REPRESENTATIONS, CERTIFICATIONS, AND

[OTHER STATEMENTS OF OFFERORS OR QUOTERS]{.underline}

[FOR]{.underline}

[REQUEST FOR OFFER 10-02-0017]{.underline}

  -----------------------------------------------------------------------
  COMPANY NAME

  AUTHORIZED COMPANY OFFICIAL NAME

  SIGNATURE

  DATE
  -----------------------------------------------------------------------

# 1. CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (52.203-2) (APR 1985)

\[WHEN USING FFP OR FP CONTRACT WHEN AN ECONOMIC PRICE ADJUSTMENT IS
CONTEMPLATED - REF: FAR 3.103-1\]

##  (a) The offeror certifies that -

## 

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

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

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

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

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

\(2\) (i) Has been authorized, in writing, to act as agent for the
following principals in certifying that those principles have not
participated, and will not participate in any action contrary to
subparagraphs (a)(1) through (a)(3) above \[Insert full name of
person(s) in the offeror\'s organization responsible for determining the
prices offered in this bid or proposal, and the title of his or her
position in the offeror\'s organization\];

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

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

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

# 2. CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL TRANSACTIONS (52.203-11) (APR 1991)

\[DELETE IF LESS THAN \$100K, REF FAR 3.808(a)\]

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

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

\(1\) No Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress on his or her behalf in
connection with the awarding of any Federal contract, the making of any
Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any Federal contract, grant, loan, or
cooperative agreement;

\(2\) If any funds other than Federal appropriated funds (including
profit or fee received under a covered Federal transaction) have been
paid, or will be paid, to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress
on his or her behalf in connection with this solicitation, the offeror
shall complete and submit, with its offer, OMB standard form LLL,
Disclosure of Lobbying Activities, to the Contracting Officer; and

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

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

3\. [TAXPAYER IDENTIFICATION (52.204-3) (OCT 1998)]{.underline}

\[REF: FAR 4.904\]

\(a\) Definitions.

\"Common parent,\" as used in this provision, means that corporate
entity that owns or controls an affiliated group of corporations that
files its Federal income tax returns on a consolidated basis, and of
which the offeror is a member.

\"Taxpayer Identification Number (TIN),\" as used in this provision,
means the number required by the Internal Revenue Service (IRS) to be
used by the offeror in reporting income tax and other returns. The TIN
may be either a Social Security Number or an Employer Identification
Number.

\(b\) All offerors must submit the information required in paragraphs
(d) through (f) of this provision to comply with debt collection
requirements of 31 U.S.C. 7701(c) and 3325(d), reporting

requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing
regulations issued by the IRS. If the resulting contract is subject to
the payment reporting requirements described in Federal Acquisition
Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish
the information may result in a 31 percent reduction of payments
otherwise due under the contract.

\(c\) The TIN may be used by the Government to collect and report on any
delinquent amounts arising out of the offeror\'s relationship with the
Government (31 U.S.C. 7701(c)(3)). If the resulting

contract is subject to the payment reporting requirements described in
FAR 4.904, the TIN provided hereunder may be matched with IRS records to
verify the accuracy of the offeror\'s TIN.

\(d\) Taxpayer Identification Number (TIN).

\[ \] TIN: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

\[ \] TIN has been applied for.

\[ \] TIN is not required because:

\[ \] Offeror is a nonresident alien, foreign corporation, or foreign
partnership that does not have income effectively connected with the
conduct of a trade or business in the United States and does not have an
office or place of business or a fiscal paying agent in the

United States;

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

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

\(e\) Type of organization.

\[ \] Sole proprietorship;

\[ \] Partnership;

\[ \] Corporate entity (not tax-exempt);

\[ \] Corporate entity (tax-exempt);

\[ \] Government entity (Federal, State, or local);

\[ \] Foreign government;

\[ \] International organization per 26 CFR 1.6049-4;

\[ \] Other \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.

