Program: 693‐S (formerly 138‐S)

Term: Date of Award to February 28, 2017

Title: Social Security Administration (Third Party Draft Checks)

BASIS OF

ITEM NO. DESCRIPTION AWARD UNIT RATE COST 

I. PREPRESS

(a) Digital Content proofs..........................................per trim/page size‐unit............ 6 $5.00 $30.00 

(b) SSA Prior to Production Test Samples.................per set of 100....................... 1 $125.00 $125.00 

II. PRINTING AND CONSTRUCTION:

Laser style...................................per 1,000 checks......................................... 160 $299.86 $47,977.60 

CONTRACTOR TOTALS $48,132.60 

DISCOUNT 0.25% $120.33 

DISCOUNTED TOTALS $48,012.27 

AWARDED

NPC INC.

CLAYSBURG, PA
Program 693-S Page 1 of 24 

Specifications by DLL 

Reviewed by SSA 

U.S. GOVERNMENT PUBLISHING OFFICE 

 

Washington, DC 

 GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

 For the Procurement of 

SSA Third Party Draft Checks 

 as requisitioned from the U.S. Government Publishing Office (GPO) by the 

Social Security Administration (SSA) 

 Single Award 

TERM OF CONTRACT: The term of this contract is for the period beginning Date of Award and ending 

February 28, 2017 plus up to four optional 12-month extension periods that may be added in accordance with the 

"OPTION TO EXTEND THE TERM OF THE CONTRACT" clause in Section 1 of this contract. 

Government processing of the security requirements and printing of Prior to Production test samples (SSA and/or 

Bank test checks) will take place from Date of Award through February 29, 2016. Actual production begins 

March 1, 2016. 

BID OPENING: Bids shall be publicly opened at 11:00 a.m., prevailing Washington, DC time, on November 3, 2015.

BID SUBMISSION: Submit bid in pre-addressed envelope furnished with solicitation or send to: U.S. Government 

Publishing Office, Bid Section, Room C-848, Stop: PPSGB, 732 North Capitol Street, NW, Washington, DC 20401. 

Facsimile bids in response to this solicitation are permitted. Facsimile bids may be submitted directly to the GPO Bid 

Section, Fax No. (202) 512-1782. The program number and bid opening date must be specified with the bid. Refer to 

Facsimile Bids in Solicitation Provisions of GPO Contract Terms, GPO Publication 310.2, as revised June 2001. Hand 

delivered bids are to be taken to: GPO Bookstore, 710 North Capitol Street, NW, Washington, DC, between the hours of 

8:00 a.m. and 4:00 p.m., Eastern Standard Time, Monday through Friday. The contractor is to follow the instructions in 

the Bid Submission/Opening area. If further instruction or assistance is required, call (202) 512-0526. 

RESTRICTION ON LOCATION OF PRODUCTION FACILITIES: Due to the security requirements set forth in 

these specifications, all checks and security paper must be produced in the United States. 

BIDDERS, PLEASE NOTE: These specifications have been extensively revised; therefore, all bidders are 

cautioned to familiarize themselves with all provisions of these specifications before bidding.

Abstracts of contract prices are available at http://www.gpo.gov/gpo/abstracts/abstract.action?region=DC

For information of a technical nature call David Love (202) 512-0310 (No collect calls).
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693-S (02/17) 

SECTION 1 - GENERAL TERMS AND CONDITIONS 

GPO CONTRACT TERMS: Any contract which results from this Invitation for Bid will be subject to the applicable 

provisions, clauses, and supplemental specifications of GPO Contract Terms (GPO Publication 310.2, effective 

December 1, 1987 (Rev. 6-01)) and GPO Contract Terms, Quality Assurance through Attributes Program for Printing 

and Binding (GPO Publication 310.1, effective May 1979 (Rev. August 2002)). 

GPO Contract Terms (GPO Publication 310.2) – http://www.gpo.gov/pdfs/vendors/sfas/terms.pdf

GPO QATAP (GPO Publication 310.1) – http://www.gpo.gov/pdfs/vendors/sfas/qatap.pdf

DISPUTES: GPO Publication 310.2, GPO Contract Terms, Contract Clause 5. Disputes, is hereby replaced with the 

June 2008 clause found at www.gpo.gov/pdfs/vendors/contractdisputes.pdf. This June 2008 clause also cancels and 

supersedes any other disputes language currently included in existing contractual actions. 

SUBCONTRACTING: The predominant production function is printing. The provisions of Government Publishing 

Office (GPO) Publication 310.2 are modified to permit subcontracting of the MICR imprinting of checks. 

Note: The contractor shall be responsible for enforcing all contract requirements outsourced to a subcontractor. 

QUALITY ASSURANCE LEVELS AND STANDARDS: The following levels and standards shall apply to these 

specifications: 

Product Quality Levels: 

(a) Printing (page related) Attributes – Level II. 

(b) Finishing (item related) Attributes – Level II. 

Inspection Levels (from ANSI/ASQC Z1.4): 

(a) Non-destructive Tests - General Inspection Level I. 

(b) Destructive Tests - Special Inspection Level S-2. 

Specified Standards: The specified standards for the attributes requiring them shall be: 

 Attribute Specified Standard 

P-7. Type Quality and Uniformity Approved Proofs/ Prior to Production samples/ 

Electronic Media Output 

P-9. Solid and Screen Tint Color Match Pantone Matching System 

QUALITY CONTROL REQUIREMENTS: Prior to start-up, the contractor must put into effect, and maintain, within 

their own organization, an independent quality assurance organization of sufficient size and expertise to monitor the 

operations performed and inspect the products of each operation to a degree and extent that will insure the Government’s 

quality assurance, inspection, and acceptance provisions herein are met. The contractor must perform the process 

controls, inspections, and tests required to substantiate that the checks provided under this contract conform to the 

specifications and contract requirements. 

OPTION TO EXTEND THE TERM OF THE CONTRACT: The Government has the option to extend the term of 

this contract for a period of 12 months by written notice to the contractor not later than 30 days before the contract 

expires. If the Government exercises this option, the extended contract shall be considered to include this clause, except, 

the total duration of the contract may not exceed approximately three (3) months for Government processing of the 

security requirements and printing of Prior to Production test samples (SSA and/or Bank test checks), and five (5) 

yearsfor actual production as a result of, and including, any extension(s) added under this clause. Further extension may 

be negotiated under the “EXTENSION OF CONTRACT TERM” clause. See also “ECONOMIC PRICE 

ADJUSTMENT” for authorized pricing adjustment(s). 
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EXTENSION OF CONTRACT TERM: At the request of the Government, the term of any contract resulting from 

this solicitation may be extended for such period of time as may be mutually agreeable to the GPO and the contractor. 

ECONOMIC PRICE ADJUSTMENT: The pricing under this contract shall be adjusted in accordance with this clause, 

provided that in no event will any pricing adjustment be made that would exceed the maximum permissible under any 

law in effect at the time of the adjustment. There will be no adjustment for orders placed during the first period specified 

below. Pricing will thereafter be eligible for adjustment during the second and any succeeding performance period(s). 

For each performance period after the first, a percentage figure will be calculated as described below and that figure will 

be the economic price adjustment for that entire next period. Pricing adjustments under this clause are not applicable to 

reimbursable postage or transportation costs, or to paper, if paper prices are subject to adjustment by separate clause 

elsewhere in this contract. 

For the purpose of this clause, performance under this contract will be divided into successive periods. The first period 

will extend from the Date of Award through February 28, 2017 and the second and any succeeding period(s) will 

extend for 12 months from the end of the last preceding period, except that the length of the final period may vary. The 

first day of the second and any succeeding period(s) will be the effective date of the economic price adjustment for that 

period. 

Pricing adjustments in accordance with this clause will be based on changes in the seasonally adjusted "Consumer Price 

Index For All Urban Consumers - Commodities Less Food" (Index) published monthly in the CPI Detailed Report by the 

U.S. Department of Labor, Bureau of Labor Statistics. 

The economic price adjustment will be the percentage difference between Index averages as specified in this paragraph. 

An index called the variable index will be calculated by averaging the monthly Indexes from the 12-month interval 

ending 3 months prior to the beginning of the period being considered for adjustment. This average is then compared to 

the average of the monthly Indexes for the 12-month interval ending July 31, 2015 called the base index. The 

percentage change (plus or minus) of the variable index from the base index will be the economic price adjustment for 

the period being considered for adjustment. 

The Government will notify the contractor by contract modification specifying the percentage increase or decrease to be 

applied to invoices for orders placed during the period indicated. The contractor shall apply the percentage increase or 

decrease against the total price of the invoice less reimbursable postage or transportation costs and separately adjusted 

paper prices. Payment discounts shall be applied after the invoice price is adjusted. 

SECURITY REQUIREMENTS: 

Protection of Confidential Information: 

(a) The contractor shall restrict access to all confidential information obtained from the SSA in the performance of 

this contract to those employees and officials who need it to perform the contract. 

Employees and officials who need access to confidential information for performance of the contract will be 

determined at the post-award conference between the Contracting Officer and the responsible contractor 

representative. 

(b) The contractor must process all confidential information obtained from SSA in the performance of this contract 

under the immediate supervision and control of authorized personnel, and in a manner that will protect the 

confidentiality of the records in such a way that unauthorized persons cannot retrieve any such records. 

(c) The contractor must inform all personnel with access to the confidential information obtained from SSA in the 

performance of this contract of the confidential nature of the information and the safeguards required to protect 

this information from improper disclosure. 

(d) For knowingly disclosing information in violation of the Privacy Act, the contractor and the contractor 

employees may be subject to the criminal penalties as set forth in 5 U.S.C Section 552a (i)(1), which is made 

applicable to contractors by 5 U.S.C. 552a (m)(1) to the same extent as employees of the SSA. For knowingly 

disclosing confidential information as described in section 1106 of the Social Security Act (42 U.S.C. 1306), the 

contractor and contractor’s employees may also be subject to the criminal penalties as set forth in that provision. 
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693-S (02/17) 

(e) The contractor shall assure that each contractor employee with access to confidential information knows the 

prescribed rules of conduct, and that each contractor employee is aware that he/she may be subject to criminal 

penalties for violations of the Privacy Act and/or the Social Security Act. 

 When the contractor employees are made aware of this information, they will be required to sign the SSA-301, 

“Contractor Personnel Security Certification”. See Exhibit A. 

 A copy of this signed certification must be forwarded to: Social Security Administration (SSA), Office of 

Printing and Alternative Media Services (OPAMS), 6401 Security Blvd., 1369 Annex Building, Baltimore, MD 

21235-6401. Attn: Kate Schmidt. 

 A copy must also be forwarded to: U.S. GPO, 732 North Capitol Street, NW, CSAPS, DCT 1, Room C-838, 

Washington, DC 20401. Attn: David Love. 

(f) All confidential information obtained from SSA for use in the performance of this contract shall, at all times, be 

stored in an area that is physically safe from unauthorized access. 

(g) Performance of this contract may involve access to tax return information as defined in 26 U.S.C. Section 

6103(b) of the Internal Revenue Code (IRC). All such information shall be handled as confidential and may not 

be disclosed without the written permission of SSA. For willingly disclosing confidential tax return information 

in violation of the IRC, the contractor and contractor employees may be subject to the criminal penalties set 

forth in 26 U.S.C. Section 7213. 

(h) The Government reserves the right to conduct on-site visits to review the contractor’s documentation and inhouse procedures for protection of confidential information. 

(i) If a subcontractor is used for the sorting and/or mailing of the notices of this contract the sub-contractor must 

conform to all security requirements of the contract. 

