Program No 0490‐S Term DATE OF AWARD To 12/31/2017

TITLE: DIRECT MAIL SCANNABLE FORMS

Basis of

Item No. Description Award

I. COMPOSITION:(a) Scannable Forms, Notices w/Micro‐Perforated Payment Stub, Instruction

Sheets & Flyer...........................................per 8‐1/2 x 11" page.......................... 26 NC ‐ $ 200.00 5,2

(b) Instruction Sheets....................................per 17 x 11" page................................ 4 NC ‐ $ 200.00 8

© Envelopes...................................................per envelope...................................... 16 NC ‐ NC 

II. PRINTING, IMAGING AND CONTRUCTION/BINDING:(a) *Make‐ready/setup charge.........................................................per order 88 200.00 $ 17,600.00 NC 

(b) Scannable Forms, Notices w/Micro‐Perforated Payment Stub (8‐1/2 X 11").....per 1,000 pages 18769 5.03 $ 94,408.07 $ 6.00 112,6

© Flyer (8‐1/2 x 11").............................................................................................................per 1,000 pages 8943 5.03 $ 44,983.29 $ 14.00 125,2

(d) Instruction Seets (8‐1/2 x 11")......................................................................................per 1,000 pages 231 5.03 $ 1,161.93 NC 

€ Instruction Seets (17 x 11")......................................................................................per 1,000 pages 36634 1.35 $ 49,455.90 NC 

(f) BRM/CRM Return Envelopes (4 x 8‐7/8")...............................................................per 1,000 envelopes 9300 4.83 $ 44,919.00 NB 

(g) Mail‐Out Envelope w/Window (4‐1/4 x 9‐1/2")...................................................per 1,000 envelopes 9274 4.00 $ 37,096.00 NB 

III. PAPER: ................................................................................................................Per 1,000 Leaves

(a) Scannable Forms, White OCR Bond (20 lb.)......................................................................................... 9269 4.64 $ 43,008.16 $ 6.00 55,6

(b) Notices w/Micro‐Perforated Payment Stub, White Offset Book (50 lb.)...................................... 14 4.64 $ 64.96 $ 9.00 1

© Single Page Flyer, White Writing (20 lb.)............................................................................................. 8943 4.64 $ 41,495.52 $ 6.00 53,6

(d) Instruction Sheets ‐ 17 x 11", White Offset Book (50 lb.)................................................................. 9159 7.97 $ 72,997.23 $ 14.00 128,2

€ Instruction Sheets ‐ 8‐1/2 x 11", White Offset Book (50 lb.)........................................................... 115 6.76 $ 777.40 $ 6.00 6

(f) BRM/CRM Return Envelope, Colored Writing (20 lb.)......................................................................... 566 10.64 $ 6,022.24 $ 13.00 7,3(g) BRM Return Envelope, Colored Writing (20 lb.)......................................................................... 212 12.32 $ 2,611.84 $ 18.00 3,8(h) Mail‐Out Envelope w/Window, White Wove (24 lb.) or White Offset Book, (50 lb.).................. 9269 10.32 $ 95,656.08 $ 14.50 134,4

IV. INSERTING AND MAILING:

(a) Inserting all required materials into mail‐out envelope (Mailers 1‐28).............per 1,000 mailers 9269 23.15 $ 214,577.35 $ 12.00 111,2

V. TRANSMISSION TEST:(a) Transmission Test......................................................................................................................................... 1 NC 0 NC 

CONTRACTOR TOTALS $766,834.97 ‐ DISCOUNT 0.25% $1,917.09 1.00% ‐ DISCOUNTED TOTALS $764,917.88 ‐ 

NPC, Inc.

Claysburg, PA

PINNACLE DATA SYSTEMS 

ATLANTA, GA
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

January 4, 2016 

This is Amendment No. 3. The specifications in our invitation for bids on Program 490-S, scheduled 

for opening at 11 am January 6, 2017, are amended as follows: 

DELETE ON PAGE 53 

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 the first 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 under this contract for a like period of time. 

The following item designations correspond to those listed in the “SCHEDULE OF PRICES”.

I. (a) 26 

(b) 4 

(c) 16 

II. (a) 88 

 (b) 36,770 

(c) 36,634 

(d) 9,300 

(e) 9,274 

III. (a) 9,269 

(b) 14 

(c) 8,943 

(d) 9,159 

(e) 115 

(f) 566 

(g) 212 

(h) 9,269 

IV. (a) 9,269 

V. (a) 1 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

REPLACE WITH: 

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 the first 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 under this contract for a like period of time. 

The following item designations correspond to those listed in the “SCHEDULE OF PRICES”.

I. (a) 26 

(b) 4 

(c) 16 

II. (a) 88 

 (b) 18,769 

(c) 8,943 

(d) 231 

(e) 36,634 

(f) 9,300 

(g) 9,274 

III. (a) 9,269 

(b) 14 

(c) 8,943 

(d) 9,159 

(e) 115 

(f) 566 

(g) 212 

(h) 9,269 

IV. (a) 9,269 

V. (a) 1 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

DELETE ON PAGE 55-56 

II. PRINTING, IMAGING AND CONSTRUCTION/BINDING: Prices offered must be all-inclusive for 

printing, imaging, and construction/binding as required, and must include the cost of all required materials 

(except paper) and operations necessary for the complete production of the product listed in accordance with 

these specifications. Cost of all required paper must be charged under Item III. “PAPER”. 

(a) *Make-ready/setup charge ............................................................................................. $_____________ 

*Contractor will be allowed only one (1) make-ready/setup charge per order. This combined charge shall 

include all materials and operations necessary to make-ready and/or setup the contractor’s equipment for that 

run. Invoices submitted with more than one make-ready/setup charge per order will be disallowed. 

(b) Scannable Forms, Notices w/Micro-Perforated Payment Stub 

Instruction Sheets & Flyer (8-1/2 x 11”) ................................. per 1,000 pages ............. $_____________ 

 _____________ 

 (Initials) 

(c) Instruction Sheets (17 x 11”) ................................................... per 1,000 pages ............. $_____________ 

(d) BRM/CRM Return Envelopes (4 x 8-7/8”) ............................. per 1,000 envelopes ...... $_____________ 

(e) Mail-Out Envelope w/Window (4-1/4 x 9-1/2”) ..................... per 1,000 envelopes ...... $_____________ 

REPLACE WITH: 

II. PRINTING, IMAGING AND CONSTRUCTION/BINDING: Prices offered must be all-inclusive for 

printing, imaging, and construction/binding as required, and must include the cost of all required materials 

(except paper) and operations necessary for the complete production of the product listed in accordance with 

these specifications. Cost of all required paper must be charged under Item III. “PAPER”. 

(a) *Make-ready/setup charge ............................................................................................. $_____________ 

*Contractor will be allowed only one (1) make-ready/setup charge per order. This combined charge shall 

include all materials and operations necessary to make-ready and/or setup the contractor’s equipment for that 

run. Invoices submitted with more than one make-ready/setup charge per order will be disallowed. 

(b) Scannable Forms, Notices w/Micro-Perforated 

Payment Stub (8-1/2 x 11”) ..................................................... per 1,000 pages ............. $_____________ 

(c) Flyer (8-1/2 x 11”) .................................................................. per 1,000 pages ............. $_____________ 

(d) Instruction Sheets (8-1/2 x 11”) .............................................. per 1,000 pages ............. $_____________ 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

(e) Instruction Sheets (17 x 11”) ................................................... per 1,000 pages ............. $_____________ 

(f) BRM/CRM Return Envelopes (4 x 8-7/8”) ............................. per 1,000 envelopes ...... $_____________ 

(g) Mail-Out Envelope w/Window (4-1/4 x 9-1/2”) ..................... per 1,000 envelopes ...... $_____________ 

 _____________ 

 (Initials) 

All other specifications remain the same. 

If amendment is not acknowledged on bid, direct acknowledgement to: 

U.S. Government Publishing Office 

Bid Section, Room C848, Stop CSPS 

732 North Capitol Street NW 

Washington, DC 20401-0001 

Amended bid or acknowledgement must be submitted using the method(s) specified in the solicitation 

for bid submission. Telephone or e-mail submission is not acceptable. 

BIDDER MUST ACKNOWLEDGE RECEIPT OF THIS AMENDMENT PRIOR TO BID OPENING. 

Failure to acknowledge receipt of amendment, by amendment number, prior to bid-opening time, may 

be reason for bid being declared nonresponsive. 

Sincerely, 

BRIAN T. COLEMAN 

Contracting Officer 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

December 29, 2016 

This is Amendment No. 2. The specifications in our invitation for bids on Program 490-S, scheduled 

for opening at 11 am December 30, 2016, are amended as follows: 

1. Change the bid opening date to 11 am January 6, 2017. 

All other specifications remain the same. 

If amendment is not acknowledged on bid, direct acknowledgement to: 

U.S. Government Publishing Office 

Bid Section, Room C848, Stop CSPS 

732 North Capitol Street NW 

Washington, DC 20401-0001 

Amended bid or acknowledgement must be submitted using the method(s) specified in the solicitation 

for bid submission. Telephone or e-mail submission is not acceptable. 

BIDDER MUST ACKNOWLEDGE RECEIPT OF THIS AMENDMENT PRIOR TO BID OPENING. 

Failure to acknowledge receipt of amendment, by amendment number, prior to bid-opening time, may 

be reason for bid being declared nonresponsive. 

Sincerely, 

BRIAN T. COLEMAN 

Contracting Officer 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

732 North Capitol Street NW, Washington, DC 20401-0001 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

December 21, 2016 

This is Amendment No. 1. The specifications in our invitation for bids on Program 490-S, scheduled 

for opening at 11 am December 22, 2016, are amended as follows: 

1. Change the bid opening date to 11 am December 30, 2016. 

2. On page 44 of 57, delete Beneficiary Recontact – Mailers 25 through 28: Each constructed 

mailer consists of four components: (1) a personalized scannable form, (2) BRM envelope, (3) an 

instruction sheet, and (4) a mail-out envelope in which components 1 through 3 are inserted into for 

mailing. Contractor to follow construction sample for proper insertion of components 1 through 3 

into component 4. 

And replace with Beneficiary Recontact – Mailers 25 through 28: Each constructed mailer 

consists of four components: (1) a personalized scannable form, (2) CRM envelope, (3) an 

instruction sheet, and (4) a mail-out envelope in which components 1 through 3 are inserted into for 

mailing. Contractor to follow construction sample for proper insertion of components 1 through 3 

into component 4.

All other specifications remain the same. 

If amendment is not acknowledged on bid, direct acknowledgement to: 

U.S. Government Publishing Office 

Bid Section, Room C848, Stop CSPS 

732 North Capitol Street NW 

Washington, DC 20401-0001 

Amended bid or acknowledgement must be submitted using the method(s) specified in the solicitation 

for bid submission. Telephone or e-mail submission is not acceptable. 

BIDDER MUST ACKNOWLEDGE RECEIPT OF THIS AMENDMENT PRIOR TO BID OPENING. 

Failure to acknowledge receipt of amendment, by amendment number, prior to bid-opening time, may 

be reason for bid being declared nonresponsive. 

Sincerely, 

BRIAN T. COLEMAN 

Contracting Officer 
Program 490-S (Formerly Program 494-S) Page 1 of 57 

Specifications by KH 

Reviewed by 

U.S. GOVERNMENT PUBLISHING OFFICE 

Washington, DC 

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

For the Procurement of 

Representative Payee and Beneficiary Recontact Reports 

(Direct Mail Scannable Forms) 

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 

December 31, 2017, plus up to four (4) optional 12-month extension period(s) that may be added in accordance with 

the “OPTION TO EXTEND THE TERM OF THE CONTRACT” clause in SECTION 1 of this contract. 

NOTE: Contractor interfacing with SSA’s National File Transfer Management System (FTMS) for electronic 

transmission of files from SSA to the production facility will take place from Date of Award through December 31, 

2017. Actual production begins May 1, 2017. 

NOTE TO BIDDERS: Due to time constraints, Qualified Bidders must possess an SSA installed/active data 

connection between the exact location specified by the bidder and SSA’s National Computer Center (NCC). 

SSA also must have security cleared the bidders physical location(s) used for production of materials for this 

contract and all employees passed Final Suitability (for same locations) completed prior to the solicitation of 

this bid to be eligible for award of this contract. If bidder does not have these completed prior to solicitation, 

that contractor will be declared non-responsible.

BID OPENING: Bids shall be publicly opened at 11:00 a.m., prevailing Washington, DC time, on December 22, 

2016.

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., prevailing Washington, DC, 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. 

BIDDERS, PLEASE NOTE: The products produced in this contract were formerly procured under Program 494-S. 

The specifications have been extensively revised; therefore, all bidders are cautioned to familiarize themselves with all 

provisions of these specifications and are strongly encouraged to ask questions regarding the program requirements 

prior to bidding.

NOTE: Due to the number of exhibit pages in these specifications, the exhibits will not be put on the Internet. A 

complete copy of these specifications, including the exhibit pages (A through J), which each bidder is cautioned to 

inspect prior to bidding, can be obtained from the GPO Bid Room, by request, on (800) 368-5762 or (202) 512-0526. 

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

For information of a technical nature, call Kevin Hodges at (202) 512-0310. (No collect calls) 
Representative Payee and Beneficiary Recontact Reports Page 2 of 57 

490-S (12/17) 

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 Pub. 310.2, effective December 1, 

1987, Rev. 6-01) and GPO Contract Terms, Quality Assurance Through Attributes Program (GPO Pub. 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 functions are the laser/ion deposition imaging of variable data 

at a minimum of 600 x 600 dpi for the notices from electronically transmitted files, folding, inserting, presorting, 

mailing, and CASS and NCOA certification. Any bidder who cannot perform the predominant production functions 

will be declared non-responsible. The contractor may subcontract the printing of the instruction sheets, single page 

flyer, and envelopes.

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

If the contractor needs to add a subcontractor at any time after award, the subcontractor must be approved by the 

Government prior to production starting in that facility. If the subcontractor is not approved by the Government, then 

the contractor must submit new subcontractor’s information to the Government for approval 60 calendar days prior to 

the start of production at that facility. 

If the contractor plans to enter into a “Contractor Team Arrangement”, or Joint Venture, to fulfill any requirements of 

this contract, all parties must comply with the terms and regulations as detailed in the Printing Procurement Regulation 

(GPO Publication 305.3; Rev. 2-11). 

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

specifications: 

Product Quality Levels: 

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

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

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

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

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

(c) Transparent, low gloss poly-type window material, covering the envelope window, must pass a readability 

test with a rejection rate of less than 1/4% when run through a USPS OCR scanner. 

(d) Exception: ANSI X3.17 “Character Set for Optical Character Recognition (OCR A)” shall apply to these 

specifications. The revisions of this standard which are effective as of the date of this contract are those which 

shall apply. 

(e) Exception: The Data Matrix 2D Barcodes must be in accordance with the requirements of ANSI MH 

10.8.3M unless otherwise specified. 

(f) The payment portion below the micro-perforation on the “payment stub” (Title II – Final Accounting 

Notices), once detached, will be scanned and must function properly when processed through the current 

high-speed scanning equipment at SSA. A form is a reject and will be considered a major defect when its 
Representative Payee and Beneficiary Recontact Reports Page 3 of 57 

490-S (12/17) 

OCR 

print cannot be correctly deciphered on the first pass through the scanning equipment (See “PRINTING”, 

“IMAGING”, and “MICRO-PERFORATED PAYMENT STUB” paragraphs specified herein for additional 

information regarding the perforated payment stub.) 

NOTE: Use of equipment or ink, which in any way adversely affects the scannability of the payment stub, will not be 

allowed. 

ANSI Standards may be obtained from the American National Standards Institute, 25 West 43rd Street, 

4th Floor, New York, NY 10036 

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

 Attribute Specified Standard

 P-7. Type Quality and Uniformity Average Type Dimensions in Publication 

 Camera Copy / Electronic Media 

PLEASE NOTE: The forms produced under these specifications require precision spacing, printing, trimming and 

folding and must be guaranteed to function properly when processed through an Integrated Image Based Data Capture 

System (IIBDCS). The barcoding must be easily readable by all standard barcode scanning devices regardless of the 

contractor’s method of reproducing the codes. (SSA equipment: hand held barcode reader and high-speed scanners for 

Mailers 1-28 and the OPEX AS 3690 Scanner for micro-perforated payment stub for Mailers 19-24.). 

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 this contract may not exceed five (5) years as a result of, and including, any extension(s) 

added under this clause. Further extensions may be negotiated under the “EXTENSION OF CONTRACT TERM” 

clause. See also “ECONOMIC PRICE ADJUSTMENT” for authorized pricing adjustment(s). 

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 Date of Award to December 31, 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. 
Representative Payee and Beneficiary Recontact Reports Page 4 of 57 

490-S (12/17) 

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 three (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 September 30, 2016 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. 

PAPER PRICE ADJUSTMENT: Paper prices charged under this contract will be adjusted in accordance with 

“Table 6 - Producer Price Indexes and Percent Changes for Commodity Groupings and Individual Items” in Producer 

Price Indexes report, published by the Bureau of Labor Statistics (BLS), as follows: 

1. BLS code 0913 for All Paper will apply to all paper required under this contract. 

2. The applicable index figures for the month of December 2016 will establish the base index. 

3. There shall be no price adjustment for the first three months of the contract. 

4. Price adjustments may be monthly thereafter, but only if the index varies by an amount (plus or minus) 

exceeding 5% by comparing the base index to the index for that month, which is two months prior to the 

month being considered for adjustment. 

5. Beginning with order placement in the fourth month, index variances will be calculated in accordance with 

the following formula: 

 X – base index __________________________ x 100 = ____________ % 

 base index 

where X = the index for that month which is two months prior to the month being considered for 

adjustment. 

6. The contract adjustment amount, if any, will be the percentage calculated in 5 above less 5%. 

7. Adjustments under this clause will be applied to the contractor's bid price(s) for line items “III. PAPER: A 

through H” in the “SCHEDULE OF PRICES” and will be effective on the first day of any month for which 

prices are to be adjusted. 

The Contracting Officer will give written notice to the contractor of any adjustments to be applied to invoices for 

orders placed during months affected by this clause. 

In no event, however, will any price adjustment be made which would exceed the maximum permissible under any 

law in effect at the time of the adjustment. The adjustment, if any, shall not be based upon the actual change in cost to 

the contractor, but shall be computed as provided above. 