\(f\) Common parent.

\[ \] Offeror is not owned or controlled by a common parent as defined
in paragraph (a) of this provision.

\[ \] Name and TIN of common parent:

Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

TIN \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

4\. [WOMEN-OWNED BUSINESS (OTHER THAN SMALL BUSINESS) (52.204-5) (MAY
1999)]{.underline}

\(a\) Definition. \"Women-owned business concern,\" as used in this
provision, means a concern that is

at least 51 percent owned by one or more women; or in the case of any
publicly owned business, at least 51 percent of its stock is owned by
one or more women; and whose management and daily business operations
are controlled by one or more women.

\(b\) Representation. The offeror represents that it \[ \] is, \[ \] is
not a women-owned business concern.

5\. [52.209-5 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED
DEBARMENT, AND OTHER RESPONSIBILITY MATTERS (JAN 2001) \[THIS DATE
STAYED INDEFINITELY. PLEASE USE THE PROVISION DATE BELOW.\]]{.underline}

[CERTIFICATION REGARDING DEBARMENT, SUSPENSION, PROPOSED DEBARMENT, AND
OTHER RESPONSIBILITY MATTERS(APR 2001)]{.underline}

[\[USE WHEN OVER \$100K - REF: FAR 9.409(a)\]]{.underline}

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

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

\(A\) Are \[ \] are not \[ \] presently debarred, suspended, proposed
for debarment, or declaredineligible for the award of contracts by any
Federal agency;

\(B\) Have \[ \] have not \[ \], within the three-year period preceding
this offer, been convicted ofor had a civil judgment rendered against
them for: commission of fraud or a criminal offensein connection with
obtaining, attempting to obtain, or performing a public (Federal, state,
orlocal) contract or subcontract; violation of Federal or state
antitrust statutes relating to thesubmission of offers; or commission of
embezzlement, theft, forgery, bribery, falsification ordestruction of
records, making false statements, tax evasion, or receiving stolen
property;\[This language stayed indefinitely. Please use paragraph
(a)(1)(i)(D) below.\]

\(C\) Are \[ \] are not \[ \] presently indicted for, or otherwise
criminally or civilly charged by agovernmental entity with, commission
of any of the offenses enumerated in paragraph(a)(1)(i)(B) of this
provision; and \[This language stayed indefinitely. Please useparagraph
(a)(1)(i)(E) below.\]

\(D\) Have \[ \] have not \[ \], within a three-year period preceding
this offer, been convicted ofor had a civil judgment rendered against
them for: commission of fraud or a criminal offensein connection with
obtaining, attempting to obtain, or performing a public (Federal, state,
orlocal) contract or subcontract; violation of Federal or state
antitrust statutes relating to thesubmission of offers; or commission of
embezzlement, theft, forgery, bribery, falsification ordestruction of
records, making false statements, tax evasion, or receiving stolen
property;and

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

(ii)(A) \[This paragraph (a)(1)(ii) is stayed indefinitely.\] The
offeror, aside from theoffenses enumerated in paragraphs (a)(1)(i)(A),
(B), and (C) of this provision, has \* has not\* within the past three
years, relative to tax, labor and employment, environmental,
antitrust,or consumer protection laws\--

\(1\) Been convicted of a Federal or State felony (or has any Federal or
State felonyindictments currently pending against them); or

\(2\) Had a Federal court judgment in a civil case brought by the United
States renderedagainst them; or

\(3\) Had an adverse decision by a Federal administrative law judge,
board, or commissionindicating a willful violation of law.

\(B\) If the offeror has responded affirmatively, the offeror shall
provide additionalinformation if requested by the Contracting Officer;
and

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

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

This Certification Concerns a Matter Within the Jurisdiction of an
Agency of the UnitedStates and the Making of a False, Fictitious, or
Fraudulent Certification May Render theMaker Subject to Prosecution
Under Section 1001, Title 18, United States Code.

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

\(c\) A certification that any of the items in paragraph (a) of this
provision exists will notnecessarily result in withholding of an award
under this solicitation. However, thecertification will be considered in
connection with a determination of the Offeror\'sresponsibility. Failure
of the Offeror to furnish a certification or provide such
additionalinformation as requested by the Contracting Officer may render
the Offeror nonresponsible.