Restrictions on Movement: Government property shall not be transferred between plants except upon the formal 

authorization of responsible officials of the contractor and the Contracting Officer. Such transfer shall be at the 

contractor's expense unless other arrangements are mutually agreed to. 

Prohibition Against Similar Printing: The contractor shall not make or sell to any person other than the Government 

Publishing Office any documents which resemble the general appearance of the blank checks or which contain such 

features as may cause confusion in the processing. 

Defective Checks: Defective checks must be held in the check manufacturing area in a secure, lockable container which 

shall be constructed of wood, metal, or any substance which deters easy access (i.e., cardboard is not acceptable). A 

department supervisor must hold the key to the container. The department supervisor will periodically transfer the 

defective checks to the vault for storage until they are delivered to the person charged with their destruction. Such 

checks shall be destroyed by shredding or hydro-pulping, after which the residue may be disposed of by the contractor as 

waste. The width of the shreds shall not be more than 3/8”. Waste/defective check destruction must be performed on 

site. 

Secure Production Area: The contractor must provide designated secure production area(s) for the manufacture of 

electronic media, plates, check print production, and the final packing into cartons. The contractor must provide a 

designated secure storage room for the storage of the following: 

 Plates used for the production of checks 

 Old plates awaiting destruction 

 Printed checks 

 Check formats 

 Defective checks 

 Check production waste 

NOTE: At contractor’s discretion, the secure production area and the secure storage room(s) may be combined 
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to accomplish both requirements. 

The contractor must provide security for the designated area to assure protection against theft. Security must include: 

 A secure room with controlled access and electronic security/intrusion detection devices. 

 Access Control: The contractor shall provide the means to prevent unauthorized personnel into the secure 

production area on a twenty-four hour basis. No personnel can access this area unless authorized by the Production 

Manager/Security Officer. 

 Exterior cameras that provide coverage of public and employee entrances and interior cameras that provide coverage 

of the entrance area and the secure room. Video data shall be stored for a minimum of 30 days. 

 A list of personnel authorized by the Production Manager/ Security Officer must be forwarded to the Social Security 

Administration. A copy of this list must be retained by the contractor for future reference during regular security 

reviews by SSA. 

 Working Hours: A system shall be implemented to prohibit the entry of unauthorized personnel into the secure area. 

 Non-working Hours: The contractor shall provide approved intrusion alarms to detect any unauthorized entry into 

the secure area with a three minute response capability by company security personnel. The intrusion alarms must 

also sound in the nearest police facility. 

 Accountability: The contractor shall provide a record of accountability which includes all personnel, dates, and 

movement throughout all phases of production to include (1) the finished product, (2) the destruction of defective 

work, and (3) production materials. 

Unauthorized persons shall not be permitted within areas where these items are being manufactured and/or stored. 

Before authorizing any employee to enter such area, the employee must adhere to the PERSONNEL SECURITY AND 

SUITABILITY and PUBLIC TRUST SECURITY REQUIREMENTS. 

The contractor will be held responsible for maintaining proper control and handling to prevent any information or 

materials required to produce the product ordered under these specifications from falling into unauthorized hands. Unless 

otherwise indicated herein, all extra copies, materials, waste, etc., must be destroyed. Paper documents containing 

confidential information must be destroyed by burning, pulping, shredding, macerating, or similar means that ensures the 

information cannot be recovered and used. Please note that hand tearing or lining through documents does not meet SSA 

guidelines for appropriate destruction of the product. Managers should remind their employees of their responsibilities 

to shred material containing confidential data. Managers should ensure that their facilities have adequate resources to 

shred the volume of sensitive material produced by their office, or securely store material pending shredding. Any theft 

or loss of items as defined in these specifications shall be reported immediately by the contractor to the nearest U.S. 

Secret Service Field Office, to the Social Security Administration and to the Contracting Officer, U.S. Government 

Publishing Office, (202)512-0310. 

NOTE: When requested by the Government, the contractor must have the capability to provide a printed 

inventory list of all Government materials in their possession. 

GOVERNMENT ACCESS: The Government shall have the right to have representatives inspect the contractor's plant: 

1) prior to award; 

2) Prior to the beginning of production; and 

3) At any time or times it may elect during the term of the contract, to ascertain whether the Third Party Draft Checks 

are being produced, stored, shipped, and delivered in accordance with these requirements, and that facilities are 

suitable, secure, and safe for storage of reproducibles, raw materials and/or checks. Inspections of the contractor’s 

plant may be announced or unannounced. 

PERSONNEL SECURITY AND SUITABILITY REQUIREMENTS: 

The Contractor must comply with the following Personnel Security and Suitability requirements: 
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 Contractor personnel are considered Federal employees for purposes of applying provisions of the Privacy Act of 

1974, Tax Reform Act of 1976, and SSA regulation 1 and Section 1106 of the Social Security Act on the 

confidentiality of and disclosure and protection of information entrusted to them. 

 Contractor personnel are subject to the same personnel security and suitability requirements as SSA employees. The 

provisions of Executive Order 10450, Executive Order 12968 and Title 5 of the Code of Federal Regulations (CFR), 

parts 731,732 and 736 require that: "Every competitive, excepted and contractor position must be designated at a 

level of sensitivity that is commensurate with the responsibilities and other attributes, (such as policy making, 

fiduciary, public contact or public trust) of the position as they relate to the efficiency of the service, and; 

 All Federal service and contractor employees must be designated, in terms of their national security sensitivity, to 

assure appropriate screening. The required background investigation is conducted to provide a basis for ensuring that 

the employment of an individual is clearly consistent with the interests of the national security." 

 The Contractor shall be required to provide the information required for such background checks and shall agree to 

abide by SSA personnel security and suitability determinations. 

 Before Government authorization is granted to any employee to enter the secured and/or vault area(s) where the 

manufacture, storage or shipment of items covered by this specification are being produced or held, the background 

security check must be conducted by the Government. The contractor shall not allow anyone into the secured area(s) 

until written security clearance has been furnished by the Government. 

 Personnel Screening: Before authorizing any employee to enter the secure room or vault, or to participate in any 

way in the manufacture, storage, or shipment of any of the items covered by this contract, the contractor shall submit 

to the Government the name, address, date and place of birth, Social Security Number, race, sex, and finger prints of 

the employee for screening purposes. The Government will retain the prerogative for granting access to any of the 

secure areas. 

PUBLIC TRUST SECURITY REQUIREMENTS: 

This contract has been designated Public Trust Position Level 5C. Due to the sensitive nature of the information 

contained in the products produced under this contract, contractor employees performing under this contract will be 

subject to a thorough civil and criminal background check. 

“Performing under this contract” is defined as working on-site at an SSA facility (including visiting the SSA site for any 

reason) or having access to Government programmatic or sensitive information. 

Within two (2) days following contract award, the contractor must provide to SSA an Electronic Questionnaire for 

Investigations Process (eQIP) applicant listing of all individuals for whom the contractor is requesting a suitability 

determination (i.e., background investigation). This listing should include the following: 

 Contractor’s name 

 Contract number 

 Contractor’s point of contact (CPOC) name 

 CPOC’s contact information including email address 

 Each applicant’s full name, Social Security Number (SSN), date of birth, and place of birth (must show city and 

state if born in the United States (U.S.) OR city and country if born outside the U.S.) 

The background investigation process will not start until the applicant listing is submitted. Send the applicant listing via 

Fax to Center for Personnel Security and Project Management (CPSPM) Suitability Team (410) 966-0640 or via 

traceable means via common carrier to the Social Security Administration, CPSPM Suitability Team, 2601 Annex 

Building, 6401 Security Boulevard, Baltimore, MD 21235. 

Once SSA receives and reviews the applicant listing, SSA will initiate the eQIP. SSA will Email notification to the 

CPOC the name of each applicant invited into the eQIP website to complete their background investigation form. The 

CPOC will provide the website to the applicants to complete their eQIP form electronically. The applicant will have up 

to 14 calendar days following SSA notification to the CPOC of the eQIP invitations to complete the eQIP form. 
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The applicant must print the signature pages of the SF 85P form prior to releasing the application in eQIP, sign the 

signature pages and provide the signed originals to the CPOC. See Exhibit B: Questionnaire for Public Trust Positions - 

Sample Form SF85P) 

The following is a list of documents the contractor employees will be responsible for completing: 

 Original signed and dated eQIP signature pages as specified in the above paragraph. 

 Two (2) “Fingerprint Cards” (FD-258). See Exhibit C. 

NOTE: The contractor will absorb the costs for obtaining fingerprints. 

 One (1) “Declaration for Federal Employment” (Optional Form 306). See Exhibit D. 

 One (1) “Fair Credit Reporting Act Authorization Form”. See Exhibit E. 

 For a non-U.S. citizen, one (1) legible photocopy of the work authorization permit and social security card. 

The CPOC must ensure all paper forms are fully completed and signed prior to submission to SSA. All forms and 

fingerprinting cards must be submitted at least 15 workdays prior to the date work is to begin on the contract. Fingerprint 

cards and all paper forms must be legible or typed in black ink and all signatures must be in black ink. There must be no 

“breaks” in residences or employment. SSA requires complete addresses, including zip codes and phone numbers with 

area code. SSA must receive forms and fingerprint cards within 30 calendar days after notification of the eQIP 

invitation. It is the responsibility of the contractor to ensure fingerprint cards are processed through their local police 

departments or other authorized finger printers. SSA will return incomplete forms back to the contractor. Forms may be 

obtained by calling SSA Personnel Security Suitability Program Officer (SPO). 

The CPOC will submit one cover sheet containing the names of all of the individuals for whom the contractor is 

submitting completed paperwork. This cover sheet should include the contract number, each applicant’s full name, each 

applicant’s Social Security Number (SSN), each applicant’s date of birth, and each applicant’s place of birth. The CPOC 

will submit this cover sheet along with the completed paper forms and two FD-258 fingerprint charts for each applicant 

via traceable means via common carrier to: SSA, CPSPM Suitability Team, 2601 Annex Building, 6401 Security 

Boulevard, Baltimore, MD 21235. 

The CPOC will also email a copy of the cover sheet to the Contracting Officer’s Technical Representative (COTR) to the 

email address shown in the contract. Before forwarding, the CPOC will remove all personal information from the 

applicant list (SSN, date of birth and place of birth). 

NOTE: IT IS THE RESPONSIBILITY OF THE CPOC TO ENSURE CLEARANCES ARE OBTAINED PRIOR TO ANY 

CONTRACT TESTING. 

The CPOC will follow this instruction for new contract employees hired during the contract term. 

Suitability Determination: 

A Federal Bureau of Investigation fingerprint check is part of the basis used for making a suitability determination. This 

determination is final unless information obtained during the remainder of the full background investigation, conducted 

by the Office of Personnel Management, is such that SSA would find the contactor personnel unsuitable to continue 

performing under this contract. CPSPM will notify the CPOC, COTR, and Contracting Officer of the result of these 

determinations. 

CONTRACTOR LIABILITY: The contractor shall be responsible for all electronic media, printed checks, plates, SSA 

Logo, blank proofs or photocopies thereof, and all other materials necessary to produce this product, while in their 

custody and control. The contractor agrees to pay the Government the amount of loss(es) sustained by misappropriation 

or improper use of the electronic media, paper, printed checks, plates or proofs in the custody and control of the 

contractor. 

The contractor shall guarantee that the imprinted checks: 

 Will have no missing numbers. 

 Will have the correct Common Accounting Number (CAN) numbers on them. 
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 Are sequential and shipped to the correct address. 

