL ESTIMATED OPTION YEAR II COST \$\_\_\_\_\_\_\_**

**TOTAL ESTIMATED CONTRACT COST FOR BASE + OPTION YEARS 1 & 2:
\$\_\_\_\_\_\_\_\_\_\_**

-   [THE SERVICES AND PRICES REPRESENT THOSE FOR WHICH THE VA IS THE
    PAYER.]{.underline}

-   [RATES ARE ALL INCLUSIVE.]{.underline}

-   [ALL TRAVEL COSTS ASSOCIATED WITH SERVICES SHALL BE INCLUDED IN UNIT
    COST FOR SERVICES PROVIDED.]{.underline}

-   [OFFERORS MUST SUBMIT A PRICE FOR ALL ITEMS LISTED.]{.underline}

**If the offeror is not able to provide coverage for all the
counties/cities listed for the PSA area in Attachment No. 1, then it
must list below all counties it will provide coverage for. If more room
is needed, please include as an attachment.**

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**DESCRIPTION/SPECIFICATIONS/WORK STATEMENT**

**1. OVERVIEW**

(a) The Hunter Holmes McGuire Veterans Affairs Medical Center (VAMC)
    provides diagnostic and therapeutic services in medicine, surgery,
    neurology, rehabilitation medicine, spinal cord injury, psychiatry,
    and skilled nursing home care. This **743**-bed tertiary care
    facility also serves as a major referral center for subspecialty
    treatment, open-heart surgery, heart transplant, vascular disease,
    oncology, and traumatic brain injury. Its ambulatory care activities
    provide a full range of services to those veterans not requiring
    hospitalization. The Medical Center maintains an intensive research
    program involved in both clinical and basic research.

(b) The Medical Center intends on entering into an agreement with a full
    service agency for the provision of the Home Hospice Care Services
    described in this solicitation. This will include, as needed, the
    on-site assignment of contracted agency nurse(s) and clerical staff
    to assist VAMC Community Health Nurse Coordinators, Case Managers,
    Social Workers, and other discharge planning personnel in processing
    referrals, coordinating hospital and home care admissions and
    discharges, and evaluating the day-to-day efficiency and
    effectiveness of the program.

(c) The overall objective of this contract is to provide timely and top
    quality home hospice care to our veterans, reduce the cost to the
    VA, and gain efficiencies in managing the home hospice care program.
    We are confident that we can realize our goal by taking advantage of
    commercially available, state of the art, community based home
    hospice services. In this pursuit, the contracted agency will be
    expected to offer a rate(s), at or **BELOW** the Medicare rate for
    those services provided. VAMC resources will be available to
    patients on an \"as needed\" basis for non-hospice related
    diagnosis.

**2. SCOPE OF WORK**

The contracted agency will furnish the management, supervision and
personnel necessary to provide all Home Hospice Care Services, as
authorized by VAMC, to VAMC patients in their homes. The contracted
agency shall provide at least the same/similar services as the Medicare
hospice benefit allows. Care shall be provided regardless of race,
color, religion, sex, or national origin. The VAMC staff will obtain
services from an agency other than the contracted agency, when, by their
professional assessment, the other agency would be the better resource
to meet the needs of the patient and/or family. When the contracted
agency cannot meet the needs of the patient, upon request, the CHNC will
refer patients to another agency. Contracted agency staff shall only
provide services, which have been validated and confirmed through CHNC,
when the VA is the payer source.

**3. DEFINITIONS:**

(a) "Certified Home Hospice Agency" means a home and community support
    service agency that provides skilled, custodial, home hospice
    service and/or hospice, and is certified by Medicare and/or JCAHO or
    CHAP. Will be referred to as "contracted agency" in this section.

(b) " Home Hospice Care Service" means the provision of one or more of
    the following health services required by an individual in their
    place of residence:

> 1\. Physician Services
>
> 2\. Nursing Services

3\. Nurse Aide Services

4\. Home Maker Services

5\. Social Services

6\. Therapy (Respiratory, Physical, Occupational, Speech, and dietary)

7\. Bereavement Services

8\. Counseling Services

9\. Volunteer Services

10\. Spiritual Care Services

11\. Pharmacy

12\. Laboratory

13\. DME

\(c\) " JCAHO" - Joint Commission on Accreditation of Healthcare
Organizations.

\(d\) " CHAP" - Community Health Accreditation Program.

\(e\) "VAMC" - Veterans Affairs Medical Center.

\(f\) \"CHNC\" - Community Health Nurse Coordinator

**4. SKILLED SERVICES:**

(a) Skilled services include medically necessary nursing, infusion
    therapy, social services, physical therapy, occupational therapy and
    hospice care; and shall be provided in accordance with a plan of
    care that requires the skills of a licensed professional
    specifically authorized by the Richmond VA Medical Center.

(b) Supervision shall be provided according to agency policy, legal
    regulations, and JCAHO or CHAP Standards.

(c) Skilled Home Hospice Services may include the following:

\(1\) Nursing services, treatment, and diagnostic and preventive
procedures requiring substantial specialized skill.

\(2\) Patient safety monitoring.

\(3\) Medication administration, including intravenous fluids,
medicines, and necessary care of the delivery lines and equipment.

\(4\) Necessary lab work with reports to the physician.

\(5\) Patient education and follow-up.

\(6\) Teaching, supervision and counseling patient and family members
regarding nursing care and other related patient problems.

\(7\) May provide a rehabilitation regimen.

\(8\) Evaluation and regular re-evaluation of patient home care needs;
make appropriate referrals to other community resources and VA
resources, as needed.

\(9\) Development, implementation, oversight, and modification of the
patient plan of care.

\(10\) Documentation of the patient's care and progress in the clinical
record.

\(11\) Physical assessment and re-assessment per written policy.

\(12\) Documentation of outcomes of care/services provided.

\(13\) Ongoing evaluation of any discharge planning needs and
appropriateness of hospice care.

**SPECIAL CONTRACT REQUIREMENTS**

The contracted agency agrees, in accordance with the terms and
conditions stated herein, to furnish to the Hunter Holmes McGuire
Veterans Affairs Medical Center, hereinafter called VA, 1201 Broad Rock
Blvd., Richmond, VA, 23249, the services specified in the SCHEDULE OF
SUPPLIES/SERVICE, and at the prices specified in the PRICE SCHEDULE of
this contract.

**2. SERVICES:**

(a) The Contracted Agency agrees to furnish all services herein
    described, if and when requested by the Contracting Officer or
    authorized representative, during the contract period and at the
    rates specified. VAMC is obligated only to the extent that
    authorized referrals of beneficiaries are made under this contract.
    VAMC does not guarantee or imply that any fixed number of
    orders/referrals for services will be placed under this contract.

(b) The services specified in the SCHEDULE OF SUPPLIES/SERVICE and the
    prices in the PRICE SCHEDULE may be changed only by written
    modification to this contract. The VA contracting officer will
    prepare the modification.

(c) Determination of allowable services, and payment for home care
    services, shall be from Medicare, Medicaid, HMO benefits, private
    insurance or VAMC Fee Basis, in compliance with regulations
    governing use of each payer. It is understood that pay sources other
    than VAMC Fee Basis shall be utilized whenever available. When the
    payer is not VAMC, billing will be handled by the agency providing
    the services. When payment is from VAMC funding sources, a fixed per
    diem rate will be established and adhered to unless changed through
    contract modification. Billing for VAMC financed services will be
    through Fiscal Service (04) billing procedures.

**3. HOME HOSPICE SERVICE STANDARDS:**

(a) The contracted agency shall directly provide services authorized by
    the VAMC; [NO Sub-Contracting is authorized.]{.underline} The
    contracted agency's direct liaison with the VAMC is the designated
    Community Health Nurse Coordinator (CHNC). The services to be
    performed by the contracted agency will be under the direction of
    the Clinician and/or Case Managers, all orders, plans of treatment,
    certifications and information concerning the Veterans Home Health
    Program should be addressed to the Clinician at VA Medical Center
    1201 Broad Rock Blvd., Richmond, VA, 23249.

(b) The contracted agency may provide, on location at the VAMC, a
    Registered Nurse(s) and clerical staff, as needed, to coordinate all
    areas of care in the continuity of care process. All
    Contractor/Agency staff assigned to perform duties, on premises, at
    the VA Medical Center **[MUST]{.underline}** be United States
    Citizens. Responsibilities will include assisting VAMC Community
    Health Nurse Coordinators, Social Workers, Case Managers, and other
    discharge planning personnel by processing the final referral,
    maintaining required written and electronic records, and
    communicating results of transactions to designated VAMC personnel.
    Referrals shall be processed from all VAMC sources, both in-patient
    and outpatient. Contracted agency support staff may be present at
    the VAMC to carry out their duties during all normal work hours as
    defined in section C.2.8.

(c) All home hospice referrals shall have prior approval through the
    designated CHNC. It is understood that the beneficiary shall be
    provided home and community support service visits for the period
    stated and properly authorized, except as provided for emergency
    visits under Section B.1 (g). Contracted agency will accept
    referrals by FAX as initial contact and confirm receipt immediately,
    however, referrals may also be phoned in, when necessary. Contracted
    agency will provide field staff making the home visits with copies
    of the VAMC referral and all other VAMC forms received upon referral
    of the patient. Contracted agency will verify payment sources and
    obtain authorization for payment of services and
    continuation/re-certification of payment as needed.

(d) Agency's contract management staff shall collaborate with CHNC's to
    ensure continuity of care and timely, appropriate hospital and home
    care admissions and discharges. This will include agency staff
    participation in quarterly meetings with CHNC's/VAMC staff for the
    purpose of coordinating activities and evaluating the day-to-day
    efficiency and effectiveness of the program.

(e) Contracted agency staff shall work with Clinician and/or Case
    Managers to ensure timely communications regarding changes in the
    condition of patients, need for updated or new orders, or any other
    change necessitating physician consultation for implementation of
    the plan of care.

(f) Contracted agency will always report lab test results to the
    designated clinician within 24 hours of lab test being done.

(g) VAMC Clinicians/Case Managers will regularly review all treatment
    plans, renewals and orders for appropriateness and medical
    necessity, and will coordinate follow-up as appropriate. The
    contracted agency will keep VA CHNC abreast of patients referred and
    opened to home care by completion of VA form "Home Hospice Referral
    Feedback" within 2-3 days after start of care (see Attachment No.
    2), provide date of discharge from home care; and any other changes
    in home hospice care status. The agency will be responsible for
    completing a ***Certification Worksheet for Home Hospice Visits***
    (See Attachment No. 3), on a monthly basis. Certification Worksheet
    for Home Hospice Visits will be faxed to VA CHNC at **(804)
    675-5383** by close of business on the ***5th business day of each
    month***.

(h) Contracted agency shall permit on-site visits by VAMC personnel to
    assess contracted services. The VAMC shall have ready access to all
    medical records concerning veterans for whom home care is being
    provided. VAMC has the option to conduct at least an annual site
    inspection of the Contracted agency's local operating offices and/or
    in the homes of the patients receiving services.

(i) It is agreed that the contracted agency will submit monthly progress
    reports to the VAMC Fee Basis along with their invoice for
    beneficiaries receiving services under this contract. The report
    should contain a safety status assessment of the patient's home.

(j) In the event a Patient requires hospitalization, it shall be at the
    nearest VA Medical Center. In the case of a life-threatening
    emergency the closest hospital should be used, and the VAMC should
    be contacted immediately re: reimbursement and transfer issues.

(k) VA will provide inpatient hospice care, unless the patient has
    another pay source and prefers to receive inpatient care elsewhere.
    Inpatient hospice care will be subject to bed availability and
    clinician acceptance. Patient may be admitted to another VAMC
    hospital service until a bed can be made available in the VAMC
    inpatient hospice unit. Home hospice patients receive priority for
    inpatient hospice unit when admission is needed.

(l) Every patient admitted to Hospice must have an attending physician
    who is primarily responsible for the medical care of that patient.
    Hospice will provide the services of a Medical Director. The Medical
    Director assumes overall responsibility for the medical direction of
    patient care and is available 24 hours per day. The role of the
    Medical Director, in relationship to the attending physician, is
    chiefly consultative, in that he/she complements the care of the
    attending physician. The Medical Director acts as a medical resource
    to hospice interdisciplinary team members. The Medical Director
    participates in the development and ongoing review of the patient
    care plans to ensure that general medical needs are met, in addition
    to palliation and management o the terminal illness. Hospice will
    provide the services of Assistant Medical Directors. The role of
    Assistant Medical Director(s) is complementary to that of the
    Medical Director. A Hospice Assistant Medical Director may also
    provide medical direction for a hospice interdisciplinary team
    and/or serve as a liaison to the staff and administration of a
    contracted facility.

(m) Bereavement services will be provided under the direction of a
    Bereavement Coordinator. Bereavement services are individualized
    according to the needs of the patient and family caregiver, but are
    offered for at least one year following the death of the patient.
    Bereavement counseling may be provided directly by the Bereavement
    Coordinator, hospice social workers, or the hospice Spiritual Care
    Coordinator, Bereavement Volunteers, or other appropriate
    counselors. Bereavement assignments depend upon the relationships
    that have been developed between the family, caregiver, and hospice
    team members. Bereavement counseling may be provided both before and
    following the patient\'s death. Hospice volunteers may participate
    in providing bereavement services under the direction of the
    Bereavement Coordinator. The family member or family caregiver may
    be referred to appropriate community agencies if a need is
    identified for intense or long-term counseling. Hospice will also
    sponsor community bereavement support groups and periodic memorial
    services as part of the bereavement program.