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

\(e\) The certification in paragraph (a) of this provision is a material
representation of factupon which reliance was placed when making award.
If it is later determined that theOfferor knowingly rendered an
erroneous certification, in addition to other remediesavailable to the
Government, the Contracting Officer may terminate the contract
resultingfrom this solicitation for default.

6\. [52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (MAY 2001)- ALT I
(OCT 2000) AND ALT II (OCT 2000)]{.underline}

(a)(1) The North American Industry Classification System (NAICS) code
for this acquisition is \_[234910.]{.underline}

\(2\) The small business size standard is [\$27.5 Million.]{.underline}

\(3\) The small business size standard for a concern which submits an
offer in its own name, other than on a construction or service contract,
but which proposes to furnish a product which it did not itself
manufacture, is 500 employees.

\(b\) *Representations*. (1) The offeror represents as part of its offer
that it \_\_\_ is, \_\_\_ is not a small business concern.

\(2\) \[*Complete only if the offeror represented itself as a small
business concern in paragraph (b)(1) of this provision\].* The offeror
represents, for general statistical purposes, that it \_\_\_ is, \_\_\_
is not, a small disadvantaged business concern as defined in 13 CFR
124.1002.

\(3\) \[*Complete only if the offeror represented itself as a small
business concern in paragraph (b)(1) of this provision*.\] The offeror
represents as part of its offer that it \_\_\_ is, \_\_\_ is not a
women-owned small business concern.

\(4\) \[*Complete only if the offeror represented itself as a small
business concern in paragraph (b)(1) of this provision*.\] The offeror
represents as part of its offer that it \_\_\_ is, \_\_\_ is not a
veteran-owned small business concern.

\(5\) \[*Complete only if the offeror represented itself as a
veteran-owned small business concern in paragraph (b)(4) of this
provision*.\] The offeror represents as part of its offer that it \_\_\_
is, \_\_\_ is not a service-disabled veteran-owned small business
concern.

\(6\) \[*Complete only if offeror represented itself as a small business
concern in paragraph (b)(1) of this provision.*\] 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 of ownership, or HUBZone employee percentage has
occurred since it was certified by the Small Business Administration in
accordance with 13 CFR part 126; and

\(ii\) It \_\_\_ is, \_\_\_ is not a joint venture that complies with
the requirements of 13 CFR part 126, and the representation in paragraph
(b)(6)(i) of this provision is accurate for the HUBZone small business
concern or concerns that are participating in the joint venture. \[*The
offeror shall enter the name or names of the HUBZone small business
concern or concerns that are participating in the joint venture*:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.\] Each HUBZone
small business concern participating in the joint venture shall submit a
separate signed copy of the HUBZone representation.

\(7\) \[*Complete if offeror represented itself as disadvantaged in
paragraph (b)(2) of this provision.*\] 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 of 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.

\(c\) *Definitions*. As used in this provision--- "Service-disabled
veteran-owned small business concern"

\(1\) Means a small business concern---

\(i\) Not less than 51 percent of which is owned by one or more
service-disabled veterans or, in the case of any publicly owned
business, not less than 51 percent of the stock 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 the size standard in paragraph (a) of this provision. "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 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.

\(d\) *Notice*. (1) If this solicitation is for supplies and has been
set aside, in whole or in part, for small business concerns, then the
clause in this solicitation providing notice of the set-aside contains
restrictions on the source of the end items to be furnished.

\(2\) Under 15 U.S.C. 645(d), any person who misrepresents a firm\'s
status as a small, HUBZone small, small disadvantaged, or women-owned
small business concern in order to obtain a contract to be awarded under
the preference programs established pursuant to section 8(a), 8(d), 9,
or 15 of the Small Business Act or any other provision of Federal law
that specifically references section 8(d) for a definition of program
eligibility, shall---

\(i\) Be punished by imposition of fine, imprisonment, or both;

\(ii\) Be subject to administrative remedies, including suspension and
debarment; and

\(iii\) Be ineligible for participation in programs conducted under the
authority of the Act.