The contractor warrants that the paper prices set forth in this contract do not include any allowance for any 

contingency to cover anticipated increased costs of paper to the extent such increases are covered by this price 

adjustment clause. 

SECURITY REQUIREMENTS: Protection of Confidential Information: 
Representative Payee and Beneficiary Recontact Reports Page 5 of 57 

490-S (12/17) 

(a) The contractor shall restrict access to all confidential information obtained from the Social Security 

Administration 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 postaward conference between the Contracting Officer and the responsible contractor 

representative. 

(b) The contractor shall 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 shall 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. 

(e) The contractor shall ensure 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 SSA301, “Contractor Personnel Security Certification.” (See Exhibit A) 

A copy of this signed certification must be forwarded to: SSA, Melissa Picone, OPAMS, 1354 Annex 

Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 

A copy must also be forwarded to: U.S. Government Publishing Office, 732 North Capitol Street, NW, 

CSAPS, DCT 1, Room C-838, Washington, DC 20401. Attn: Kevin Hodges 

(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 must 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. 

SSA EXTERNAL SERVICE PROVIDER SECURITY REQUIREMENTS: This resource identifies the basic 

information security requirements related to the procurement of Information Technology (IT) services hosted 

externally to SSA’s Network. See Exhibit B for References for External Service Providers (ESP).

The following general security requirements apply to all External Service Providers (ESP): 

a. The solution must be located in the United States1

, its territories or possessions. 

 

1 ”United States” means the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana Islands, American Samoa, Guam, the U.S. 

Virgin Islands, Johnston Island, Wake Island, and Outer Continental Shelf Lands as defined in the Outer Continental Shelf Lands Act (43 U.S.C. 
Representative Payee and Beneficiary Recontact Reports Page 6 of 57 

490-S (12/17) 

b. Upon request from the SSA Contracting Officer Technical Representative (COTR) the vendor shall provide 

access to the hosting facility to the U.S. Government or authorized agents for inspection and facilitate an 

on-site security risk and vulnerability assessment. 

c. The solution must meet Federal Information Processing Standards (FIPS) and guidance developed by the 

National Institute of Science and Technology (NIST) under its authority provided by the Federal Information 

Security Management Act (FISMA) to develop security standards for federal information processing systems, 

and Office of Management and Budget’s (OMB) Circular A-130 Appendix III. 

d. Solutions classified as Cloud Service Providers (CSP) must adhere to additional FedRAMP security control 

requirements. Further information may be found at: http://www.gsa.gov/portal/category/102371. As part of 

these requirements, CSPs must have a security control assessment performed by a Third Party Assessment 

Organization2

. 

e. Before SSA provides data to the vendor, the vendor shall submit a System Security Plan (SSP) which 

documents how the solution implements security controls in accordance with the designated FIPS 199 

security categorization and the Minimum Security Requirements for Federal Information and Information 

Systems which requires the use of NIST SP 800-53 or the vendor shall provide a Security Assessment 

Package (SAP) completed by either an independent assessor3 or another federal agency. 

f. SSA will consider a self-assessment of security controls for solutions that do not involve sensitive information 

or PII4

. 

References – Refer to most up to date revision 

 Federal Information Security Management Act (FISMA) of 2002. 

 Clinger‐Cohen Act of 1996 also known as the “Information Technology Management Reform Act of 1996.” 

 Privacy Act of 1974 (5 U.S.C. § 552a). 

 Homeland Security Presidential Directive (HSPD‐12), “Policy for a Common Identification Standard for 

Federal Employees and Contractors”, August 27, 2004. 

 Office of Management and Budget (OMB) Circular A‐130, “Management of Federal Information Resources”, 

and Appendix III, “Security of Federal Automated Information Systems”, as amended. 

 OMB Memorandum M‐04‐04, “E‐Authentication Guidance for Federal Agencies.” 

 FIPS PUB 199, “Standards for Security Categorization of Federal Information and Information Systems.” 

 FIPS PUB 200, “Minimum Security Requirements for Federal Information and Information Systems.” 

 FIPS PUB 140‐2, “Security Requirements for Cryptographic Modules.” 

 NIST Special Publication 800-18, “Guide for Developing Security Plans for Federal Information Systems.” 

 NIST Special Publication 800-30, “Risk Management Guide for Information Technology Security Risk 

Assessment Procedures for Information Technology Systems.” 

 NIST Special Publication 800-34, “Contingency Planning Guide for Information Technology Systems.” 

 NIST SP 800‐37 “Guide for the Security Certification and Accreditation of Federal Information Systems.” 

 NIST Special Publication 800-47, “Security Guide for Interconnecting Information Technology Systems.” 

 NIST Special Publication 800-53, “Recommended Security Controls for Federal Information Systems.” 

 NIST Special Publication 800-53A, “Guide for Assessing the Security Controls in 

 1331, et seq.), but does not include any other place subject to U.S. jurisdiction or any U.S. base or possession within a foreign country (29 CFR 

4.112). 

2 A Third Party Assessment organization is an organization that has been certified to help cloud service providers and government agencies 

meet FedRAMP compliance regulations. 

3 Independent assessor is any individual or group capable of conducting an impartial assessment of security controls employed within or 

inherited by an information system. 

4 PII is any information about an individual maintained by an agency, including (1) any information that can be used to distinguish or trace an 

individual‘s identity, such as name, social security number, date and place of birth, mother‘s maiden name, or biometric records; and (2) any 

other information that is linked or linkable to an individual, such as medical, educational, financial, and employment information.
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 Federal Information Systems, “CIO Council’s Federal Identity, Credential, and Access Management 

(FICAM) Roadmap and Implementation Guidance” 

 NIST Special Publication 800-60 

 OMB M-07-16, AIMS Chapter 15: Personally Identifiable Information Loss and Remediation 

PHYSICAL SECURITY: Contractor’s facilities storing SSA assets and information are required to meet the 

Interagency Security Committee’s standard for Federal facilities. This information can be found in the “Facility 

Security Plan: An Interagency Security Committee Guide,” dated February 2015, 1st Edition. SSA reserves the right 

to inspect contractor facilities to ensure compliance with the ISC guidelines. If facilities are found deficient, the 

contractor must implement corrective actions within 60 calendar days of notification. Requirements can include, but 

not be limited to, the physical security countermeasures, such as access control systems, closed circuit television 

systems, intrusion detection systems, and barriers. 

SECURITY WARNING: It is the contractor’s responsibility to properly safeguard Personally Identifiable 

Information (PII) from loss, theft or inadvertent disclosure and to immediately notify the Government of any loss 

of PII. PII is “any information which can be used to distinguish or trace an individual’s identity, such as their name, 

social security number, biometric records, etc., alone or when combined with other personal or other identifying 

information which is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, 

etc.” 

All employees working on this contract must: 

 Be familiar with current information on security, privacy and confidentiality as they relate to the 

requirements of this contract. 

 Obtain pre-screening authorization before using sensitive or critical applications pending a final 

suitability determination as applicable to the specifications. 

 Lock or logoff their workstation/terminal prior to leaving it unattended 

 Act in an ethical, informed and trustworthy manner. 

 Protect sensitive electronic records. 

 Be alert to threats and vulnerabilities to their systems. 

 Be prohibited from having any mobile devices or cameras in sensitive areas that contain any confidential 

materials, including areas where shredding and waste management occurs. 

Contractor’s managers working on this contract must: 

 Monitor use of mainframes, PCs, LANs, and networked facilities to ensure compliance with national and 

local policies, as well as the Privacy Act statement. 

 Ensure that employee screening for sensitive positions has occurred prior to any individual being 

authorized access to sensitive or critical data. 

 Implement, maintain, and enforce the security standards and procedures as they appear in this contract 

and 

as outlined by the contractor in their approved Security Plan. 

 Contact the Contracting Officer immediately whenever a systems security violation is discovered or 

suspected. 

Applicability: The responsibility to protect PII applies during the entire term of this contract and all option year 

terms if exercised. All contractors must secure and retain written acknowledgement from their employees stating they 

understand these policy provisions and their duty to safeguard PII. These policy provisions include, but are not limited 

to, the following:

 Employees are required to have locking file cabinets or desk drawers for storage of confidential material, 

if applicable. 
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 Material is not to be taken from the contractor’s facility without express permission from the 

Government. 

 Employees must safeguard and protect all Government records from theft and damage while being 

transported to and from contractor’s facility. 

The following list provides examples of situations where PII is not properly safeguarded: 

 Leaving an unprotected computer containing Government information in a non-secure space (e.g., leaving 

the computer unattended in a public place, in an unlocked room, or in an unlocked vehicle). 

 Leaving an unattended file containing Government information in a non-secure area (e.g., leaving the file 

in a break-room or on an employee’s desk). 

 Storing electronic files containing Government information on a computer or access device (flash drive, 

CD, etc.) that other people have access to (not password-protected). 

This list does not encompass all failures to safeguard PII but is intended to act as an alert to the contractor’s employees 

to situations that must be avoided. Misfeasance occurs when an employee is authorized to access Government 

information that contains sensitive or personally identifiable information and, due to the employee’s failure to exercise 

due care, the information is lost, stolen or inadvertently released. 

Whenever the Contractor has doubts about a specific situation involving their responsibilities for safeguarding PII, 

they should consult GPO and/or SSA. 

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 (e-QIP) 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 e-mail 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 e-QIP. SSA will e-mail notification to the 

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

CPOC will provide the website to the applicants to complete their e-QIP form electronically. The applicant will have 

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

signature pages and provide the signed originals to the CPOC. See Exhibit C: 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 e-QIP signature pages as specified in the above paragraph. 

 Two (2) “Fingerprint Cards” (FD-258). See Exhibit D. NOTE: The contractor will absorb the costs for 

obtaining fingerprints. 

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

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

 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 e-QIP 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 e-mail a copy of the cover sheet to the Contracting Officer Technical Representative (COTR) to 

the e-mail 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. 

Contractors may call the e-QIP Help Line at 1-844-874-9940 for any e-QIP related issues. 

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.

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 of all of the contractor’s computer, printing, 

and inserting/mailing equipment which will be used on this contract or to require other evidence of technical, 

production, managerial, financial, and similar abilities to perform, prior to the award of a contract. 
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The preaward survey will include a review of: all subcontractors involved, along with their specific functions; and the 

contractor’s/subcontractor’s mail, material, personnel, production, quality control/recovery program, security and 

backup facility 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, be installed and fully functional at least 120 calendar days prior 

to the start of live production. 

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 below. Five (5) additional workdays will be permitted to provide a Security Assessment Package 

as required. The contractor, at SSA discretion, may be granted five (5) additional workdays if additional information 

is required for the Security Assessment Package. The workday after notification to submit will be the first day of the 

schedule. If the government request additional information after review of plans, the contractor must submit updated 

plans within two (2) workdays of request. 

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

Backup Facility ─ The failure to deliver these notices/forms/publications in a timely manner would have an 

impact on the daily operations of SSA. Therefore, if for any reason(s) (act of God, labor disagreements, etc.) the 

contractor is unable to perform at said location for a period longer than twenty-four (24) hours, the contractor 

must have a backup facility with the capability of producing the notices/forms/publications. The contractor must 

operate the backup facility. 

Plans for their 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 the facility, and a timetable for the start of production at that facility. 

Part of the plans must also include the transportation of Government materials from one facility to another. The 

contractor must produce items from a test file at the new facility for verification of software prior to producing 

notices at this facility. SSA has the option to install a data connection into the contractor’s backup facility. 

NOTE: All terms and conditions of this contract will apply to the backup facility. 

Quality Control Plan ─ The contractor must provide and maintain, within their organization, an independent 

quality assurance team of sufficient size and expertise. The team must monitor the operations performed and 

inspect the products of each operation to a degree and extent that will ensure the Government’s quality assurance, 

inspection, and acceptance provisions specified herein are met. The contractor must perform, or have performed, 

the process controls, inspections, and tests required to substantiate that the products provided under this contract 

conform to the specifications and contract requirements. The contractor must describe in detail their quality 

control/quality assurance and recovery plans describing how, when and by whom the plans will be performed. 

The quality control plan must also include examples and a detailed description of all quality control samples and 

their corresponding inspection reports or logs the contractor will keep to document the quality control inspections 

performed on each run. Furthermore, the plan must include the names of all quality assurance officials and 

describe their duties in relationship to the quality control plan. 

The quality control system must include all aspects of the job including mail flow and materials handling. The 

plan must also allow for a complete audit trail (e.g., it must be possible to locate any piece of mail at any time 

from the point it leaves the press up to and including the point at which the mail is off-loaded at the USPS 

facility). SSA will not, as a routine matter, request the contractor to produce pieces in transit within the 

contractor’s plant. 
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The quality control plan must account for the number of pieces mailed daily, and must also cover the security over 

the postage meters as well as the controls for the setting of the meters (if meters will be used). 

Quality Control Sample Plan ─ The plan must provide a description of how the contractor will create quality 

control samples for periodic samplings to be taken during the production run and provide for back-up and 

re-running in the event of an unsatisfactory sample. The plan must contain control systems that will detect 

defective, missing, or mutilated pieces. 

The plan should include the sampling interval (minimum pull- first from each file and then one every 4,000 

notices) the contractor intends to utilize. The contractor will perform programming to create two (2) duplicate 

notices (Q.C. Documents) at set intervals throughout production and diverted samples at the insertion stage to 

complete the following: 

 One (1) sample will be drawn, inspected, and retained as part of the contractor’s quality assurance 

records. 

 One (1) sample will be drawn for the SSA, packed with the remaining samples associated with each print 

order, and shipped to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, 

Baltimore, MD 21235-6401. 

NOTE: For smaller quantities, the contractor/sampling rate must be adjusted as necessary to generate at 

least one (1) sample per file. Samples must be bulk shipped back to SSA weekly/monthly for each print 

order. 

The plans must detail the actions to be taken by the contractor when defects, missing, or mutilated items are 

discovered. These actions must be consistent with the requirements found in GPO Contract Terms (GPO 

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

The plan must monitor all aspects of the job including material handling and mail flow, to assure the production 

and delivery of these notices meet specifications and Government requirements. This includes maintaining 

100% accountability in the accuracy of imaging and mailing of all pieces throughout each run. The contractor 

must ensure that there are no missing or duplicate pieces. 

NOTE: Contractor must submit samples of the Automated Audit Report and 100% Accountability Summary 

Report. (See “100% ACCOUNTABILITY OF PRODUCTION AND MAILING”). 

The contractor must maintain quality control samples, inspection reports and records for a period of no less than 

120 days subsequent to the date of the check tendered for final payment by the Government Publishing Office. 

The Government will periodically verify that the contractor is complying with the approved quality control plan 

through on-site examinations and/or requesting copies of the contractor’s quality assurance records and quality 

assurance random copies. 

Computer System Plan ─ This plan must include a detailed listing of the contractor’s operating software 

platform and file transfer system necessary to interface with SSA’s National File Transfer Management System 

(FTMS) for electronic transmission of files from SSA. The plan must also include the media type on which files 

from SSA will be received to the extent that operator intervention (e.g., a tape mount) is not required at SSA or 

the contractor’s production facility. 

The system plan must demonstrate the contractor’s ability to provide complete hardware and software 

compatibility with SSA’s existing network. (See “FILE TRANSFER MANAGEMENT SYSTEM (FTMS) 

REQUIREMENTS”) The contractor must complete the System Plan, See Exhibit G. 
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Included with the Computer System Plan must be a resume for each employee responsible for the monitoring and 

the programming of the contractor’s computer system and file transmissions. If the contractor plans to use a 

consultant for either task, a resume must still be included. 

Mail Plan ─ This plan should include sufficient detail as to how the contractor will comply with all applicable 

USPS mailing requirements as listed in the USPS Domestic and International Mail Manuals in effect at the time 

of the mailing and other USPS instructional material such as the Postal Bulletin. The contractor must also disclose 

how they will achieve multi-level USPS automated presort postal discounts as outlined in the contract. 

Material Handling and Inventory Control Plan ─ This plan should explain in detail how the following 

materials will be handled: incoming raw materials; work-in-progress materials; quality control inspection 

materials; USPS inspection materials; and all outgoing materials cleared for USPS pick-up/delivery. 

Personnel Plan ─ In conjunction with the required applicant listing (See “PUBLIC TRUST SECURITY 

REQUIREMENTS”), this plan should include a listing of all personnel who will be involved with this contract. 

For any new employees, the plan should include the source of these employees and a description of the training 

programs the employees will receive to familiarize them with the requirements of this program. 

Production Plan ─ The contractor is to provide a detailed plan of the following: 

(a) List of all production equipment and equipment capacities to be utilized on this contract; 

(b) The production capacity currently being utilized on this equipment; 

(c) Capacity that is available for these workloads; and, 

(d) If new equipment is to be utilized, documentation of the purchase order, source, delivery schedule 

and installation dates are required. 

NOTE: The last leaf of the Title II - Final Accounting notices (Mailers 19-24) contain a micro-perforated 

payment stub. The contractor will be required to identify the payment stub page (English or Spanish) requiring 

perforation. Regarding the “select-a-perf” requirement, the contractor’s production plan must explain how they 

will handle imaging and collating the required micro-perforated sheet into the proper sequence of leaves. The plan 

shall also detail how the contractor intends to meet the critical margins associated with the scan line. (See 

“IMAGING” and “CONSTRUCTION/BINDING”). 

The contractor must disclose in their production plan their intentions for the use of any subcontractor(s). The plan 

must include the same information required from the contractor for all items contained under “SECURITY 

REQUIREMENTS” and “PREAWARD SURVEY”. If a 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. 

If the subcontractor is not approved by the Government, then the contractor has 60 calendar days prior to 

production to submit to the Government the new subcontractor’s information. 

Security Control Plan ─ The contractor shall maintain in operation, an effective security system where items by 

these specifications are manufactured and/or stored (awaiting distribution or disposal) to assure against theft 

and/or the product ordered falling into unauthorized hands. 

Contractor is cautioned that no Government provided information shall be used for non-Government business. 

Specifically, no Government information shall be used for the benefit of a third party. 