(n) A Director of Clinical Services, who is a registered nurse,
    administers all clinical services of the hospice program. The agency
    assigns a hospice nurse, who is a registered nurse, to each patient
    at the time of admission. The hospice nurse, often with the support
    of a social worker, initiates the initial physical, psychosocial,
    and spiritual assessment and develops the initial plan of care. The
    initial plan of care will include the frequency of scheduled nursing
    visits based upon the identified needs of the patient and family.
    The hospice nurse works closely with the attending physician and
    with the patient and caregiver to manage symptoms related to the
    terminal illness. A hospice nurse is on call 24 hours a day. Hospice
    nursing services will be provided in the patient\'s home
    environment, whether that be his/her own home, the home of family or
    friends, a group home, boarding house, or a long term care facility.
    If a patient requires short- term inpatient care, the hospice nurse
    collaborates with the inpatient nursing staff to communicate the
    hospice plan of care and provide continuity of nursing care for the
    patient.

(o) Social services will be provided by a qualified hospice social
    worker. The psychological, social and spiritual needs of the patient
    and the family caregiver will be assessed on an on-going basis,
    beginning at the time of admission to the hospice program. The
    hospice social worker reviews the psychosocial assessment of each
    patient and participates in the development of the plan of care.
    Hospice social workers will make scheduled visits to patients and
    families based upon identified needs, at least every month and prn.
    Hospice social workers provide counseling and coordination of
    community resources to assist patients and families.

(p) Spiritual care services will be provided under the direction of a
    Spiritual Care Coordinator. A spiritual/religious assessment will be
    initiated at the time of admission to hospice. Every effort will be
    made to involve the patient and family\'s clergy person and
    community of faith in the provision of spiritual care, provided that
    the patient and/or family express a desire for this involvement. If
    the patient or family expresses a spiritual religious need and the
    desire for pastoral care, but are not presently affiliated with a
    clergy person or community of faith; the hospice Spiritual Care
    Coordinator will arrange for scheduled visits by an appropriate
    clergy person to the patient/family. No belief system shall ever be
    imposed upon any hospice patient or family.

(q) Volunteer services will be provided under the direction of a
    Volunteer Coordinator. Hospice provides trained volunteers to assist
    patients and families. The volunteers provide a variety of direct
    and supportive services, depending on the individual needs of the
    organization, patient, and/or family. The Volunteer Coordinator
    assigns carefully selected volunteers to each patient and family
    requesting volunteer services, based upon identified needs of the
    patient and/or family caregiver. Volunteers visit the patient and/or
    caregiver based upon the Plan of Care and provides the comfort and
    support of a \"good friend." Volunteers participate as members of
    the interdisciplinary team under the direction of the Volunteer
    Coordinator.

(r) Certified nurse\'s aides (CNAS) who work under the direction of the
    Patient Care Coordinators and/or Hospice Nurses will provide home
    health aide services and homemaker. Home Health Aide services will
    be evaluated every two weeks by a Registered Nurse. Home health
    aides make regularly scheduled visits to assist with personal care
    of the patients according to needs identified in the hospice plan of
    care as well as to assist with homemaker services.

(s) All correspondence **must** contain the patient\'s name and **social
    security number**.

**4. MANAGEMENT, SUPERVISION AND TRAINING:**

(a) The contracted agency shall be responsible for the supervision of
    the daily services provided under this contract by agency staff.

(b) The contracted agency shall have written policies and procedures
    regarding staff credentials. All home hospice care services shall be
    performed by a competent professional who is familiar with the
    nature of the services involved and fully qualified under the laws
    of the State of Virginia. A copy of each employee's
    certification/training shall be provided to the Contracting Officer.

(c) VAMC will provide orientation for on-site Contracted agency staff
    (*if applicable*) to expected duties and any VAMC policy,
    procedures, and processes necessary to cooperative functioning
    between the agency and VAMC. Up-dates and refreshers shall be
    provided upon request and when policy, procedures or processes
    change.

(d) Contracted agency shall be responsible for supervising the daily
    services provided under this contract; and shall provide and
    document orientation and training programs for all employees
    regarding safety, equipment management, and patient confidentiality
    appropriate to the service provided. Contracted agency shall
    supervise and ensure the competency of their staff according to
    agency policy and JCAHO or CHAP Standards.

(e) Contracted agency staff nurse (RN) shall perform admission and
    supervisory visits.

(f) In the contractor provides infusion therapy, the infusion therapy
    shall be performed in accordance with JCAHO, CHAP, and/or Medicare
    standards, by certified Registered Nurses only.

(g) Contracted agency shall complete background investigations to ensure
    that employees do not have a record of criminal offenses or
    substantiated incidents of patient abuse; and, if required to
    perform their duties, employees are properly licensed and insured to
    operate motor vehicles.

**5. ACCREDITATION**:

(a) Contracted agency shall maintain Medicare certification and/or
    JCAHO/CHAP accreditation, including day-to-day compliance with
    current Medicare, JCAHO or CHAP Standards for Home Care.

(b) Contracted agency shall maintain current Medicare and Medicaid
    certifications, and current State License. Proof of certifications
    and licensure shall be furnished to the Contracting Officer.

(c) Certificate of insurance, evidencing that the required coverage has
    been obtained, shall be furnished to the Contracting Officer.

(d) Contracted agency shall participate in those activities designated
    by the VAMC to ensure quality of VAMC's contracted services, as
    needed.

**6. QUALITY IMPROVEMENT**

(a) Contracted agency shall provide to the VAMC evidence of Quality
    Improvement activities, including patient satisfaction indicators.
    Reports shall be submitted to the VAMC at least quarterly. The
    Contracted agency will maintain a record of patient complaints,
    including problem resolution, and all Quality Improvement
    activities, in a retrievable file, and shall be furnished to the
    VAMC CHNC.

(b) Contracted agency shall provide a written emergency preparedness
    plan to ensure continuing care and support in the event of an
    emergency that would interrupt normal services to patients.

(c) Contracted agency shall provide a written plan for ensuring the
    evaluation, reporting and maintenance of records related to
    infection among patients and, as appropriate, among staff.
    Documentation of plan implementation shall be provided upon request.
    The VAMC shall be notified of significant variances.

(d) Contracted agency shall document, and immediately FAX a report to
    the Community Health Nurse Coordinator, any known incidents of
    death, accidents, injury or infection related to furnished
    medications, supplies or medical equipment and any life-threatening
    equipment malfunctions or equipment recalls. The Contracted agency
    shall maintain a recall plan.

**7. QUALIFICATIONS**:

(a) The Contracted agency must be licensed by the State of Virginia and
    approved for Medicare and/or Medicaid patients. All personnel
    assigned the Contracted agency to perform services covered by this
    contract shall be licensed and/or certified by the State of
    Virginia. Contractor employees, if assigned to perform duties in the
    VA Medical Center shall be United States Citizens.

(b) Offers will be considered from offerors who are regularly
    established in the business called for, and who are financially
    responsible, and have the necessary equipment and personnel to
    furnish service in the volume required for all items under this
    contract. Successful Offeror shall meet all requirements of Federal,
    State or city codes regarding operation of this type of service.

(c) Upon request of the Government, the Offeror must be able to show
    evidence of his/her reliability, ability and experience by
    furnishing (1) a list of personnel who will perform under the
    contract showing the length and type of experience of such
    personnel, and (2) the names and addresses of other concerns and/or
    Government agencies for which this type of services were rendered by
    the Offeror.

(d) The Government reserves the right to thoroughly inspect and
    investigate the establishment, facilities, business reputation and
    other qualifications of any Offeror and to reject any offer,
    irrespective of price, that shall be administratively determined to
    be lacking in any of the essentials necessary to assure acceptable
    standards of performance.

**8. WORK HOURS:**

(a) Upon receipt of a referral form from the Richmond VA Medical Center,
    the contracted agency will call patient within the first 24 hours
    and the home visit will be made within 24 hours, if requested.
    Urgent cases may require same day visit.

(b) The on-site support staff services covered by this contract may be
    furnished by the contracted agency as defined herein. The contractor
    may provide Registered Nurse(s) and clerical staff, at the VAMC,
    during the work hours (excluding National Holidays) stated below:

The following terms have the following meanings:

\(1\) [Work Hours:]{.underline} Normal working hours - Monday through
Friday, 8:00 AM to 4:30 PM. Actual work hours will be determined by the
workload and schedules established by the Community Health Nurse
Coordinator and may require work during weekend and off-duty hours.

\(2\) Off-duty hours: 4:30 PM to 8:00 AM, Mondays through Fridays, all
day weekends and national holidays, unless required as stated in (1)
above.

\(3\) [National Holidays:]{.underline} The 10 holidays observed by the
Federal Government:

New Year\'s Day

Washington\'s Birthday

Martin Luther King\'s Birthday

Memorial Day

Independence Day

Labor Day

Columbus Day

Veterans Day

Thanksgiving Day

Christmas

Any other day specifically declared by the President of the United
States to be a national holiday.

**9. PERSONNEL POLICY:**

The contractor shall be responsible for protecting the personnel
furnishing services under this contract. To carry out this
responsibility, the contractor shall provide the following for these
personnel:

\- worker\'s compensation

\- professional liability insurance

\- health examinations

\- income tax withholding

\- social security payments

The parties agree that such personnel shall be considered employees of
the contractor.

**10. NOTICE:**

The Government may evaluate the quality of professional and
administrative services provided, but retain no control over the
medical, professional aspects of services rendered (e.g. professional
judgments, diagnosis for specific medical treatment), in accordance with
FAR 37.401(b).

**11. ORIENTATION:**

a\. The Contractor's staff will be oriented to the VA Medical Center.
All efforts will be made to accommodate the contractor; however,
orientation will be at the VA's convenience.

b\. On-going orientation will be provided within two weeks of the
contractor's request.

c\. If contractor personnel have not worked at the facility in the
previous six months, he/she will be re-oriented at the contractors
expense as directed by the VA.

**12. INVOICE AND PAYMENT PROCEDURES**

\(a\) Payments - Payments made by the VA under this contract constitute
the total costs of all services rendered. No charges will be billed to
Medicare, ([unless patient is Medicare pay and not VA pay]{.underline});
the beneficiary or his/her family, either by the health care agency
(contractor) or third party furnishing services or supplies required for
such care, unless and until specific [prior]{.underline} authorization,
in writing, is obtained from the VA facility authorizing placement.
**The Contracted Agency or his/her employees will not solicit
contributions, donations, or gifts from patients or family members.**

\(b\) Invoices - Payment will be made monthly, in arrears, following
receipt of proper invoice. Separate invoices will be submitted for each
veteran approved for services under this contract. Invoice must include:

\(1\) Names of Veteran

\(2\) Social Security Number

\(3\) Description of Services

\(4\) Dates of Services rendered

\(5\) Quantities (visits/treatments)

\(6\) Unit prices with extended totals

\(c\) Proof of service will be provided with each invoice, i.e. copy of
Certification Worksheet (Attachment No. 2).

**13. MONITORING PROCEDURES:**

The Contracting Officers Technical Representative, appointed in writing,
will be responsible for monitoring the contractor\'s performance. He/she
will review/approve requests for payment for accuracy and
appropriateness. The COTR will submit requests to Fee Basis for final
authorization. Fee Basis shall forward letters of approval for payment
to the Home Hospice Agency. Fee Basis will be responsible for certifying
all invoices.

**14. ON-SITE STAFF:**

On-site staff will be accepted based upon space availability, resources,
and need.

**15. TERMINATION OF AGREEMENT**

This Basic Ordering Agreement may be terminated by either party with 30
days written notice from one party to the other.

**16. TERM OF CONTRACT:**

This contract is effective for twelve (12) months from date of award
with an option to renew for two additional years. The contract is
subject to the availability of VA funds. The contractor shall perform no
service after the end of the Fiscal Year (September 30) until the
contracting officer authorizes such services in writing.

**CONTRACT CLAUSES**

#### 52.212-4 \-- Contract Terms and Conditions \-- Commercial Items. (Oct. 2003)

\(a\) *Inspection/Acceptance.* The Contractor shall only tender for
acceptance those items that conform to the requirements of this
contract. The Government reserves the right to inspect or test any
supplies or services that have been tendered for acceptance. The
Government may require repair or replacement of nonconforming supplies
or reperformance of nonconforming services at no increase in contract
price. The Government must exercise its post-acceptance rights \--

> \(1\) Within a reasonable time after the defect was discovered or
> should have been discovered; and
>
> \(2\) Before any substantial change occurs in the condition of the
> item, unless the change is due to the defect in the item.

\(b\) *Assignment*. The Contractor or its assignee may assign its rights
to receive payment due as a result of performance of this contract to a
bank, trust company, or other financing institution, including any
Federal lending agency in accordance with the Assignment of Claims Act
(31 U.S.C.3727). However, when a third party makes payment (*e.g.,* use
of the Governmentwide commercial purchase card), the Contractor may not
assign its rights to receive payment under this contract.

\(c\) *Changes*. Changes in the terms and conditions of this contract
may be made only by written agreement of the parties.

\(d\) *Disputes*. This contract is subject to the Contract Disputes Act
of 1978, as amended (41 U.S.C. 601-613). Failure of the parties to this
contract to reach agreement on any request for equitable adjustment,
claim, appeal or action arising under or relating to this contract shall
be a dispute to be resolved in accordance with the clause at FAR
52.233-1, Disputes, which is incorporated herein by reference. The
Contractor shall proceed diligently with performance of this contract,
pending final resolution of any dispute arising under the contract.

\(e\) *Definitions*. The clause at FAR 52.202-1, Definitions, is
incorporated herein by reference.