7\. [EQUAL LOW BIDS (52.219-2) (OCT 1995)]{.underline}

\(a\) This provision applies to small business concerns only.

\(b\) The bidder\'s status as a labor surplus area (LSA) concern may
affect entitlement to award in case of tie bids. If the bidder wishes to
be considered for this priority, the bidder must identify, in the
following space, the LSA in which the costs to be incurred on account of
manufacturing or production (by the bidder or the first-tier
subcontractors) amount to more than 50 percent of the contract price.

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

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

\(c\) Failure to identify the labor surplus areas as specified in
paragraph (b) of this provision will preclude the bidder from receiving
priority consideration. If the bidder is awarded a contract as a result
of receiving priority consideration under this provision and would not
have otherwise received award, the bidder shall perform the contract or
cause the contract to be performed in accordance with the obligations of
an LSA concern.

# 8**.** SMALL BUSINESS CONCERN REPRESENTATION FOR THE SMALL BUSINESS COMPETITIVENESS DEMONSTRATION PROGRAM (52.219-19) (OCT 2000)

\[If falls into one of the 4 Designated Industry Groups: Construction,
Refuse, Non-nuclear ship repair, and A&E Services - Ref: FAR
19.1007(a)\]

\(a\) [Definition]{.underline}.

\"Emerging small business,\" as used in this solicitation, means a small
business concern whose size is no greater than 50 percent of the
numerical size standard applicable to the North American Industry
Classification System (NAICS) code assigned to a contracting
opportunity.

\(b\) (Complete only if the Offeror has represented itself under the
provision at 52.219-1 as a small business concern under the size
standards of this solicitation.)

The Offeror \[ \] is, \[ \] is not an emerging small business.

\(c\) (Complete only if the Offeror is a small business or an emerging
small business, indicating its size range.)

Offeror\'s number of employees for the past 12 months (check this column
if size standard stated in solicitation is expressed in terms of number
of employees) [or]{.underline} Offeror\'s average annual gross revenue
for the last 3 fiscal years (check this column if size standard stated
in solicitation is expressed in terms of annual receipts). (Check one of
the following.)

  ---------------------------------- ------------------------------------
  NO. OF EMPLOYEES                   AVG. ANNUAL GROSS REVENUES

  \_\_\_\_ 50 or fewer               \_\_\_\_ \$1 million or less

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

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

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

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

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

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

9\. SMALL DISADVANTAGED BUSINESS STATUS (52.219-22) (OCT 1999) ALTERNATE
I

(OCTOBER 1998)

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

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

\[ \] (i) It has received certification by the Small Business
Administration as a small disadvantaged business concern consistent with
13 CFR 124, Subpart B; and

\(A\) No material change in disadvantaged ownership and control has
occurred since its certification;

\(B\) Where the concern is owned by one or more disadvantaged
individuals, the net worth of each individual upon whom the
certification is based does not exceed \$750,000 after taking into

account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and

\(C\) It is listed, on the date of this representation, on the register
of small disadvantaged business concerns maintained by the Small
Business Administration or

\[ \] (ii) It has submitted a completed application to the Small
Business Administration or a Private Certifier to be certified as a
small disadvantaged business concern in accordance with 13 CFR 124,
Subpart B, and a decision on that application is pending, and that no
material change in disadvantaged ownership and control has occurred
since its application was submitted.

\(2\) \[ \] For Joint Ventures. The offeror represents, as part of its
offer, that it is a joint venture that complies with the requirements at
13 CFR 124.1002(f) and that the representation in paragraph (b)(1) of
this provision is accurate for the small disadvantaged business concern
that is participating in the joint venture. \[The offeror shall enter
the name of the small disadvantaged business concern that is
participating in the joint
venture:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.\]

\(3\) Address. The offeror represents that its address \* is, \* is not
in a region for which a small disadvantaged business procurement
mechanism is authorized and its address has not changed since its
certification as a small disadvantaged business concern or submission

of its application for certification. The list of authorized small
disadvantaged business procurement mechanisms and regions is posted at
http://www.arnet.gov/References/sdbadjustments.htm. The offeror shall
use the list in effect on the date of this solicitation. \"Address,\" as
used in this provision, means the address of the offeror as listed on
the Small Business Administration\'s register of small disadvantaged
business concerns or the address on the completed application that the
concern has submitted to the Small Business Administration or a Private
Certifier in accordance with 13 CFR part

124, subpart B. For joint ventures, \"address\" refers to the address of
the small disadvantaged business concern that is participating in the
joint venture.