 That duplicate numbers or blank checks will not be included in shipments. 

NOTE: The contractor shall reimburse the Government for any costs incurred from the use of checks furnished by the 

contractor which do not conform to the specifications. 

The contractor may be held responsible and/or liable to reimburse SSA and/or the bank for any misprinted, incorrect 

and/or duplicate stock, blank stock and/or incorrectly delivered stock resulting in fraudulent or counterfeit activity. Such 

activity will be determined by SSA and/or the bank and reimbursement will be required by the contractor within 30 

workdays upon notification. 

Upon notification from SSA of any incorrect printing or incorrect shipment, the contractor will replace order(s) with a 

new shipment of stock within two (2) workdays and shall deliver to the office by overnight, traceable delivery at no 

additional cost to the Government. 

PREAWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, the 

Government reserves the right to conduct an on-site preaward survey at the contractor’s/subcontractor’s facility or to 

require other evidence of technical, production, managerial, financial, and similar abilities to perform, prior to the award 

of a contract. 

“Prime Contractor”, specified in the “Preaward Survey” section, is defined to include wholly owned subsidiaries of the 

Prime Contractor. As such, the facilities of the wholly owned subsidiaries are also eligible to perform the predominant 

function of presswork under their current contractor codes and their current quality level certifications (at time of bid 

submission), and as the back-up facility in accordance with the specifications of Program. 

Attending the preaward survey will be representatives from GPO and/or SSA. The preaward survey will include a 

review of all subcontractors involved, along with their specific functions; and, the contractor’s production plans as 

required by this specification. 

If award is predicated on the purchase of production and/or systems equipment, the contractor must provide purchase 

order(s) with delivery date(s) of equipment to arrive at least 90 calendar days prior to the start of live production, on or 

about December 1, 2015. 

If the Government, during the preaward survey, concludes that the contractor does not or cannot meet all of the 

requirements as described in this contract, the Government reserves the right to deem the contractor unresponsive and 

will proceed to the next responsive bidder, if applicable. 

PRODUCTION PLANS: The contractor shall present, in writing, to the Contracting Officer within five (5) workdays 

of being notified to do so by the Contracting Officer or his/her representative, detailed plans for each of the following 

activities. The workday after notification to submit will be the first day of the schedule. These proposed plans are 

subject to review and approval by the government and award will not be made prior to approval of same. 

NOTE: THE GOVERNMENT RESERVES THE RIGHT TO WAIVE SOME OR ALL OF THESE PLANS. 

Backup Facility/Contingency Plan - Failure to deliver checks in a timely manner would have a major negative impact 

on the Government. Therefore, if for any reason(s) (Act of God, labor disagreements, etc.) the contractor is unable to 

perform at the said location for a period longer than forty-eight (48) hours, the contractor must have a backup facility 

with the capability of producing the checks. This backup facility must be operated by the contractor, and must meet the 

requirements of this contract. 

Plans for this contingency production must be prepared and submitted to the Contracting Officer as part of the preaward 

survey. These plans must include the location of the facility to be used, equipment available at the facility, security plans 

at that facility, and a timetable for the start of production at that facility. Part of this plan must also include the 

transportation of Government materials from one facility to the other. 

Note: All terms and conditions of this contract will apply to the back up facility. 
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Distribution Plan - This plan must include sufficient detail as to how the Contractor will comply with all applicable 

shipping requirements. 

Material Handling and Inventory Control - This plan must explain in detail how the following materials will be 

handled: incoming raw materials, work-in-progress materials, and quality control inspection materials. 

Personnel Plan - This plan must include a listing of all personnel who will be involved with this contract. For any new 

employees, the plan must include the source of these employees, and a description of the training programs the 

employees will be given to familiarize them with the requirements of this program. 

Production Plan - This plan must include items such as a detailed listing of all production equipment and equipment 

capacities to be utilized on this contract. If new equipment is to be utilized, documentation of the source, delivery 

schedule, and installation dates are required. 

The contractor must disclose in their production plan their intentions for the use of any subcontractors for any materials 

necessary under this contract, capacity that is available for these workloads and if a subcontractor will be handling SSA 

checks, the plan must include the same information required from the contractor for all items contained under “Security 

Requirements” and “Preaward Survey”. If the subcontractor for any operation is added at any time after award, the 

contractor must submit the subcontractor’s proposed plans which are subject to review and approval by the Government. 

NOTE: The subcontractor must be approved by the Government prior to production starting in that facility. 

Security Control Plan - This plan must provide the details of the contractor’s entire production facility and surrounding 

areas. Part of the Security Control Plan must include a floor plan detailing the area(s) to be used, showing existing walls, 

equipment to be used, and the printing and finishing locations. This plan must also address all topics noted in the section 

detailing the Security Requirements. 

See Page 3 of 24: SECURITY REQUIREMENTS

Quality Control Plan - The contractor must describe in detail their quality control/quality assurance plan including how, 

when, where, and by whom the items in the plan will be performed. This plan must also address all topics noted in the 

section detailing the Quality Control Requirements. 

The Quality Control Plan must include, as a minimum, the following elements: 

1. Quality assurance of all materials (e.g., check paper and inks). Each homogeneous lot of check paper and inks 

shall be tested for compliance with specification requirements. Records of all materials tests and inspections shall 

be maintained and made available to the Government upon request. These records include tests and inspections 

performed by the contractor and/or by third party laboratories. If the contractor is receiving test and inspection 

data from material suppliers, these records shall also be maintained and made available to the Government upon 

request. 

2. Process controls inspections and tests during all phases of production. 

3. Targets for control and measurement of color register. 

4. Use of standard specimens for color and printing matching purposes when printing checks. 

5. Independent inspections during the printing process of printed checks for conformance to the standard. 

6. Use of equipment in the manufacture of checks which will reject, or identify for rejection, those with defects 

which cause incorrect operation of high speed print equipment, high speed MICR Reader/Sorter, or other 

equipment used in the issuance and payment of checks. 

7. Examination of each delivery order to assure that pre-printed serial numbers are not duplicated from previous 

orders. If this is the case, the contractor must immediately notify the Contracting Officer or designee. 

8. Independent verification of the machine set-up as to disbursing check serial number at the beginning of the 

numerical printing operations and prior to resuming such operations after each machine stoppage. 
SSA Third Party Draft Checks Page 10 of 24 

693-S (02/17) 

9. Audit of each batch of checks involved in a machine jam or malfunction during numerical printing or MICR 

encoding to verify the accuracy of such printing and MICR encoding. 

10. Independent inspection and approval of checks made up specifically to replace defective checks and of their 

insertion in numerical sequence within the related batches. 

11. All records covering the manufacturing, packaging and shipping of the checks must be identified by the serial 

numbers of the checks when applicable. They must also contain the following information: 

(a) Employee(s) handling the checks 

(b) Description of any difficulties encountered 

(c) Date 

(d) Time 

(e) Machine identification 

12. Records of all tests and inspections. When quantitative results are available, they shall be recorded. Results of 

non-quantitative inspections (e.g. visual matches) shall also be recorded. 

13. Records of process controls sufficient to validate their effectiveness. 

14. All quality system records shall be maintained throughout production and be made available to the Government 

upon request. 

15. Appointment of an official who shall be responsible for the operation of the quality control system and for 

investigating and ascertaining the causes of deficiencies found in checks shipped. 

NOTE: A Certificate of Inspection of each shipment, certifying that the checks were tested and inspected and 

found to comply with all requirements and giving the number of the final inspection, may be required by the 

Contracting Officer. 

16. Inspection for conformance to color standards and integrity of numbers. 

17. Performance of Finished Product: Checks produced under these specifications must be guaranteed to function 

properly when processed. Checks require precision spacing, printing, perforating, and trimming. 

Recovery Plan - A recovery system will be required to ensure that all defective, missing, or mutilated pieces detected are 

identified, reprinted, and replaced. 

Material Plan - The contractor must describe in detail how all accountable materials will be handled throughout all 

phases of production. This plan must also include the method of disposal of all production waste materials. 

POSTAWARD CONFERENCE: The total requirements of the job as indicated in these specifications will be 

reviewed by Government representatives with the contractor’s representatives at the Social Security Administration, 

Baltimore, MD, immediately after award. 

ASSIGNMENT OF JACKETS, PURCHASE AND PRINT ORDERS: A GPO jacket number will be assigned and a 

purchase order issued to the contractor to cover work performed. The purchase order will be supplemented by an 

individual "Print Order" for each job placed with the contractor. The print order, when issued, will indicate the quantity 

to be produced and any other information pertinent to the particular order. 

ORDERING: Items to be furnished under the contract shall be ordered by the issuance of print orders by the 

Government. Orders may be issued under the contract from Date of Award through February 28, 2017, plus for such 

additional period(s) as the contract is extended. All print orders issued hereunder are subject to the terms and conditions 

of the contract. The contract shall control in the event of conflict with any print order. A print order shall be "issued" for

purposes of the contract, when it is either deposited in the U.S. Postal Service mail or otherwise furnished to the 

contractor in conformance with the schedule. 
SSA Third Party Draft Checks Page 11 of 24 

693-S (02/17) 

REQUIREMENTS: This is a requirements contract for the items and for the period specified herein. 

Shipment/delivery of items or performance of work shall be made only as authorized by orders issued in accordance with 

the clause entitled "ORDERING". The quantities of items specified herein are estimates only, and are not purchased 

hereby. 

Except as may be otherwise provided in this contract, if the Government's requirements for the items set forth herein do 

not result in orders in the amounts or quantities described as "estimated", it shall not constitute the basis for an equitable 

price adjustment under this contract. 

Except as otherwise provided in this contract, the Government will order from the contractor all the items set forth which 

are required to be purchased by the Government activity identified on page 1. 

The Government will not be required to purchase from the contractor, requirements in excess of the limit on total orders 

under this contract, if any. 

Orders issued during the effective period of this contract and not completed within that time must be completed by the 

contractor within the time specified in the order, and the rights and obligations of the contractor and the Government 

respecting those orders shall be governed by the terms of this contract to the same extent as if completed during the 

effective period of this contract. 

If shipment/delivery of any quantity of an item covered by the contract is required by reason of urgency prior to the 

earliest date that shipment/delivery may be specified under this contract, and if the contractor will not accept an order 

providing for the accelerated shipment/delivery, the Government may procure this requirement from another source. 

The Government may issue orders which provide for shipment/delivery to or performance at multiple destinations. 

Subject to any limitations elsewhere in this contract, the contractor shall furnish to the Government all items set forth 

herein which are called for by print orders issued in accordance with the "ORDERING" clause of this contract. 

CRIMINAL/CIVIL SANCTIONS: 

(1) Each officer or employee of any person to whom returns or return information is or may be disclosed must be 

notified in writing by such person that returns or return information disclosed to such officer or employee can be 

used only for a purpose and to the extent authorized herein, and that further disclosure of any such returns or 

return information for a purpose or to an extent unauthorized herein constitutes a felony punishable upon 

conviction by a fine of as much as $5,000 or imprisonment for as long as five years, or both, together with the 

costs of prosecution. 

Such person shall also notify each such officer and employee that any such unauthorized further disclosure of 

returns or return information may also result in an award of civil damages against the officer or employee in an 

amount not less than $1,000 with respect to each instance of unauthorized disclosure. These penalties are 

prescribed by IRC Sections 7213 and 7431 and set forth at 26 CFR 301.6103(n). 