The Government retains the right to conduct on-site security reviews at any time during the term of the contract. 
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The plan shall contain at a minimum: 

(1) How Government files (data) will be secured to prevent disclosure to a third party; 

(2) How the disposal of waste materials will be handled; 

(3) How all applicable Government-mandated security/privacy/rules and regulations as cited in this contract 

shall be adhered to by the contractor and/or subcontractor(s). 

Materials: The contractor is required to explain 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. 

Disposal of Waste Materials: The contractor is required to demonstrate how all waste materials used in the 

production of sensitive SSA records (records containing PII information as identified in “SECURITY 

WARNING”) will be definitively destroyed (e.g., burning, pulping, shredding, macerating, or other suitable 

similar means). Electronic records must be definitively destroyed in a manner that prevents reconstruction. 

Sensitive records are records that are national security classified or exempted from disclosure by statute, including 

the Privacy Act or regulation. 

Definitively destroying the records means the material cannot be reassembled and used in an inappropriate 

manner in violation of law and regulations.

The contractor, at a minimum, must crosscut shred all documents into squares not to exceed one-quarter inch. All 

documents to be destroyed cannot leave the security of the building, must be destroyed at contractor’s printing 

site, and cannot be subcontracted. The contractor must specify the method planned to dispose of the material. 

Production Area: The contractor must provide a secure area(s) dedicated to the processing and storage of data 

for SSA notices, either a separate facility dedicated to this product, or a walled-in limited access area within the 

contractor’s existing facility. Access to the area(s) must be limited to security-trained employees involved in the 

production of notices. 

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. The plan must include a description of the physical 

security of the facility as well as the physical security of this notice contract as it progresses to completion. 

Contractor must have, in place, a building security system that is monitored 24 hours a day, seven (7) days a 

week, and a badging/keypunch system that limits access to Government materials (data processing 

center/production facility and other areas where Government materials with PII are stored or are accessible) that is 

only accessible by approved personnel. Contractor must present this information, in detail, in the production 

plans. 

Contractors using Cloud Service Providers (CSP) must adhere to additional FedRAMP security control 

requirements. CSPs must have a security control assessment performed by a Third Party Assessment 

Organization. Contractor may refer to “SSA EXTERNAL SERVICE PROVIDER SECURITY 

REQUIREMENTS” for additional information. 

The Contractor shall submit a System Security Plan which documents how they will implement security controls 

in accordance with the designated FIPS 199 security categorization and the Minimum Security Requirements for 

Federal Information and Information Systems which requires the use of NIST SP 800-53 and the vendor shall 

provide a Security Assessment Package completed by either an independent assessor or another federal agency. 

Contractor may refer to “SSA EXTERNAL SERVICE PROVIDER SECURITY REQUIREMENTS” for 

additional information. 
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THESE PROPOSED PLANS ARE SUBJECT TO REVIEW AND APPROVAL BY THE GOVERNMENT 

AND AWARD WILL NOT BE MADE PRIOR TO APPROVAL OF THE SAME. 

UNIQUE IDENTIFICATION NUMBER: Unique identifying numbers will be used to track each individual notice, 

thereby providing 100% accountability. This enables the contractor to track each notice through completion of the 

project. The contractor will be required to create a test sample every 4,000 notices. Each file must have a minimum of 

one (1) test sample. This sample must have a unique number and must be produced on each notice. The contractor will 

generate a list of the unique identifying numbers for each sample. As samples are pulled, the unique numbers will be 

marked off the list. This enables the contractor to track which samples have been produced and pulled and what 

records have been produced. 

The contractor may create their own sequence number and run date to facilitate their presorting and inserting process 

but must maintain the original SSA identification number. 

RECOVERY SYSTEM: A recovery system will be required to ensure that all defective, missing and/or mutilated 

pieces detected are identified, reprinted and replaced. The contractor’s recovery system must use the unique sequential 

alpha/numeric identifiers assigned to each piece (including quality control samples) to aid in the recovery and 

replacement of any defective, missing and/or mutilated pieces, and must be capable of tracking and/or locating 

any individual piece of mail from the time it leaves the press, up to and including when it is off-loaded at the USPS 

facility. An explanation of the contractor’s sequential numbering system is required to understand the audit trail 

required for every piece. 

100% ACCOUNTABILITY OF PRODUCTION AND MAILING: Contractor must have a closed loop process* 

to determine that the data from the original print file is in the correct envelope with the correct number of pages and 

inserts. Notices requiring print regeneration must be reprinted from their original print image with the original job ID 

and piece ID remaining unchanged as each mail piece continues through the inserting life cycle. This process will 

repeat itself (since subsequent reprint runs may yield damages) until all mail pieces from the original print run have 

been inserted and accounted for. 

*Closed Loop Processing - A method for generating a plurality of mail pieces including error detection and reprinting 

capabilities. The method provides a mail handling process, which tracks processing errors with the use of a first and 

second scan code, which obtain information regarding each mail piece, diverts mail pieces in response to error 

detection, transmits such errors to a processor, and automatically generates a reconfigured print file to initiate reprints 

for the diverted mail pieces. 

Contractor will be responsible for providing a unique identifying number that will be used to track each individual 

notice, thereby providing 100% accountability and validating the integrity of every notice produced in all phases 

of printing, inserting and mailing and to ensure all notices received from SSA were correctly entered into the USPS 

system. 

NOTE: Contractor must have all hardware, programming and finalized reports in place to meet this requirement. The 

equipment must arrive, be installed and fully functional at least 120 calendar days prior to the start of live production, 

on or about May 1, 2017. Contractor must submit a sample of their proposed Audit and Summary reports with the 

required Preaward production plans for approval. The government considers grounds for the immediate default of this 

contract if the contractor, at any time, is unable to perform or found not complying with any part of this requirement. 

Notice integrity must be defined as follows: 

 Each notice must include all pages (and only those pages) intended for the designated recipient as contained 

in the print files received from SSA. 

 The contractor’s printing process must have automated systems, which can detect all sync errors, stop printing 

when detected, and identify, remove and reprint all affected notices. 
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Mailing integrity must be defined as follows: 

 All notices received from SSA for each file date were printed, inserted and entered correctly into the USPS 

system. 

The contractor is responsible for providing the automated inserted notice tracking/reporting systems and processes 

required to validate that 100% of all notices received from SSA were printed, all pages for each notice with the correct 

inserts are accounted for, inserted and mailed correctly. 

The contractor’s inserting equipment must have automated systems that include notice coding and scanning 

technology capable of the following: 

(a) Uniquely identifying each notice and corresponding notice leaves within each individual file by mailer 

number and file date. 

(b) Unique identifier to be scanned during insertion to ensure all notices and corresponding notice leaves are 

present and accounted for. 

(c) Entrance Scanning: A camera system must electronically track and scan all leaves of each mail piece as the 

inserting equipment pulls them into the machine to ensure each mail piece was produced and inserted. If there 

is any variance on a mail piece or if a mail piece is not verified that all leaves are present, that piece and the 

piece prior to and immediately following must be diverted and sent back for reprint. All instances of variance 

must be logged. 

(d) Touch and Toss: All spoilage, diverted mutilated or mail piece that is acted upon directly by a human hand 

prior to sealing must be immediately recorded, discarded, properly destroyed, and automatically regenerated 

in a new print file for reprint. Exception – Intentionally diverted pieces due to a requirement for a product, 

which cannot be intelligently inserted and requires manual insertion such as a publication, can be sealed, rescanned and placed back into production. These must be programmed diverts and sent to a separate bin for 

processing to ensure they are not mixed with other problem diverts and logged into the Audit system as such. 

NOTE: Due to inserting equipment limitations, the contractor can divert and insert by hand notices over 50 

leaves. These notices, to ensure notice integrity, are to be scanned and collated by an automated process prior 

to manual handling for inserting. The completed mail package must then be processed through exit scanning. 

The event log report must show these as “50+ Manual”. 

(e) Exit Scanning: A camera system must be mounted just aft of the inserting equipment. This camera system 

must read a unique code through the window of each mail piece and capable of identifying and reporting all 

missing notices that were lost or spoiled during production for each individual file by mailer number and file 

date. This system ensures that no missing mail pieces have been inadvertently inserted into another mail 

piece. The equipment must check the mail pieces, after insertion and verification that all leaves are accounted 

for, and divert any suspect product. During exit scanning, if a sequence number is missing the notice prior to 

and immediately after must be diverted. The equipment must divert all products that exhibit missing or out of 

order sequence numbers and any other processing errors. All diverted pieces are to be automatically recorded 

and regenerated in a new print file for reprint. 

(f) Reconciliation: All notices and the amount of correct finished product must be electronically accounted for 

after insertion through the use of the audit system that is independent of the inserting equipment as well as 

independent of the operation. The sequence numbers, for each file, must be reconciled; taking into account 

any spoilage, duplicate and/or diverted product. If the reconciliation yields divergent results, corrective action 

must be taken to locate the mail pieces that are causing any difference between the input and outputs of the 

inserting process. Therefore, all finished mail for that sequence run must be held in an accessible area until 

this reconciliation is complete. 
Representative Payee and Beneficiary Recontact Reports Page 16 of 57 

490-S (12/17) 

(g) Generate a new production file for all missing, diverted or mutilated notices (reprint file). 

(h) Contractor must generate an Automated Audit Report from the information gathered from scanning for each 

mailer number, file date and for each notice (manual inputs are not allowed). This audit report will contain 

detailed information for each notice as outlined above for each individual file by mailer number and file date. 

Contractor must maintain this information for a 6-month period after mailing. 

(i) Audit report must contain the following information: 

1. Job name 

2. Mailer number, file date and mail date(s) 

3. Machine ID 

4. Date of production with start and end time for each phase of the run (i.e., machine ID). 

5. Start and end sequence numbers in each run 

6. Status of all sequence numbers in a run 

7. Total volume in run 

8. Status report for all incidents for each sequence number and cause (i.e., inserted, diverted and reason 

for divert such as missing sequence number, missing leave, mutilated, duplicate, pulled for inspection, 

etc.) 

9. Bottom of audit report must contain total number of records for that run, quantity sent to reprint, 

number of duplicates, duplicates verified and pulled, total completed. 

10. Audit report must contain the same information for all the reprints married with the report as listed 

above showing that all pieces for each mailer number and file date are accounted for. 

(j) Contractor must generate a final automated 100% Accountability Summary Report for each individual file 

by mailer number and file date. This information must be generated directly from the audit report. Manual 

inputs are not allowed. The 100% Accountability Summary Report must contain the following: 

1. Job name 

2. Each individual file by mailer number and file date (must show sequence numbers for each section, i.e. 

first pass and then reprints) 

3. Sequence number range for each individual file by mailer number and file date 

4. Volume of all sequence numbers associated with an individual file by mailer number and file date were 

inserted. 

5. Volume of reprints that were inserted for each file date. 

6. Volumes for each file date that each was completed. 

NOTE: A PDF copy of the summary report(s) and matching USPS 3607R and/or GPO 712 form(s) must be 

e-mailed to Melissa Picone at melissa.picone@ssa.gov for each file date within three (3) workdays of mailing. 

NOTE: Contractor must submit a sample of their Audit and Summary Reports (See Exhibit H) with the required 

Preaward production plans for approval. 

Contractor must generate an automated audit report when necessary showing the tracking of all notices through all 

phases of production for each mail piece. This audit report will contain all information as outlined in item (i) above. 

Contractor is required to provide any requested Summary and/or Audit reports within an hour of a request via e-mail 

in MS Word, MS Excel or PDF. 

All notice tracking/reporting data must be retained in electronic form for 210 days after mailing, and must be made 

available to SSA for auditing of contractor performance upon request. 
Representative Payee and Beneficiary Recontact Reports Page 17 of 57 

490-S (12/17) 

The contractor must maintain quality control samples, inspection reports and records for a period of no less than 180 

days subsequent to the date of the check tendered for final payment by the GPO. The Government will periodically 

verify that the contractor is complying with the approved quality control plan through on-site examinations and/or 

requesting copies of the contractor’s quality assurance records and quality assurance random copies. 

NOTE: The Government will not as a routine matter request the contractor produce individual pieces in transit within 

the plant, however, the contractor must demonstrate they will have an audit trail established that has the ability to 

comply with this type of request when and if the need arises. 

Pulling of Notices from Production: The Government may request that certain notices be removed from the 

production stream based on Social Security Number (SSN). When this occurs, the Government will supply the 

contractor with a list of Social Security Numbers (SSNs) that need to be pulled. 

The contractor must be able to run a sort to find and eliminate the notice from the production run. If the list is 

provided after the notice had been produced, the contractor must be capable of identifying the notice and pulling it 

from the production floor. It is anticipated that this will be an infrequent occurrence. 

Option Years: For each option year that may be exercised, the contractor will be required to review their plans and 

re-submit in writing the above plans detailing any changes and/or revisions that may have occurred. The revised plans 

are subject to Government approval and must be submitted to the Contracting Officer or his/her representative within 

five (5) workdays of notification of the option year being exercised. 

NOTE: If there are no changes/revisions, the contractor will be required to submit to the Contracting Officer or 

his/her representative a statement confirming that the current plans are still in effect. 

ON-SITE REPRESENTATIVES: One (1) or two (2) full-time Government representatives may be placed on the 

contractor's premises on a limited basis or throughout the term of the contract. 

The contractor will be required to provide a private workspace with a telephone line, internet access, and one facsimile 

machine. 

On-site representative(s) may be stationed at the contractor's facility to: provide project coordination in receipt of 

transmissions; verify addresses; monitor the printing, folding, inserting, mail processing, quality control, sample 

selections and inspections; and monitor the packing and staging of the mail. 

These coordinators will not have contractual authority, and cannot make changes in the specifications or in contract 

terms, but will bring defects detected, to the attention of the company Quality Control Officer. The coordinators must 

have full and unrestricted access to all production areas where work on this program is being performed. 

POSTAWARD CONFERENCE: In order to ensure that the contractor fully understands the total requirements of 

the job as indicated in these specifications, Government representatives will conduct a conference with the 

Contractor's representatives at the Social Security Administration (SSA), 6401 Security Boulevard, Baltimore, MD, 

21235 immediately after award. 

NOTE: Person(s) that the contractor deems necessary for the successful implementation of the contract must be in 

attendance. 

PRE-PRODUCTION MEETING: A pre-production meeting covering the printing, imaging, folding, inserting, and 

mailing must be held at the contractor's facility after award of the contract to review the contractor's production plan 

and to establish coordination of all operations. Attending this meeting will be representatives from the GPO, SSA, and 

USPS. 
Representative Payee and Beneficiary Recontact Reports Page 18 of 57 

490-S (12/17) 

The contractor must present and explain their final plan for the printing, imaging, folding, inserting, and mailing of all 

notices. In addition, the contractor must be prepared to present detailed production plans, including such items as 

quality assurance, projected commencement dates, equipment loading, pallet needs, etc. 

The contractor must meet with SSA and USPS representatives to present and discuss their plan for mailing. The preproduction meeting will include a visit to the contractor's mailing facility, where the contractor is to furnish specific 

mail flow information. The contractor must present documentation of the plant loading agreement and either a copy of 

the optional procedure, which has been negotiated with the USPS or a draft of the original procedure that the 

contractor intends to negotiate with the USPS for SSA approval. The contractor also needs to present SSA with a copy 

or a draft of the manifest (tracking system) to be used to accomplish the above. 

SSA may conduct unscheduled visits during the term of this contract at the contractor’s mailing facility. In addition, 

a mail plan detailing how the contractor will obtain maximum automation postage discounts will be e-mailed to: 

Francine.Moore@ssa.gov after the contract award. The contractor is to provide the name of the representative 

responsible for the mailing operation and that individual's backup. 

NOTE: THE GOVERNMENT RESERVES THE RIGHT TO WAIVE THE PRE-PRODUCTION MEETING. 

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

a purchase order issued to the contractor to cover the 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 order. 

ORDERING: Items to be furnished under the contract must be ordered by the issuance of weekly (Title II – Final 

Accounting) or monthly (Title II, Title XVI, Beneficiary Recontact) print orders. Orders may be issued under the 

contract from Date of Award through December 31, 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 must 

control in the event of conflict with any print order. A print order (GPO Form 2511) to be used for billing purposes 

will be issued weekly/monthly. 

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 shall order from the contractor all the items set forth 

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

The estimated quantities specified in the “Determination of Award” are not the total requirements of the Government 

but are the estimates of requirements. The Government shall 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 shall 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 must 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. 
Representative Payee and Beneficiary Recontact Reports Page 19 of 57 

490-S (12/17) 

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. 

PRIVACY ACT NOTIFICATION: This procurement action requires the contractor to do one or more of the 

following: design, develop, or operate a system of records on individuals to accomplish an agency function in 

accordance with the Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable 

agency regulations. Violation of the Act may involve the imposition of criminal penalties. 

PRIVACY ACT 

(a) The contractor agrees: 

(1) to comply with the Privacy Act of 1974 and the rules and regulations issued pursuant to the Act in the 

design, development, or operation of any system of records on individuals in order to accomplish an 

agency function when the contract specifically identifies (i) the system or systems of records and (ii) the 

work to be performed by the contractor in terms of any one or combination of the following: (A) design, 

(B) development, or (C) operation; 

(2) to include the solicitation notification contained in this contract in every solicitation and resulting 

subcontract and in every subcontract awarded without a solicitation when the statement of work in the 

proposed subcontract requires the design, development, or operation of a system of records on individuals 

to accomplish an agency function; and 

(3) to include this clause, including this paragraph (3), in all subcontracts awarded pursuant to this contract 

which require the design, development, or operation of such a system of records. 

(b) In the event of violations of the Act, a civil action may be brought against the agency involved where the 

violation concerns the design, development, or operation of a system of records on individuals to accomplish 

an agency function, and criminal penalties may be imposed upon the officers or employees of the agency 

where the violation concerns the operation of a system of records on individuals to accomplish an agency 

function. For purposes of the Act when the contract is for the operation of a system of records on individuals 

to accomplish an agency function, the Contractor and any employee of the Contractor is considered to be an 

employee of the agency. 

(c) The terms used in this clause have the following meanings: 

(1) “Operation of a system of records” means performance of any of the activities associated with 

maintaining the system of records including the collection, use, and dissemination of records. 

(2) “Record” means any item, collection or grouping of information about an individual that is maintained by 

an agency, including, but not limited to, his education, financial transactions, medical history, and 

criminal or employment history and that contains his name, or the identifying number, symbol, or other 

identifying particular assigned to the individual, such as a finger or voice print or a photograph. 