\(c\) Penalties and Remedies. Anyone who misrepresents any aspects of
the disadvantaged status of a concern for the purposes of securing a
contract or subcontract shall\--

\(1\) Be punished by imposition of a fine, imprisonment, or both;

\(2\) Be subject to administrative remedies, including suspension and
debarment; and

\(3\) Be ineligible for participation in programs conducted under the
authority of the Small Business Act.

# 10. PROHIBITION OF SEGREGRATED FACILITIES (52.222-21) (FEB 1999)

\[Use if over \$10K - Ref: FAR 22.810(a)(1)\]

\(a\) \"Segregated facilities,\" as used in this clause, means any
waiting rooms, work areas,

rest rooms and wash rooms, restaurants and other eating areas, time
clocks, locker

rooms and other storage or dressing areas, parking lots, drinking
fountains, recreation or

entertainment areas, transportation, and housing facilities provided for
employees, that

are segregated by explicit directive or are in fact segregated on the
basis of race, color,

religion, sex, or national origin because of written or oral policies or
employee custom.

The term does not include separate or single-user rest rooms or
necessary dressing or

sleeping areas provided to assure privacy between the sexes.

\(b\) The Contractor agrees that it does not and will not maintain or
provide for its

employees any segregated facilities at any of its establishments, and
that it does not and

will not permit its employees to perform their services at any location
under its control

where segregated facilities are maintained. The Contractor agrees that a
breach of this

clause is a violation of the Equal Opportunity clause in this contract.

\(c\) The Contractor shall include this clause in every subcontract and
purchase order that

is subject to the Equal Opportunity clause of this contract.

11\. [PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (52.222-22) (FEB
1999)]{.underline}

As prescribed in 22.810(a)(2), insert the following provision:

The offeror represents that\--

\(a\) It \[ \] has, \[ \] has not participated in a previous contract or
subcontract subject the

Equal Opportunity clause of this solicitation;

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

\(c\) Representations indicating submission of required compliance
reports, signed by

proposed subcontractors, will be obtained before subcontract awards.

12\. [CERTIFICATION OF TOXIC CHEMICAL RELEASE REPORTING (52.223-13) (OCT
2000)]{.underline}

\(a\) Submission of this certification is a prerequisite for making or
entering into this contract imposed by Executive Order 12969, August 8,
1995.

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

\(1\) As the owner or operator of facilities that will be used in the
performance of this contract that are subject to the filing and
reporting requirements described in section 313 of the Emergency
Planning and Community Right-to-Know Act of 1986 (EPCRA) (42 U.S.C.
11023) and section 6607 of the Pollution Prevention Act of 1990 (PPA)
(42 U.S.C. 13106), the offeror will file and continue to file for such
facilities for the life of the contract the Toxic Chemical Release
Inventory Form (Form R) as described in sections 313(a) and (g) of EPCRA
and section 6607 of PPA; or

\(2\) None of its owned or operated facilities to be used in the
performance of this contract is subject to the Form R filing and
reporting requirements because each such facility is exempt for at least
one of the following reasons: \[Check each block that is applicable.\]

\[ \] (i) The facility does not manufacture, process, or otherwise use
any toxic chemicals listed under section 313(c) of EPCRA, 42 U.S.C.
11023(c);

\[ \] (ii) The facility does not have 10 or more full-time employees as
specified in section 313(b)(1)(A)

of EPCRA, 42 U.S.C. 11023(b)(1)(A);

\[ \] (iii) The facility does not meet the reporting thresholds of toxic
chemicals established under section 313(f) of EPCRA, 42 U.S.C. 11023(f)
(including the alternate thresholds at 40 CFR 372.27,

provided an appropriate certification form has been filed with EPA);

\[ \] (iv) The facility does not fall within Standard Industrial
Classification Code (SIC) designations 20 through 39 or their
corresponding North American Industry Classification System (NAICS)
sectors 31 through 33; or

\[ \] (v) The facility is not located within any State of the United
States, the District of Columbia, the Commonwealth of Puerto Rico, Guam,
American Samoa, the United States Virgin Islands, the Northern Mariana
Islands, or any other territory or possession over which the United
States has jurisdiction.