 

(2) Additionally, it is incumbent upon the contractor to inform its officers and employees of the penalties for improper 

disclosure imposed by the Privacy Act of 1974, 5 U.S.C. 552a. Specifically, 5 U.S.C. 552a(i)(1), which is made 

applicable to contractors by 5 U.S.C. 552a(m)(1), provides that any officer or employee of a contractor, who by 

virtue of his/her employment of official position, has possession of or access to agency records which contain 

individually identifiable information, the disclosure of which is prohibited by the Privacy Act or regulations 

established there under, and who knowing that disclosure of the specific material is prohibited, willfully discloses 

the material in any manner to any person or agency not entitled to receive it, shall be guilty of a misdemeanor and 

fined not more than $10,000. 
SSA Third Party Draft Checks Page 12 of 24 

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SECTION 2 – SPECIFICATIONS

SCOPE: These specifications cover the production of paper SSA checks requiring such operations as composition, 

printing, MICR numbering, construction, collating, packing, and distribution. 

TITLE: SSA Third Party Draft Checks. 

FREQUENCY OF ORDERS: 

Approximately three (3) orders will be placed during the base period of live production - March 1, 2016 through 

February 28, 2017.

Approximately four (4) orders will be placed in each option year, if exercised. 

It is possible that additional special re-stocking requests for approximately 1,000 to 10,000 printed checks may be 

required on occasion. The contractor will meet the delivery requirements for restocking within 48 hours by over-night 

delivery at a premium rate. Contractor will be reimbursed for all shipping of special stocking requests by submitting the 

overnight shipping receipts with the invoice for billing. 

See pages 19 and 20 of 24: SCHEDULE; SPECIAL RE-STOCKING REQUESTS 

QUANTITY: Each order placed will range in quantity between an estimated 25,000 to 55,000 checks. (Approximately 

100,000 to 220,000 checks per year) 

NOTE: Due to Electronic Funds Transfer (EFT) and consolidation of disbursing locations, it is anticipated that 

the estimated annual quantities may gradually decrease during the term of this contract. 

QUANTITY VARIATION ALLOWED: None. 

TRIM SIZE: 8-1/2 x 11” 

GOVERNMENT TO FURNISH: 

 Artwork for artificial (SSA logo) watermark 

 Check samples 

 Distribution list with delivery quantities will be forwarded to the contractor via email. 

 One reproduction proof, Form 905 (R. 6/03) with labeling and marking specifications 

 GPO Form 892 proof label 

 Name and address of financial institution (for contractor to forward test checks for approval) 

 Check numbering sequence and Common Accounting Numbers (CAN) - to be provided after award 

 Exhibit A: Form SSA-301, Contractor Personnel Security Certification 

 Exhibit B: Questionnaire for Public Trust Positions - Sample Form SF85P 

 Exhibit C: Sample Finger Print Card FD-258 

 Exhibit D: Declaration for Federal Employment Optional Form 306 

 Exhibit E: Fair Credit Reporting Act Authorization Form 

 Exhibit F: Check Sample – not available in contract, only available upon request. 

 Exhibit G: Bank Check Testing Specifications 

NOTE: Bank check testing specifications are subject to change at any time. 

Identification markings such as register marks, ring folios, rubber stamped jacket numbers, commercial identification 

marks of any kind, etc., carried on copy or film, must not print on finished product. 
SSA Third Party Draft Checks Page 13 of 24 

693-S (02/17) 

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “Government to Furnish,” 

necessary to produce the product(s) in accordance with these specifications. 

All technology necessary to produce signature security line (micro printing).

COMPOSITION: 

The entirety of all composition must be identical throughout the products ordered under these specifications. 

Typefaces and Sizes: The contractor is required to match the Government furnished samples. 

Text Matter: Imprint lines. 

Base stock is personalized to include a static 10 digit MICR number (the first four digits represent the static CAN and the 

last six digits represent the consecutive check/draft number), a static 9-digit bank routing transit number, and one of the 

13 to 15 different static 8-digit SSA Account numbers (no spaces, dashes, or alpha characters may be used in this 

number). 

The design of the SSA Third Party Payment System check shall be subject to approval of SSA and consist of, at a 

minimum, the following items: 

 Pre-numbered check number 

 Social Security Administration, Office of Travel and Administrative Payment Services address. 

 Payee line. 

 Date line. 

 Amount line (for spelling the money amount) 

 Amount block (for numeric amount). 

 Three accounting/management information memo lines. 

 Authorized signature line.

 Include the statement “Void After 60 Days” 

CHECK SECURITY FEATURES: The contractor must provide the Government with the following security features 

built into the checks ordered during the course of this contract: 

 Chain-link Design Watermark – Created by the Fourdrinier (dandy-roll) papermaking process, this overall 

design is pressed into the wet paper, displacing some fibers thereby achieving various levels of light 

transmission which allow easy recognition from either side as a two-dimensional watermark which cannot be 

photocopied or scanned, removed, corrupted or faithfully replicated. The watermark design must be 

Conservator or SSA approved functional and aesthetic equivalent. 

 Invisible Fluorescent Security Fibers – Paper must contain two (2) different colors of fibers (blue and yellowgreen) that are embedded into the paper, invisible to the naked eye and viewable only with a U-V light. This 

feature therefore cannot be photocopied or scanned and is valuable as an additional tool in determining 

document authenticity. 

 Toner Retention Treatment – At least the front of the paper must be fully treated with a security level toner 

retention purposed to facilitate the bonding of laser printed toner characters to the paper surface to deter 

mechanical alteration through removal of toner data via tape-lift, scraping or other abrasive techniques so that 

attack results in either the inability to effectively remove laser printed data, or a perceptible disruption of the 

surface print and/or fibers. The toner retention treatment must be either TA4 or SSA approved functional 

equivalent to TA4 which is a full-face toner retention treatment developed for high-speed laser printers such as 

the Xerox 4635 series and Xerox DP180 as well as for general laser-printers. 

 Full Chemical Sensitization – The paper pulp must contain chemical reagents to the five (5) families of known 

chemical alteration agents. If chemicals from the families of oxidants, polar solvents, non-polar solvents, acids, 

or alkalis are applied to attempt localized chemical alteration, noticeable colored stains will appear through the 
SSA Third Party Draft Checks Page 14 of 24 

693-S (02/17) 

paper and be visible from either side. 

 Warning Band on top of check 

 Logo line of the words “SECURE DOCUMENT” document for the signature line 

 VOID pantograph if check is copied. Void Pantograph should not appear in amount box and signature line. 

NOTE: ANY VOID FEATURE USED BY THE CONTRACTOR CANNOT VIOLATE ANY COPYRIGHTS 

OR PATENTS. 

 Padlock icon on the face. Exact location to be determined. 

The contractor may also suggest or notify the Government of additional industry standard security features and 

technologies when possible to improve the security of the checks during the course of this contract. Acceptance of new 

technologies or altering of the checks is at the Government’s discretion. In the event any new technology is approved by 

SSA, the cost will be negotiated between the contractor and the Government. 

PAPER SAMPLES: Contractor to supply ten (10) 8-1/2 x 11” sheets of blank production stock containing all security 

features and meeting all required paper specifications. 

PROOFS: Proofs are required for the initial order and as a result of any required re-design. 

See page 19 of 24: SCHEDULE; PROOFS AND PAPER SAMPLES 

Contractor must supply three (3) sets of digital color content proofs. Proofs must be created using the same Raster Image 

Processor (RIP) that will be used to produce the product. Proofs shall be imaged face and back with all elements in 

proper position (not pasted up) and trimmed to the finished size of the product. 

The contractor will be required to furnish an overlay (film positive) of the black image of the check to show the exact 

position of the MICR line and the Check number. 

 All proofs must be uniform in size and must contain a single imprint to a sheet. 

 The imprint information contained on each proof will be overprinted. 

 Contractor will produce generic stock for overprinting the information, as well as the numbering sequence. 

At agency’s option, Contractor to submit ink drawdowns on actual production stock with Pantone colors to be used in 

job. 

The Government may require one (1) or more sets of revised proofs before rendering an “O.K. to print”. 

If any contractor’s errors are serious enough in the opinion of the GPO to require revised proofs, the revised proofs are to 

be provided at no expense to the Government. No extra time can be allowed for this reproofing; such operations must be 

accomplished within the original production schedule allotted in the specifications. 

NOTE: All proofs must be manufactured at the facility in which the contract production quantities are to be 

manufactured. 

PRIOR TO PRODUCTION SAMPLES: 

See Exhibit G: Check Testing Specifications 

See page 19 of 24: SCHEDULE; PRIOR TO PRODUCTION SAMPLES 

1. Bank Test Checks: Prior to the commencement of production on the first order and as required*, the contractor 

must submit 15 test checks (of the first part of the actual check) for each of SSA’s 15 accounts for bank testing of 

MICR printing specifications. These samples are to be printed on the actual security paper to be used in this 

contract. 

* At any time during the duration of this contract, SSA may re-design any feature of the checks. As a result, the 

Government may request bank test checks as noted above. 
SSA Third Party Draft Checks Page 15 of 24 

693-S (02/17) 

The Government may exercise the option to waive bank test checks. 

All costs for the bank test checks must be included in the contract price for the production quantity. 

2. SSA Test Checks: Prior to the commencement of production on the first order and as required*, the contractor must 

submit 100 laser style test checks for SSA testing (NOTE – the full 8-1/2 x 11” sheet is required). 

For testing purposes only, contractor is to ensure the top portion of the check is voided and the middle and bottom 

portions contain a “Non Negotiable” pantograph (location to be determined at Post Award). Samples are to be 

printed on the actual security paper to be used in this contract, but do not have to contain the MICR printing. 

* At any time during the duration of this contract, SSA may re-design any feature of the checks. As a result, the 

Government may request 100 laser style test checks for SSA testing based on Check requirements as noted above. 

All samples must be produced using the ink, paper, equipment, and method of production which will be used in 

producing the finished product and must be of the kind, size, and quality the contractor will furnish. Face of check prints 

in Blue and Black plus MICR. The top portion of the check must contain the word “VOID” (ink color to be determined) 

The “NON-NEGOTIABLE” text prints in PMS 185 (red) (or match sample) in the middle and bottom portion of the 

sample. All colors are subject to government approval. The warning band and SSA logo is knocked out on the check. 

Micro printing is required on the signature line and dollar amount box. 

Samples must have a “VOID” pantograph (incorporated into the background) intended for use on products produced on 

this program. The proposed “VOID” pantograph is subject to Government approval and must be created by the 

contractor. The word(s) “VOID” will print on the face of the check. The word(s) “VOID” must not be visible on the 

printed check, but must appear when the check is reproduced by use of a single or multi-color laser copier or other 

similar duplicating processes on the market today. “VOID” pantograph should not appear in amount box and signature 

line. 

NOTE: No additional time will be given in the contract schedule for creating the “VOID” pantograph and/or 

performing any testing of the “VOID” pantograph. Bidders unable to comply shall be declared non-responsible. 

Samples will be inspected and tested and must comply with the specifications as to construction, kind and quality of 

materials, and satisfactory processing. 

If the samples are disapproved by the Government, the Government at its option may require the contractor to submit 

additional samples for inspection and testing, in the time and under the terms and conditions specified in the notice of 

rejection. Such additional samples shall be furnished, and necessary changes made, at no additional cost to the 

Government and with no extension in the shipping schedule. The Government will require the time specified above to 

inspect and test any additional samples required. 

In the event the samples are disapproved by the Government, the contractor shall be deemed to have failed to make 

delivery within the meaning of the default clause. In which event, this contract shall be subject to termination for 

default, provided however, that the failure of the Government to terminate the contract for default in such event shall not 

relieve the contractor of the responsibility to deliver the contract quantities in accordance with the shipping schedule. 