\(f\) *Excusable delays*. The Contractor shall be liable for default
unless nonperformance is caused by an occurrence beyond the reasonable
control of the Contractor and without its fault or negligence such as,
acts of God or the public enemy, acts of the Government in either its
sovereign or contractual capacity, fires, floods, epidemics, quarantine
restrictions, strikes, unusually severe weather, and delays of common
carriers. The Contractor shall notify the Contracting Officer in writing
as soon as it is reasonably possible after the commencement of any
excusable delay, setting forth the full particulars in connection
therewith, shall remedy such occurrence with all reasonable dispatch,
and shall promptly give written notice to the Contracting Officer of the
cessation of such occurrence.

\(g\) *Invoice*.

> \(1\) The Contractor shall submit an original invoice and three copies
> (or electronic invoice, if authorized) to the address designated in
> the contract to receive invoices. An invoice must include \--
>
> \(i\) Name and address of the Contractor;
>
> \(ii\) Invoice date and number;
>
> \(iii\) Contract number, contract line item number and, if applicable,
> the order number;
>
> \(iv\) Description, quantity, unit of measure, unit price and extended
> price of the items delivered;
>
> \(v\) Shipping number and date of shipment, including the bill of
> lading number and weight of shipment if shipped on Government bill of
> lading;
>
> \(vi\) Terms of any discount for prompt payment offered;
>
> \(vii\) Name and address of official to whom payment is to be sent;
>
> \(viii\) Name, title, and phone number of person to notify in event of
> defective invoice; and
>
> \(ix\) Taxpayer Identification Number (TIN). The Contractor shall
> include its TIN on the invoice only if required elsewhere in this
> contract.
>
> \(x\) Electronic funds transfer (EFT) banking information.
>
> \(A\) The Contractor shall include EFT banking information on the
> invoice only if required elsewhere in this contract.
>
> \(B\) If EFT banking information is not required to be on the invoice,
> in order for the invoice to be a proper invoice, the Contractor shall
> have submitted correct EFT banking information in accordance with the
> applicable solicitation provision, contract clause (*e.g.*, 52.232-33,
> Payment by Electronic Funds Transfer-Central Contractor Registration,
> or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central
> Contractor Registration), or applicable agency procedures.
>
> \(C\) EFT banking information is not required if the Government waived
> the requirement to pay by EFT.
>
> \(2\) Invoices will be handled in accordance with the Prompt Payment
> Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt
> payment regulations at 5 CFR part 1315.

\(h\) *Patent indemnity*. The Contractor shall indemnify the Government
and its officers, employees and agents against liability, including
costs, for actual or alleged direct or contributory infringement of, or
inducement to infringe, any United States or foreign patent, trademark
or copyright, arising out of the performance of this contract, provided
the Contractor is reasonably notified of such claims and proceedings.

\(i\) *Payment*. Payment shall be made for items accepted by the
Government that have been delivered to the delivery destinations set
forth in this contract. The Government will make payment in accordance
with the Prompt Payment Act (31 U.S.C. 3903) and OMB prompt payment
regulations at 5 CFR part 1315. In connection with any discount offered
for early payment, time shall be computed from the date of the invoice.
For the purpose of computing the discount earned, payment shall be
considered to have been made on the date which appears on the payment
check or the specified payment date if an electronic funds transfer
payment is made.

\(j\) *Risk of loss*. Unless the contract specifically provides
otherwise, risk of loss or damage to the supplies provided under this
contract shall remain with the Contractor until, and shall pass to the
Government upon:

> \(1\) Delivery of the supplies to a carrier, if transportation is
> f.o.b. origin; or
>
> \(2\) Delivery of the supplies to the Government at the destination
> specified in the contract, if transportation is f.o.b. destination.

\(k\) *Taxes*. The contract price includes all applicable Federal,
State, and local taxes and duties.

\(l\) *Termination for the Government\'s convenience*. The Government
reserves the right to terminate this contract, or any part hereof, for
its sole convenience. In the event of such termination, the Contractor
shall immediately stop all work hereunder and shall immediately cause
any and all of its suppliers and subcontractors to cease work. Subject
to the terms of this contract, the Contractor shall be paid a percentage
of the contract price reflecting the percentage of the work performed
prior to the notice of termination, plus reasonable charges the
Contractor can demonstrate to the satisfaction of the Government using
its standard record keeping system, have resulted from the termination.
The Contractor shall not be required to comply with the cost accounting
standards or contract cost principles for this purpose. This paragraph
does not give the Government any right to audit the Contractor\'s
records. The Contractor shall not be paid for any work performed or
costs incurred which reasonably could have been avoided.

\(m\) *Termination for cause*. The Government may terminate this
contract, or any part hereof, for cause in the event of any default by
the Contractor, or if the Contractor fails to comply with any contract
terms and conditions, or fails to provide the Government, upon request,
with adequate assurances of future performance. In the event of
termination for cause, the Government shall not be liable to the
Contractor for any amount for supplies or services not accepted, and the
Contractor shall be liable to the Government for any and all rights and
remedies provided by law. If it is determined that the Government
improperly terminated this contract for default, such termination shall
be deemed a termination for convenience.

\(n\) *Title*. Unless specified elsewhere in this contract, title to
items furnished under this contract shall pass to the Government upon
acceptance, regardless of when or where the Government takes physical
possession.

\(o\) *Warranty*. The Contractor warrants and implies that the items
delivered hereunder are merchantable and fit for use for the particular
purpose described in this contract.

\(p\) *Limitation of liability*. Except as otherwise provided by an
express warranty, the Contractor will not be liable to the Government
for consequential damages resulting from any defect or deficiencies in
accepted items.

\(q\) *Other compliances*. The Contractor shall comply with all
applicable Federal, State and local laws, executive orders, rules and
regulations applicable to its performance under this contract.

\(r\) *Compliance with laws unique to Government contracts.* The
Contractor agrees to comply with 31 U.S.C. 1352 relating to limitations
on the use of appropriated funds to influence certain Federal contracts;
18 U.S.C. 431 relating to officials not to benefit; 40 U.S.C. 327, *et
seq*., Contract Work Hours and Safety Standards Act; 41 U.S.C. 51-58,
Anti-Kickback Act of 1986; 41 U.S.C. 265 and 10 U.S.C. 2409 relating to
whistleblower protections; 49 U.S.C. 40118, Fly American; and 41 U.S.C.
423 relating to procurement integrity.

\(s\) *Order of precedence*. Any inconsistencies in this solicitation or
contract shall be resolved by giving precedence in the following order:

> \(1\) The schedule of supplies/services.
>
> \(2\) The Assignments, Disputes, Payments, Invoice, Other Compliances,
> and Compliance with Laws Unique to Government Contracts paragraphs of
> this clause.
>
> \(3\) The clause at 52.212-5.
>
> \(4\) Addenda to this solicitation or contract, including any license
> agreements for computer software.
>
> \(5\) Solicitation provisions if this is a solicitation.
>
> \(6\) Other paragraphs of this clause.
>
> \(7\) The Standard Form 1449.
>
> \(8\) Other documents, exhibits, and attachments.
>
> \(9\) The specification.

\(t\) *Central Contractor Registration (CCR)*.

> \(1\) Unless exempted by an addendum to this contract, the Contractor
> is responsible during performance and through final payment of any
> contract for the accuracy and completeness of the data within the CCR
> database, and for any liability resulting from the Government\'s
> reliance on inaccurate or incomplete data. To remain registered in the
> CCR database after the initial registration, the Contractor is
> required to review and update on an annual basis from the date of
> initial registration or subsequent updates its information in the CCR
> database to ensure it is current, accurate and complete. Updating
> information in the CCR does not alter the terms and conditions of this
> contract and is not a substitute for a properly executed contractual
> document.
>
> \(2\)
>
> \(i\) If a Contractor has legally changed its business name, \"doing
> business as\" name, or division name (whichever is shown on the
> contract), or has transferred the assets used in performing the
> contract, but has not completed the necessary requirements regarding
> novation and change-of-name agreements in Subpart 42.12, the
> Contractor shall provide the responsible Contracting Officer a minimum
> of one business day\'s written notification of its intention to:
>
> \(A\) Change the name in the CCR database;
>
> \(B\) Comply with the requirements of Subpart 42.12 of the FAR;
>
> \(C\) Agree in writing to the timeline and procedures specified by the
> responsible Contracting Officer. The Contractor must provide with the
> notification sufficient documentation to support the legally changed
> name.
>
> \(ii\) If the Contractor fails to comply with the requirements of
> paragraph (t)(2)(i) of this clause, or fails to perform the agreement
> at paragraph (t)(2)(i)(C) of this clause, and, in the absence of a
> properly executed novation or change-of-name agreement, the CCR
> information that shows the Contractor to be other than the Contractor
> indicated in the contract will be considered to be incorrect
> information within the meaning of the \"Suspension of Payment\"
> paragraph of the electronic funds transfer (EFT) clause of this
> contract.
>
> \(3\) The Contractor shall not change the name or address for EFT
> payments or manual payments, as appropriate, in the CCR record to
> reflect an assignee for the purpose of assignment of claims (see FAR
> Subpart 32.8, Assignment of Claims). Assignees shall be separately
> registered in the CCR database. Information provided to the
> Contractor\'s CCR record that indicates payments, including those made
> by EFT, to an ultimate recipient other than that Contractor will be
> considered to be incorrect information within the meaning of the
> \"Suspension of payment\" paragraph of the EFT clause of this
> contract.
>
> \(4\) Offerors and Contractors may obtain information on registration
> and annual confirmation requirements via the Internet at
> [http://www.ccr.gov](http://www.ccr.gov/) or by calling
> 1-888-227-2423, or 269-961-5757.

(End of Clause)

**Addendum to 52.212-4**

**52.252-2 CLAUSES INCORPORATED BY REFERENCE. (FEB 1998)**

This contract incorporates one or more clauses by reference, with the
same force and effect as if they were given in full text. Upon request,
the Contracting Officer will make their full text available. Also, the
full text of a clause may be accessed electronically at this/these
address(es):

\[http://www.arnet.gov/far\]

\[http://www.vaar.gov\]

**I. FEDERAL ACQUISITION REGULATIONS (48 CFR CHAPTER 1) CLAUSES:**

**52.216-18 ORDERING OCT 1995**

**52.216-19 ORDER LIMITATIONS OCT 1995**

**52.216-21 REQUIREMENTS OCT 1995**

**52.224-1 PRIVACY ACT NOTIFICATION. APR 1984**

**52.224-2 PRIVACY ACT. APR 1984**

**II. VETERANS ADMINISTRATION ACQUISITION REGULATIONS (48 CFR CHAPTER 8)
CLAUSES:**

**852.203-71 DISPLAY OF VA HOTLINE POSTER DEC 1992**

**852.219-70 COMMERCIAL ADVERTISING NOV 1984**

**852.237-70 CONTRACTOR\'S RESPONSIBILITIES APR 1984**

**852.271-70 NONDISCRIMINATION IN SERVICES**

**PROVIDED ELIGIBLE BENEFICIARIES APR 1984**

**52.216-27 SINGLE OR MULTIPLE AWARDS. (OCT 1995)**

The Government may elect to award a single delivery order contract or
task order contract or to award multiple delivery order contracts or
task order contracts for the same or similar supplies or services to two
or more sources under this solicitation.

**52.217-8 OPTION TO EXTEND SERVICES. (AUG 1989)**

The Government may require continued performance of any services within
the limits and at the rates specified in the contract. These rates may
be adjusted only as a result of revisions to prevailing labor rates
provided by the Secretary of Labor. The option provision may be
exercised more than once, but the total extension of performance
hereunder shall not exceed 6 months. The Contracting Officer may
exercise the option by written notice to the Contractor within the
period specified in the Schedule.

#### 52.217-9 \-- Option to Extend the Term of the Contract (Mar 2000).

\(a\) The Government may extend the term of this contract by written
notice to the Contractor within [30 days]{.underline} **;** provided,
that the Government gives the Contractor a preliminary written notice of
its intent to extend at least [60]{.underline} days before the contract
expires. The preliminary notice does not commit the Government to an
extension.

\(b\) If the Government exercises this option, the extended contract
shall be considered to include this option clause.

\(c\) The total duration of this contract, including the exercise of any
options under this clause, shall not exceed 3 (months)(years).

(End of Clause)

**52.232-18 AVAILABILITY OF FUNDS. (APR 1984)**

Funds are not presently available for this contract. The Government's
obligation under this contract is contingent upon the availability of
appropriated funds from which payment for contract purposes can be made.
No legal liability on the part of the Government for any payment may
arise until funds are made available to the Contracting Officer for this
contract and until the Contractor receives notice of such availability,
to be confirmed in writing by the Contracting Officer.

**52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR. (APR 1984)**

Funds are not presently available for performance under this contract
beyond \[**September 30 of each year**\]. The Government's obligation
for performance of this contract beyond that date is contingent upon the
availability of appropriated funds from which payment for contract
purposes can be made. No legal liability on the part of the Government
for any payment may arise for performance under this contract beyond
\[**September 30 of each year**\], until funds are made available to the
Contracting Officer for performance and until the Contractor receives
notice of availability, to be confirmed in writing by the Contracting
Officer.

**852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE (OCT 1996)**

\(a\) It is expressly agreed and understood that this is a nonpersonal
services contract, as defined in Federal Acquisition Regulation (FAR)
37.101, under which the professional services rendered by the Contractor
or its health-care providers are rendered in its capacity as an
independent contractor. The Government may evaluate the quality of
professional and administrative services provided but retains no control
over professional aspects of the services rendered, including by
example, the Contractor\'s or its health-care providers\' professional
medical judgment, diagnosis, or specific medical treatments. The
Contractor and its health-care providers shall be liable for their
liability-producing acts or omissions. The Contractor shall maintain or
require all health-care providers performing under this contract to
maintain, during the term of this contract, professional liability
insurance issued by a responsible insurance carrier of not less than the
following amount(s) per specialty per occurrence:
**\[\$1,000,000.00\].** However, if the Contractor is an entity or a
subdivision of a State that either provides for self-insurance or limits
the liability or the amount of insurance purchased by State entities,
then the insurance requirement of this contract shall be fulfilled by
incorporating the provisions of the applicable State law.