(3) “System of records” on individuals means a group of any records under the control of any agency from 

which information is retrieved by the name of the individual or by some identifying number, symbol, or 

other identifying particular assigned to the individual. 

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 
Representative Payee and Beneficiary Recontact Reports Page 20 of 57 

490-S (12/17) 

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. 
Representative Payee and Beneficiary Recontact Reports Page 21 of 57 

490-S (12/17) 

SECTION 2. – SPECIFICATIONS 

SCOPE: These specifications cover the production of mailing packages from four (4) identified workloads* (total of 

twenty-eight (28) mailers), consisting of English or Spanish Personalized Scannable Forms; an English or Spanish 

Personalized Notice w/Micro-Perforated Payment Stub (Title II – Final Accounting ONLY); English or Spanish 

Instruction Sheet; Single Page Flyer (English ONLY); Business Reply Mail (BRM) envelopes (English and Bilingual 

English/Spanish), Courtesy Reply Mail (CRM) envelopes (English ONLY), and Mail-Out envelopes (English and 

Bilingual English/Spanish); requiring such operations as: the receipt and processing of transmitted data; composition; 

programming & set-up; printing and imaging (including computerized printing) in one ink color; duplex printing; 

perforating (micro-perforated payment stub pages); folding; inserting; and mailing. 

Performance of Finished Product: The forms produced under these specifications require precision spacing, 

printing, trimming and folding and must be guaranteed to function properly when processed through an Integrated 

Image Based Data Capture System (IIBDCS). The barcoding must be easily readable by all standard barcode scanning 

devices regardless of the contractor’s method of reproducing the codes. (SSA equipment: hand-held barcode reader 

and high-speed scanners for Mailers 1-28 and the OPEX AS 3690 Scanner for micro-perforated payment stub for 

Mailers 19-24). 

TITLE: Representative Payee and Beneficiary Recontact Reports

*The four (4) identified workloads thus far are as follows: 

Representative Payee Reports: 

1. Title II 

2. Title XVI 

3. Title II – Final Accounting 

Beneficiary Recontact Reports: 

4. Beneficiary Recontact 

NEW NOTICES: During the term of this contract, the Government anticipates developing new notice workloads 

with the same requirements as the mailing packages described by these specifications. All terms and conditions in 

these specifications will apply to any future notice workloads. SSA estimates that approximately one (1) to three (3) 

new notice workloads may be added during the term of this contract. File names/dataset names for the new mailers 

will be supplied to the contractor as they are developed. 

The dataset names listed below may not be the final dataset names transmitted to the contractor. If there are 

changes, final dataset names will be provided to the contractor at the Postaward Conference. 

WORKLOAD MAILER DATASET NAME 

TITLE II 1 OLBG.NDA.vendor.RPAPROD.CSACCFIR.ryymmdd

 2 OLBG.NDA.vendor.RPAPROD.CSACCSEC.ryymmdd 

 3 OLBG.NDA.vendor.RPAPROD.CSACCSP1.ryymmdd 

 4 OLBG.NDA.vendor.RPAPROD.CSACCSP2.ryymmdd

 5 OLBG.NDA.vendor.RPAPROD.CSMLTFIR.ryymmdd 

 6 OLBG.NDA.vendor.RPAPROD.CSMLTSEC.ryymmdd 

 7 OLBG.NDA.vendor.RPAPROD.CSMLTSP1.ryymmdd

 8 OLBG.NDA.vendor.RPAPROD.CSMLTSP2.ryymmdd 

 9 OLBG.NDA.vendor.RPAPROD.CSORGFIR.ryymmdd 

 10 OLBG.NDA.vendor.RPAPROD.CSORGSEC.ryymmdd

 11 OLBG.NDA.vendor.RPAPROD.CSORGSP1.ryymmdd

 12 OLBG.NDA.vendor.RPAPROD.CSORGSP2.ryymmdd 
Representative Payee and Beneficiary Recontact Reports Page 22 of 57 

490-S (12/17) 

TITLE XVI 13 OLBG.BTI.vendor.Z01RPALT.ryymmdd 

 14 OLBG.BTI.vendor.Z02RPALT.ryymmdd 

 15 OLBG.BTI.vendor.Z01R6230.ryymmdd 

 16 OLBG.BTI.vendor.Z02R6230.ryymmdd 

 17 OLBG.BTI.vendor.Z01R6234.ryymmdd 

 18 OLBG.BTI.vendor.Z02R6234.ryymmdd 

TITLE II – 19 OLBG.NDA.vendor.RPAPROD.CSFACFIR.ryymmdd 

FINAL ACCOUNTING 20 OLBG.NDA.vendor.RPAPROD.CSFACSP1.ryymmdd 

 21 OLBG.NDA.vendor.RPAPROD.CSFAMFIR.ryymmdd 

 22 OLBG.NDA.vendor.RPAPROD.CSFAMSP1.ryymmdd 

 23 OLBG.NDA.vendor.RPAPROD.CSFAOFIR.ryymmdd

 24 OLBG.NDA.vendor.RPAPROD.CSFAOSP1.ryymmdd 

BENEFICIARY 25 OLBG.BTI.vendor.SARCONIE.ryymmdd

RECONTACT 26 OLBG.BTI.vendor.SARCONIS.ryymmdd

 27 OLBG.BTI.vendor.SARCONFE.ryymmdd

 28 OLBG.BTI.vendor.SARCONFS.ryymmdd

CERTIFIED MAIL: Contractor will be required to process Special Notice Option (SNO) mail pieces using USPS 

certified mail. Dataset names for SSA-623, SSA-6230, and SSA-1588 Certified Mail files are as follows. 

NOTE: There are no Certified Mail Files for SSA-6234. See “DISTRIBUTION”. 

WORKLOAD MAILER DATASET NAME (Certified Mail) 

TITLE II 1 OLBG.NDA.vendor.RPAPROD.CSACCE1C.ryymmdd

 2 OLBG.NDA.vendor.RPAPROD.CSACCE2C.ryymmdd

 3 OLBG.NDA.vendor.RPAPROD.CSACCS1C.ryymmdd 

 4 OLBG.NDA.vendor.RPAPROD.CSACCS2C.ryymmdd

 5 OLBG.NDA.vendor.RPAPROD.CSMLTE1C.ryymmdd

 6 OLBG.NDA.vendor.RPAPROD.CSMLTE2C.ryymmdd 

 7 OLBG.NDA.vendor.RPAPROD.CSMLTS1C.ryymmdd

 8 OLBG.NDA.vendor.RPAPROD.CSMLTS2C.ryymmdd

TITLE XVI 13 OLBG.BTI.vendor.Z01RPALC.ryymmdd 

 14 OLBG.BTI.vendor.Z02RPALC.ryymmdd

 15 OLBG.BTI.vendor.Z016230C.ryymmdd 

 16 OLBG.BTI.vendor.Z026230C.ryymmdd

TITLE II – 19 OLBG.NDA.vendor.RPAPROD.CSFACE1C.ryymmdd

FINAL ACCOUNTING 20 OLBG.NDA.vendor.RPAPROD.CSFACS1C.ryymmdd

 21 OLBG.NDA.vendor.RPAPROD.CSFAME1C.ryymmdd 

 22 OLBG.NDA.vendor.RPAPROD.CSFAMS1C.ryymmdd

BENEFICIARY 25 OLBG.BTI.vendor.NCRTPRD.SARCONIE.ryymmdd

RECONTACT 26 OLBG.BTI.vendor.NCRTPRD.SARCONIS.ryymmdd

 27 OLBG.BTI.vendor.NCRTPRD.SARCONFE.ryymmdd 

 28 OLBG.BTI.vendor.NCRTPRD.SARCONFS.ryymmdd

NOTE: In the production file, the RYYMMDD represents the weekly or monthly run date. For example, if the run 

date for October 01, 2016 notices is 10/01/16, the RYYMMDD in the file name will be “R161001”. 
Representative Payee and Beneficiary Recontact Reports Page 23 of 57 

490-S (12/17) 

MAKE-UP OF MAILERS: A record containing variable data will be transmitted for each mailing address. Each 

record will contain all variable data relevant to that address. Any alteration of the notice content in the file is not 

permitted. 

TITLE II

The Title II mailers are divided into twelve (12) categories by dataset name: 

Mailer 1 Personalized English Scannable Form (SSA-623-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-623-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 7 & 8) 

Mailer 2 Personalized English Scannable Form (SSA-623-OCR-SM) – Second Request 

Single Page Flyer 

 English Instruction Sheet (SSA-623-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 7 & 8) 

Mailer 3 Personalized Spanish Scannable Form (SSA-623-OCR-SM-SP) – First Request 

 Spanish Instruction Sheet (SSA-623-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 7 & 8) 

Mailer 4 Personalized Spanish Scannable Form (SSA-623-OCR-SM-SP) – Second Request 

 Spanish Instruction Sheet (SSA-623-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 7 & 8) 

Mailer 5 Personalized English Scannable Form (SSA-6230-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6230-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 7 & 8) 

Mailer 6 Personalized English Scannable Form (SSA-6230-OCR-SM) – Second Request 

Single Page Flyer 

 English Instruction Sheet (SSA-6230-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 7 & 8) 

Mailer 7 Personalized Spanish Scannable Form (SSA-6230-OCR-SM-SP) – First Request 

 Spanish Instruction Sheet (SSA-6230-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 7 & 8) 

Mailer 8 Personalized Spanish Scannable Form (SSA-6230-OCR-SM-SP) – Second Request 

 Spanish Instruction Sheet (SSA-6230-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 7 & 8) 
Representative Payee and Beneficiary Recontact Reports Page 24 of 57 

490-S (12/17) 

Mailer 9 Personalized English Scannable Form (SSA-6234-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6234-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 6, 7 & 8) 

Mailer 10 Personalized English Scannable Form (SSA-6234-OCR-SM) – Second Request 

Single Page Flyer 

 English Instruction Sheet (SSA-6234-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 6, 7 & 8) 

Mailer 11 Personalized Spanish Scannable Form (SSA-6234-OCR-SM-SP) – First Request 

 Spanish Instruction Sheet (SSA-6234-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Back: English/Spanish Items 6, 7 & 8) 

Mailer 12 Personalized Spanish Scannable Form (SSA-6234-OCR-SM-SP) – Second Request 

 Spanish Instruction Sheet (SSA-6234-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 Pink Business Reply Envelope (BRM) (PO Box 6232) (Back: English/Spanish Items 6, 7 & 8) 

TITLE XVI

The Title XVI mailers are divided into six (6) categories by dataset name: 

Mailer 13 Personalized English Scannable Form (SSA-623-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-623-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 White Business Reply Envelope (BRM) (PO Box 6231) (Back: English/Spanish Items 7 & 8) 

Mailer 14 Personalized English Scannable Form (SSA-623-OCR-SM) – Second Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-623-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 Pink Business Reply Envelope (BRM) (PO Box 6237) (Back: English/Spanish Items 7 & 8) 

Mailer 15 Personalized English Scannable Form (SSA-6230-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6230-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 White Business Reply Envelope (BRM) (PO Box 6231) (Back: English/Spanish Items 7 & 8) 

Mailer 16 Personalized English Scannable Form (SSA-6230-OCR-SM) – Second Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6230-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 Pink Business Reply Envelope (BRM) (PO Box 6237) (Back: English/Spanish Items 7 & 8) 

Mailer 17 Personalized English Scannable Form (SSA-6234-OCR-SM) – First Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6234-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 White Business Reply Envelope (BRM) (PO Box 6231) (Back: English/Spanish Items 6, 7 & 8) 
Representative Payee and Beneficiary Recontact Reports Page 25 of 57 

490-S (12/17) 

Mailer 18 Personalized English Scannable Form (SSA-6234-OCR-SM) – Second Request 

 Single Page Flyer 

 English Instruction Sheet (SSA-6234-OCR-SM) 

 Window Mail-Out Envelope (Front: Address Service Requested) (Back: English Only) 

 Pink Business Reply Envelope (BRM) (PO Box 6237) (Back: English/Spanish Items 6, 7 & 8) 

TITLE II – FINAL ACCOUNTING

The Title II – Final Accounting mailers are divided into six (6) categories by dataset name: 

Mailer 19 Personalized English Scannable Form (SSA-623-OCR-SM) – First Request 

 Personalized English Notice w/Micro-Perforated Payment Stub** 

 English Instruction Sheet (SSA-623-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

Mailer 20 Personalized Spanish Scannable Form (SSA-623-OCR-SM-SP) – First Request 

 Personalized Spanish Notice w/Micro-Perforated Payment Stub** 

 Spanish Instruction Sheet (SSA-623-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

Mailer 21 Personalized English Scannable Form (SSA-6230-OCR-SM) – First Request 

 Personalized English Notice w/Micro-Perforated Payment Stub** 

 English Instruction Sheet (SSA-6230-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

Mailer 22 Personalized Spanish Scannable Form (SSA-6230-OCR-SM-SP) – First Request 

 Personalized Spanish Notice w/Micro-Perforated Payment Stub** 

 Spanish Instruction Sheet (SSA-6230-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

Mailer 23 Personalized English Scannable Form (SSA-6234-OCR-SM) – First Request 

 Personalized English Notice w/Micro-Perforated Payment Stub** 

 English Instruction Sheet (SSA-6234-OCR-SM) 

 Window Mail-Out Envelope (Back: English/Spanish) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 6, 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

Mailer 24 Personalized Spanish Scannable Form (SSA-6234-OCR-SM-SP) – First Request 

 Personalized Spanish Notice w/Micro-Perforated Payment Stub** 

 Spanish Instruction Sheet (SSA-6234-OCR-SM-SP) 

 Window Mail-Out Envelope (Back: English/Spanish) 
Representative Payee and Beneficiary Recontact Reports Page 26 of 57 

490-S (12/17) 

 White Business Reply Envelope (BRM) (PO Box 6230) (Front: * Indicator) 

 (Back: English/Spanish Items 6, 7 & 8) 

 Green Business Reply Envelope (BRM) (PO Box 3430) 

** Title II – Final Accounting Payment Stub Requirement: 

The last leaf of the English and the Spanish Title II – Final Accounting Personalized Notices require a 

full horizontal micro-perforation 3-1/2 inches up from bottom of page and runs along the entire 8-

1/2” length dimension. Only the payment stub page is to contain the perforation. 

TITLE II, TITLE XVI, TITLE II – FINAL ACCOUNTING TRIM SIZES: 

 Scannable Forms: 8-1/2 x 11” flat size, folds down to 8-1/2 x 3-2/3” 

 Personalized Notice w/Payment Stub: 8-1/2 x 11” flat size, folds down to 8-1/2 x 3-2/3” 

 Single Page Flyer: 8-1/2 x 11” flat size, folds down to 8-1/2 x 3-2/3” 

 Instruction Sheets: 17 x 11” flat size, folds down to 8-1/2 x 11”, 

 then to 8-1/2 x 3-2/3” 

 Window Mail-Out Envelopes: 4-1/4 x 9-1/2” 

 White Business Reply Envelopes (BRM): 4 x 8-7/8” 

 Pink Business Reply Envelopes (BRM): 4 x 8-7/8” 

 Green Business Reply Envelope (BRM): 4 x 8-7/8” 

 See “CONSTRUCTION/BINDING” for further requirements. 

BENEFICIARY RECONTACT 

The Beneficiary Recontact mailers are divided into four (4) categories by dataset name: 

Mailer 25 Personalized English Scannable Form (SSA-1588-SM) – Initial Request 

 English Instruction Sheet (SSA-1588-SM) 

 Window Mail-Out Envelope 

 White Courtesy Reply Envelope (CRM) (PO Box 5888) 

Mailer 26 Personalized Spanish Scannable Form (SSA-1588-SM-SP) – Initial Request 

 Spanish Instruction Sheet (SSA-1588-SM-SP) 

 Window Mail-Out Envelope 

 White Courtesy Reply Envelope (CRM) (PO Box 5888) 

Mailer 27 Personalized English Scannable Form (SSA-1588-SM) – Final Request 

 English Instruction Sheet (SSA-1588-SM) 

 Window Mail-Out Envelope 

 White Courtesy Reply Envelope (CRM) (PO Box 5888) (Front: “2” Indicator) 

Mailer 28 Personalized Spanish Scannable Form (SSA-1588-SM-SP) – Final Request 

 Spanish Instruction Sheet (SSA-1588-SM-SP) 

 Window Mail-Out Envelope 

 White Courtesy Reply Envelope (CRM) (PO Box 5888) (Front: “2” Indicator) 

BENEFICIARY RECONTACT TRIM SIZES: 

 Scannable Forms: 8-1/2 x 11” flat size, folds down to 8-1/2 x 3-2/3” 

 Instruction Sheets: 8-1/2 x 11” flat size, folds down to 8-1/2 x 3-2/3” 

 Window Mail-Out Envelope: 4-1/4 x 9-1/2” 

 White Courtesy Reply Envelopes (CRM): 4 x 8-7/8” 

 See “CONSTRUCTION/BINDING” for further requirements. 
Representative Payee and Beneficiary Recontact Reports Page 27 of 57 

490-S (12/17) 

FOR QUALITY CONTROL AND AUDITING PURPOSES: 

The contractor must not merge file dates and mailers during processing, printing and inserting. All files transmitted by 

SSA will be physical sequential. Any alteration of the notice content in the file is not permitted. 

FREQUENCY OF ORDERS AND ESTIMATED QUANTITIES:

Transmission of the Title II, Title XVI, Title II – Final Accounting, and Beneficiary Recontact notices will begin in 

May 1, 2017 and continue throughout the term of the contract. A print order will be issued weekly for Title II – Final 

Accounting notices, and monthly for the Title II, Title XVI, and Beneficiary Recontact notices. 

The combined yearly total for all mailers (1-28) is approximately 9,273,704 notices per year. The estimated annual 

quantity for the Title II notices is 4,944,000, Title XVI notices is 4,152,000, Title II – Final Accounting notices is 

62,504, and the Beneficiary Recontact notices is 115,200. 

NOTE: The quantities for Mailers 1–28 are approximate. The Government reserves the right to increase or decrease 

the quantity by up to 20% of the total number of notices ordered annually. This 20% includes the additional notices 

occasioned by the one (1) to three (3) new notice workloads that may be added during the term of this contract. 