In the event the Government fails to approve, conditionally approve, or disapprove the samples within the time specified, 

the Contracting Officer shall automatically extend the shipping schedule in accordance with article 12 “Notice of 

Compliance With Schedules” of Contract Clauses in GPO Contract Terms (Pub. 310.2, effective December 1, 1987 

(Rev. June 2001). 

All samples shall be manufactured at the facility in which the contract production quantities are to be manufactured. 

Samples will not be returned to the contractor. 

NOTE: Manufacture of the final product prior to the approval of the proofs and samples submitted is not 

permitted. Violation of this restriction shall be considered a breach of security and contractor shall be subject to 

default. 

STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein. 
SSA Third Party Draft Checks Page 16 of 24 

693-S (02/17) 

Color of paper furnished shall be of a uniform shade and a close match to samples provided after award. 

The Contracting Officer reserves the right to reject shipments of any order printed on paper the color of which, in his 

opinion, materially differs from that of the color sample(s). 

White, Safety Check Paper for laser printers with the following characteristics:

Basis Weight: 17 x 22 inches, 500 sheets ....................................................................... pounds ........ 25 

A tolerance of -4 and +1.3 percent shall be allowed. 

Caliper (in mils=.001”) Target .................................................................................................... 5.0 (.005”) 

A tolerance of 0.0004 inches shall be allowed. 

Paper shall be uniform and shall not vary more than 0.0004 inch from one edge to the other. 

Tearing strength: Elmendorf Tester 

Target Machine Direction (MD) ....................................................................................... grams ........ 70 

Target Cross Machine Direction (CD) .............................................................................. grams ........ 75 

Stiffness: Gurley Tester 

Target MD ................................................................................................................. milligrams ...... 200 

Target CD .................................................................................................................. milligrams ...... 130 

Smoothness: Sheffield Tester 

Target, Felt side and Wire side ............................................................................................ units ....... 160 

Porosity: Sheffield Tester 

Target ................................................................................................................................... units ......... 11 

Opacity: Target ............................................................................................................... percent ......... 91 

A tolerance of -6 percent shall be allowed. 

Brightness: Target ............................................................................................................ percent ......... 84 

A tolerance of -4 and +3 percent shall be allowed. 

Shade L: Target .................................................................................................................... UV- ...... 93.5 

Shade a: Target .................................................................................................................... UV- ........ 0.2 

Shade b: Target .................................................................................................................... UV- ........ 1.6 

U-V Fluorescent Component: Target.................................................................................. units ..... . 0.2 

A maximum tolerance of +0.6 units shall be allowed. 

Tensile strength: CD Target ................................................................................................. units ......... 17 

Bursting strength: Mullen 

Target ................................................................................................................................... units ......... 45 

Moisture content: Target ............................................................................................... percent. ........ 5.5 

A tolerance of -5 and +3 percent shall be allowed. 

Pulp components: ................................................................................................ no post-consumer waste 

The paper must be a true security paper with fully integrated security features. Print-based features such as an artificial 

watermark are not acceptable. Paper must be U-V Dull and contain a Fourdrinier process two-dimensional chain link 

design mill-formed into the fibers of the security paper which is the first line of defense containing features that provide 

deterrence to counterfeiting, chemical alteration, and mechanical alteration. 

PRINTING: (LIVE CHECK STOCK) 

NOTE: Contractor is to meet the industry standards for Third Party Draft checks for all the ink, OCR, MICR 

and Check Numbering requirements. 
SSA Third Party Draft Checks Page 17 of 24 

693-S (02/17) 

Face of Check - Prints in PMS 185 Red, Blue and Black plus MICR. The warning band and SSA logo is reversed out of 

Blue at the top of the check. The “NON-NEGOTIABLE” text prints in PMS 185 Red (or match sample) in the middle 

and bottom portions of the check. All other text prints in Black. All colors are subject to government approval. 

Micro printing is required on the signature line and dollar amount box. Contractor to print the following on stub (at top 

of page): “PLEASE REMOVE THIS STUB BEFORE CASHING”. 

Only the top and middle check portions need to reflect the SSA emblem printed in the background in a phantom manner 

so as not to interfere with other information printed or written on the check. Only the original check shall be imprinted 

with the MICR encoded account number line. 

Check stock is to be printed on appropriate quality security paper. Printed checks must be imprinted on the front with a 

legend limiting negotiability to 60 calendar days after issuance. 

Checks must have a “VOID” pantograph (incorporated into the background) intended for use on products produced on 

this program. The proposed “VOID” pantograph is subject to Government approval and must be created by the 

contractor. The word(s) “VOID” will print on the face of the check. The word(s) “VOID” must not be visible on the 

printed check, but must appear when the check is reproduced by use of a single or multi-color laser copier or other 

similar duplicating processes on the market today. “VOID” pantograph should not appear in amount box and signature 

line. 

No additional time will be given in the contract schedule for creating the “VOID” pantograph and/or performing any 

testing of the “VOID” pantograph. Any void feature used by the contractor cannot violate any copyrights or patents. 

NOTE: Bidders unable to comply shall be declared non-responsible. 

Base stock is personalized to include a static 10 digit MICR number (the first four digits represent the static CAN and the 

last six digits represent the consecutive check/draft number), a static 9-digit bank routing transit number, and one of the 

13 to 15 different static 8-digit SSA Account numbers (no spaces, dashes, or alpha characters may be used in this 

number). 

Back of Check - Prints black only with custom check endorsement copy*. 

* Location and dimensions of the endorsement copy will be provided at the Post-Award Conference. 

All inks, screens and pantographs must be image-friendly as the checks will be processed through the IBM image 

capture deposit and check payment processing system. 

NOTE: The Government reserves the right to alter base stock requirements or make format/text changes to the checks at 

any time during the term of the contract. Notification of a proposed change will be given with sufficient time for the 

contractor to allow for the change, and submit stock samples, proofs, and test checks to the Government and test checks 

to the bank. Therefore, the contractor is not to preprint or maintain a surplus/inventory of base stock greater than as is 

necessary to meet restocking requirements under the accelerated schedule. The Government shall not be obligated to 

purchase from the contractor any surplus/inventory of unused paper or base stock remaining on hand beyond this 

requirement when a stock or format/text change is implemented OR at the end of the term of the contract. 

MARGINS: Follow exhibit samples (See Exhibit A) and bank check testing specifications provided (See Exhibit G). 

PRESS SHEET INSPECTION: Final make-ready press sheets will be inspected and approved at the contractor’s plant 

for the purpose of establishing specified standards for use during the actual press run. Upon approval of the sheets, 

contractor is charged with maintaining those standards throughout the press run (within QATAP tolerances when 

applicable) and with discarding all make-ready sheets that preceded approval. When a press sheet inspection is required, 

it will be specified on the individual print order. See GPO Publication 315.3 (Guidelines for Contractors Holding Press 

Sheet Inspections) dated August 2002. 

NOTE: A press sheet inspection is for the purpose of setting specific standards that are to be maintained throughout the 

entire run. It does not constitute a prior approval of the entire run. 

CONSTRUCTION: Finished checks must be suitable for continuous operation on laser compatible printers.

The document is 8-1/2 x 11” with three horizontal perforations. The first perforation is 3/8” from the top of the check 
SSA Third Party Draft Checks Page 18 of 24 

693-S (02/17) 

page. This is the top stub portion of the check. The second and third perforations are every 3-9/16” from the first 

perforation. This document must be cut exactly to specifications in order to properly be used with SSA’s software that is 

required for issuing checks. No magnetic ink, other than the encoded MICR may appear on the lower 5/8” of the 

document. This includes additional printing, signature, or printing on the reverse of the document. 

The check is comprised of 3 parts: one original check at the top, the middle portion a blank section containing only the 

“NON NEGOTIABLE” marking. The bottom portion shall be a contrasting color to the top (check) portion. 

DEFECTIVES: The contractor shall examine finished checks, to the extent necessary, to eliminate imperfect work 

prior to delivery. Defective work includes, but is not limited to, the following defects: not color specified; scuffs or 

tears; broken corners; split, ragged or crushed edges; wrinkles; grain not long and/or short; encoding quality not equal to 

the standard; slime spots, dirt spots, knots, lumps, or blisters in excess of standard; improper registration; incorrect 

printing; defective tinting; printing quality not equal to the standard; checks not in number sequence; missing checks; 

and duplicate checks. The Contracting Officer reserves the right to require the contractor to replace any defective checks 

and any related copies or stubs found in any order or to replace all checks within a continuous series if, in his/her 

opinion, segregation of the defective items would not be feasible. The determination by the Contracting Officer as to 

defective workmanship in a particular check or lots of checks shall be final and conclusive, subject to normal appeal 

procedures as outlined in the Disputes Clause as indicated in GPO Contract Terms. 

A single check is defective if it fails to conform to any applicable requirements of this specification. 

Testing and Inspection by the Contracting Officer: The Contracting Officer will, at his/her option, make tests from time 

to time to determine that the checks being manufactured adhere to the specifications and standards prescribed herein. 

He/she may use either or both of the following methods for obtaining samples: 

 a. An authorized representative may periodically visit the contractor’s manufacturing plant to inspect quality of 

printing, shade of tint, the methods of packing, etc., and will select or require the contractor to furnish samples 

of blank stock, printed work, ink, packing material, etc., for laboratory testing. 

 b. The Contracting Officer may request the contractor to take samples of the security paper, checks, ink, packing 

material, etc. and promptly forward them by registered mail or by hand delivery with appropriate receipt to the 

GPO. All photo prints or specimens of checks shall be voided in an approved manner before being permitted to 

leave the contractor's plant. 

PACKING: 

Checks must be bagged in lots of 100 (because of bending, no shrink wrap will be permitted). 

Pack into shipping containers in multiples of 100. 

Shipping containers must be white or brown and approved by SSA. 

Contractor is required to use a sealing tape on the outer shipping container that will detect if the tape has been tampered 

with or broken. Tape used must be approved by SSA. 

LABELING AND MARKING: Reproduce shipping container label from furnished repro, fill in appropriate blanks and 

attach to shipping containers. 

DISTRIBUTION: 

Deliver f.o.b. Contractor’s City by small package common carrier in lots of 100, or multiples thereof to approximately 50 

to 200 addresses nationwide (including U.S. Territories, i.e., Puerto Rico, Guam, Virgin Islands) per order out of an 

estimated 1,500 addresses (including SSA Headquarters). Contractor will be reimbursed for all shipping costs by 

submitting shipping receipts with billing invoice for payment. 

Distribution lists will be provided via email with the print order. 

Printed checks must be shipped by a 2 or 3-day delivery service (pre-approved by SSA) with a required signature of the 

receiving office. Contractor must begin shipping to destinations with the furthest delivery point (specific 
SSA Third Party Draft Checks Page 19 of 24 

693-S (02/17) 

CANs/addresses may require shipping first as directed on the print order). No orders are to be shipped by U.S. Postal 

Service. 

The contractor shall provide hardcopy or electronic confirmation of deliveries to SSA no later than 3 calendar days 

following complete distribution. The Government reserves the right to request from the contractor and obtain the 

tracking numbers, CANs and delivery dates for all offices not receiving their deliveries by the required due date. 

NOTE: Contractor is required to notify SSA immediately of any undeliverable addresses. Contractor CANNOT make 

any address corrections. If an address discrepancy is identified, the contractor must ask SSA for clarification. 

One copy of the billing invoice and all supporting documentation for each print order must be sent within 5 

working days of the delivery date by e-mail to Kate Schmidt – Kathryn.Schmidt@ssa.gov.