\(b\) An apparently successful offeror, upon request of the Contracting
Officer, shall, prior to contract award, furnish evidence of the
insurability of the offeror and/or of all health-care providers who will
perform under this contract. The submission shall provide evidence of
insurability concerning the medical liability insurance required by
paragraph (a) of this clause or the provisions of State law as to
self-insurance, or limitations on liability or insurance.

\(c\) The Contractor shall, prior to commencement of services under the
contract, provide to the Contracting Officer Certificates of Insurance
or insurance policies evidencing the required insurance coverage and an
endorsement stating that any cancellation or material change adversely
affecting the Government\'s interest shall not be effective until 30
days after the insurer or the Contractor gives written notice to the
Contracting Officer. Certificates or policies shall be provided for the
Contractor and/or each health-care provider who will perform under this
contract.

\(d\) The Contractor shall notify the Contracting Officer if it, or any
of the health-care providers performing under this contract, change
insurance providers during the performance period of this contract. The
notification shall provide evidence that the Contractor and/or
health-care providers will meet all the requirements of this clause,
including those concerning liability insurance and endorsements. These
requirements may be met either under the new policy, or a combination of
old and new policies, if applicable.

\(e\) The Contractor shall insert the substance of this clause,
including this paragraph (e), in all subcontracts for health-care
services under this contract. The Contractor shall be responsible for
compliance by any subcontractor or lower-tier subcontractor with the
provisions set forth in paragraph (a) of this clause.

**852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS. (APR 1984)**

The contracting officer reserves the right to designate representatives
to act for him/her in furnishing technical guidance and advice or
generally supervise the work to be performed under this contract. Such
designation will be in writing and will define the scope and limitation
of the designee\'s authority. A copy of the designation shall be
furnished the contractor.

#### 52.212-5 \-- Contract Terms and Conditions Required to Implement Statutes or Executive Orders \-- Commercial Items (Oct. 2003).

\(a\) The Contractor shall comply with the following Federal Acquisition
Regulation (FAR) clause, which are incorporated in this contract by
reference, to implement provisions of law or Executive orders applicable
to acquisitions of commercial items: 52.233-3, Protest after Award (Aug
1996)(31 U.S.C 3553).

\(b\) The Contractor shall comply with the FAR clauses in this paragraph
(b) that the contracting officer has indicated as being incorporated in
this contract by reference to implement provisions of law or Executive
orders applicable to acquisitions of commercial items:

> *\[Contracting Officer shall check as appropriate.\]*
>
> [X]{.underline} (1) 52.203-6, Restrictions on Subcontractor Sales to
> the Government (Jul 1995), with Alternate I (Oct 1995)(41 U.S.C. 253g
> and 10 U.S.C. 2402).
>
> [NA]{.underline} (2) 52.219-3, Notice of Total HUBZone Set-Aside (Jan
> 1999)(15 U.S.C. 657a).
>
> [NA]{.underline} (3) 52.219-4, Notice of Price Evaluation Preference
> for HUBZone Small Business Concerns (Jan 1999) (if the offeror elects
> to waive the preference, it shall so indicate in its offer)(15 U.S.C.
> 657a).
>
> [NA]{.underline} (4) (i) 52.219-5, Very Small Business Set-Aside (June
> 2003)(Pub. L. 103-403, section 304, Small Business Reauthorization and
> Amendments Act of 1994).
>
> [NA]{.underline} (ii) Alternate I (Mar 1999) of 52.219-5.
>
> [NA]{.underline} (iii) Alternate II (June 2003) of 52.219-5.
>
> [NA]{.underline} (5) (i) 52.219-6, Notice of Total Small Business
> Aside (June 2003) (15 U.S.C. 644).
>
> [NA]{.underline} (ii) Alternate I (Oct 1995) of 52.219-6.
>
> [NA]{.underline} (6) (i) 52.219-7, Notice of Partial Small Business
> Set-Aside (June 2003)(15 U.S.C. 644).
>
> [NA]{.underline} (ii) Alternate I (Oct 1995) of 52.219-7.
>
> [NA]{.underline} (7) 52.219-8, Utilization of Small Business Concerns
> (Oct 2000) (15 U.S.C. 637(d)(2) and (3)).
>
> [NA]{.underline} (8) (i) 52.219-9, Small Business Subcontracting Plan
> (Jan 2002)(15 U.S.C. 637 (d)(4)).
>
> [NA]{.underline} (ii) Alternate I (Oct 2001) of 52.219-9.
>
> [NA]{.underline} (iii) Alternate II (Oct 2001) of 52.219-9.
>
> [X]{.underline} (9) 52.219-14, Limitations on Subcontracting (Dec
> 1996)(15 U.S.C. 637(a)(14)).
>
> [NA]{.underline} (10) (i) 52.219-23, Notice of Price Evaluation
> Adjustment for Small Disadvantaged Business Concerns (June 2003)(Pub.
> L. 103-355, section 7102, and 10 U.S.C. 2323) (if the offeror elects
> to waive the adjustment, it shall so indicate in its offer).
>
> [NA]{.underline} (ii) Alternate I (June 2003) of 52.219-23.
>
> [NA]{.underline} (11) 52.219-25, Small Disadvantaged Business
> Participation Program-Disadvantaged Status and Reporting (Oct
> 1999)(Pub. L. 103-355, section 7102, and 10 U.S.C. 2323).
>
> [NA]{.underline} (12) 52.219-26, Small Disadvantaged Business
> Participation Program-Incentive Subcontracting (Oct 2000)(Pub. L.
> 103-355, section 7102, and 10 U.S.C. 2323).
>
> [NA]{.underline} (13) 52.222-3, Convict Labor (June 2003)(E.O. 11755).
>
> [NA]{.underline} (14) 52.222-19, Child Labor-Cooperation with
> Authorities and Remedies (Sep 2002)(E.O. 13126).
>
> [X]{.underline} (15) 52.222-21, Prohibition of Segregated Facilities
> (Feb 1999).
>
> [X]{.underline} (16) 52.222-26, Equal Opportunity (Apr 2002)(E.O.
> 11246).
>
> [X]{.underline} (17) 52.222-35, Equal Opportunity for Special Disabled
> Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans
> (Dec 2001)(38 U.S.C. 4212).
>
> [X]{.underline} (18) 52.222-36, Affirmative Action for Workers with
> Disabilities (Jun 1998)(29 U.S.C. 793).
>
> [X]{.underline} (19) 52.222-37, Employment Reports on Special Disabled
> Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans
> (Dec 2001)(38 U.S.C. 4212).
>
> [NA]{.underline} (20) (i) 52.223-9, Estimate of Percentage of
> Recovered Material Content for EPA-Designated Products (Aug 2000)(42
> U.S.C. 6962(c)(3)(A)(ii)).
>
> [NA]{.underline} (ii) Alternate I (Aug 2000) of 52.223-9 (42 U.S.C.
> 6962(i)(2)(C)).
>
> [NA]{.underline} (21) 52.225-1, Buy American Act\--Supplies (June
> 2003)(41 U.S.C. 10a-10d).
>
> [NA]{.underline} (22) (i) 52.225-3, Buy American Act - North American
> Free Trade Agreement - Israeli Trade Act (June 2003)(41 U.S.C.
> 10a-10d, 19 U.S.C. 3301 note, 19 U.S.C. 2112 note).
>
> [NA]{.underline} (ii) Alternate I (May 2002) of 52.225-3.
>
> [NA]{.underline} (iii) Alternate II (May 2002) of 52.225-3.
>
> [NA]{.underline} (23) 52.225-5, Trade Agreements (June 2003)(19 U.S.C.
> 2501, *et seq.*, 19 U.S.C. 3301 note).
>
> [NA]{.underline} (24) 52.225-13, Restriction on Certain Foreign
> Purchases (June 2003)(E.O. 12722, 12724, 13059, 13067, 13121, and
> 13129).
>
> [NA]{.underline} (25) 52.225-15, Sanctioned European Union Country End
> Products Feb 2000)(E.O. 12849).
>
> [NA]{.underline} (26) 52.225-16, Sanctioned European Union Country
> Services (Feb 2000)(E.O. 12849).
>
> [NA]{.underline} (27) 52.232-29, Terms for Financing of Purchases of
> Commercial Items (Feb 2002)(41 U.S.C. 255(f), 10 U.S.C. 2307(f)).
>
> [NA]{.underline} (28) 52.232.30, Installment Payments for Commercial
> Items (Oct 1995)(41 U.S.C. 255(f), 10 U.S.C. 2307(f)).
>
> [X]{.underline} (29) 52.232-33, Payment by Electronic Funds
> Transfer-Central Contractor Registration (Oct. 2003)(31 U.S.C. 3332).
>
> [X]{.underline} (30) 52.232-34, Payment by Electronic Funds
> Transfer-Other Than Central Contractor Registration (May 1999)(31
> U.S.C. 3332).
>
> [NA]{.underline} (31) 52.232-36, Payment by Third Party (May 1999)(31
> U.S.C. 3332).
>
> NA (32) 52.239-1, Privacy or Security Safeguards (Aug 1996)(5 U.S.C.
> 552a).
>
> [NA]{.underline} (33) (i) 52.247-64, Preference for Privately Owned
> U.S.-Flag Commercial Vessels (Apr 2003)(46 U.S.C. 1241 and 10 U.S.C.
> 2631).
>
> [NA]{.underline} (ii) Alternate I (Apr 1984) of 52.247-64.
>
> **[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

\(c\) The Contractor shall comply with the FAR clauses in this paragraph
(c), applicable to commercial services, that the Contracting Officer has
indicated as being incorporated in this contract by reference to
implement provisions of law or executive orders applicable to
acquisitions of commercial items:

> \[*Contracting Officer check as appropriate*.\]
>
> [X]{.underline} (1) 52.222-41, Service Contract Act of 1965, as
> Amended (May 1989)(41 U.S.C. 351, *et seq.*).
>
> [NA]{.underline} (2) 52.222-42, Statement of Equivalent Rates for
> Federal Hires (May 1989)(29 U.S.C. 206 and 41 U.S.C. 351, *et seq.*).
>
> [X]{.underline} (3) 52.222-43, Fair Labor Standards Act and Service
> Contract Act \-- Price Adjustment (Multiple Year and Option Contracts)
> (May 1989)(29 U.S.C.206 and 41 U.S.C. 351, *et seq*.).
>
> [NA]{.underline} (4) 52.222-44, Fair Labor Standards Act and Service
> Contract Act \-- Price Adjustment (Feb 2002)(29 U.S.C. 206 and 41
> U.S.C. 351, *et seq.*).
>
> [NA]{.underline} (5) 52.222-47, SCA Minimum Wages and Fringe Benefits
> Applicable to Successor Contract Pursuant to Predecessor Contractor
> Collective Bargaining Agreements (CBA) (May 1989)(41 U.S.C. 351, *et
> seq.*).
>
> **[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}**

\(d\) *Comptroller General Examination of Record*. The Contractor shall
comply with the provisions of this paragraph (d) if this contract was
awarded using other than sealed bid, is in excess of the simplified
acquisition threshold, and does not contain the clause at 52.215-2,
Audit and Records \-- Negotiation.

> \(1\) The Comptroller General of the United States, or an authorized
> representative of the Comptroller General, shall have access to and
> right to examine any of the Contractor\'s directly pertinent records
> involving transactions related to this contract.
>
> \(2\) The Contractor shall make available at its offices at all
> reasonable times the records, materials, and other evidence for
> examination, audit, or reproduction, until 3 years after final payment
> under this contract or for any shorter period specified in FAR Subpart
> 4.7, Contractor Records Retention, of the other clauses of this
> contract. If this contract is completely or partially terminated, the
> records relating to the work terminated shall be made available for 3
> years after any resulting final termination settlement. Records
> relating to appeals under the disputes clause or to litigation or the
> settlement of claims arising under or relating to this contract shall
> be made available until such appeals, litigation, or claims are
> finally resolved.
>
> \(3\) As used in this clause, records include books, documents,
> accounting procedures and practices, and other data, regardless of
> type and regardless of form. This does not require the Contractor to
> create or maintain any record that the Contractor does not maintain in
> the ordinary course of business or pursuant to a provision of law.

\(e\)

> \(1\) Notwithstanding the requirements of the clauses in paragraphs
> (a), (b), (c) and (d) of this clause, the Contractor is not required
> to flow down any FAR clause, other than those in paragraphs (i)
> through (vi) of this paragraph in a subcontract for commercial items.
> Unless otherwise indicated below, the extent of the flow down shall be
> as required by the clause\--
>
> \(i\) 52.219-8, Utilization of Small Business Concerns (Oct 2000)(15
> U.S.C. 637(d)(2) and (3)), in all subcontracts that offer further
> subcontracting opportunities. If the subcontract (except subcontracts
> to small business concerns) exceeds \$500,000 (\$1,000,000 for
> construction of any public facility), the subcontractor must include
> 52.219-8 in lower tier subcontracts that offer subcontracting
> opportunities.
>
> \(ii\) 52.222-26, Equal Opportunity (Apr 2002)(E.O. 11246).
>
> \(iii\) 52.222-35, Equal Opportunity for Special Disabled Veterans,
> Veterans of the Vietnam Era, and Other Eligible Veterans (Dec 2001)(38
> U.S.C. 4212).
>
> \(iv\) 52.222-36, Affirmative Action for Workers with Disabilities
> (June 1998)(29 U.S.C. 793).
>
> \(v\) 52.222-41, Service Contract Act of 1965, as Amended (May 1989),
> flow down required for all subcontracts subject to the Service
> Contract Act of 1965 (41 U.S.C. 351, *et seq*.)
>
> \(vi\) 52.247-64, Preference for Privately-Owned U.S. Flag Commercial
> Vessels (Apr 2003)(46 U.S.C. Appx 1241 and 10 U.S.C. 2631). Flow down
> required in accordance with paragraph (d) of FAR clause 52.247-64,
>
> \(2\) While not required, the contractor may include in its
> subcontracts for commercial items a minimal number of additional
> clauses necessary to satisfy its contractual obligations.