The figures indicated below are estimates based on historical data of past production runs. Exact quantities will not be 

known until each run is electronically transmitted to the contractor. NO SHORTAGES WILL BE ALLOWED. 

Transmission Schedule: 

This is an anticipated transmission schedule. Delays and changes to the schedule may occur. Contractor must be 

prepared to receive files 24/7/365. 

 Title II Notices will transmit between the twentieth and twenty-seventh of each month 

 Title XVI Notices will transmit on the first Saturday of each month 

 Title II – Final Accounting Notices will transmit on Sunday of each week 

 Beneficiary Recontact Notices will transmit between the twentieth and thirty-first of each month 

TITLE II: 

 Estimated 

Mailer Form Number Language Request Quantity/Month 

Mailer 1 SSA-623-OCR-SM English First 100,200 

Mailer 2 SSA-623-OCR-SM English Second 36,200 

Mailer 3 SSA-623-OCR-SM-SP Spanish First 6,100 

Mailer 4 SSA-623-OCR-SM-SP Spanish Second 1,880 

Mailer 5 SSA-6230-OCR-SM English First 158,250 

Mailer 6 SSA-6230-OCR-SM English Second 60,600 

Mailer 7 SSA-6230-OCR-SM-SP Spanish First 3,300 

Mailer 8 SSA-6230-OCR-SM-SP Spanish Second 1,300 

Mailer 9 SSA-6234-OCR-SM English First 35,100 

Mailer 10 SSA-6234-OCR-SM English Second 8,900 

Mailer 11 SSA-6234-OCR-SM-SP Spanish First 115 

Mailer 12 SSA-6234-OCR-SM-SP Spanish Second 55 

 Total Estimated Quantity/Month: 412,000 

TITLE XVI: 

 Estimated 

Mailer Form Number Language Request Quantity/Month 

Mailer 13 SSA-623-OCR-SM English First 129,000 

Mailer 14 SSA-623-OCR-SM English Second 49,900 
Representative Payee and Beneficiary Recontact Reports Page 28 of 57 

490-S (12/17) 

Mailer 15 SSA-6230-OCR-SM English First 88,300 

Mailer 16 SSA-6230-OCR-SM English Second 39,800 

Mailer 17 SSA-6234-OCR-SM English First 30,900 

Mailer 18 SSA-6234-OCR-SM English Second 8,100 

 Total Estimated Quantity/Month: 346,000 

TITLE II - FINAL ACCOUNTING: 

 Estimated 

Mailer Form Number Language Request Quantity/Week

Mailer 19 SSA-623-OCR-SM English First 506 

Mailer 20 SSA-623-OCR-SM-SP Spanish First 11 

Mailer 21 SSA-6230-OCR-SM English First 294 

Mailer 22 SSA-6230-OCR-SM-SP Spanish First 3 

Mailer 23 SSA-6234-OCR-SM English First 386 

Mailer 24 SSA-6234-OCR-SM-SP Spanish First 2 

 Total Estimated Quantity/Week: 1,202 

BENEFICIARY RECONTACT: 

 Estimated 

Mailer Form Number Language Request Quantity/Month 

Mailer 25 SSA-1588-OCR-SM English Initial 7,450 

Mailer 26 SSA-1588-OCR-SM-SP Spanish Initial 200 

Mailer 27 SSA-1588-OCR-SM English Final 1,900 

Mailer 28 SSA-1588-OCR-SM-SP Spanish Final 50 

Total Estimated Quantity/Month: 9,600

REPRESENTATIVE PAYEE REPORTS: 

 30-CALENDAR 

WHITE WINDOW MAIL-OUT ENVELOPES (4-1/4 x 9-1/2”) DAY VOLUME

Title II & Title II-Final Accounting Back: English/Spanish 416,808 

Title XVI Front: Address Service Requested 346,000 

 Back: English Only 

 30-CALENDAR 

INSTRUCTION SHEETS (17 x 11”) DAY VOLUME 

SSA-623-OCR-SM English 4-Page 317,493 

SSA-623-OCR-SM-SP Spanish 4-Page 8,028 

SSA-6230-OCR-SM English 4-Page 348,224 

SSA-6230-OCR-SM-SP Spanish 4-Page 4,613 

SSA-6234-OCR-SM English 4-Page 84,672 

SSA-6234-OCR-SM-SP Spanish 4-Page 178 

 30-CALENDAR 

SINGLE PAGE FLYER (8-1/2 x 11”) DAY VOLUME 

Title II & Title XVI English Only 745,250 

 30-CALENDAR 

BUSINESS REPLY ENVELOPES (BRM) (4 x 8-7/8”) DAY VOLUME

Title II 

White PO Box 6230 Back: English/Spanish Items 7 & 8 267,850 

White PO Box 6230 Back: English/Spanish Items 6, 7 & 8 35,215 
Representative Payee and Beneficiary Recontact Reports Page 29 of 57 

490-S (12/17) 

Pink PO Box 6232 Back: English/Spanish Items 7 & 8 99,980 

Pink PO Box 6232 Back: English/Spanish Items 6, 7 & 8 8,955 

Title XVI 

White PO Box 6231 Back: English/Spanish Items 7 & 8 217,300 

White PO Box 6231 Back: English/Spanish Items 6, 7 & 8 30,900 

Pink PO Box 6237 Back: English/Spanish Items 7 & 8 89,700 

Pink PO Box 6237 Back: English/Spanish Items 6, 7 & 8 8,100 

Title II – Final Accounting 

White PO Box 6230 Front: * Indicator Back: English/Spanish Items 7 & 8 3,527 

White PO Box 6230 Front: * Indicator Back: English/Spanish Items 6, 7 & 8 1,681 

Green PO Box 3430 Back: English/Spanish 5,208 

BENEFICIARY RECONTACT REPORTS: 

 30-CALENDAR 

WHITE WINDOW MAIL-OUT ENVELOPE (4-1/4 x 9-1/2”) DAY VOLUMES

Beneficiary Recontact 9,600 

 30-CALENDAR 

INSTRUCTION SHEETS (8-1/2 x 11”) DAY VOLUMES 

SSA-1588-SM English Single Leaf 9,350 

SSA-1588-SM-SP Spanish Single Leaf 250 

 30-CALENDAR 

COURTESY REPLY ENVELOPES (CRM) (4 x 8-7/8”) DAY VOLUMES

White PO Box 5888 7,650 

White PO Box 5888 Front: “2” Indicator 1,950 

GOVERNMENT TO FURNISH: 

Manuscript copy for three (3) mail-out envelopes, eleven (11) BRM return envelopes, and two (2) CRM return 

envelopes 

Manuscript copy for twenty-eight (28) scannable forms 

Manuscript copy for six (6) personalized notices w/micro-perforated payment stub 

Manuscript copy, camera copy, or electronic files (PostScript or PDF format) for six (6) four-page instruction 

sheets, two (2) single leaf instruction sheets and one (1) single page flyer 

Camera copy or electronic files for the recycled paper logo and legend 

Camera copy for the Facing Identification Mark (FIM) and the Intelligent Mail Barcode (IMB) required for the 

business reply and courtesy reply envelopes. 

Coding Accuracy Support System (CASS) Certificate 

National Change of Address (NCOA) Certificate 

PS Form 3615 (Mailing Permit Application and Customer Profile) 

GPO Form 712 (Certificate of Conformance) 

Permit Mailing Indicia - “Postage and Fees Paid” 
Representative Payee and Beneficiary Recontact Reports Page 30 of 57 

490-S (12/17) 

Official Government Postage Meters 

A data connection between the contractors specified location and the nearest available SSA network interface 

location or SSA’s National Computer Center in Baltimore, MD, if necessary. 

Exhibit A: Contractor Personnel Security Certification (Form SSA-301) 

Exhibit B: References for External Service Providers (ESP) 

Exhibit C: Questionnaire for Public Trust Positions - Sample Form SF85P 

Exhibit D: Fingerprint Card (FD-258) 

Exhibit E: Declaration for Federal Employment (Optional Form 306) 

Exhibit F: Fair Credit Reporting Act Authorization Form 

Exhibit G: System Plan 

Exhibit H: Audit and Summary Report 

Exhibit I: Vendor Record Specifications (will be furnished after award) 

Exhibit J: SSA Postage Meter Activity Log

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. 

COMPOSITION: Text and form work will be required. Contractor will be required to typeset all scannable forms 

and personalized notices w/micro-perforated payment stub utilizing Century Schoolbook, or similar serif typeface. 

NOTE: FORM ID number located in the form identifier box at the top of each scannable form must be set in OCR A 

18 point typeface. 

Contractor will be required to typeset all instruction sheets utilizing Century Schoolbook, or similar serif typeface. 

NOTE: The numbers located within the boxes on the first page of each instruction sheet will be typeset utilizing OCR 

hand printed characters typeface. 

Contractor will be required to typeset all envelopes utilizing Helvetica, or similar typeface. 

SSA reserves the right to require samples and to judge the suitability of any alternate typeface offered in order to make 

an award, which is deemed to be in the best interest of the Government. 

The entirety of each category of composition (text, tabular, and display) must be identical throughout the product(s) 

ordered under these specifications. Contractor is to match the type size on the manuscript copy. Exact spacing of scan 

boxes and variable data must be maintained for readability of pre-programmed scanning equipment. 

Form work will be defined as matter set in all sizes, and will include vertical, horizontal, and diagonal rules, box 

heads, numbered lines, checkboxes, arrows, type matter, etc., positioned in the proper location to provide spaces for 

information to be filled in individually. 

PROOFS: Six (6) sets of digital content proofs of all components (Scannable Forms, Personalized Notices w/MicroPerforated Payment Stub, Instruction Sheets, Single Page Flyer, and Envelopes) will be required. Proofs must be 

created using the same Raster Image Processor (RIP) that will be used to produce the product. Proofs must be collated 

with all elements in their proper position (not pasted up), imaged face and back, trimmed and folded to the finished 

size of the product. 

Proofs will be required with the initial order and any time a copy change is required during the term of the contract. 

The Government reserves the right to request PDF proofs. 

SSA reserves the right to make changes to all proofs. The Government may require one (1) or more sets of revised 

proofs before rendering an “OK to print”. 
Representative Payee and Beneficiary Recontact Reports Page 31 of 57 

490-S (12/17) 

NOTE: The contractor will be responsible for performing all necessary proofreading to ensure that the proofs are in 

conformity with the copy submitted 

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

be provided at no additional expense to the Government. No extra time can be allowed for this reproofing operation; 

such operations must be accomplished within the original production schedule allotted in the specifications. 

The contractor must not print prior to receipt of an “OK TO PRINT”. 

STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein or listed 

for 

the corresponding JCP Code numbers in the “Government Paper Specification Standards No. 12” dated March 2011; 

http://www.gpo.gov/pdfs/customers/sfas/vol12/vol_12.pdf. 

Color of paper furnished must be of a uniform shade and a close match by visual inspection of the JCP and/or attached 

color sample(s). 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). 

All paper used in each order must be of a uniform shade. 

Scannable Forms: White OCR Bond, (basis weight: 20 lbs. per 500 sheets, 17 x 22”), equal to JCP Code O-25. 

Personalized Notice w/Micro-Perforated Payment Stub: White Offset Book, (basis weight: 50 lbs. per 500 sheets, 

25 x 38”), equal to JCP Code A60. 

Instruction Sheets: White Offset Book, (basis weight: 50 lbs. per 500 sheets, 25 x 38”), equal to JCP Code A60. 

Single Page Flyer: White Writing, (basis weight: 20 lbs. per 500 sheets, 8-1/2”), equal to JCP Code D10. 

Mail-Out Window Envelopes: White Wove, (basis weight: 24 lbs. per 500 sheets, 17 x 22”), or at contractor's 

option, White Offset Book, (basis weight: 60 lbs. per 500 sheets, 25 x 38”), equal to JCP Code A60. 

BRM & CRM Return Envelopes: Any white stock, any pink stock (match of PMS 210), any green stock (match of 

PMS 344), (basis weight: 20 lbs. per 500 sheets, 17 x 22”), equal to JCP Code D10. 

Title II Notices:

Mailers 1, 3, 5, 7 BRM White PO Box 6230 English/Spanish Items 7 & 8 

Mailers 2, 4, 6, 8 BRM Pink PO Box 6232 English/Spanish Items 7 & 8 

Mailers 9, 11 BRM White PO Box 6230 English/Spanish Items 6, 7 & 8 

Mailers 10, 12 BRM Pink PO Box 6232 English/Spanish Items 6, 7 & 8 

Title XVI Notices: 

Mailers 13, 15 BRM White PO Box 6231 English/Spanish Items 7 & 8 

Mailers 14, 16 BRM Pink PO Box 6237 English/Spanish Items 7 & 8 

Mailer 17 BRM White PO Box 6231 English/Spanish Items 6, 7 & 8 

Mailer 18 BRM Pink PO Box 6237 English/Spanish Items 6, 7 & 8 

Title II – Final Accounting Notices: 

Mailers 19-22 BRM White PO Box 6230 * Indicator English/Spanish Items 7 & 8 

Mailers 23, 24 BRM White PO Box 6230 * Indicator English/Spanish Items 6, 7 & 8 

Mailers 19-24 BRM Green PO Box 3430 

Beneficiary Recontact Notices: 

Mailers 25, 26 CRM White PO Box 5888 
Representative Payee and Beneficiary Recontact Reports Page 32 of 57 

490-S (12/17) 

Mailers 27, 28 CRM White PO Box 5888 “2”Indicator 

NOTE: At contractor’s option, the pink return envelopes may be surface tinted to a close match of Pantone 210 and 

the green return envelopes may be surface tinted to a close match of Pantone 344. Surface tinting must cover all 

exposed surfaces (front and back) of the envelope when sealed. 

Envelope color must meet USPS print reflectance difference requirements. 

PRINTING: 

All printing/imaging must have a minimum resolution of 600 x 600 dpi.

The Government reserves the right to make changes to the envelopes or to the format/text of the forms, personalized 

notices, payment stubs, instruction sheets, or single page flyer at any time during the term of this contract. Notification 

of a proposed change will be given with sufficient time for the contractor to allow for the change, and submit proofs to 

the Government. 

The contractor is not to pre-print or maintain any of the components other than a 3-month supply of the instruction 

sheets, single page flyer, and envelopes as required by this contract. See 30-Calender Day Volumes listed under 

“FREQUENCY OF ORDERS AND ESTIMATED QUANTITIES” for monthly quantities. 

In the event that the agency makes changes to any or all of the instruction sheets, single page flyer, or envelopes, the 

agency will exhaust the current supply before requiring the contractor to begin using the updated components. The 

Government will not be required to purchase from the contractor the surplus/inventory of any component remaining 

on-hand in excess of what was authorized when an envelope or format/text change is implemented. 

Scannable Forms: Prints face and back, head-to-head in black ink 

Personalized Notice w/Micro-Perforated Payment Stub: 4-page (2 leaves), prints face and back, head-to-head 

in black ink 

Instruction Sheets: Single leaf or 4-page product, prints face and back, head-to-head in black ink 

Single Page Flyer: Single page, prints face only in black ink 

Envelopes: Envelopes print face and back (after manufacturing) in black ink. There are three (3) mail-out window 

envelopes, eleven (11) BRM return envelopes, and two (2) CRM return envelopes. Printing must be in accordance 

with the requirements for the style envelope ordered. All printing must comply with all applicable USPS regulations. 

The envelope must accept printing without feathering or penetrating to the reverse side. 

All envelopes require a security tint (straight-line tint is not acceptable) printed on the inside (back - before 

manufacturing) in black ink. The contractor may use his own design but must guarantee that the product will ensure 

complete opacity and prevent show through of any material contained therein. 

NOTE: The inside of the BRM and CRM return envelopes must contain a clear area (no pantograph design), 

approximate size 3-1/2 x 5/8”, behind the IMB to ensure the readability by USPS equipment. 

BRM Return Envelopes: Face of envelopes to be in BUSINESS REPLY FORMAT. Print Facing Identification 

Marks (FIM) and Intelligent Mail Barcodes (IMB) using the camera-ready positives provided for each envelope. 

Contractor is responsible for placing the FIM and IMB on the mailing piece according to the current USPS Domestic 

Mail Manual. 

CRM Return Envelopes: Face of envelopes to be in COURTESY REPLY FORMAT. Print Facing Identification 

Marks (FIM) and Intelligent Mail Barcodes (IMB) using the camera-ready positives provided for each envelope. 
Representative Payee and Beneficiary Recontact Reports Page 33 of 57 

490-S (12/17) 

Contractor is responsible for placing the FIM and IMB on the mailing piece according to the current USPS Domestic 

Mail Manual. 

NOTE: The Mail-Out Envelope for the Title XVI Notices must contain the ADDRESS SERVICE REQUESTED 

endorsement on the front of the envelope. 

RECYCLED PAPER LOGO AND LEGEND:

See Government Paper Specification Standards No. 12 for recycled content requirements. 

If recycled paper is used, the recycled paper logo and legend must be printed on the back of all envelopes in black ink 

in the bottom left corner. 

IMAGING:

Contractor will be required to convert furnished data from the electronic transmission for laser/ion deposition printing 

in black ink with a minimum resolution of 600 x 600 dpi, utilizing Century Schoolbook, or similar serif typeface on 

the scannable forms in accordance with the following: 

Variable Data: 

Form SSA-623-OCR-SM 

Face of Scannable Form – Maximum 28 type lines of alpha-numeric characters (includes form identifier 

located in the box at the top of each form), Data Matrix 2D barcode located at the top of each form (7/16” to 

the right of the form identifier box), plus the Intelligent Mail Barcode (IMB). 

Back of Scannable Form – 2 type lines of alpha-numeric characters matching the barcodes on the back of 

the form, 1 type line of alpha-numeric characters located in the form identifier box at the top of each form, 

plus Data Matrix 2D barcode located at the top of each form (1/4” to the right of the form identifier box). 

Form SSA-6230-OCR-SM 

Face of Scannable Form – Maximum 27 type lines of alpha-numeric characters (includes form identifier 

located in the box at the top of each form), Data Matrix 2D barcode located at the top of each form (7/16” to 

the right of the form identifier box), plus the Intelligent Mail Barcode (IMB). 

Back of Scannable Form – 2 type lines of alpha-numeric characters matching the barcodes on the back of 

the form, 1 type line of alpha-numeric characters located in the form identifier box at the top of each form, 

plus Data Matrix 2D barcode located at the top of each form (1/4” to the right of the form identifier box). 