Upon close of contract, all furnished material must be returned to Social Security Administration, 6401 Security 

Boulevard, 1369 Annex Building, Baltimore, MD 21235 ATTN: Kate Schmidt. 

All expenses incidental to returning materials, submitting proofs, and furnishing sample copies must be borne by the 

contractor. 

PAYMENTS ON PRINT ORDERS: 

Billing invoices must be submitted by Fax or mail to the U.S. GPO for the processing of vouchers for payment. Billing 

and payment instructions can be accessed on our website by the following hyperlinks: 

http://www.gpo.gov/vendors/billing.htm and http://www.gpo.gov/vendors/payment.htm

If faxed, send the completed invoice to GPO utilizing the payment processing cover sheet. Access the following 

hyperlink for preparation instructions: http://winapps.access.gpo.gov/fms/vouchers/barcode/instructions.html 

NOTE: Facsimile transmission should only be used when no samples are required with your invoice, otherwise payment 

will be held up while the invoice is returned to you for the required sample(s). 

If mailed, all voucher packages and envelopes MUST be mailed to: COMPTROLLER-FMCE, Office of Financial 

Management, U.S. Government Printing Office, Washington, DC 20401 

NOTE: Do not mail your invoice to any other GPO Procurement Office as this will delay payment. 

SCHEDULE: Adherence to this schedule must be maintained. Contractor must not start production of any job prior to 

receipt of the individual print order. 

 Most Government furnished materials will be supplied by e-mail. All other Government furnished materials must be 

picked up from SSA in Baltimore MD at the contractor’s expense. 

The following schedules begin the workday (WD) after notification of the availability of print order and furnished 

material; the workday after notification will be the first workday of the schedule. 

PROOFS AND PAPER SAMPLES (as required)

Submit proofs AND paper samples to: Social Security Administration, Office of Printing and Alternative Media 

Service (OPAMS), 1369 Annex Building, 6401 Security Blvd., Baltimore, MD 21235-6401. Attn: Kate Schmidt. 

The container and accompanying documentation must be marked “PROOFS”, and must include the GPO jacket, 

purchase, and program numbers. The contractor must provide their UPS number for SSA to use to return signed-off 

proofs. 

No specific date is set for submission of proofs. Proofs must be submitted as soon as possible to allow for revised 

proofs, if contractor’s errors are judged serious enough to require them. 

Proofs will be withheld no more than two (2) workdays from their receipt at the ordering agency until they are made 

available for pickup. (NOTE: The first workday after receipt of proofs at the ordering agency is day one (1) of the 

hold time.) 
SSA Third Party Draft Checks Page 20 of 24 

693-S (02/17) 

NOTE: If revised proofs or test samples are required due to contractor’s error, the original schedule must be 

maintained. 

In the event that revised proofs are required, contractor must submit the revised proofs within two (2) workdays. 

The Government will hold the proofs up to two (2) workdays until available for pickup. 

PRIOR TO PRODUCTION SAMPLES (as required) 

The samples must be submitted within seven (7) workdays 

Bank Test Checks – Samples deliver directly to the financial institution by the contractor. 

Contractor must notify SSA of bank approval of test checks via email to Kathryn.Schmidt@ssa.gov . 

SSA Test Checks – Samples are to be submitted to: Social Security Administration, Office of Printing and 

Alternative Media Service (OPAMS), 1369 Annex Building, 6401 Security Blvd., Baltimore, MD 21235-6401. 

Attn: Kate Schmidt. The container and accompanying documentation must be marked “PREPRODUCTON 

SAMPLES”, and must include the GPO jacket, purchase, and program numbers. 

The Government will approve, conditionally approve or disapprove the samples with in seven (7) workdays of the 

receipt thereof. 

Approval or conditional approval shall not relieve the contractor from complying with the specifications and all 

other terms and conditions of the contract. A conditional approval shall state any further action required by the 

contractor. A notice of disapproval shall state the reasons therefor. 

In the event that Prior to Production test samples are required, contractor must submit the Prior to production test 

samples within two (2) workdays. The Government will hold the samples up to seven (7) workdays until available 

for pickup. 

PRODUCTION SCHEDULE 

If proofs and Prior to Production test samples are not required, all products must deliver to each destination within 

 fifteen (15) workdays. 

If proofs and Prior to Production test samples (SSA and/or bank test checks) are required, all products must deliver 

to each destination within thirty-six (36) workdays. 

Note: With notification provided to SSA the Contractor is authorized to deliver any completed Print Order prior to 

the contracted delivery date. 

Proofs and test checks will be a requirement prior to the commencement of production on the first order. For the 

initial order, SSA will provide the final quantity per print order, as well as the correct mailing addresses, after 

approval of the prior to production samples and/or bank test checks. The addresses will be cross-referenced to 

appropriate subaccount (CAN) numbers. 

At any time during the duration of this contract, SSA may re-design any feature of the checks. As a result, the 

Government may request a complete set of proofs and/or prior to production test samples. 

SPECIAL RESTOCKING REQUESTS 

The contractor will meet the delivery requirements for this order within 48 hours by over-night delivery*. 

Approximately 1,000 to 10,000 printed checks may be required under an accelerated schedule. 

* Contractor to utilize overnight shipping for all special restocking requests in order to meet accelerated schedule 

requirements. Reimbursement will be made by submitting the receipts with the invoice for billing. 
SSA Third Party Draft Checks Page 21 of 24 

693-S (02/17) 

NOTE: Orders requiring this accelerated schedule will be paid at the premium rate of an additional 25% of 

the line items charged under I. Prepress and II. Printing and Construction in Section 4 Schedule of Prices. 

Shipping costs cannot be included when calculating the premium rate. 

Press Sheet Inspections: 

The contractor must notify the U.S. GPO of the date and time the press sheet inspection can be performed. In order for 

proper arrangements to be made, notification must be given at least 48 hours prior to the inspection. Notify the U.S. 

Government Publishing Office, Quality Control for Procured Printing, Washington, DC 20401 at (202) 512-0542. 

Telephone calls will only be accepted between the hours of 8:00 a.m. and 2:00 p.m., prevailing Eastern Time, Monday 

through Friday. NOTE: See contract clauses, paragraph 14(e)(1), Inspections and Tests of GPO Contract Terms (GPO 

Publication 310.2, effective December 1, 1987 (Rev. 6-01)). 

NOTE: When supplies are not ready at the time specified by the contractor for inspection, the Contracting 

Officer may charge to the contractor the additional cost of the inspection. 

The ship/deliver date indicated on the print order is the date products ordered for delivery f.o.b. Contractor’s City must 

be delivered to the destination(s) specified. 

Unscheduled material such as shipping documents, receipts or instructions, delivery lists, labels, etc., will be furnished 

with each order or shortly thereafter. In the event such information is not received in due time, the contractor will not be 

relieved of any responsibility in meeting the shipping schedule because of failure to request such information. 

For compliance reporting purposes, contractors are to report information regarding each order with date of shipment or 

delivery, as applicable, in accordance with the contract requirements by contacting the Shared Support Services 

Compliance Section via email at compliance@gpo.gov, via telephone at (202) 512-0520, or via facsimile at (202) 512-

1364. Personnel receiving the email, call, or facsimile will be unable to respond to questions of a technical nature or to 

transfer any inquiries. 
SSA Third Party Draft Checks Page 22 of 24 

693-S (02/17) 

SECTION 3 – DETERMINATION OF AWARD 

 The Government will determine the lowest bid by applying the prices offered in the “Schedule of Prices” to the 

following units of production which are the estimated requirements to produce one year’s production under this contract. 

These units do not constitute, nor are they to be construed as, a guarantee of the volume of work which may be ordered 

for as a like period of time. 

 

All orders will be paid for at the basic prices offered. 

I. (a) 6 

 (b) 1 

II. 160 
SSA Third Party Draft Checks Page 23 of 24 

693-S (02/17) 

SECTION 4 – SCHEDULE OF PRICES 

Bids offered are f.o.b. contractor’s city. 

Prices must include the cost of all required materials and operations for each item listed in accordance with these 

specifications. 

Bidder must make an entry in each of the spaces provided. Bids submitted with any obliteration, revision, or alteration 

of the order and manner of submitting bids, may be declared nonresponsive. 

An entry of NC (No Charge) shall be entered if bidder intends to furnish individual items at no charge to the 

Government. 

Bids submitted with NB (No Bid) or blank spaces for an item may be declared nonresponsive. 

The Contracting Officer reserves the right to reject any offer that contains prices for individual items of production 

(whether or not such items are included in the Determination of Award) that are inconsistent or unrealistic in regard to 

other prices in the same offer or to GPO prices for the same operation if such action would be in the best interest of the 

Government. 

All vouchers submitted to the GPO shall be based on the most economical method of production. 

I. PREPRESS 

 (a) Digital Content proofs ........................................................ per trim/page-size unit .............. $ _________ 

 

 (b) SSA Prior to Production Test samples ............................... per set of 100 ............................. $ _________ 

II. PRINTING AND CONSTRUCTION: Prices offered shall include the cost of all required materials and operations 

(including all composition, proofs, stock and packing) necessary for the production and distribution of the product 

listed in accordance with these specifications. Cost of makeready must be included. 

 Laser style ............................................................................... per 1,000 checks ........................ $ _________ 

 ____________ 

(Initials) 
SSA Third Party Draft Checks Page 24 of 24 

693-S (02/17) 

INSTRUCTIONS FOR BID SUBMISSION: Fill out "Section 4.- Schedule of Prices," initialing or signing each page 

in the space(s) provided. Submit two copies (original and one exact duplicate) of the "Schedule of Prices" with two 

copies of the GPO Form 910, "BID" form. Do not enter bid prices on GPO Form 910; prices entered in the "Schedule of 

Prices" will prevail. 

Bidder ______________________________________________________________________________________ 

 ____________________________________________________________________________________________ 

 ____________________________________________________________________________________________ 

 (City - State) 

By __________________________________________________________________________________________ 

(Signature and title of person authorized to sign this bid) 

 ____________________________________________________________________________________________ 

 (Person to be contacted) (Telephone Number) 













 

FD-258 (Rev. 9-9-13) 1110-0046 

LEAVE BLANK 

APPLICANT

SIGNATURE OF PERSON FINGERPRINTED 

RESIDENCE OF PERSON FINGERPRINTED 

DATE 

EMPLOYER AND ADDRESS 

REASON FINGERPRINTED 

SIGNATURE OF OFFICIAL TAKING FINGERPRINTS

 1. R. THUMB 2. R. INDEX 

6. L. THUMB 7. L. INDEX 

LEFT FOUR FINGERS TAKEN SIMULTANEOUSLY 

* See Privacy Act Notice on Back 

TYPE OR PRINT ALL INFORMATION IN BLACK FBI LEAVE BLANK LAST NAME NAM FIRST NAME MIDDLE NAME

ALIASES AKA 

DATE OF BIRTH DOB 

Month Day Year 

SEX RACE HGT. WGT. EYES HAIR PLACE OF BIRTH POB

LEAVE BLANK 

CITIZENSHIP CTZ 

YOUR NO. OCA 

O 

R 

I 

CLASS 

REF. 

FBI NO. FBI 

ARMED FORCES NO. MNU 

SOCIAL SECURITY NO. SOC 

MISCELLANEOUS NO. MNU 

3. R. MIDDLE 4. R. RING 5. R. LITTLE 

8. L. MIDDLE 9. L. RING 10. L. LITTLE 

L. THUMB R. THUMB RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY 
1. PRINTS MUST GENERALLY BE CHECKED THROUGH THE APPROPRIATE STATE IDENTIFICATION BUREAU, AND ONLY THOSE 

FINGERPRINTS FOR WHICH NO DISQUALIFYING RECORD HAS BEEN FOUND LOCALLY SHOULD BE SUBMITTED FOR FBI SEARCH. 