13\. [52.226-2 Historically Black College or University and Minority
Institution Representation (MAY 2001)]{.underline}

\(a\) Definitions. As used in this provision--- "Historically black
college or university" means an

institution determined by the Secretary of Education to meet the
requirements of 34 CFR 608.2. For the Department of Defense, the
National Aeronautics and Space Administration, and the Coast Guard, the
term also includes any nonprofit research institution that was an
integral part of such a college or university before November 14, 1986.

"Minority institution" means an institution of higher education meeting
the requirements of Section 1046(3) of the Higher Education Act of 1965
(20 U.S.C. 1067k, including a Hispanic-serving institution of higher
education, as defined in Section 316(b)(1) of the Act (20 U.S.C.

1101a)) .

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

n is n is not a historically black college or university;

n is n is not a minority institution.

14\. [USE OF GOVERNMENT-OWNED PROPERTY (1852.245-79) (JULY
1997]{.underline})

\(a\) The offeror ( ) does, ( ) does not intend to use in performance of
any contract awarded as a result of this solicitation existing
Government-owned facilities (real property or plant equipment), special
test equipment, or special tooling (including any property offered by
this solicitation). The offeror shall identify any offered property not
intended to be used. If the offeror does intend to use any of the above
items, the offeror must furnish the following information required by
Federal Acquisition Regulation (FAR) 45.205(b), and NASA FAR Supplement
(NFS) 1845.102-71:

\(1\) Identification and quantity of each item. Include the item\'s
acquisition cost if it is not property offered by this solicitation.

\(2\) For property not offered by this solicitation, identification of
the Government contract under which the property is accountable and
written permission for its use from the cognizant Contracting Officer.

\(3\) Amount of rent, calculated in accordance with FAR 45.403 and the
clause at FAR 52.245-9, Use and Charges, unless the property has been
offered on a rent-free basis by this solicitation.

\(4\) The dates during which the property will be available for use, and
if it is to be used in more than one contract, the amounts of respective
uses in sufficient detail to support proration of the rent. This
information is not required for property offered by this solicitation.

\(b\) The offeror ( ) does, ( ) does not request additional
Government-provided property for use in performing any contract awarded
as a result of this solicitation. If the offeror requests additional
Government-provided property, the offeror must furnish

\--

\(1\) Identification of the property, quantity, and estimated
acquisition cost of each item; and

\(2\) The offeror\'s written statement of its inability to obtain
facilities as prescribed by FAR 45.302-1(a)(4).

\(c\) If the offeror intends to use any Government property (paragraph
(a) or (b) of this provision), the offer must also furnish the
following:

\(1\) The date of the last Government review of the offeror\'s property
control and accounting system, actions taken to correct any deficiencies
found, and the name and telephone number of the cognizant property
administrator.

\(2\) A statement that the offeror has reviewed, understands, and can
comply with all property management and accounting procedures in the
solicitation, FAR Subpart 45.5, and NFS Subparts 1845.5 and 1845.71.

\(3\) A statement indicating whether or not the costs associated with
paragraph (c)(2) of this provision, including plant clearance and/or
plant reconversion costs, are included in its cost proposal.

15\. [COMPLIANCE WITH VETERAN'S EMPLOYMENT REPORTING REQUIREMENTS (FEB
1999)]{.underline}

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

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

[\[APPLICABLE IN SOLICITATIONS THAT ARE FOR OR SPECIFY USE OF RECOVERED
MATERIALS - REFERENCE FAR SUBPART 23.4)]{.underline}

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