(End of Clause)

**[DOCUMENTS, EXHIBITS OR ATTACHMENTS]{.underline}**

ATTACHMENT NO. 1: PRIMARY SERVICE AREA

ATTACHMENT NO. 2: CERTIFICATION WORKSHEET FOR

HOME HOSPICE VISITS

ATTACHMENT NO. 3: WAGE DETERMINATION

**[ATTACHMENT NO. 1]{.underline}**

***[PRIMARY SERVICE AREA]{.underline}***

  ----------------------------------- -----------------------------------
  ***COUNTIES***                      ***CITIES***

  Chesterfield                        Colonial Heights

  Henrico                             Hopewell

  Hanover                             Petersburg

                                      Richmond

  Albemarle                           Madison

  Amelia                              Mecklenburg

  Amherst                             New Kent

  Augusta                             Nottoway

  Brunswick                           Powhatan

  Buckingham                          Prince Edward

  Campbell                            Prince George

  Caroline                            Rockbridge

  Charlotte                           Rockingham

  Culpepper                           Southampton

  Dinwiddie                           Spotsylvania

  Essex                               Stafford

  Fluvanna                            Surry

  Gloucester                          Sussex

  Goochland                           Westmoreland

  Greene                              

  Greensville                         ***CITIES***

  Halifax                             Bedford

  James City                          Charlottesville

  King and Queen                      Fredericksburg

  King George                         Lynchburg

  King William                        South Boston

  Lancaster                           Staunton

  Louisa                              Virginia Beach

  Lunenburg                           Williamsburg
  ----------------------------------- -----------------------------------

**[ATTACHMENT NO. 2]{.underline}**

**Certification Worksheet for Home Hospice Visits**

**Authorized by McGuire VA Medical Center**

# **For Payment Under VA Basic Ordering Agreement**

**Month** of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Year**
of\_\_\_\_\_\_\_\_\_

**Patient's
Name**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**SS#**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Home Health
Agency\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  --------- --------- ------------ ------------ ----------------- --------------------------
  **Visit   **Visit   **Provider   **Provider   **Pt./Caregiver   **Comments**
  \#**      Date**    Type (RN,PT, Initials**   Initials**        
                      etc)**                                      

  1\.                                                             

  2\.                                                             

  3\.                                                             

  4\.                                                             

  5\.                                                             

  6\.                                                             

  7\.                                                             

  8\.                                                             

  9\.                                                             

  10\.                                                            

  11\.                                                            

  12\.                                                            

  13\.                                                            

  14\.                                                            

  15\.                                                            
  --------- --------- ------------ ------------ ----------------- --------------------------

## FAX AT END OF EACH MONTH TO: CHNC OFFICE (804) 675-5383. (Attach copy of progress notes for each visit.)

## Page \_\_\_\_ of \_\_\_\_ 

**[ATTACHMENT NO. 3]{.underline}**

**94-2545 VA,RICHMOND** 07/29/03

\*\*\*FOR OFFICIAL USE ONLY BY FEDERAL AGENCIES PARTICIPATING IN MOU
WITH DOL\*\*\*

\| WASHINGTON D.C. 20210

\|

\|

\|

\| Wage Determination No.: 1994-2545

William W.Gross Division of \| Revision No.: 22

Director Wage Determinations\| Date Of Last Revision: 07/22/2003

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\|\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

State: Virginia

Area: Virginia Counties of Albemarle, Amelia, Brunswick, Buckingham,
Caroline,

Charles City, Charlotte, Charlottesville, Chesterfield, Colonial Hghts,
Cumberland,

Dinwiddie, Essex, Fluvanna, Goochland, Greensville, Hanover, Henrico,
Hopewell, King

William, King and Queen, Lancaster, Louisa, Lunenburg, Mecklenburg,
Middlesex, New

Kent, Northumberland, Nottoway, Orange, Petersburg, Powhatan, Prince
Edward, Prince