Form SSA-6234-OCR-SM 

Face of Scannable Form – Maximum 30 type lines of alpha-numeric characters (includes form identifier 

located in the box at the top of each form), Data Matrix 2D barcode located at the top of each form (7/16” to 

the right of the form identifier box), plus the Intelligent Mail Barcode (IMB). 

Back of Scannable Form – 2 type lines of alpha-numeric characters matching the barcodes on the back of 

the form, 1 type line of alpha-numeric characters located in the form identifier box at the top of each form, 

plus Data Matrix 2D barcode located at the top of each form (1/4” to the right of the form identifier box). 
Representative Payee and Beneficiary Recontact Reports Page 34 of 57 

490-S (12/17) 

Form SSA-1588-0CR-SM 

Face of Scannable Form – Maximum 11 type lines of alpha-numeric characters (includes form identifier 

located in the box at the top of each form), Data Matrix 2D barcode located at the top of each form (7/16” to 

the right of the form identifier box), plus the Intelligent Mail Barcode (IMB). 

Back of Scannable Form – No variable data on back of forms. 

Contractor must determine type size (largest size that can be accommodated in the available space) subject to SSA 

approval. 

Numeric Scan Lines on Face of Forms: 

Title II and Title II – Final Accounting 

Form SSA-623-OCR-SM – Maximum 60 characters printed on two lines 

(line 1: 28 characters; line 2: 32 characters), OCR A font. 

Form SSA-6230-OCR-SM – Maximum 70 characters printed on two lines 

(line 1: 35 characters; line 2: 35 characters), OCR A font. 

Form SSA-6234-OCR-SM – Maximum 70 characters printed on two lines 

(line 1: 28 characters; line 2: 42 characters), OCR A font. 

Title XVI 

Form SSA-623-OCR-SM – Maximum 79 characters printed on two lines 

(line 1: 40 characters; line 2: 39 characters), OCR A font. 

Form SSA-6230-OCR-SM – Maximum 79 characters printed on two lines 

(line 1: 40 characters; line 2: 39 characters), OCR A font. 

Form SSA-6234 OCR-SM – Maximum 84 characters printed on two lines 

(line 1: 42 characters; line 2: 42 characters), OCR A font. 

Beneficiary Recontact 

Form SSA-1588-OCR-SM – Maximum 53 characters printed on two lines 

(line 1: 35 characters; line 2: 18 characters), OCR A font. 

NOTE: Scan lines located on the face of the scannable forms must not fall on a fold. 

The numeric scan line must be printed using the OCR A font. The OCR printing must read continuously on an 

Integrated Image Based Data Capture System (IIBDCS). The reject rate due to manufacturing deficiencies shall not 

exceed .65% of the items when run on the specified reading equipment. A form is a reject when its OCR print cannot 

be correctly deciphered on the first pass through the specified reading equipment. Acceptability of the lot for OCR 

readability will be based on the number of rejected items in a sample of the size specified in ANSI/ASQC Z1.4, 

General Inspection Level I, with AQL equal to .65%. For OCR evaluation, the sampling unit of production will be an 

individual form. OCR tests are independent of tests and evaluations of all other product characteristics and have 

separate AQL’s and sample sizes. At the option of the Government, the sample may consist of sequential items from 

one or more portions of the lot rather than a random sample. 
Representative Payee and Beneficiary Recontact Reports Page 35 of 57 

490-S (12/17) 

ANSI X3.17 “Character Set for Optical Character Recognition (OCR A)” shall apply to these specifications. The 

revisions of this standard which are effective as of the date of this contract are those which shall apply. 

ANSI Standards may be obtained from the American National Standards Institute, 25 West 43rd Street, 4th Floor, New 

York, NY 10036. 

MICRO-PERFORATED PAYMENT STUB: 

The Title II – Final Accounting personalized notice contains a micro-perforated payment stub with an alpha-numeric 

scan line. The alpha-numeric scan line must be printed using the OCR-A font. The payment stub page is part of the 

notice itself and will be electronically transmitted. The payment stub page is the only page that should contain the 

micro-perforation. 

The payment stub portion, once detached, will be scanned. It is critical that the bottom of the OCR-A scan line be 

1/2 inch from the bottom and 1/4 inch from the right leading edge on the payment stub page. The payment stub 

produced must be guaranteed to function properly when processed through the current high-speed scanning equipment 

at SSA. A form is a reject when its OCR print cannot be correctly deciphered on the first pass through the specified 

reading equipment. 

The contractor must not use magnetic ink to print the payment stub as it will affect its ability to scan. Use of 

equipment or ink, which in any way adversely affects the ability to scan the payment stub, will not be allowed. 

BARCODE REQUIREMENTS: 

The scannable forms contain Data Matrix 2D barcodes and Standard 3 of 9 barcodes. See manuscript copy for precise 

placement and size of barcodes. 

Carbon black ink must be used to image barcodes. Barcodes must not fall on a fold. Contractor will be required to 

have the necessary equipment to perform all quality assurance tests and to verify the accuracy of the barcodes and 

scannable lines during the term of this contract. 

Data Matrix 2D Barcode 

Title II, Title XVI, Title II – Final Accounting: 

Two (2) Data Matrix 2D barcodes will be required on all SSA-623, SSA-6230, and SSA-6234 scannable 

forms as follows: 

 Face: Located at the top, 7/16” to the right of the form identifier box of each form. 

Height is 1/2” plus or minus 1/16”; length/width is 1/2” plus or minus 1/16” 

 Back: Located at the top, 1/4” to the right of the form identifier box of each form. 

Height is 1/2” plus or minus 1/16”; length/width is 1/2” plus or minus 1/16” 

 NOTE: At least 1/8” margin (quiet zone) is required top, bottom, left, and right of each 

Data Matrix 2D barcode. 

The Data Matrix 2D barcodes must contain the following data elements: 

Form ID: 4 positions (6230, 6231, 6232, 6233, 6234, 6235, 6236, 6237, 6239) 

Page Number: 1 position (1 for face, 2 for back) 

Language: 1 position (E for English, S for Spanish) 

Second Request: 1 position (Y for yes, N for no, and F for final accounting) 

Printer Information: variable length (contractor’s name) 
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490-S (12/17) 

Edition Date: 6 positions (2 positions for month, 4 positions for year; 

 value must always reflect the edition date on form) 

Scan Lines: variable length (See “NUMERIC SCAN LINES 

ON FACE OF FORMS”) 

Beneficiary Recontact: 

One (1) Data Matrix 2D barcode will be required on all SSA-1588 scannable forms as follows: 

 Face: Located at the top, 7/16” to the right of the form identifier box of each form. 

Height is 1/2” plus or minus 1/16”; length/width is 1/2” plus or minus 1/16” 

 NOTE: At least 1/8” margin (quiet zone) is required top, bottom, left, and right of each 

Data Matrix 2D barcode. 

The Data Matrix 2D barcode must contain the following data elements: 

Form ID: 4 positions (1588) 

Page Number: 1 position (1 for face) 

Language: 1 position (E for English, S for Spanish) 

Request: 1 position (value 1 = first request, value 2 = final request) 

Printer Information: variable length (contractor’s name) 

Edition Date: 6 positions (2 positions for month, 4 positions for year; 

 value must always reflect the edition date on form) 

Scan Lines: 53 positions 

Beneficiary’s First Name: 15 positions 

Beneficiary’s Middle Initial: 1 position 

Beneficiary’s Surname: 20 positions 

Data columns are to be preceded and followed by the standard Data Matrix 2D barcode start/stop patterns, left row 

indicator, and right row indicator. Additionally, a delimiter character (comma) must be inserted between each element. 

The Data Matrix 2D barcodes must be in accordance with the requirements of ANSI MH 10.8.3M, unless otherwise 

specified. 

The Data Matrix 2D barcodes produced under these specifications must be guaranteed to function properly when 

processed through an Integrated Image Based Data Capture System (IIDBCS). The barcoding must be readable by all 

standard barcode scanning devices regardless of the contractor’s method of reproducing the codes. 

Standard 3 of 9 Barcode 

The Standard 3 of 9 barcode consists of a maximum 16 characters. Two (2) barcodes will be required on the back of 

all scannable forms as follows: 

Title II, Title XVI, Title II – Final Accounting: 

First Barcode: Type of Event (TOE). 6 characters + start/stop = 8 characters encoded. Height is 1/2” ± 1/16”, 

density of 6.6 CPI. NOTE: A standard 1/2” margin (quiet zone) is required left and right of each barcode. 
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490-S (12/17) 

A. If the Processing Center Code (PC Code) is 0 through 6, the barcode should be: 

 Position Code 

 1 start 

 2 8 

 3 6 

 4 1 

 5 0 

 6 0 

 7 4 

 8 stop 

B. If the PC Code is 7 or 8, the barcode should be: 

 Position Code 

 1 start 

 2 8 

 3 6 

 4 1 

 5 0 

 6 8 

 7 6 

 8 stop 

Second Barcode: (Social Security Number (SSN), PC Code, 0, 1, 8, and 9). 14 characters + start/stop = 16 

characters encoded. Height is 1/2” ± 1/16”, density of 6.6 CPI. NOTE: A standard 1/2” margin (quiet zone) is 

required left and right of each barcode. 

Position Field/Entry 

 1 *start/stop 

 2-10 SSN 

 11 PC Code 

 12 0 

 13 1 

 14 8 

 15 9 

 16 *start/stop 

NOTE: The Title XVI forms selection process does not always identify a processing center code (PC Code). The 

contractor must force a PC Code of 0 (zero) for the barcode on the reverse side of the form on Title XVI 

selections unless a PC Code is present in the files. This will allow the barcode to be used for Title XVI forms. If 

the PC Code is 0, the PC field on the face of the form must be blank. If a PC Code of 1-8 is present, then that 

number must be part of the barcode and must be shown in the PC field on the face of the form. 

Beneficiary Recontact: 

First Barcode: Type of Event (TOE). The Toe for all Beneficiary Recontact Forms is 270. The Toe is 

6 characters + start/stop = 8 characters encoded. Minimum length is 1-3/4” and maximum length is 1-7/8” (not 

including the quite zones). Height is 1/2” ± 1/16”. The “TOE 270” is literally interpreted just to the right of the 

TOE bar. NOTE: A standard 1/2” margin (quiet zone) is required left and right of each barcode. 
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490-S (12/17) 

A. The barcode interpretation should be: 

Position Code 

 1 start 

 2 8 

 3 6 

 4 1 

 5 0 

 6 6 

 7 8 

 8 stop 

Second Barcode: (Social Security Number (SSN), PC Code, 0, 1, 8, and 1). 14 characters + start/stop = 16 

characters encoded. Minimum length is 3-1/2” and maximum length is 3-3/4” (not including the quiet zones). 

Height is 1/2” ± 1/16”. NOTE: A standard 1/2” margin (quiet zone) is required left and right of each barcode. 

 Position Code 

 1 start (*) 

 2-10 SSN 

 11 PC Code 

 12 0 

 13 1 

 14 8 

 15 1 

 16 stop (*) 

The SSN is literally interpreted between the TOE and SSN/SSNZ barcodes, the TOE, SSN/SSNX and PI literally 

interpreted directly below the SSN. The PI value should reflect the PC code printed on the front of the form. 

The SSN is to be printed landscape style in the center of the form. 

All encoded data is to be preceded and followed by the Standard 3 of 9 barcode start/stop (*) code. Additionally, 

where blanks occur in fields identified for conversion to barcode, these blanks should be expressed as barcoded 

blanks. 

The Standard 3 of 9 barcode must be in accordance with the requirements of AIM Uniform Symbology Specifications, 

Code 39 and ANSI X3.182-1990 (Barcode Print Quality Guidelines), unless otherwise specified. 

TRANSMISSION: Upon award of this contract, the Government will determine the connectivity method between 

SSA and the contractor. Internet Protocol (IP) will be the connection protocol for the transmissions. The connectivity 

method will be through the Internet using an encrypted VPN tunnel or the Government will place an order for a 

dedicated circuit under GSA’s Networx contract to be installed within 60 to 90 calendar days between the 

contractor’s location and SSA’s network interface location. Either connectivity method will be encrypted with the 

AES256 encryption algorithm. For the Internet option to be used the contractor must have an Internet ready VPN 

IPSec capable hardware device. The Government will not be responsible for any cost associated with the VPN Internet 

connection that the contractor may incur. The connection method is at the sole discretion of the Government. The cost 

of the dedicated circuit connection will be borne by the Government. The Government shall not be responsible for 

installation delays of data connections due to any external influences such as employee strikes, weather, supplies, etc.; 

which conditions are beyond the control of the Government. 

If a dedicated circuit is deemed necessary, SSA will provide the dedicated data connection, including a router, and 

firewall at the contractor’s specified locations. The contractor shall provide adequate rack space for securing the router 

and firewall; the contractor shall provide a dedicated analog dial-up line within 8 feet of the router. This dedicated 
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490-S (12/17) 

analog dial-up line will be used for router management and access for troubleshooting. The line must be in place and 

active prior to the installation of the circuit/router. 

In addition, upon contract award, the contractor shall provide a complete delivery address with nearest cross-street, 

contact name and phone number for installation of data transmission services and equipment. The contractor’s contact 

person shall be available for delivery of services at the specified location. The Government shall not be responsible for 

incorrect or lack of address information, nor for non-availability of contact person(s) at the delivery site. 

It is the contractor’s responsibility to notify SSA when systems or data line problems arise and transmission(s) cannot 

take place. SSA’s first point of contact for systems or data line problems shall be the HELP DESK at 877-697-4889. 

The contractor must also notify OPAMS at melissa.picone@ssa.gov or by phone: (410) 965-3350. 

Any reprogramming and/or reformatting of data supplied by wire transmission or VPN Internet transmission 

necessitated due to the contractor's method of production shall be the responsibility of the contractor. It is solely the 

contractor’s responsibility to ensure proper printing and inserting in their environment.

SECURE FILE TRANSFER PROTOCOL (SFTP) SITE: The contractor is required to have a Secure SFTP site 

set-up that will permit SSA to transmit files electronically. The site must allow SSA the ability to upload and 

download files for proofing and validation. The contractor cannot send PDF notices with PII via e-mail.

FILE TRANSFER MANAGEMENT SYSTEM (FTMS) REQUIREMENTS: The contractor shall provide the 

capability to interface with SSA’s National File Transfer Management System (FTMS) for electronic transmission of 

notice files from SSA to the production facility. SSA will provide the necessary data connection into the contractor’s 

location. At the discretion of SSA, the line speed may be either increased or decreased depending on utilization.

The contractor must provide, at their expense, the equipment and operating software platform, and the file transfer 

software required at their location. The contractor assumes all responsibility for configuration, maintenance, and 

troubleshooting of their equipment and software. 

SSA utilizes, and the contractor must provide compatibility with, Managed File Transfer (formerly known as 

Cyberfusion Integration Suite) software from TIBCO. The contractor may implement the Managed File Transfer 

Platform Server that has embedded software encryption capable of being enabled. The personal computers/servers 

must have the capability to run Managed File Transfer software with encryption enabled using IP protocols on 

Windows, UNIX (i.e., IBM’s AIX, SUN or HP), or z/OS platforms. 

SSA will not permit any private class A, B or C IP addresses, i.e., 10.xxx.xxx.xxx type IP addresses from external 

users on its network. At connection time to SSA, the contractor will be provided a suitable IP address for access to 

SSA’s network via a firewall. SSA will provide the necessary subnet(s) for connection at the remote site. The 

contractor will be responsible for their own name/address translation to fulfill the intended purpose of data transfers. 

SSA will provide Managed File Transfer node information to the contractor as required to accomplish file transfers. 

The contractor may determine the media type on which files from SSA will be received, to the extent that operator 

intervention (e.g., a tape mount) is not required at SSA or the contractor’s production facility. Simultaneous multiple 

transmission sessions must be possible on the contractor’s equipment. All files transmitted by the SSA will be written 

as Physical Sequential or “flat” files at the contractor’s location and will be distinguished with a “run date” in the 

contractor’s file name. Virtual Storage Access Method files and Generation Data Groups, supported by IBM/MVS or 

IBM z/OS operating systems are not permitted under this contract. The contractor’s storage format must not preclude 

the availability of the Managed File Transfer software Checkpoint/Restart feature. 

NOTE: The contractor may not use VM/VSE/ESA on a mainframe system, as this hampers automated file 

transmission. 

The contractor’s FTMS software shall be operational for the receipt of data files 24 hours a day, 7 days a week, unless 

otherwise specified by the Government. The communications protocol between SSA and the contractor shall be the 
Representative Payee and Beneficiary Recontact Reports Page 40 of 57 

490-S (12/17) 

Internet Protocol (IP). The contractor must specify the type of Local Area Network (LAN) connection that will be 

used at the location where the SSA connection is to be installed. The contractor is responsible for providing complete 

hardware and software compatibility with SSA’s existing network. Production file transfers will be established 

according to SSA’s standard procedures for transmission control, dataset naming, and resource security. The 

contractor’s file management system must accommodate multiple file transmission sessions without intervention at 

either end. The contractor must have sufficient capacity to support the number of concurrent transmission file sessions 

as dictated by SSA. 

The above will apply, regardless of the number of workloads transmitted to the contractor daily. If the contractor is 

awarded multiple SSA notice workloads, there must be sufficient capacity at the contractor’s production facility to 

accept transmission of all files according to their schedules. 

In the event that any transmission cannot be processed due to media problems, link problems or data transmission 

circuit/connection outages, the contractor shall notify SSA’s HELP DESK operations immediately at 877-697-4889 

and report required observations and findings. 

Transmission of production files shall be the standard, automated technique. In the event that the transmission network 

is unavailable for a time period deemed critical by the Government, the files may, at the Government’s option, be 

processed at the SSA print/mail facility. 

NOTE: THE CONTRACTOR MUST NOT COMPRESS FILES! 

All data provided by the Government or duplicates made by the contractor or his representatives and any resultant 

printouts must be accounted for and kept under strict security to prevent their release to any unauthorized persons. 

Data may not be duplicated in whole or in part for any other purpose than to create material to be used in the 

performance of this contract. 

Any duplicate data and any resultant printouts must be destroyed by the contractor. Data provided to the contractor 

must be retained for 21 workdays after mailing. 