2. IDENTITY OF PRIVATE CONTRACTORS SHOULD BE SHOWN IN SPACE “EMPLOYER AND ADDRESS”. THE 

CONTRIBUTOR IS THE NAME OF THE AGENCY SUBMITTING THE FINGERPRINT CARD TO THE FBI. 

3. FBI NUMBER, IF KNOWN, SHOULD ALWAYS BE FURNISHED IN THE APPROPRIATE SPACE. 

MISCELLANEOUS NO. - RECORD: OTHER ARMED FORCES NO. PASSPORT NO. [FP], ALIEN REGISTRATION NO. 

(AR), PORT SECURITY CARD NO. (PS), SELECTIVE SERVICE NO. (SS) VETERANS’ ADMINISTRATION CLAIM NO. (VA). 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FEDERAL BUREAU OF INVESTIGATION
 

UNITED STATES DEPARTMENT OF JUSTICE
 

CJIS DIVISION/CLARKSBURG, WV 26306
 1.LOOP 

CENTER 

OF LOOP 

DELTA 

THE LINES BETWEEN CENTER OF
 

LOOP AND DELTA MUST SHOW
 

APPLICANT 

THIS CARD FOR USE BY: 

1. LAW ENFORCEMENT AGENCIES IN FINGERPRINTING APPLICANTS FOR LAW ENFORCEMENT POSITIONS.* 

2. OFFICIALS OF STATE AND LOCAL GOVERNMENTS FOR PURPOSES OF EMPLOYMENT, LICENSING, AND 

PERMITS, AS AUTHORIZED BY STATE STATUTES AND APPROVED BY THE ATTORNEY GENERAL OF THE 

UNITED STSTES. LOCAL AND COUNTY ORDINANCES, UNLESS SPECIFICALLY BASED ON 

APPLICABLE STATE STATUTES DO NOT SATISFY THIS REQUIREMENT.* 

3. U.S. GOVERNMENT AGENCIES AND OTHER ENTITIES REQUIRED BY FEDERAL LAW.** 

4. OFFICIALS OF FEDERALLY CHARTERED OR INSURED BANKING INSTITUTIONS TO PROMOTE OR MAINTAIN 

THE SECURITY OF THOSE INSTITUTIONS. 

Please review this helpful information to aid in the successful processing of hard copy criminal and civil fingerprint submissions in order to prevent delays 

or rejections. Hard copy fingerprint submissions must meet specific criteria for processing by the Federal Bureau of Investigation. 

Ensure all information is typed or legibly printed using blue or black ink.
 

Enter data within the boundaries of the designated field or block.
 

Complete all required fields. (If a required field is left blank, the fingerprint card may be immediately rejected without further processing.)


 •	 The required fields for hard copy fingerprint cards are: originating agency identifier number - date of birth - place 

of birth - name - sex fingerprint impressions - any applicable state stamp - Other (race, height, weight, eye color, 

hair color) 

* criminal fingerprint cards also require an arrest charge and date of arrest. 

* civil fingerprint cards also require a reason fingerprinted and date fingerprinted 

2.WHORL Do not use highlighters on fingerprint cards. 

3. ARCH 

THESE LINES RUNNING BETWEEN 

DELTAS MUST BE CLEAR 

DELTAS 

Do not enter data or labels within ‘Leave Blank’ areas.
 

Ensure the ‘Reply Desired’ field is checked when applicable (criminal only).
 

Ensure fingerprint impressions are rolled completely from nail to nail.
 

Ensure fingerprint impressions are in the correct sequence.
 

Ensure notations are made for any missing fingerprint impression (i.e. amputation).
 

Do not use more than two retabs per fingerprint impression block.
 

Ensure no stray marks are within the fingerprint impression blocks.
 

Training aids can be ordered online via the Internet by accessing the FBI’s website at: fbi.gov, click on ‘Fingerprints’, then click on ‘Ordering 

Fingerprint Cards & Training Aids’. Direct questions to the Identification and Investigative Services Section’s Customer Service Group at (304) 625-5590 

or by e-mail at <liaison@leo.gov>. 

PRIVACY ACT STATEMENT 

Authority: The FBI's acquisition, preservation, and exchange of ILQJHUSULQWVDQGDVVRFLDWHGinformation is generally authorized under 

86&534. Depending on the nature of your application, supplemental authorities include Federal statutes, 6tate statutesSXUVXDQWto 

Pub.L. 92-544, Presidential (xecutive 2rders,DQGIHGHUDOProviding \RXUILQJHUSULQWVDQGDVVRFLDWHGLQIRUPDWLRQLVYROXQWDU\KRZHYHU

IDLOXUHWRGRVRPD\DIIHFWFRPSOHWLRQRUDSSURYDORI\RXUDSSOLFDWLLRQ

Social Security Account Number (SSAN). Your SSAN is needed to keep records accurate because other people may have the same 

name and birth date. Pursuant to the Federal Privacy Act of 1974 (5 USC 552a), the requesting agency is responsible for informing you whether 

disclosure is mandatory or voluntary, by what statutory or other authority your SSAN is solicited, and what uses will be made of it. Executive 

Order 9397 also asks Federal agencies to use this number to help identify individuals in agency records. 

Principal Purpose: Certain determinations, such as employment, licensing, and VHFXULW\FOHDUDQFHVmay be predicated on fingerprint-based EDFNJURXQGchecks. Your fingerprints DQGDVVRFLDWHG informationELRPHWULFVPay be SURYLGHGWRWKHHPSOR\LQJLQYHVWLJDWLQJRURWKHUZLVH UHVSRQVLEOHDJHQF\DQGRUWKHFBI for the SXUSRVHRIFRPSDULQJ\RXUILQJHUSULQWVWRRWKHUILQJHUSULQWVLQWKH)%,
V1H[W*HQHUDWLRQ

,GHQWLILFDWLRQ1*,V\VWHPRULWVVXFFHVVRUV\VWHPVLQFOXGLQJFLYLOFULPLQDODQGODWHQWILQJHUSULQWUHSRVLWRULHVRURWKHUDYDLODEOHUHFRUGVRIWKH HPSOR\LQJLQYHVWLJDWLQJRURWKHUZLVHUHVSRQVLEOHDJHQF\The FBI may retain \RXUILQJHUSULQWVDQGDVVRFLDWHGLQIRUPDWLRQELRPHWULFVLQ1*, DIWHUWKHFRPSOHWLRQRIWKLVDSSOLFDWLRQDQGZKLOHUHWDLQHG\RXUILQJHUSULQWVPD\FRQWLQXHWREHFRPSDUHGDJDLQVWRWKHUILQJHUSULQWVVXEPLWWHG

WRRUUHWDLQHGE\1*,

Routine Uses: 'XULQJWKHSURFHVVLQJRIWKLVDSSOLFDWLRQDQGIRUDVORQJWKHUHDIWHUDV\RXUILQJHUSULQWVDQGDVVRFLDWHGLQIRUPDWLRQELRPHWULFV

DUHUHWDLQHGLQ1*,\RXULQIRUPDWLRQPD\EHGLVFORVHGSXUVXDQWWR\RXUFRQVHQWDQGPD\EHGLVFORVHGZLWKRXWyour consent as permitted by 

the Privacy Act of 1974 DQGDOODSSOLFDEOH5RXQWLQH8VHVDVmay be published at any time in the Federal Register, including the 5outine 8ses 

for the 1*,V\VWHPDQGWKH)BI's Blanket Routine UsesRoutine uses include, but are not limited to, disclosures to: HPSOR\LQJJRYHUQPHQWDO

or authorized non-governmental agencies responsible for employment, contracting licensing, security clearances, and other suitability

determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security

or public safety. 

Additional Information: The requesting agency and/or the agency conducting the application-investigation will provide you additional 

information pertinent to the specific circumstances of this application, which may include identification of other authorities, purposes, uses, and 

consequences of not providing requested information. In addition, any such agency in the Federal Executive Branch has also published notice 

in the Federal Register describing any system(s) of records in which that agency may also maintain your records, including the authorities, 

purposes, and routine uses for the system(s). 

INSTRUCTIONS: 

ARCHES HAVE NO DELTAS *

FD-258 (REV. 9-9-13) 

**



Federal Investigations Notice 

Letter No. 98-02 

Date: March 6, 1998

On September 30, 1997, amendments to the Fair Credit Reporting Act (FCRA) (15 

U.S.C. § 1681, et seq.) became effective as a result of the Consumer Credit 

Reporting Reform Act of 1996. The amendments require changes on the part of the 

users of consumer reports and providers of information to consumer reporting 

agencies. These changes impact on OPM-IS as the provider of investigative 

services to other Federal agencies, and on our customer agencies as the final users 

of credit information gathered as a result of OPM's investigations. 

Most notably, Section 1681b of title 15 addresses permissible purposes for which 

consumer reports may be furnished and conditions for furnishing and using 

consumer reports for employment purposes. If an a enc. intends to use a consumer 

report for employment purposes, Subsection 1681b (b) (2) of title 15 requires that 

the applicant/employee be notified in a document consisting solely of the notice 

that a consumer report may be used, and the applicant/employee must authorize 

this use in writing before the consumer report is obtained. Subsection 1681b (b)(3) 

of title 15 requires that, before taking adverse action relative to an employment 

decision based on a consumer report, the agency must provide the consumer with a 

copy of the report, and a copy of the Federal Trade Commission's (FTC) Consumer 

Rights Notice. 

The notice, disclosure, certification and adverse action requirements of the FCRA

do not directly apply to OPM-IS in its role as the provider of investigative services 

to other requesting Federal agencies. However, we do obtain credit reports on 

behalf of other Federal agencies, and will require those Federal agencies to certify 

that they are the procurer of the credit report and that they are compliant with the 

FCRA's relevant provisions. We are, therefore, sending under separate cover a 

request to each agency for a one-time blanket certification to this effect, to be 

completed and returned to OPM-IS no later than May 1, 1998. 

We will ask that the certification acknowledge that the requesting Federal agency 

is the procurer of the credit report for purposes of compliance with the FCRA. We 

will also ask that the requesting Federal agency certify that it is compliant with all 

relevant provisions of the FCRA. This certification should include certification that 

the agency will (a) clearly and conspicuously disclose to the subject of 

investigation, in a written document consisting solely of the disclosure, that the 

agency may obtain a credit report for employment purposes; and (b) obtain the 

subject's written authorization to obtain the credit report. It will also state that the 
agency will not take adverse action against the subject of investigation, based in 

whole or in part upon the credit report, without first providing the subject a copy of 

the report and a written description of the subject's rights as described by the FTC 

under Section 1681g(c)(3) of title 15. Finally, the certification must state that the 

requesting Federal agency will not use any information from the consumer report 

in violation of any applicable equal employment opportunity law or regulation. 

A sample release for obtaining written authorization from each affected 

applicant/employee, as well as a copy of the FTC's Consumer Rights Notice are 

attached for your information and may be reproduced as necessary. You can obtain 

additional information regarding the FCRA at the Federal Trade Commission's 

web site (http://www.ftc.gov). 