George, Richmond, Sussex, Westmoreland

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

\*\*Fringe Benefits Required Follow the Occupational Listing\*\*

OCCUPATION CODE - TITLE MINIMUM WAGE RATE

01000 - Administrative Support and Clerical Occupations

01011 - Accounting Clerk I 9.69

01012 - Accounting Clerk II 10.75

01013 - Accounting Clerk III 13.07

01014 - Accounting Clerk IV 16.33

01030 - Court Reporter 14.31

01050 - Dispatcher, Motor Vehicle 14.84

01060 - Document Preparation Clerk 12.16

01070 - Messenger (Courier) 10.41

01090 - Duplicating Machine Operator 12.16

01110 - Film/Tape Librarian 12.55

01115 - General Clerk I 8.77

01116 - General Clerk II 10.33

01117 - General Clerk III 12.96

01118 - General Clerk IV 17.12

01120 - Housing Referral Assistant 16.29

01131 - Key Entry Operator I 11.59

01132 - Key Entry Operator II 13.55

01191 - Order Clerk I 12.06

01192 - Order Clerk II 13.18

01261 - Personnel Assistant (Employment) I 10.79

01262 - Personnel Assistant (Employment) II 12.85

01263 - Personnel Assistant (Employment) III 14.95

01264 - Personnel Assistant (Employment) IV 17.29

01270 - Production Control Clerk 17.84

01290 - Rental Clerk 11.81

01300 - Scheduler, Maintenance 12.56

01311 - Secretary I 12.56

01312 - Secretary II 14.33

01313 - Secretary III 16.29

01314 - Secretary IV 19.19

01315 - Secretary V 23.11

01320 - Service Order Dispatcher 13.20

01341 - Stenographer I 10.31

01342 - Stenographer II 11.57

01400 - Supply Technician 19.19

01420 - Survey Worker (Interviewer) 13.59

01460 - Switchboard Operator-Receptionist 10.58

01510 - Test Examiner 14.33

01520 - Test Proctor 14.33

01531 - Travel Clerk I 10.09

01532 - Travel Clerk II 10.71

01533 - Travel Clerk III 11.40

01611 - Word Processor I 10.41

01612 - Word Processor II 12.54

01613 - Word Processor III 14.02

03000 - Automatic Data Processing Occupations

03010 - Computer Data Librarian 12.59

03041 - Computer Operator I 12.59

03042 - Computer Operator II 14.46

03043 - Computer Operator III 16.96

03044 - Computer Operator IV 18.86

03045 - Computer Operator V 20.87

03071 - Computer Programmer I (1) 16.44

03072 - Computer Programmer II (1) 19.01

03073 - Computer Programmer III (1) 22.93

03074 - Computer Programmer IV (1) 27.62

03101 - Computer Systems Analyst I (1) 26.16

03102 - Computer Systems Analyst II (1) 27.62

03103 - Computer Systems Analyst III (1) 27.62

03160 - Peripheral Equipment Operator 11.64

05000 - Automotive Service Occupations

05005 - Automotive Body Repairer, Fiberglass 17.26

05010 - Automotive Glass Installer 15.69

05040 - Automotive Worker 15.69

05070 - Electrician, Automotive 16.49

05100 - Mobile Equipment Servicer 14.12

05130 - Motor Equipment Metal Mechanic 17.26

05160 - Motor Equipment Metal Worker 15.69

05190 - Motor Vehicle Mechanic 17.99

05220 - Motor Vehicle Mechanic Helper 13.32

05250 - Motor Vehicle Upholstery Worker 14.90

05280 - Motor Vehicle Wrecker 15.69

05310 - Painter, Automotive 16.49

05340 - Radiator Repair Specialist 15.69

05370 - Tire Repairer 13.64

05400 - Transmission Repair Specialist 17.26

07000 - Food Preparation and Service Occupations

(not set) - Food Service Worker 8.38

07010 - Baker 10.73

07041 - Cook I 9.52

07042 - Cook II 10.64

07070 - Dishwasher 7.17

07130 - Meat Cutter 12.98

07250 - Waiter/Waitress 7.03

09000 - Furniture Maintenance and Repair Occupations

09010 - Electrostatic Spray Painter 18.89

09040 - Furniture Handler 13.26

09070 - Furniture Refinisher 18.89

09100 - Furniture Refinisher Helper 15.44

09110 - Furniture Repairer, Minor 17.02

09130 - Upholsterer 18.89

11030 - General Services and Support Occupations

11030 - Cleaner, Vehicles 8.91

11060 - Elevator Operator 8.10

11090 - Gardener 11.36

11121 - House Keeping Aid I 7.24

11122 - House Keeping Aid II 7.85

11150 - Janitor 8.91

11210 - Laborer, Grounds Maintenance 9.37

11240 - Maid or Houseman 7.31

11270 - Pest Controller 12.31

11300 - Refuse Collector 8.91

11330 - Tractor Operator 10.69

11360 - Window Cleaner 9.58

12000 - Health Occupations

12020 - Dental Assistant 12.66

12040 - Emergency Medical Technician (EMT)/Paramedic/Ambulance Driver
12.67

12071 - Licensed Practical Nurse I 12.58

12072 - Licensed Practical Nurse II 14.12

12073 - Licensed Practical Nurse III 15.79

12100 - Medical Assistant 10.90

12130 - Medical Laboratory Technician 13.20

12160 - Medical Record Clerk 11.33

12190 - Medical Record Technician 13.65

12221 - Nursing Assistant I 8.63

12222 - Nursing Assistant II 9.71

12223 - Nursing Assistant III 10.59

12224 - Nursing Assistant IV 11.89

12250 - Pharmacy Technician 12.28

12280 - Phlebotomist 12.49

12311 - Registered Nurse I 18.32

12312 - Registered Nurse II 21.98

12313 - Registered Nurse II, Specialist 21.98

12314 - Registered Nurse III 26.61

12315 - Registered Nurse III, Anesthetist 26.61

12316 - Registered Nurse IV 31.89

13000 - Information and Arts Occupations

13002 - Audiovisual Librarian 20.58

13011 - Exhibits Specialist I 17.50

13012 - Exhibits Specialist II 21.67

13013 - Exhibits Specialist III 26.50

13041 - Illustrator I 16.13

13042 - Illustrator II 19.98

13043 - Illustrator III 24.42

13047 - Librarian 23.49

13050 - Library Technician 14.63

13071 - Photographer I 13.61

13072 - Photographer II 15.92

13073 - Photographer III 19.73

13074 - Photographer IV 24.11

13075 - Photographer V 29.19

15000 - Laundry, Dry Cleaning, Pressing and Related Occupations

15010 - Assembler 7.24

15030 - Counter Attendant 7.48

15040 - Dry Cleaner 9.37

15070 - Finisher, Flatwork, Machine 7.48

15090 - Presser, Hand 7.48

15100 - Presser, Machine, Drycleaning 7.48

15130 - Presser, Machine, Shirts 7.48

15160 - Presser, Machine, Wearing Apparel, Laundry 7.48

15190 - Sewing Machine Operator 10.14

15220 - Tailor 11.29

15250 - Washer, Machine 8.08

19000 - Machine Tool Operation and Repair Occupations

19010 - Machine-Tool Operator (Toolroom) 18.89

19040 - Tool and Die Maker 22.63

21000 - Material Handling and Packing Occupations

21010 - Fuel Distribution System Operator 16.08

21020 - Material Coordinator 17.84

21030 - Material Expediter 17.84

21040 - Material Handling Laborer 13.29

21050 - Order Filler 12.09

21071 - Forklift Operator 14.07

21080 - Production Line Worker (Food Processing) 14.35

21100 - Shipping/Receiving Clerk 11.33

21130 - Shipping Packer 11.43

21140 - Store Worker I 9.70

21150 - Stock Clerk (Shelf Stocker; Store Worker II) 13.40

21210 - Tools and Parts Attendant 13.32

21400 - Warehouse Specialist 14.35

23000 - Mechanics and Maintenance and Repair Occupations

23010 - Aircraft Mechanic 19.82

23040 - Aircraft Mechanic Helper 15.44

23050 - Aircraft Quality Control Inspector 20.72

23060 - Aircraft Servicer 17.02

23070 - Aircraft Worker 17.94

23100 - Appliance Mechanic 18.89

23120 - Bicycle Repairer 15.54

23125 - Cable Splicer 21.80

23130 - Carpenter, Maintenance 18.89

23140 - Carpet Layer 17.94

23160 - Electrician, Maintenance 24.34

23181 - Electronics Technician, Maintenance I 17.53

23182 - Electronics Technician, Maintenance II 20.96

23183 - Electronics Technician, Maintenance III 22.10

23260 - Fabric Worker 17.02

23290 - Fire Alarm System Mechanic 19.82

23310 - Fire Extinguisher Repairer 16.08

23340 - Fuel Distribution System Mechanic 19.82

23370 - General Maintenance Worker 17.94

23400 - Heating, Refrigeration and Air Conditioning Mechanic 19.82

23430 - Heavy Equipment Mechanic 19.82

23440 - Heavy Equipment Operator 18.35

23460 - Instrument Mechanic 19.82

23470 - Laborer 8.91

23500 - Locksmith 18.89

23530 - Machinery Maintenance Mechanic 21.34

23550 - Machinist, Maintenance 19.82

23580 - Maintenance Trades Helper 15.44

23640 - Millwright 20.97

23700 - Office Appliance Repairer 18.89

23740 - Painter, Aircraft 18.89

23760 - Painter, Maintenance 18.89

23790 - Pipefitter, Maintenance 20.89

23800 - Plumber, Maintenance 18.89

23820 - Pneudraulic Systems Mechanic 19.82

23850 - Rigger 19.82

23870 - Scale Mechanic 17.94

23890 - Sheet-Metal Worker, Maintenance 19.82

23910 - Small Engine Mechanic 17.94

23930 - Telecommunication Mechanic I 19.82

23931 - Telecommunication Mechanic II 20.72

23950 - Telephone Lineman 19.82

23960 - Welder, Combination, Maintenance 19.82

23965 - Well Driller 19.82

23970 - Woodcraft Worker 19.82

23980 - Woodworker 16.08

24000 - Personal Needs Occupations

24570 - Child Care Attendant 9.74

24580 - Child Care Center Clerk 12.15

24600 - Chore Aid 7.20

24630 - Homemaker 14.76

25000 - Plant and System Operation Occupations

25010 - Boiler Tender 20.70

25040 - Sewage Plant Operator 18.89

25070 - Stationary Engineer 19.82

25190 - Ventilation Equipment Tender 15.44

25210 - Water Treatment Plant Operator 18.89

27000 - Protective Service Occupations

(not set) - Police Officer 17.99

27004 - Alarm Monitor 12.43

27006 - Corrections Officer 15.66

27010 - Court Security Officer 16.20

27040 - Detention Officer 15.66

27070 - Firefighter 16.63

27101 - Guard I 9.61

27102 - Guard II 10.74

28000 - Stevedoring/Longshoremen Occupations

28010 - Blocker and Bracer 17.07

28020 - Hatch Tender 17.07

28030 - Line Handler 17.07

28040 - Stevedore I 16.06

28050 - Stevedore II 17.94

29000 - Technical Occupations

21150 - Graphic Artist 22.56

29010 - Air Traffic Control Specialist, Center (2) 29.65

29011 - Air Traffic Control Specialist, Station (2) 20.45

29012 - Air Traffic Control Specialist, Terminal (2) 22.53

29023 - Archeological Technician I 16.03

29024 - Archeological Technician II 18.04

29025 - Archeological Technician III 22.25

29030 - Cartographic Technician 23.00

29035 - Computer Based Training (CBT) Specialist/ Instructor 26.46

29040 - Civil Engineering Technician 18.16

29061 - Drafter I 13.47

29062 - Drafter II 15.36

29063 - Drafter III 17.97

29064 - Drafter IV 22.25

29081 - Engineering Technician I 16.30

29082 - Engineering Technician II 18.31

29083 - Engineering Technician III 20.47

29084 - Engineering Technician IV 25.84

29085 - Engineering Technician V 31.60

29086 - Engineering Technician VI 38.23

29090 - Environmental Technician 17.10

29100 - Flight Simulator/Instructor (Pilot) 27.62

29160 - Instructor 21.07

29210 - Laboratory Technician 18.10

29240 - Mathematical Technician 23.00

29361 - Paralegal/Legal Assistant I 15.17

29362 - Paralegal/Legal Assistant II 19.67

29363 - Paralegal/Legal Assistant III 24.06

29364 - Paralegal/Legal Assistant IV 29.12

29390 - Photooptics Technician 23.00

29480 - Technical Writer 23.19

29491 - Unexploded Ordnance (UXO) Technician I 18.85

29492 - Unexploded Ordnance (UXO) Technician II 22.81

29493 - Unexploded Ordnance (UXO) Technician III 27.33

29494 - Unexploded (UXO) Safety Escort 18.85

29495 - Unexploded (UXO) Sweep Personnel 18.85

29620 - Weather Observer, Senior (3) 20.35

29621 - Weather Observer, Combined Upper Air and Surface Programs (3)
18.32

29622 - Weather Observer, Upper Air (3) 18.32

31000 - Transportation/ Mobile Equipment Operation Occupations

31030 - Bus Driver 14.82

31260 - Parking and Lot Attendant 6.79

31290 - Shuttle Bus Driver 10.47

31300 - Taxi Driver 10.44

31361 - Truckdriver, Light Truck 10.47

31362 - Truckdriver, Medium Truck 16.37

31363 - Truckdriver, Heavy Truck 17.56

31364 - Truckdriver, Tractor-Trailer 17.56

99000 - Miscellaneous Occupations

99020 - Animal Caretaker 8.66

99030 - Cashier 7.96

99041 - Carnival Equipment Operator 8.65

99042 - Carnival Equipment Repairer 9.19

99043 - Carnival Worker 7.04

99050 - Desk Clerk 9.74

99095 - Embalmer 18.36

99300 - Lifeguard 9.90

99310 - Mortician 20.20

99350 - Park Attendant (Aide) 12.44

99400 - Photofinishing Worker (Photo Lab Tech., Darkroom Tech) 10.33

99500 - Recreation Specialist 13.50

99510 - Recycling Worker 10.93

99610 - Sales Clerk 9.61

99620 - School Crossing Guard (Crosswalk Attendant) 8.78

99630 - Sport Official 9.90

99658 - Survey Party Chief (Chief of Party) 17.69

99659 - Surveying Technician (Instr. Person/Surveyor Asst./Instr.) 15.86

99660 - Surveying Aide 11.58

99690 - Swimming Pool Operator 10.92

99720 - Vending Machine Attendant 9.20

99730 - Vending Machine Repairer 10.92

99740 - Vending Machine Repairer Helper 9.20

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

ALL OCCUPATIONS LISTED ABOVE RECEIVE THE FOLLOWING BENEFITS:

HEALTH & WELFARE: \$2.36 an hour or \$94.40 a week or \$409.07 a month

VACATION: 1 week paid vacation after 1 year of service with a contractor
or

successor; 2 weeks after 2 years; 3 weeks after 5 years; and 4 weeks
after 15 years.

Length of service includes the whole span of continuous service with the
present

contractor or successor, wherever employed, and with the predecessor
contractor in

the performance of similar work at the same Federal facility. (Reg. 29
CFR 4.173)

HOLIDAYS: A minimum of ten paid holidays per year: New Year\'s Day,
Martin Luther

King Jr.\'s Birthday, Washington\'s Birthday, Memorial Day, Independence
Day,

Labor Day, Columbus Day, Veterans\' Day, Thanksgiving Day, and Christmas
Day. (A

contractor may substitute for any of the named holidays another day off
with pay in

accordance with a plan communicated to the employees involved.) (See 29
CFR 4.174)

THE OCCUPATIONS WHICH HAVE PARENTHESES AFTER THEM RECEIVE THE FOLLOWING
BENEFITS (as

numbered):

1\) Does not apply to employees employed in a bona fide executive,
administrative,

or professional capacity as defined and delineated in 29 CFR 541. (See
CFR 4.156)

2\) APPLICABLE TO AIR TRAFFIC CONTROLLERS ONLY - NIGHT DIFFERENTIAL: An
employee is

entitled to pay for all work performed between the hours of 6:00 P.M.
and 6:00 A.M.

at the rate of basic pay plus a night pay differential amounting to 10
percent of

the rate of basic pay.

3\) WEATHER OBSERVERS - NIGHT PAY & SUNDAY PAY: If you work at night as
part of a

regular tour of duty, you will earn a night differential and receive an
additional

10% of basic pay for any hours worked between 6pm and 6am. If you are a
full-time

employed (40 hours a week) and Sunday is part of your regularly
scheduled workweek,

you are paid at your rate of basic pay plus a Sunday premium of 25% of
your basic

rate for each hour of Sunday work which is not overtime (i.e. occasional
work on

Sunday outside the normal tour of duty is considered overtime work).

HAZARDOUS PAY DIFFERENTIAL: An 8 percent differential is applicable to
employees

employed in a position that represents a high degree of hazard when
working with or

in close proximity to ordinance, explosives, and incendiary materials.
This

includes work such as screening, blending, dying, mixing, and pressing
of sensitive

ordance, explosives, and pyrotechnic compositions such as lead azide,
black powder

and photoflash powder. All dry-house activities involving propellants or

explosives. Demilitarization, modification, renovation, demolition, and
maintenance

operations on sensitive ordnance, explosives and incendiary materials.
All

operations involving regrading and cleaning of artillery ranges.

A 4 percent differential is applicable to employees employed in a
position that

represents a low degree of hazard when working with, or in close
proximity to

ordance, (or employees possibly adjacent to) explosives and incendiary
materials

which involves potential injury such as laceration of hands, face, or
arms of the

employee engaged in the operation, irritation of the skin, minor burns
and the

like; minimal damage to immediate or adjacent work area or equipment
being used. All

operations involving, unloading, storage, and hauling of ordance,
explosive, and

incendiary ordnance material other than small arms ammunition. These
differentials

are only applicable to work that has been specifically designated by the
agency for

ordance, explosives, and incendiary material differential pay.

\*\* UNIFORM ALLOWANCE \*\*

If employees are required to wear uniforms in the performance of this
contract

(either by the terms of the Government contract, by the employer, by the
state or

local law, etc.), the cost of furnishing such uniforms and maintaining
(by

laundering or dry cleaning) such uniforms is an expense that may not be
borne by an

employee where such cost reduces the hourly rate below that required by
the wage

determination. The Department of Labor will accept payment in accordance
with the

following standards as compliance:

The contractor or subcontractor is required to furnish all employees
with an

adequate number of uniforms without cost or to reimburse employees for
the actual

cost of the uniforms. In addition, where uniform cleaning and
maintenance is made

the responsibility of the employee, all contractors and subcontractors
subject to

this wage determination shall (in the absence of a bona fide collective
bargaining

agreement providing for a different amount, or the furnishing of
contrary

affirmative proof as to the actual cost), reimburse all employees for
such cleaning

and maintenance at a rate of \$3.35 per week (or \$.67 cents per day).
However, in

those instances where the uniforms furnished are made of \"wash and
wear\"

materials, may be routinely washed and dried with other personal
garments, and do

not require any special treatment such as dry cleaning, daily washing,
or commercial

laundering in order to meet the cleanliness or appearance standards set
by the terms

of the Government contract, by the contractor, by law, or by the nature
of the work,

there is no requirement that employees be reimbursed for uniform
maintenance costs.

\*\* NOTES APPLYING TO THIS WAGE DETERMINATION \*\*

Source of Occupational Title and Descriptions:

The duties of employees under job titles listed are those described in
the

\"Service Contract Act Directory of Occupations,\" Fourth Edition,
January 1993, as

amended by the Third Supplement, dated March 1997, unless otherwise
indicated. This

publication may be obtained from the Superintendent of Documents, at
202-783-3238,

or by writing to the Superintendent of Documents, U.S. Government
Printing Office,

Washington, D.C. 20402. Copies of specific job descriptions may also be
obtained

from the appropriate contracting officer.

REQUEST FOR AUTHORIZATION OF ADDITIONAL CLASSIFICATION AND WAGE RATE
{Standard Form

1444 (SF 1444)}

Conformance Process:

The contracting officer shall require that any class of service employee
which is

not listed herein and which is to be employed under the contract (i.e.,
the work to

be performed is not performed by any classification listed in the wage

determination), be classified by the contractor so as to provide a
reasonable

relationship (i.e., appropriate level of skill comparison) between such
unlisted

classifications and the classifications listed in the wage
determination. Such

conformed classes of employees shall be paid the monetary wages and
furnished the

fringe benefits as are determined. Such conforming process shall be
initiated by

the contractor prior to the performance of contract work by such
unlisted class(es)

of employees. The conformed classification, wage rate, and/or fringe
benefits shall

be retroactive to the commencement date of the contract. {See Section
4.6 (C)(vi)}

When multiple wage determinations are included in a contract, a separate
SF 1444

should be prepared for each wage determination to which a class(es) is
to be

conformed.

The process for preparing a conformance request is as follows:

1\) When preparing the bid, the contractor identifies the need for a
conformed

occupation) and computes a proposed rate).

2\) After contract award, the contractor prepares a written report
listing in order

proposed classification title), a Federal grade equivalency (FGE) for
each

proposed classification), job description), and rationale for proposed
wage

rate), including information regarding the agreement or disagreement of
the

authorized representative of the employees involved, or where there is
no authorized

representative, the employees themselves. This report should be
submitted to the

contracting officer no later than 30 days after such unlisted class(es)
of employees

performs any contract work.

3\) The contracting officer reviews the proposed action and promptly
submits a report

of the action, together with the agency\'s recommendations and pertinent

information including the position of the contractor and the employees,
to the Wage

and Hour Division, Employment Standards Administration, U.S. Department
of Labor,

for review. (See section 4.6(b)(2) of Regulations 29 CFR Part 4).

4\) Within 30 days of receipt, the Wage and Hour Division approves,
modifies, or

disapproves the action via transmittal to the agency contracting
officer, or

notifies the contracting officer that additional time will be required
to process the

request.

5\) The contracting officer transmits the Wage and Hour decision to the
contractor.

6\) The contractor informs the affected employees.

Information required by the Regulations must be submitted on SF 1444 or
bond paper.

When preparing a conformance request, the \"Service Contract Act
Directory of

Occupations\" (the Directory) should be used to compare job definitions
to insure

that duties requested are not performed by a classification already
listed in the

wage determination. Remember, it is not the job title, but the required
tasks that

determine whether a class is included in an established wage
determination.

Conformances may not be used to artificially split, combine, or
subdivide

classifications listed in the wage determination.