Proofs will be required for the initial order and any time a copy change is required during the term of the contract. 

Proofing for Initial Start-Up: The contractor must submit proofs for all scannable forms, personalized notices 

w/micro-perforated payment stub, instructions sheets, flyer, and envelopes under this contract within seven (7) 

workdays after receipt of furnished materials. Furnished materials (if manuscript or camera is provided) must be 

returned with proofs. 

PROOFING, TRANSMISSION TEST AND PRE-PRODUCTION VALIDATION TESTS: 

Proofs will be required for the initial order and any time a copy change is required during the term of the contract. 

Proofing for Initial Start-Up: The contractor must submit proofs for all scannable forms, personalized notices 

w/micro-perforated payment stub, instructions sheets, flyer, and envelopes under this contract within seven (7) 

workdays after receipt of furnished materials. Furnished materials (if manuscript or camera is provided) must be 

returned with proofs. 

Prior to the commencement of production of orders placed under this contract, the contractor will be required to 

demonstrate their ability to perform the contract requirements. The Government will furnish electronic test files that 

are to be used in performing the Transmission Test and Pre-Production Validation Tests. .

NOTE: Failure of the contractor to perform the Transmission Test and/or the Pre-Production Validation Tests to the 

satisfaction of the Government may be cause for default. The Government reserves the right to waive the requirements 

of any or all of these tests. The contractor will be notified at the Postaward Conference if any test(s) will be waived. 
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490-S (12/17) 

See “PROOF SCHEDULE & TEST SCHEDULE” 

The contractor will be required to perform the following tests: 

TRANSMISSION TEST:

After the appropriate data connection has been installed, the contractor will be required to receive, within one (1) 

workday, data for approximately 761,500 notices (Mailers 1–28). The contractor will be required to perform a Record 

Count Verification and a Coding Accuracy Support System (CASS) certification within one (1) workday after the 

complete transmission of the test files. The contractor will be required to copy the files to their own system and e-mail 

Melissa Picone at melissa.picone@ssa.gov with the exact counts received (broken down by dataset name), before 

proceeding with any other processing. SSA will respond within one (1) workday of receipt for verification.

The contractor will be required to run the test file through their CASS certification system to ensure there are no 

problems with the reading of the address file. The contractor will be required to report to SSA with the test results. 

When the record count verification and CASS certification have been successfully completed, the contractor will be 

required to process the test files and provide SSA, within three (3) workdays, 10 sample documents from the 

Transmission Test for each file (Mailers 1 through 28) transmitted during the test. The samples will be produced using 

the data from each of the files that were transmitted during the transmission test. Samples may be imaged on white 

paper and contain only variable information. Transmission Test samples do not require inserts or envelopes. Submit 

the test samples to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 

21235-6401. 

The Government will approve, conditionally approve, or disapprove the samples from the Transmission Test within 

two (2) workdays of 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 thereof. 

Note: If errors are found, additional samples will be required until the validation produces no errors. 

PRE-PRODUCTION VALIDATION TESTS: 

Prior to commencement of production of orders placed under this contract, the Government will furnish electronic test 

files shortly after the postaward conference to be used in performing the Pre-Production Validation Tests.

NOTE: The contractor is required to complete all Pre-Production Validation Tests on the equipment they 

intend to use during live production and using their personnel. 

NOTE: The Government will issue a print order for validation. Upon completion of all validation requirement the 

Contractor will be reimbursed for all applicable costs according to “SECTION 3 – SCHEDULE OF PRICES”. 

Scannable Forms Validation Test: 

Within five (5) workdays after receipt of the Governments final approval on the twenty-eight (28) Scannable Form 

proofs, the contractor must conduct a Scannable Forms Validation Test and furnish 1,400 printed samples (50 samples 

of each Mailer 1-28) for validation. Forms must be complete and include all variable data from the Government 

furnished test files. 

The contractor must send 25 test samples directly to: Social Security Administration, ATTN: Patrice Gallagher, 

Analysis Staff, Room 341, 1150 East Mountain Drive, Wilkes-Barre, PA 18702-7997, and a DUPLICATE 25 test 

samples directly to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 

21235-6401. The container and accompanying documentation must include the GPO Jacket, Purchase Order, and 

Program Number. 

The Government will approve, conditionally approve, or disapprove the pre-production validation samples within five 

(5) workdays of the receipt thereof. SSA will test these sample copies on their scanner and barcode reading device(s) 
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490-S (12/17) 

as specified in these specifications. 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. 

If the Government disapproves the samples due to printer errors, 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. Additional samples must be furnished and necessary changes made at no additional 

cost to the Government. In the event the Government disapproves the additional samples due to printer errors, the 

contractor may 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. A notice of disapproval shall state the reasons thereof. 

Submit revised samples, if necessary, due to author's alterations (AA’s) by the Government, within three (3) 

workdays after receipt of notification and furnished materials. Revised sample copies will be available for pick up 

within three (3) workdays. 

Micro-Perforated Payment Stub Validation Test:

Within five (5) workdays after receipt of the Governments final approval on the six (6) Title II – Final Accounting 

Personalized Notices w/Micro-Perforated Payment Stub proofs, the contractor must conduct a Micro-Perforated 

Payment Stub Validation Test and furnish 300 printed samples (50 samples of each Mailer 19-24) for validation of the 

alpha-numeric scan line. Notices/Payment Stub must be complete and include all variable data from the Government 

furnished test files. The micro-perforation on the payment stub page must be precisely located and the payment stub 

must function properly when processed through the current high-speed scanning equipment owned by SSA. A form is 

a reject when its OCR print cannot be correctly deciphered on the first pass through the specified reading equipment. 

The contractor must send 25 test samples directly to: Danielle N. McCray, Program Analyst, OAS 7th Floor NW, 

Mid-Atlantic Program Service Center, 300 Spring Garden Street, Philadelphia, PA 19123, and a DUPLICATE 25 test 

samples directly to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 

21235-6401. The container and accompanying documentation must include the GPO Jacket, Purchase Order, and 

Program Number. 

NOTE: The same testing schedule under “SCANNABLE FORMS VALIDATION TEST” applies. 

Construction Samples Validation Test: 

Within five (5) workdays after the Governments final approval of all the necessary components including the PreProduction Validation Tests for the Scannable Forms and Title II – Final Accounting Notices w/Micro-Perforated 

Payment Stub, the contractor must conduct a Construction Samples Validation Test and furnish 420 sample notice 

packages (15 samples of each Mailer 1-28) of the completed product. The samples must be complete and include all 

variable data from the Government furnished test files, inserted into the outer envelope with all required inserts and 

envelopes, leaving the outer envelope unsealed. The contractor will be required to have all the necessary inserts and 

envelopes completed prior to beginning this validation test. The contractor must send the test samples directly to: 

SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. The 

container and accompanying documentation must include the GPO Jacket, Purchase Order, and Program Number. 

NOTE: The same testing schedule under “SCANNABLE FORMS VALIDATION TEST” applies. 

NOTE: Failure of the contractor to perform any of the start-up tests (i.e., Transmission Test and/or Pre-Production 

Validation Tests) satisfactorily during the course of the contract may be cause for default. The Government reserves 

the right to waive the requirements of any of these tests. Contractor will be notified at the postaward conference if any 

start-up test(s) is to be waived. 

NOTE: The Government may require the contractor to make changes to the formats of the scannable forms, notices 

w/micro-perforated payment stub, instruction sheets, flyer, or envelopes at any time during the term of the contract. 
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490-S (12/17) 

Whenever such copy changes are required, all aspects of the “test schedule” (proofs, schedule, and quantity of test 

samples) must be maintained. Live production of all the mailers will continue during this transition period. 

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

subcontractor’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. See GPO 

Publication 315.3 (Guidelines for Contractors Holding Press Sheet Inspections) issued 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. A press sheet inspection(s) may be required at 

the contractor’s/subcontractor’s plant before production begins on any new or existing workload. 

When a press sheet inspection is required, the Government will notify the contractor. 

PRODUCTION INSPECTION: Product inspection(s) may be required at the contractor’s/subcontractor’s plant for 

the purpose of establishing the receipt of transmitted files, the printing of notices/forms; instruction sheets, single page 

flyers, and envelopes; and the imaging, collating, folding, inserting, and mailing is being accomplished in accordance 

with the contract quality attributes and requirements. 

NOTE: A production inspection is for the purpose of setting specific standards to be maintained throughout the 

duration of the contract. A production inspection(s) may be required at the contractor’s/subcontractor’s plant before 

production begins on any new workload. 

When a production inspection is required, the Government will notify the contractor. 

MARGINS: Margins on the Scannable Forms must be a minimum of 1/4” on all sides. Contractor is to follow 

manuscript copy, electronic file, or other given instruction for proper margins on the instruction sheets, single page 

flyer, Personalized Final Accounting Notice w/Micro-Perforated Payment Stub, and envelopes. 

CONSTRUCTION/BINDING: 

Title II – English Mailers 1, 2, 5, 6, 9, 10: Each constructed mailer consists of five components: (1) a personalized 

scannable form, (2) BRM envelope, (3) an instruction sheet, (4) flyer, and (5) a mail-out envelope in which 

components 1 through 4 are inserted into for mailing. Contractor to follow construction sample for proper insertion of 

components 

1 through 4 into component 5. 

Title II – Spanish Mailers 3, 4, 7, 8, 11, 12: Each constructed mailer consists of four components: (1) a personalized 

scannable form, (2) BRM envelope, (3) an instruction sheet, and (4) a mail-out envelope in which components 

1 through 3 are inserted into for mailing. Contractor to follow construction sample for proper insertion of components 

1 through 3 into component 4. 

Title XVI – Mailers 13 through 18: Each constructed mailer consists of five components: (1) a personalized 

scannable form, (2) BRM envelope, (3) an instruction sheet, (4) flyer, and (5) a mail-out envelope in which 

components 1 through 4 are inserted into for mailing. Contractor to follow construction sample for proper insertion of 

components 

1 through 4 into component 5. 

Title II-Final Accounting – Mailers 19 through 24: Each constructed mailer consists of six components: (1) a 

personalized scannable form, (2) a personalized notice w/micro-perforated payment stub, (3) a white BRM envelope, 

(4) a green BRM envelope, (5) an instruction sheet, and (6) a mail-out envelope in which components 1 through 5 

are inserted into for mailing. Contractor to follow construction sample for proper insertion of components 1 through 5 

into component 6. 
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490-S (12/17) 

Beneficiary Recontact – Mailers 25 through 28: Each constructed mailer consists of four components: (1) a 

personalized scannable form, (2) BRM envelope, (3) an instruction sheet, and (4) a mail-out envelope in which 

components 1 through 3 are inserted into for mailing. Contractor to follow construction sample for proper insertion of 

components 1 through 3 into component 4. 

Scannable Forms: Fold from 8-1/2 x 11” flat size down to 8-1/2 x 3-2/3” with 2 parallel accordion folds, title out. 

The recipient’s name and address must be visible through the window envelope. NOTE: Scan lines located on the 

face and barcodes located on the back of the scannable forms must not fall on a fold. 

Final Accounting Notice w/Micro-Perforated Payment Stub: Fold the four page notice (two 8-1/2 x 11 leaves) 

from 8-1/2 x 11” flat size down to 8-1/2 x 3-2/3” with 2 parallel accordion folds, and micro-perforation to fall on fold. 

NOTE: For the Title II – Final Accounting workload, the Final Accounting Personalized Notice w/Micro-Perforated 

Payment Stub sheets will nest behind the Final Accounting Personalized Scannable Form to create a 6-page 

form/notice. The recipient’s name and address on the Scannable Form must be visible through the window envelope. 

It is the contractor’s responsibility to assure that the correct package material is inserted into each envelope. The 

recipient’s name and address on the Final Accounting Personalized Notice w/Micro-Perforated Payment Stub must be 

matched with the Personalized Scannable Form for that recipient. 

Instruction Sheets (Title II, Title XVI, Title II – Final Accounting): Fold from 17 x 11” flat size down to 8-1/2 x 

11”, then to 8-1/2 x 3-2/3” for insertion. 

Instruction Sheets (Beneficiary Recontact): Fold from 8-1/2 x 11” flat size down to 8-1/2 x 3-2/3” for insertion 

Flyer: Fold from 8-1/2 x 11” flat size down to 8-1/2 x 3-2/3” for insertion. 

White, Pink, and Green BRM Return Envelopes 4 x 8-7/8”: Manufacture open side, side seams, security tint, and 

gummed fold-over flap for sealing. Flap depth is at contractor’s option, but must meet all USPS requirements. Flap 

must be coated with suitable remoistenable glue the entire length of flap that will securely seal the return envelope for 

mailing. Adhesive must not adhere to the contents of the envelope. The white and pink BRM return envelopes must 

accommodate the scannable form with only those manufactured folds as specified above. The green BRM return 

envelope must accommodate the payment stub. 

White CRM Return Envelopes 4 x 8-7/8”: Manufacture open side, side seams, security tint, and gummed fold-over 

flap for sealing. Flap depth is at contractor’s option, but must meet all USPS requirements. Flap must be coated with 

suitable remoistenable glue the entire length of flap that will securely seal the return envelope for mailing. Adhesive 

must not adhere to the contents of the envelope. The white CRM return envelopes must accommodate the scannable 

form with only those manufactured folds as specified above. 

White Window Mail-Out Envelopes 4-1/4 x 9-1/2”: Manufacture open side with side or diagonal seams, security 

tint, and gummed flap. Flap depth is at contractor’s option, but must meet all USPS requirements. Die-cut a 3-3/4 x 1-

1/2” address window with rounded corners on the face of the envelope, positioned 7/8” from the bottom edge and 5/8” 

from the left edge. Contractor has the option to adjust the size of the window opening (subject to SSA approval) 

providing the visibility of the mailing address and IMB on the form is not obscured, and other extraneous information 

is not visible when material is inserted into the envelope. Cover the window on the inside with a poly-type, or equal, 

low gloss transparent material. The window material must be clear of smudges, lines, or any distortions that would not 

meet USPS’s readability standards. The envelope flap must be coated with a suitable, remoistenable glue that will 

securely seal the envelope for mailing, permit easy opening by the recipient, but will not permit resealing of the 

envelope. Mail-out envelope must be securely sealed on all sides and must remain sealed under mailing conditions. 

(Adhesive must not adhere to the contents of the envelope). 
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PACKING: It is the contractor’s responsibility to assure that only the computer-generated address and Intelligent 

Mail barcode (IMB) on the form will be visible through the window in the envelope and that only one form is inserted 

into each envelope. In addition, it is the contractor’s responsibility to ensure that the Final Accounting Personalized 

Notice w/Micro-Perforated Payment Stub imaged with recipient’s name (and other personal information) will be 

matched with the scannable form (which contain 2-D barcodes with personalized data) for the same recipient and be 

inserted correctly into the envelope. 

DISTRIBUTION: 

Deliver f.o.b. destination (with the first order and whenever SSA makes a significant change to the language, 

format, or appearance of a form/notice/envelope) 10 complete copies of each of the 28 versions inserted into mailout envelopes but not sealed. Samples must be printed and constructed in accordance with these specifications and 

delivered to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-

6401. 

Deliver f.o.b. destination (with the first order and whenever SSA makes a copy change to any envelope) 

10 production samples of each mail-out envelope and BRM/CRM return envelopes to Social Security Administration 

(SSA), Mail and Postage Policy Team, ATTN: Francine Moore, 1712 Annex Building, 6401 Security Boulevard, 

Baltimore, MD 21235-6401. 

Mail f.o.b.contractor’s city: The contractor is responsible for all costs incurred in transporting this product to the U.S. 

Postal Service facility. 

DOMESTIC FIRST-CLASS LETTER-SIZE MAIL: The contractor is required to prepare domestic First-Class 

letter-size mail in accordance with appropriate USPS rules and regulations, including the USPS Domestic Mail 

Manual and Postal Bulletins, in effect at the time of the mailing. 

The contractor is required to prepare Domestic First-Class letter-size mail pieces and obtain the maximum postage 

discount allowed by USPS in accordance with the appropriate USPS rules and regulations, including USPS Domestic 

Mail Manual, and Postal Bulletins on Automation-Compatible First-Class Domestic Mail Automated and Nonautomated mail discount structure in effect at the time of the mailing; a) Automation (5-digit); (b) Automation (3-

digit);(c) Automation (AADC); (d) Automation (Mixed AADC); (e) Non-automation (Presorted); and (f) Nonautomation (Single Piece). 

Contractor will be required to presort all mail in this contract and achieve USPS automated postal rates. To achieve the 

maximum automation compatible postal discount, the contractor is required to either presort the notices prior to 

printing or sort the mail after the notices are inserted. The contractor may use a Presort subcontractor for the mailing 

portion of the contract. SSA has the right to inspect the subcontractor for the security of the mailing operation and 

compliance with the contract. The contractor must disclose how they will achieve maximum postage discounts as 

required in the contract. 

NOTE: Mail addressed to United States territories and possessions (e.g., American Samoa, Federated States of 

Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico and U.S. Virgin Islands, Wake 

Island) and Military Overseas Addresses (APO/FPO mail) is Domestic Mail, not International Mail, and should be 

included in the discount sorting.

SSA requires the use of Permit Imprint. The contractor must use SSA’s “FIRST-CLASS MAIL POSTAGE AND 

FEES PAID” permit imprint mailing indicia printed on each mail piece. Each mail piece sent under this payment 

method must bear a permit imprint indicia showing that postage is paid. Permit imprint indicia may be printed directly 

on mail pieces. Permit imprint mailings must contain at least 200 identical pieces or 50 pounds. The contractor is 

cautioned to use the permit imprint only for mailing material produced under this contract. 

Permit imprint may not be used if the mailing is less than 200 identical pieces or 50 pounds. Instead, the mail must be 

metered and any permit imprint must be covered/concealed by a meter strip. The contractor will be reimbursed for 
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postage by submitting a properly completed U.S. Postal Service form (or equivalent). All meter supplies will be borne 

by the contractor. 

NOTE: The Government will furnish an Official Government Postage Meter for volumes of notices that do not meet 

USPS minimum requirements for permit imprint. Postage meter replenishments are done by the contractor and the 

funds come from a Government account. 