Attachments 

Inquiries: OPM-IS, Oversight and Technical Assistance Division, 202-606-1042 

OPM-FIPC, Contract Management Branch, 724-794-5612 

Code:736 

Distribution: SOI/SON's 

Letter Expires: When superseded

 SAMPLE RELEASE 

 Fair Credit Reporting Act of 1970, as amended 

 PLEASE TAKE NOTICE THAT ONE OR MORE CONSUMER CREDIT REPORTS MAY BE 

 OBTAINED FOR EMPLOYMENT PURPOSES PURSUANT TO THE FAIR CREDIT REPORTING 

 ACT, AS AMENDED, 15 U. S. C., §1681, ET SEQ. SHOULD A DECISION TO TAKE ANY 

 ADVERSE ACTION AGAINST YOU BE MADE, BASED EITHER IN WHOLE OR IN PART ON 

 THE CONSUMER CREDIT REPORT, THE CONSUMER REPORTING AGENCY THAT 

 PROVIDED THE REPORT PLAYED NO ROLE IN THE AGENCY'S DECISION TO TAKE SUCH 

 ADVERSE ACTION. 

 Information provided by you on this form will be furnished to the consumer reporting agency in order 

 to obtain information in connection with an investigation to determine your (1) fitness for Federal 

 employment, (2) clearance to perform contractual service for the Federal Government, and/or (3) 

 security clearance or access. The information obtained may be redisclosed to other Federal agencies 

 for the above purposes and in fulfillment of official responsibilities to the extent that such disclosure is 

 permitted by law. 

 I hereby authorize the _____________________________ to obtain such report(s) from any 

 (Name of Requesting Agency) 

 consumer/credit reporting agency for employment purposes. 

 ____________________ _______________________ 

 (Print Name) (SSN) 

 ____________________ _______________________ 

 (Signature) (Date) 

 Your Social Security Number is needed to keep records accurate, because other people may have the 

 same name. Executive Order 9397 also asks Federal agencies to use this number to help identify 

 individuals in agency records. 

 A Summary of Your Rights Under the Fair Credit Reporting Act 

 The federal Fair Credit Reporting Act (FCRA) is designed to promote accuracy, fairness, and 

 privacy of information in the files of every "consumer reporting agency" (CRA). Most CRAs are 
 credit bureaus that gather and sell information about you -- such as if you pay your bills on time 

 or have filed bankruptcy -- to creditors, employers, landlords, and other businesses. You can find 

 the complete text of the FCRA, 15 U.S. C. 1681-168 1 u, at the Federal Trade Commission's web 

 site (http:www.FTC.GOV). The FCRA gives you specific rights, as outlined below. You may have 

 additional rights under state law. You may contact a state or local consumer protection agency or 

 a state attorney general to learn those rights. 

 • You must be told if information in your file has been used against you. Anyone who uses 

 information from a CRA to take action against you -- such as denying an application for 

 credit, insurance, or employment -- must tell you, and give you the name, address, and phone 

 number of the CRA that provided the consumer report. 

 • You can find out what is in your file. At your request, a CRA must give you the 

 information in your file, and a list of everyone who has requested it recently. There is no 

 charge for the report if a person has taken action against you because of information supplied 

 by the CRA, if you request the report within 60 days of receiving notice of the action. You 

 also are entitled to one free report every twelve months upon request if you certify that (1) 

 you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or 

 (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you up to eight 

 dollars. 

 • You can dispute inaccurate information with the CRA. If you tell a CRA that your file 

 contains inaccurate information, the CRA must investigate the items (usually within 30 days) 

 by presenting to its information source all relevant evidence you submit, unless your dispute is 

 frivolous. The source must review your evidence and report its findings to the CRA. (The 

 source also must advise national CRAs -- to which it has provided the data -- of any error.) 

 The CRA must give you a written report of the investigation, and a copy of your report if the 

 investigation results in any change. If the CRA's investigation does not resolve the dispute, 

 you may add a brief statement to your file. The CRA must normally include a summary of 

 your statement in future reports. If an item is deleted or a dispute statement is filed, you may 

 ask that anyone who has recently received your report be notified of the change. 

 • Inaccurate information must be corrected or deleted. A CRA must remove or correct 

 inaccurate or unverified information from its files, usually within 30 days after you dispute it. 

 However, the CRA is not required to remove accurate data from your file unless it is outdated 

 (as described below) or cannot be verified. If your dispute results in any change to your 

 report, the CRA cannot reinsert into your file a disputed item unless the information source 

 verifies its accuracy and completeness. In addition, the CRA must give you a written notice 

 telling you it has reinserted the item. The notice must include the name, address and phone 

 number of the information source. 

 • You can dispute inaccurate items with the source of the information. If you tell anyone - 

 - such as a creditor who reports to a CRA -- that you dispute an item, they may not then 

 report the information to a CRAwithout including a notice of your dispute. In addition, once 

 you've notified the source of the error in writing, it may not continue to report the information 

 if it is, in fact, an error. 

 • Outdated information may not be reported. In most cases, a CRA may not report 

 negative information that is more than seven years old; ten years for bankruptcies. 

 • Access to your file is limited. A CRA may provide information about you only to people 

 with a need recognized by the FCRA -- usually to consider an application with a creditor, 

 insurer, employer, landlord, or other business. 

 • Your consent is required for reports that are provided to employers, or reports that 

 contain medical information. A CRA may not give out information about you to your 

 employer, or prospective employer, without your written consent. A CRA may not report 

 medical information about you to creditors, insurers, or employers, without your permission. 

 • You may choose to exclude your name from CRA lists for unsolicited credit and 

 insurance offers. Creditors and insurers may use file information as the basis for sending you 

 unsolicited offers of credit or insurance. Such offers must include a toll-free phone number 

 for you to call if you want your name and address removed from future lists. If you call, you 

 must be kept off the lists for two years. If you request, complete, and return the CRA form 

 provided for this purpose, you must be taken off the lists indefinitely. 
 • You may seek damages from violators. If a CRA, a user or (in some cases) a provider of 

 CRA data, violates the FCRA, you may sue them in state or federal court. 

 The FCRA gives several different federal agencies authority to enforce the FCRA: 

FOR QUESTIONS OR CONCERNS 

REGARDING: 

PLEASE CONTACT:

CRA's creditors and others not listed below Federal Trade Commission 

Consumer Response Center-FCRA 

Washington , DC 20580 202-326-3761 

National banks, Federal branches/agencies of 

foreign banks (word "National" or initials 

"N.A" appear in or after banks name) 

Office of the Comptroller of the Currency 

Compliance Management Mail Stop 6-6 

Washington , DC 20219 800-613-6743 

Federal Reserve System member banks (except 

national banks, and Federal branches/agencies 

of foreign banks) 

Federal Reserve Board 

Division of Consumer & Community Affairs 

Washington, DC 20551 

202-452-3693 

Savings associations and federally chartered 

savings banks (word "Federal or initials 

"F.S.B." appear in federal institutions name" 

Office of Thrift Supervision 

Consumer Programs 

Washington, DC 20552 

800-842-6929 

Federal credit unions (words "Federal Credit 

Union" appear in institution's name) 

National Credit Union Administration 

1775 Duke Street 

Alexandria VA 22314 

703-518-6360 

State chartered banks that are not members of 

the Federal Reserve System 

Federal Deposit Insurance Corp. 

Div. of Compliance & Consumer Affairs 

Washington, DC 20429 

202-934-FDIC 

Air, surface, or rail common carriers regulated 

by former Civil Aeronautics Board of Interstate 

Commerce Commission 

Department of Transportation 

Office of Financial Management 

Washington, DC 20590 

202-366-1306 

Activities subject to the Packers and Stockyards 

Act, 1921 

Department of the Agriculture 

Office of Deputy Administrator-GIPSA 

Washington, DC 20250 

202-720-7051 

 
CHECK TESTING SPECIFICATIONS

Delaware Accounts

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©2009 Citibank, N.A. All rights reserved. Citi and Arc Design is a service mark of Citigroup Inc., used and registered throughout the world. 

GENERAL INFORMATION Height of the document must be between 2-3/4 and 3-5/8 inches. Length of the document must be between 6-1/2 and 8-3/4 inches. Citi recommends choosing a stock between 6-3/4 and 8-1/2 inches.The company name must appear at the top of the check. “Citibank, N.A. - One Penn’s Way - New Castle DE 19720” must appear on the face of the document.The Fractional Transit Routing Code ( 62-20/311) must appear on the face of the document. Citi recommends the Routing Code be located in the top right corner of the check. The serial number must be printed in the upper right-hand corner of the document. The entire serial number must be printed in the same size font and color. The number must match the serial number encoded in the MICR line. Serial number must be 4-10 digits. No spaces, dashes or alpha characters may be used in the serial number. Check stock must be 24 lb. paper or better. Safety paper is recommended. IMAGING The minimum background paper reflectance is 60%. The printed background pattern of the check in the payee area must be light enough to not interfere with the imaging. GREEN or RED backgrounds are NOT recommended as these colors are not as image friendly as BLUE or YELLOW.Check Printing: Dot Matrix printers are NOT recommended when printing checks. Laser printing quality is preferred. 

MICR LINE No magnetic ink, other than the encoded MICR may appear on the lower 5/8” of the document. This includes additional printing, signature, or printing on the reverse of the document. Please ensure signatures DO NOT cross into the 5/8” MICR band area. Characters must be black MICR ink, printed in E13-B font. Signal strength must be between 50% and 200 % of nominal strength. There must be at least 1/4” margin between trailing edge of check and the left-most MICR character. On-Us Field: Opening On-us symbol must be within positions 14 to 23. Citi recommends position 19. No blanks or dashes are permitted between the On-Us symbol and the account number. (Reference check #) Account number must be within positions 15 to 31. - Citi recommends positions 20 to 27 - Account numbers must NOT have blanks or dashes. Transit Number field: Positions 32 and 44 must be blank Transit symbols must be in positions 33 and 43 Citi Transit #: 031100209 Auxiliary On-Us field: Opening symbol must be in position 45 or 46; closing symbol must be immediately to the left of the serial number. No blanks or dashes are permitted between the On-Us symbols. Serial number must be 4 to 10 digits. The maximum number is 10 digits. No pre-filled zeros required. Check Printing: Dot Matrix printers are NOT permitted when printing the MICR line on checks.Laser printing quality is preferred. 

PAYEE NAME The payee name inEXACTLY MATCof the payee name file. The first two matched on the cheprinted per line. CPayee details will bimplementation pro(and address, if preusing fixed pitch (wwidth). During imbe tested to see if following font typeSerifs and DecoratVariations to this sbased on font typeHelvetica and AriaNO HANDWRITTEN PNA PROCESSING. Citi recommends 1

Print with default fa clear separation bbetween lines of teCheck Printing: Dwhen printing chec

The payee name mfrom the bottom of which the payee naextending at least .white (clear band), print contrast signainformation, lines, region. This will pinterfering with the The location of the payee font type maimmediately of any 
SAMPLE CHECK AND GRID NOT TO SCALE

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©2009 Citibank, N.A. All rights reserved. Citi and Arc Design is a service mark of Citigroup Inc., used and registered throughout the world. 

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Company Name 62-20

311

1/4"

Payee Name 1

Pay to the order of: Payee Name 2 (Typically A ddress line 1 )

1/4" Address Line 2 1/4"

Address Line 3

1/4"

 Citibank, N.A. One Penn's Way New Castle, DE 19720

3/16"

1 2 3 4 5 6 7 8 9 0 0 3 1 1 0 0 2 0 9 

3/16"

65 60 55 50 45 40 35 30 25 20 15 10 

ALIGNING 

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A

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L

I

N

G

ED

G

E

OUTBOARD EDGE

Auxiliary On-Us Field Transit Field On-Us Field Am