####  

#### 52.212-1 \-- Instructions to Offerors \-- Commercial Items (Oct. 2003).

\(a\) *North American Industry Classification System (NAICS) code and
small business size standard.* The NAICS code and small business size
standard for this acquisition appear in Block 10 of the solicitation
cover sheet (SF 1449). However, the small business size standard for a
concern which submits an offer in its own name, but which proposes to
furnish an item which it did not itself manufacture, is 500 employees.

\(b\) *Submission of offers*. Submit signed and dated offers to the
office specified in this solicitation at or before the exact time
specified in this solicitation. Offers may be submitted on the SF 1449,
letterhead stationery, or as otherwise specified in the solicitation. As
a minimum, offers must show \--

> \(1\) The solicitation number;
>
> \(2\) The time specified in the solicitation for receipt of offers;
>
> \(3\) The name, address, and telephone number of the offeror;
>
> \(4\) A technical description of the items being offered in sufficient
> detail to evaluate compliance with the requirements in the
> solicitation. This may include product literature, or other documents,
> if necessary;
>
> \(5\) Terms of any express warranty;
>
> \(6\) Price and any discount terms;
>
> \(7\) \"Remit to\" address, if different than mailing address;
>
> \(8\) A completed copy of the representations and certifications at
> FAR 52.212-3;
>
> \(9\) Acknowledgment of Solicitation Amendments;
>
> \(10\) Past performance information, when included as an evaluation
> factor, to include recent and relevant contracts for the same or
> similar items and other references (including contract numbers, points
> of contact with telephone numbers and other relevant information); and
>
> \(11\) If the offer is not submitted on the SF 1449, include a
> statement specifying the extent of agreement with all terms,
> conditions, and provisions included in the solicitation. Offers that
> fail to furnish required representations or information, or reject the
> terms and conditions of the solicitation may be excluded from
> consideration.

\(c\) *Period for acceptance of offers*. The offeror agrees to hold the
prices in its offer firm for 30 calendar days from the date specified
for receipt of offers, unless another time period is specified in an
addendum to the solicitation.

\(d\) *Product samples*. When required by the solicitation, product
samples shall be submitted at or prior to the time specified for receipt
of offers. Unless otherwise specified in this solicitation, these
samples shall be submitted at no expense to the Government, and returned
at the sender\'s request and expense, unless they are destroyed during
preaward testing.

\(e\) *Multiple offers*. Offerors are encouraged to submit multiple
offers presenting alternative terms and conditions or commercial items
for satisfying the requirements of this solicitation. Each offer
submitted will be evaluated separately.

\(f\) *Late submissions, modifications, revisions, and withdrawals of
offers*.

> \(1\) Offerors are responsible for submitting offers, and any
> modifications, revisions, or withdrawals, so as to reach the
> Government office designated in the solicitation by the time specified
> in the solicitation. If no time is specified in the solicitation, the
> time for receipt is 4:30 p.m., local time, for the designated
> Government office on the date that offers or revisions are due.
>
> \(2\)
>
> \(i\) Any offer, modification, revision, or withdrawal of an offer
> received at the Government office designated in the solicitation after
> the exact time specified for receipt of offers is \"late\" and will
> not be considered unless it is received before award is made, the
> Contracting Officer determines that accepting the late offer would not
> unduly delay the acquisition; and-
>
> **(A)** If it was transmitted through an electronic commerce method
> authorized by the solicitation, it was received at the initial point
> of entry to the Government infrastructure not later than 5:00 p.m. one
> working day prior to the date specified for receipt of offers; or
>
> **(B)** There is acceptable evidence to establish that it was received
> at the Government installation designated for receipt of offers and
> was under the Government\'s control prior to the time set for receipt
> of offers; or
>
> **(C)** If this solicitation is a request for proposals, it was the
> only proposal received.
>
> \(ii\) However, a late modification of an otherwise successful offer,
> that makes its terms more favorable to the Government, will be
> considered at any time it is received and may be accepted.
>
> **(3)** Acceptable evidence to establish the time of receipt at the
> Government installation includes the time/date stamp of that
> installation on the offer wrapper, other documentary evidence of
> receipt maintained by the installation, or oral testimony or
> statements of Government personnel.
>
> **(4)** If an emergency or unanticipated event interrupts normal
> Government processes so that offers cannot be received at the
> Government office designated for receipt of offers by the exact time
> specified in the solicitation, and urgent Government requirements
> preclude amendment of the solicitation or other notice of an extension
> of the closing date, the time specified for receipt of offers will be
> deemed to be extended to the same time of day specified in the
> solicitation on the first work day on which normal Government
> processes resume.
>
> **(5)** Offers may be withdrawn by written notice received at any time
> before the exact time set for receipt of offers. Oral offers in
> response to oral solicitations may be withdrawn orally. If the
> solicitation authorizes facsimile offers, offers may be withdrawn via
> facsimile received at any time before the exact time set for receipt
> of offers, subject to the conditions specified in the solicitation
> concerning facsimile offers. An offer may be withdrawn in person by an
> offeror or its authorized representative if, before the exact time set
> for receipt of offers, the identity of the person requesting
> withdrawal is established and the person signs a receipt for the
> offer.

\(g\) *Contract award (not applicable to Invitation for Bids).* The
Government intends to evaluate offers and award a contract without
discussions with offerors. Therefore, the offeror\'s initial offer
should contain the offeror\'s best terms from a price and technical
standpoint. However, the Government reserves the right to conduct
discussions if later determined by the Contracting Officer to be
necessary. The Government may reject any or all offers if such action is
in the public interest; accept other than the lowest offer; and waive
informalities and minor irregularities in offers received.

\(h\) *Multiple awards*. The Government may accept any item or group of
items of an offer, unless the offeror qualifies the offer by specific
limitations. Unless otherwise provided in the Schedule, offers may not
be submitted for quantities less than those specified. The Government
reserves the right to make an award on any item for a quantity less than
the quantity offered, at the unit prices offered, unless the offeror
specifies otherwise in the offer.

\(i\) *Availability of requirements documents cited in the
solicitation.*

> (1)(i) The GSA Index of Federal Specifications, Standards and
> Commercial Item Descriptions, FPMR Part 101-29, and copies of
> specifications, standards, and commercial item descriptions cited in
> this solicitation may be obtained for a fee by submitting a request
> to\--
>
> GSA Federal Supply Service Specifications Section
>
> Suite 8100\
> 470 L\'Enfant Plaza, SW\
> Washington, DC 20407\
> Telephone (202) 619-8925)
>
> Facsimile (202 619-8978).
>
> \(ii\) If the General Services Administration, Department of
> Agriculture, or Department of Veterans Affairs issued this
> solicitation, a single copy of specifications, standards, and
> commercial item descriptions cited in this solicitation may be
> obtained free of charge by submitting a request to the addressee in
> paragraph (i)(1)(i) of this provision. Additional copies will be
> issued for a fee.
>
> \(2\) The DoD Index of Specifications and Standards (DoDISS) and
> documents listed in it may be obtained from the**\--**
>
> Department of Defense Single Stock Point (DoDSSP)\
> Building 4, Section D
>
> 700 Robbins Avenue\
> Philadelphia, PA 19111-5094
>
> Telephone (215) 697-2667/2179
>
> Facsmilie (215) 697-1462.
>
> \(i\) Automatic distribution may be obtained on a subscription basis.
>
> \(ii\) Order forms, pricing information, and customer support
> information may be obtained-
>
> \(A\) By telephone at (215) 697_2667/2179; or
>
> \(B\) Through the DoDSSP Internet site at
> [http://dodssp.daps.mil](http://dodssp.daps.mil/).
>
> \(3\) Nongovernment (voluntary) standards must be obtained from the
> organization responsible for their preparation, publication or
> maintenance.

\(j\) *Data Universal Numbering System (DUNS) Number.* (Applies to
offers exceeding \$25,000, and offers of \$25,000 or less if the
solicitation requires the Contractor to be registered in the Central
Contractor Registration (CCR) database. The offeror shall enter, in the
block with its name and address on the cover page of its offer, the
annotation \"DUNS\" or \"DUNS+4\" followed by the DUNS or DUNS+4 number
that identifies the offeror\'s name and address. The DUNS+4 is the DUNS
number plus a 4-character suffix that may be assigned at the discretion
of the offeror to establish additional CCR records for identifying
alternative Electronic Funds Transfer (EFT) accounts (see FAR Subpart
32.11) for the same parent concern. If the offeror does not have a DUNS
number, it should contact Dun and Bradstreet directly to obtain one. An
offeror within the United States may contact Dun and Bradstreet by
calling 1-866-705-5711 or via the Internet at
[http://www.dnb.com](http://www.dnb.com/). An offeror located outside
the United States must contact the local Dun and Bradstreet office for
DUNS number.

\(k\) *Central Contractor Registration.* Unless exempted by an addendum
to this solicitation, by submission of an offer, the offeror
acknowledges the requirement that a prospective awardee shall be
registered in the CCR database prior to award, during performance and
through final payment of any contract resulting from this solicitation.
If the Offeror does not become registered in the CCR database in the
time prescribed by the Contracting Officer, the Contracting Officer will
proceed to award to the next otherwise successful registered Offeror.
Offerors may obtain information on registration and annual confirmation
requirements via the Internet at
[http://www.ccr.gov](http://www.ccr.gov/) or by calling 1-888-227-2423
or 269-961-5757.

**ADDENDUM TO FAR 52.212-1**

**52.233‑2 SERVICE OF PROTEST (AUG 1996)**

\(a\) Protests, as defined in section 33.101 of the Federal Acquisition
Regulation, that are filed directly with an agency, and copies of any
protests that are filed with the General Accounting Office (GAO), shall
be served on the Contracting Officer (addressed as follows) by obtaining
written and dated acknowledgment of receipt from:

Hand‑Carried Address: Contracting Officer (90C)

VA Medical Center

Bldg. 27

100 Emancipation Drive

Hampton, VA 23667

Mailing Address: Same as above

\(b\) The copy of any protest shall be received in the office designated
above within one day of filing a protest with the GAO.

(End of Provision)

**VAAR 852.233‑70 PROTEST CONTENT (JAN 1998)**

\(a\) Any protest filed by an interested party shall:

\(1\) Include the name, address, fax number, and telephone number of the
protester;

\(2\) Identify the solicitation and/or contract number;

\(3\) Include an original signed by the protester or the protester\'s
representative, and at least one copy;

\(4\) Set forth a detailed statement of the legal and factual grounds of
the protest, including a description of resulting prejudice to the
protester, and provide copies of relevant documents;

\(5\) Specifically request a ruling of the individual upon whom the
protest is served;

\(6\) State the form of relief requested; and

\(7\) Provide all information establishing the timeliness of the
protest.

\(b\) Failure to comply with the above may result in dismissal of the
protest without further consideration.

(End of Provision)

VAAR 852.233‑71 ALTERNATIVE PROTEST PROCEDURE (JAN 1998)

As an alternative to filing a protest with the contracting officer, an
interested party may file a protest with the Deputy Assistant Secretary
for Acquisition and Materiel Management, Acquisition Administration
Team, Department of Veterans Affairs, 810 Vermont Avenue, NW,
Washington, DC, 20420, or, for solicitations issued by the Office of
Facilities Management, the Chief Facilities Management Officer, Office
of Facilities Management, 810 Vermont Avenue, NW, Washington, DC 20420.
The protest will not be considered if the interested party has a protest
on the same or similar issues pending with the contracting officer.

(End of Provision)

**REPRESENTATIONS AND CERTIFICATIONS**

#### 52.212-3 \-- Offeror Representations and Certifications \-- Commercial Items (June 2003).

\(a\) *Definitions.* As used in this provision:

> \"Emerging small business\" means a small business concern whose size
> is no greater than 50 percent of the numerical size standard for the
> NAICS code designated.
>
> \"Forced or indentured child labor\" means all work or service-
>
> \(1\) Exacted from any person under the age of 18 under the menace of
> any penalty for its nonperformance and for which the worker does not
> offer himself voluntarily; or
>
> \(2\) Performed by any person under the age of 18 pursuant to a
> contract the enforcement of which can be accomplished by process or
> penalties.
>
> \"Service-disabled veteran-owned small business concern\"-
>
> \(1\) Means a small business concern-
>
> \(i\) Not less than 51 percent of which is owned by one or more
> service-disabled veterans or, in the case of any publicly owned
> business, not less than 51 percent of the stock of which is owned by
> one or more service-disabled veterans; and
>
> \(ii\) The management and daily business operations of which are
> controlled by one or more service-disabled veterans or, in the case of
> a veteran with permanent and severe disability, the spouse or
> permanent caregiver of such veteran.
>
> \(2\) Service-disabled veteran means a veteran, as defined in 38
> U.S.C. 101(2), with a disability that is service-connected, as defined
> in 38 U.S.C. 101(16).
>
> \"Small business concern\" means a concern, including its affiliates,
> that is independently owned and operated, not dominant in the field of
> operation in which it is bidding on Government contracts, and
> qualified as a small business under the criteria in 13 CFR Part 121
> and size standards in this solicitation.
>
> \"Veteran-owned small business concern\" means a small business
> concern-
>
> \(1\) Not less than 51 percent of which is owned by one or more
> veterans(as defined at 38 U.S.C. 101(2)) or, in the case of any
> publicly owned business, not less than 51 percent of the stock of
> which is owned by one or more veterans; and
>
> \(2\) The management and daily business operations of which are
> controlled by one or more veterans.
>
> \"Women-owned business concern\" means a concern which is at least 51
> percent owned by one or more women; or in the case of any publicly
> owned business, at least 51 percent of the its stock is owned by one
> or more women; and whose management and daily business operations are
> controlled by one or more women.
>
> \"Women-owned small business concern\" means a small business concern
> \--
>
> \(1\) That is at least 51 percent owned by one or more women or, in
> the case of any publicly owned business, at least 51 percent of the
> stock of which is owned by one or more women; and
>
> \(2\) Whose management and daily business operations are controlled by
> one or more women.

\(b\) *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 (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 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
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\(c\) Offerors must complete the following representations when the
resulting contract is to be performed in the United States or its
outlying areas. Check all that apply.

> \(1\) *Small business concern*. The offeror represents as part of its
> offer that it \* is, \* is not a small business concern.
>
> \(2\) *Veteran-owned small business concern.* \[*Complete only if the
> offeror represented itself as a small business concern in paragraph
> (c)(1) of this provision.*\] The offeror represents as part of its
> offer that it \* is, \* is not a veteran-owned small business concern.
>
> \(3\) *Service-disabled veteran-owned small business concern.*
> \[*Complete only if the offeror represented itself as a veteran-owned
> small business concern in paragraph (c)(2) of this provision.*\] The
> offeror represents as part of its offer that it \* is, \* is not a
> service-disabled veteran-owned small business concern.
>
> \(4\) *Small disadvantaged business concern*. \[*Complete only if the
> offeror represented itself as a small business concern in paragraph
> (c)(1) of this provision.*\] The offeror represents, for general
> statistical purposes, that it \* is, \* is not, a small disadvantaged
> business concern as defined in 13 CFR 124.1002.
>
> \(5\) *Women-owned small business concern*. \[*Complete only if the
> offeror represented itself as a small business concern in paragraph
> (c)(1) of this provision.*\] The offeror represents that it \* is, \*
> is not a women-owned small business concern.
>
> **Note:** Complete paragraphs (c)(6) and (c)(7) only if this
> solicitation is expected to exceed the simplified acquisition
> threshold.
>
> \(6\) *Women-owned business concern (other than small business
> concern)*. \[*Complete only if the offeror is a women-owned business
> concern and did not represent itself as a small business concern in
> paragraph (c)(1) of this provision*.\]. The offeror represents that it
> \* is, a women-owned business concern.
>
> \(7\) *Tie bid priority for labor surplus area concerns.* If this is
> an invitation for bid, small business offerors may identify the labor
> surplus areas in which costs to be incurred on account of
> manufacturing or production (by offeror or first-tier subcontractors)
> amount to more than 50 percent of the contract price:
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> \(8\) Small Business Size for the Small Business Competitiveness
> Demonstration Program and for the Targeted Industry Categories under
> the Small Business Competitiveness Demonstration Program. *\[Complete
> only if the offeror has represented itself to be a small business
> concern under the size standards for this solicitation.\]*
>
> \(i\) \[*Complete only for solicitations indicated in an addendum as
> being set-aside for emerging small businesses in one of the four
> designated industry groups (DIGs)*.\] The offeror represents as part
> of its offer that it \* is, \* is not an emerging small business.
>
> \(ii\) \[*Complete only for solicitations indicated in an addendum as
> being for one of the targeted industry categories (TICs) or four
> designated industry groups (DIGs).*\] Offeror represents as follows:
>
> \(A\) Offeror\'s number of employees for the past 12 months (check the
> Employees column if size standard stated in the solicitation is
> expressed in terms of number of employees); or
>
> \(B\) Offeror\'s average annual gross revenue for the last 3 fiscal
> years (check the Average Annual Gross Number of Revenues column if
> size standard stated in the solicitation is expressed in terms of
> annual receipts).
>
> *(Check one of the following):*

  ----------------------------------- -----------------------------------
  **[Number of                        **[Average Annual Gross
  Employees]{.underline}**            Revenues]{.underline}**

  50 or fewer                         \$1 million or less

  51-100                              \$1,000,001-\$2 million

  101-250                             \$2,000,001-\$3.5 million

  251-500                             \$3,500,001-\$5 million

  501-750                             \$5,000,001-\$10 million

  751-1,000                           \$10,000,001-\$17 million

  Over 1,000                          Over \$17 million
  ----------------------------------- -----------------------------------

> \(9\) \[*Complete only if the solicitation contains the clause at FAR
> 52.219-23, Notice of Price Evaluation Adjustment for Small
> Disadvantaged Business Concerns, or FAR 52.219-25, Small Disadvantaged
> Business Participation Program-Disadvantaged Status and Reporting, and
> the offeror desires a benefit based on its disadvantaged status.*\]
>
> \(i\) *General.* The offeror represents that either-
>
> \(A\) It \* is, \* is not certified by the Small Business
> Administration as a small disadvantaged business concern and
> identified, on the date of this representation, as a certified small
> disadvantaged business concern in the database maintained by the Small
> Business Administration (PRO-Net), and that no material change in
> disadvantaged ownership and control has occurred since its
> certification, and, where the concern is owned by one or more
> individuals claiming disadvantaged status, the net worth of each
> individual upon whom the certification is based does not exceed
> \$750,000 after taking into account the applicable exclusions set
> forth at 13 CFR 124.104(c)(2); or
>
> \(B\) It \*has, \* has not submitted a completed application to the
> Small Business Administration or a Private Certifier to be certified
> as a small disadvantaged business concern in accordance with 13 CFR
> 124, Subpart B, and a decision on that application is pending, and
> that no material change in disadvantaged ownership and control has
> occurred since its application was submitted.
>
> \(ii\) *Joint Ventures under the Price Evaluation Adjustment for Small
> Disadvantaged Business Concerns*. The offeror represents, as part of
> its offer, that it is a joint venture that complies with the
> requirements in 13 CFR 124.1002(f) and that the representation in
> paragraph (c)(9)(i) of this provision is accurate for the small
> disadvantaged business concern that is participating in the joint
> venture. \[*The offeror shall enter the name of the small
> disadvantaged business concern that is participating in the joint
> venture: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.*\]
>
> \(10\) *HUBZone small business concern*. \[*Complete only if the
> offeror represented itself as a small business concern in paragraph
> (c)(1) of this provision*.\] The offeror represents, as part of its
> offer, that\--
>
> \(i\) It \* 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
> 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, \* not a joint venture that complies with the
> requirements of 13 CFR part 126, and the representation in paragraph
> (c)(10)(i) of this provision is accurate for the HUBZone small
> business concern or concerns that are participating in the joint
> venture. \[*The offeror shall enter the name or names of the HUBZone
> small business concern or concerns that are participating in the joint
> venture*: \_\_\_\_\_\_\_\_\_\_.\] Each HUBZone small business concern
> participating in the joint venture shall submit a separate signed copy
> of the HUBZone representation.

\(d\) *Representations required to implement provisions of Executive
Order 11246* \--

> \(1\) Previous contracts and compliance. The offeror represents that
> \--
>
> \(i\) It \* has, \* has not, participated in a previous contract or
> subcontract subject to the Equal Opportunity clause of this
> solicitation; and
>
> \(ii\) It \* has, \* has not, filed all required compliance reports.
>
> \(2\) *Affirmative Action Compliance*. The offeror represents that \--
>
> \(i\) It \* has developed and has on file, \* has not developed and
> does not have on file, at each establishment, affirmative action
> programs required by rules and regulations of the Secretary of Labor
> (41 CFR parts 60-1 and 60-2), or
>
> \(ii\) It \* has not previously had contracts subject to the written
> affirmative action programs requirement of the rules and regulations
> of the Secretary of Labor.

\(e\) *Certification Regarding Payments to Influence Federal
Transactions (31 U.S.C. 1352).* (Applies only if the contract is
expected to exceed \$100,000.) By submission of its offer, the offeror
certifies to the best of its knowledge and belief that no Federal
appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress or an
employee of a Member of Congress on his or her behalf in connection with
the award of any resultant contract.

\(f\) *Buy American Act Certificate.* (Applies only if the clause at
Federal Acquisition Regulation (FAR) 52.225-1, Buy American Act -
Supplies, is included in this solicitation.)

> \(1\) The offeror certifies that each end product, except those listed
> in paragraph (f)(2) of this provision, is a domestic end product and
> that the offeror has considered components of unknown origin to have
> been mined, produced, or manufactured outside the United States. The
> offeror shall list as foreign end products those end products
> manufactured in the United States that do not qualify as domestic end
> products. The terms \"component,\" \"domestic end product,\" \"end
> product,\" \"foreign end product,\" and \"United States\" are defined
> in the clause of this solicitation entitled \"Buy American
> Act-Supplies.\"
>
> \(2\) Foreign End Products:

  ---------------------------------- ------------------------------------
  LINE ITEM NO.                      COUNTRY OF ORIGIN

                                     

                                     

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

> \[*List as necessary*\]
>
> \(3\) The Government will evaluate offers in accordance with the
> policies and procedures of FAR Part 25.

\(g\)

> \(1\) *Buy American Act \-- North American Free Trade Agreement \--
> Israeli Trade Act Certificate*. (Applies only if the clause at FAR
> 52.225-3, Buy American Act \-- North American Free Trade Agreement \--
> Israeli Trade Act, is included in this solicitation.)
>
> \(i\) The offeror certifies that each end product, except those listed
> in paragraph (g)(1)(ii) or (g)(1)(iii) of this provision, is a
> domestic end product and that the offeror has considered components of
> unknown origin to have been mined, produced, or manufactured outside
> the United States. The terms \"component,\" \"domestic end product,\"
> \"end product,\" \"foreign end product,\" and \"United States\" are
> defined in the clause of this solicitation entitled \"Buy American
> Act-North American Free Trade Agreement-Israeli Trade Act.\"
>
> \(ii\) 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\":
>
> NAFTA Country 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) or this
> provision) as defined in the clause of this solicitation entitled
> \"Buy American Act-North American Free Trade Agreement-Israeli Trade
> Act.\" The offeror shall list as other foreign end products those end
> products manufactured in the United States that do not qualify as
> domestic end products.
>
> Other Foreign End Products:

  ----------------------------------- -----------------------------------
  LINE ITEM NO.                       COUNTRY OF ORIGIN

                                      

                                      

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

> \[*List as necessary*\]
>
> \(iv\) The Government will evaluate offers in accordance with the
> policies and procedures of FAR Part 25.
>
> \(2\) *Buy American Act-North American Free Trade Agreements-Israeli
> Trade Act Certificate, Alternate I (May 2002)*. If Alternate I to the
> clause at FAR 52.225-3 is included in this solicitation, substitute
> the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii) of the
> basic provision:
>
> (g)(1)(ii) The offeror certifies that the following supplies are
> Canadian end products as defined in the clause of this solicitation
> entitled \"Buy American Act-North American Free Trade
> Agreement-Israeli Trade Act\":
>
> Canadian End Products:

Line Item No.:

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

*\[List as necessary\]*

> \(3\) *Buy American Act-North American Free Trade Agreements-Israeli
> Trade Act Certificate, Alternate II (May 2002).* If Alternate II to
> the clause at FAR 52.225-3 is included in this solicitation,
> substitute the following paragraph (g)(1)(ii) for paragraph (g)(1)(ii)
> of the basic provision:
>
> (g)(1)(ii) The offeror certifies that the following supplies are
> Canadian end products or Israeli end products as defined in the clause
> of this solicitation entitled \`\`Buy American Act\--North American
> Free Trade Agreement\--Israeli Trade Act\'\':
>
> Canadian or Israeli End Products:

  ----------------------------------- -----------------------------------
  Line Item No.:                      Country of Origin:

                                      

                                      

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

> \[*List as necessary*\]
>
> \(4\) *Trade Agreements Certificate*. (Applies only if the clause at
> FAR 52.225-5, Trade Agreements, is included in this solicitation.)
>
> \(i\) The offeror certifies that each end product, except those listed
> in paragraph (g)(4)(ii) of this provision, is a U.S.-made, designated
> country, Caribbean Basin country, or NAFTA 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, designated country, Caribbean Basin country,
> or NAFTA 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 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. 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 the
> solicitation.

\(h\) *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 Product

  ----------------------------------- -----------------------------------
  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 is 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.

(End of Provision)

*Alternate I* (*Apr 2002).* As prescribed in
[12.301](http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/12.htm#P79_13482)(b)(2),
add the following paragraph (c)(11) to the basic provision:

> \(11\) (Complete if the offeror has represented itself as
> disadvantaged in paragraph (c)(4) or (c)(9) of this provision.) \[*The
> offeror shall check the category in which its ownership falls*\]:
>
> **\_\_\_\_** Black American.
>
> \_\_\_ Hispanic American.
>
> \_\_\_ Native American (American Indians, Eskimos, Aleuts, or Native
> Hawaiians).
>
> \_\_\_ Asian-Pacific American (persons with origins from Burma,
> Thailand, Malaysia, Indonesia, Singapore, Brunei, Japan, China,
> Taiwan, Laos, Cambodia (Kampuchea), Vietnam, Korea, The Philippines,
> U.S. Trust Territory or the Pacific Islands (Republic of Palau),
> Republic of the Marshall Islands, Federated States of Micronesia, the
> Commonwealth of the Northern Mariana Islands, Guam, Samoa, Macao, Hong
> Kong, Fiji, Tonga, Kiribati, Tuvalu, or Nauru).
>
> \_\_\_ Subcontinent Asian (Asian-Indian) American (persons with
> origins from India, Pakistan, Bangladesh, Sri Lanka, Bhutan, the
> Maldives Islands, or Nepal).
>
> \_\_\_ Individual/concern, other than one of the preceding.

*Alternate II* *(Oct 2000).* As prescribed in
[12.301](http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/12.htm#P79_13482)(b)(2),
add the following paragraph (c)(9)(iii) to the basic provision:

> \(iii\) 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]{.underline}.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.