The contractor is strongly encouraged to use manifest mail when postal regulations allow. The contractor must have a 

Manifest Mailing System (MMS) for First-Class Mail, which has been approved by USPS to document postage 

charges for this mailing. Each mail piece must be identified with a unique identification number or with a keyline 

containing a unique identification number and rate information about the piece. Requirements for the MMS are 

contained in Publication 401 “USPS Guide to the Manifest Mailing System” in effect at the time of the mailing. A 

copy of the USPS approval for the MMS must be presented at the postaward conference. 

Contractor will be required to produce and use a USPS Intelligent Mail Barcode (IMB) Full-Service option and 

achieve the maximum postage discounts available with this option. The contractor will be required to comply with 

USPS requirements and place the IMB on all mail pieces of this workload The contractor is required to be capable of 

achieving the postage discounts available with the Full-Service option of the IMB program. The Full-Service option 

requires the contractor to use Postal One. 

NOTE: The contractor is responsible for producing and providing all reporting data required for acceptance and 

processing of Full-Service mail required by USPS for the IMB. IMB, delivery address placement, and envelopes used 

for the mailing are among the items must comply with USPS requirements for automation-compatible mail in effect at 

the time of the mailing. 

SSA will provide the contractor with a six-digit Mailer Identifier (MID) for the mailing. The Mailer Identifier (MID) 

is a field within the Intelligent Mail barcode that is used to identify the owner of the mail. 

In addition, USPS has instituted a verification procedure called a “tap” test. This test is used to screen all mailings 

with barcoded inserts for proper barcode spacing within the envelope window. When the insert showing through the 

window is moved to any of its limits inside the envelope, the entire barcode must remain within the barcode clear 

zone. In addition, a clear space must be maintained that is at least 0.125” between left and right edges of the window, 

and at least 0.028” clearance between the IMB and the top and bottom edges of the window. 

All letters in a mailing must pass the “tap” test in order to obtain the maximum postal discounts for the agency. The 

contractor will be responsible for payment of any additional postage resulting from a loss of postage discounts due to 

failure to pass the “tap” test because of inaccuracy or failure to conform to USPS specifications 

Contractor should be aware that the USPS uses the Mail Evaluation Readability Lookup Instrument (MERLIN) to 

evaluate barcodes. If MERLIN is in effect in the contractor’s geographic area, the contractor must ensure that all 

barcoded mail meets the new barcode standards. The contractor will be responsible for payment of any additional 

postage resulting from a loss of such discounts due to failure of the contractor-generated barcodes to pass the 

MERLIN test because of inaccuracy or failure to conform to USPS specifications. 

METERED MAIL: 

The contractor is responsible for the security of the SSA postage meters and access is to be restricted to authorized 

personnel only. Contractors are to place SSA postage meters in a locked position and place them in a secure server 

room or safe when not in use. The contractor is to advise all staff there is a penalty for the private use of official 

postage meters (39USC3203). 

Contractors should always maintain sufficient postage on the SSA meters. The contractor should contact SSA if they 

are not sure of how much postage to load or frequency. 
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The contractor is required to submit spoiled postage/postage error envelope(s)/meter strip(s) and prepare a Postal 

Service Form 3533, Application for Refund of Fees, Products and Withdraw of Customer Accounts. Forms are not 

obtainable from the United States Postal Service (USPS) website since they contain a barcode making each form 

unique. Contractors will go to local Post Offices, postal retail units, or Bulk Mailing Units to obtain the hardcopy 

version of the revised PS Form 3533. USPS will credit the postage refund to SSA through the Official Mail 

Accounting System (OMAS). SSA requires the contractor to submit a copy of Form 3533 along with the associated 

print order in which the spoilage occurred and all other postal documentation to the SSA Program Lead. 

The contractor must have approval from SSA’s Postage Meter Accountability Team for turn-in of SSA postage 

meter(s) to the meter manufacturer (e.g., excess meter, defective meter, etc.). If the contractor requires a replacement 

postage meter, USPS credits any remaining postage to SSA through the USPS’ Official Mail Accounting System 

(OMAS) or the meter manufacturer may transfer the remaining postage from the old meter to the new meter. The 

contractor should be sure to document the last meter reading (postage remaining amount) before the meter is checked 

out of service. The Contractor may receive a PS Form 3601-C, Postage Meter Activity Report from the meter 

manufacturer. The contractor is to forward a copy of this report to SSA within three workdays of the transaction. 

On the first workday of each month, the contractor must load $5.00 on all SSA postage meters (including back-up 

postage meters). In addition to the monthly upload, the government reserves the right to request the contractor to 

upload additional funds at any time. These uploads are in addition to any routine meter replenishments. As a result of 

the postage uploads, the contractor may receive a Postage Meter Reset Activity Report Statement from the meter 

manufacturer. If received, the contractor should retain this documentation for 12 months. 

Do not relocate SSA postage meters to any other building. Contactors are required to contact the SSA Program Lead 

before any movement of an SSA postage meter. 

The contractor is required to prepare all metered mail in accordance with the rules and regulations in USPS’s 

Domestic Mail Manual and International Mail Manual.

NOTE: Contractors should not receive invoicing for meter rentals. If you do receive an invoice, contact your 

SSA Program Lead immediately.

Contractor Sites Using “Official Government” Postage Meters with Automated Reporting Capability 

(detailed and limited): 

Postage meters with “Detailed Account Reporting” are capable of providing trend reports, postal class reports, 

summary reports, chart production, accounts, sub-accounts, operator ID’s, etc. These meters provide SSA with 

remote tracking per print program of postage used. This is SSA’s preferred meter type. This meter type is ideal 

for use when processing multiple SSA workloads because of the account and sub-account feature. Contractors 

will be required to utilize the postage meter account feature for each SSA print program. Contractors may also be 

required to use sub-account features for each SSA program. If a contractor requires assistance with set-up and 

operating the “accounting” features of the postage meters, SSA will provide a contact to assist them. 

Postage meters with “Limited Account Reporting” are capable of providing SSA with remote tracking of the 

meter date, contractor/location, meter used, start funds available, any refills/refunds, number of pieces (postage 

applied), total cost, end funds available, and postage used. This meter is best suited for use when processing one 

single SSA workload. No action is necessary on the part of the contractor since SSA will be view postage meter 

usage remotely for the individual workload. 

Contractor Sites Using an SSA Postage Meter Activity Log (manual process): 

Contractors using mailing equipment that cannot support a postage meter with an internal accounting feature 

and/or capable of remotely providing SSA with the detailed data it requires when producing multiple workloads 

will receive a compatible meter but will be required to complete an SSA Postage Meter Activity Log (Exhibit J). 
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490-S (12/17) 

The contractor will forward a completed SSA Postage Meter Activity Log to the appropriate SSA Program 

Lead/or back-up for each print order. If the contractor is producing multiple workloads using the same postage 

meter, the contractor is required to send the log to each Program Lead/back-up. Every field must contain an entry 

or an N/A if the field does not apply. SSA will return incomplete or incorrect activity logs to the contractor for 

correction. Note: If a primary meter fails and a back-up meter is needed to complete the workload, the contractor 

will need to document the primary meter log in the note field (i.e., meter failed, out of postage, etc.) and create a 

new activity log (documenting the necessary fields) to use with the back-up meter. 

NOTE: Use of the above accounting feature or manual logs does not alter the current postal process. Contractors 

will continue to forward all postal documentation as required in the contract requirements. 

NATIONAL CHANGE-OF-ADDRESS (NCOA) AND CODING ACCURACY SUPPORT SYSTEM (CASS): 

Addresses for this contract will come from the SSA’s Master Beneficiary Record (MBR) and Supplemental Security 

Record (SSR). SSA will provide certificates indicating that the addresses have been matched against USPS certified 

Coding Accuracy Support System (CASS) ZIP Code software. The contractor must generate an Intelligent Mail 

Barcode (IMB) from the ZIP+4 data on SSA’s files.. 

SSA will provide a certificate indicating the MBR (Title II) addresses have been processed by a licensed National 

Change of Address service vendor. New CASS and NCOA certificates will be provided to the contractor by SSA as 

required by the USPS Domestic Mail Manual. 

“ADDRESS SERVICE REQUESTED” endorsement must appear on the SSR (Title XVI) notice envelopes in one of 

the locations approved by USPS. (This endorsement must not be used on the MBR (Title II) notice envelopes). 

All versions mailed will have a printed “Postage and Fees Paid” First Class Mail permit mailing indicia. The 

contractor is cautioned that this “Postage and Fees Paid” indicia may be used only for the purpose of mailing material 

produced under this contract. 

All copies mailed must conform to the appropriate regulations in the USPS manuals for “Domestic Mail” 

USPS CERTIFIED MAIL: 

The domestic mail pieces included in these mailings may be required to be mailed using USPS Certified Mail. The 

contractor will prepare these mail pieces according to USPS regulations contained in the Domestic Mail Manual 

(DMM) under Section 503.3.0, Certified Mail. Notices associated with the certified mail file shall be inserted into 

envelopes and processed as certified mail. The contractor must place the current U.S. Postal Service Form 3800 (20 

digit certified number and barcode) on the envelope. The contractor must prepare the file as a separate permit imprint 

mailing of identical weight pieces using the appropriate U.S. Postal Service mailing statement. 

MAILING DOCUMENTATION: 

The contractor shall provide SSA with complete copies of all documents, including GPO’s Form 712 (Certificate of 

Conformance), used by USPS to verify and accept the mail (e.g., computer records of presort ZIP+4, barcode 

breakdown, press runs, etc.). The contractor shall place the number that is on top of the GPO Form 712 (the number 

that starts with “A”) in the space provided on the USPS mailing statements. If no space is provided on the mailing 

statement, place the number in the upper right margin of the mailing statement. 

NOTE: The contractor will use Federal Agency Cost Code 276-00020 on all mailing documents.. 

The contractor shall provide, within 72 hours of each print order being provided to the USPS, PDF copies of all 

mailing documentation and matching 100% Accountability Summary Reports via e-mail to Melissa Picone at 

Melissa.picone@ssa.gov. All copies must be legible, include both obverse and reverse sides, and any required 

information for dissemination. 
Representative Payee and Beneficiary Recontact Reports Page 49 of 57 

490-S (12/17) 

Furnished material, proofs, and USPS validated copies of postal documentation must be delivered (via overnight 

carrier or PDF copies via e-mail) to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, 

Baltimore, MD 21235-6401.. 

Upon completion of this contract, the contractor must return all Governments furnished materials (Manuscript copy, 

camera copy, PDF file or electronic media) for each product to: SSA, Melissa Picone, OPAMS, 1354 Annex 

Building, 6401 Security Boulevard, Baltimore, MD 21235-6401.. 

All expenses incidental to returning this material, submitting proofs, and furnishing samples copies must be borne by 

the contractor.

PAYMENTS ON PURCHASE ORDER: 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 

FAX 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

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

willbe 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 Publishing Office, Washington, DC 20401 

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

BILLING DOCUMENTATION: Within ten (10) workdays following the completion of each print order, the 

contractor must submit via e-mail one (1) copy of the contractor’s billing voucher showing amount of billing invoice 

to melissa.picone@ssa.gov. The original voucher will be sent to the COMPTROLLER-FMCE, U.S. Government 

Publishing Office.

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

to receipt of the individual print order (GPO Form 2511). 

In the event that it becomes necessary for the contractor to deviate from the specified mail out date or the quantity to 

be mailed, SSA must be notified immediately. 

Furnished material and proofs must be picked up from and delivered to: SSA, Melissa Picone, OPAMS, 1354 Annex 

Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 

Manuscript copy, camera copy, PDF file or electronic media for forms, notices w/micro-perforated payment stub, 

instruction sheets, flyer, and envelopes will be provided at the postaward meeting or immediately following post 

award. 

Print orders will be released as follows: 

Title II - between the twentieth and twenty-seventh of each month 

Title XVI - on the Monday following the first Saturday of each month 

Title II-Final Accounting – on the Monday following each Sunday of each week 

Beneficiary Recontact – between the twentieth and thirty-first of each month 
Representative Payee and Beneficiary Recontact Reports Page 50 of 57 

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PROOF SCHEDULE: 

Proofs will be required for the initial order and any time a copy change is required during the term of the contract. 

Proofing for Initial Start-Up: The contractor must submit proofs for all scannable forms, personalized notices 

w/micro-perforated payment stub, instructions sheets, flyer, and envelopes under this contract within seven (7) 

workdays after receipt of furnished materials. Furnished materials (if manuscript or camera is provided) must be 

returned with proofs. 

Scannable Forms – Submit 25 printed samples of the Scannable Forms, Mailers 1-28, (no variable data) to: 

Social Security Administration, ATTN: Patrice Gallagher, Analysis Staff, Room 341, 1150 East Mountain Drive, 

Wilkes-Barre, PA 18702-7997, and to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security 

Boulevard, Baltimore, MD 21235-6401. 

Personalized Notices w/Micro-Perforated Payment Stub – Submit 25 printed samples of the Personalized 

Notices w/Micro-Perforated Payment Stub, Mailers 19-24 (no variable data) to: SSA, Melissa Picone, OPAMS, 

1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 

Instruction Sheets, Flyer, and Envelopes – Submit 10 printed samples of the instruction sheets, flyer, and 

envelopes to: SSA, Melissa Picone, OPAMS, 1354 Annex Building, 6401 Security Boulevard, Baltimore, MD 

21235-6401. 

NOTE: The Government reserves the right to request PDF proofs. When PDF proofs are requested, the contractor 

must submit the PDF’s within 48 hours 

The Government will approve, conditionally approve or disapprove the proofs within five (5) workdays of receipt 

thereof. The contractor must submit revised proofs, if necessary, due to author’s alterations (AA’s) within three (3) 

workdays after notification and receipt of furnished materials. No additional time will be permitted due to 

contractor’s errors (PE’s). Revised proofs will be available for pickup within three (3) workdays. The first workday 

after receipt of proofs at SSA is day one (1) of the hold time. 

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 thereof. 

Proofing (other than initial start-up): The contractor must submit proofs for all scannable forms, personalized 

notices w/micro-perforated payment stub, instructions sheets, flyer, and envelopes under this contract within five (5) 

workdays after receipt of furnished materials. Furnished materials (if manuscript or camera is provided) must be 

returned with proofs. 

The Government will approve, conditionally approve or disapprove the proofs within five (5) workdays of receipt 

thereof. The contractor must submit revised proofs, if necessary, due to author’s alterations (AA’s) within three (3) 

workdays after notification and receipt of furnished materials. No additional time will be permitted due to 

contractor’s errors (PE’s). Revised proofs will be available for pickup within three (3) workdays. The first workday 

after receipt of proofs at SSA is day one (1) of the hold time. 

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 thereof. 

NOTE: The Government reserves the right to request PDF proofs. When PDF proofs are requested, the contractor 

must submit the PDF’s within 48 hours. 
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TEST SCHEDULE: 

Prior to receiving transmission of live production data files, the contractor will be required to perform the following 

tests: (The Transmission Test will begin after the Government is notified of the availability of the system.) 

See “TRANSMISSION TEST AND PRE-PRODUCTION VALIDATION TESTS”.

1) Transmission Test: The contractor will be required to receive approximately 761,500 notices within one (1) 

workday. The contractor will be required to perform a Record Count Verification within one (1) workday after 

the complete transmission of the test files. The contractor will be required to copy the files to their own system 

and provide the exact file counts received (broken down by dataset name) via email to melissa.picone@ssa.gov

before proceeding with any other processing. SSA will verify that the counts match and notify the contractor 

within one (1) workday. The contractor will be required to run the test file through their CASS certification 

system. When the Record Count Verification and CASS certification have been successfully completed, the 

contractor will be required to provide SSA, within three (3) workdays, 10 test samples from each file transmitted. 

The Government will approve, conditionally approve, or disapprove the samples from the Transmission Test 

within two (2) workdays of receipt thereof.

2) Pre-Production Validation Tests:

Scannable Forms Validation Test - Within five (5) workdays after receipt of the Governments final approval on 

the twenty-eight (28) Scannable Form proofs, the contractor must conduct a Scannable Forms Validation Test and 

furnish 1,400 printed samples (50 samples of each Mailer 1-28) for validation. Forms must be complete and 

include all variable data from the Government furnished test files. The Government will approve, conditionally 

approve, or disapprove the pre-production validation samples within five (5) workdays of the receipt thereof. 

Micro-Perforated Payment Stub Validation Test - Within five (5) workdays after receipt of the Governments 

final approval on the six (6) Title II – Final Accounting Personalized Notices w/Micro-Perforated Payment Stub 

proofs, the contractor must conduct a Micro-Perforated Payment Stub Validation Test and furnish 300 printed 

samples (50 samples of each Mailer 19-24) for validation of the alpha-numeric scan line. The Government will 

approve, conditionally approve, or disapprove the pre-production validation samples within five (5) workdays of 

the receipt thereof. 

Construction Samples Validation Test - Within five (5) workdays after the Governments final approval of all 

the necessary components including the Pre-Production Validation Tests for the Scannable Forms and Title II – 

Final Accounting Notices w/Micro-Perforated Payment Stub, the contractor must conduct a Construction Samples 

Validation Test and furnish 420 sample notice packages (15 samples of each Mailer 1-28) of the completed 

product. The Government will approve, conditionally approve, or disapprove the pre-production validation 

samples within five (5) workdays of the receipt thereof. 

The contractor will be required to have all material necessary to perform these tests. The contractor must produce 

a sufficient amount of notices that will prove to the Government representatives the contractor can satisfactorily 

complete the requirements of this contract during live production. 

NOTE: Failure of the contractor to perform any of the above tests satisfactorily may be cause for default. The 

Government reserves the right to waive the requirements of these tests. The contractor will be notified at the 

Postaward Conference if any test(s) will be waived.

NOTE: The Government may require the contractor to make changes to the formats of the scannable forms, notices 

w/micro-perforated payment stub, instruction sheets, flyer, or envelopes at any time during the term of the contract. 

Whenever such copy changes are required, all aspects of the “test schedule” (proofs, schedule, and quantity of test 

samples) must be maintained. Live production of all the mailers will continue during this transition period. 
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PRODUCTION SCHEDULE: 

WORKDAY - The term “workday” is defined as Monday through Friday* each week, exclusive of the days on which 

Federal Government holidays are observed. 

Federal Government Holidays are as follows: New Year’s Day, Martin Luther King’s Birthday, President’s Day, 

Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, Christmas Day. 

*NOTE: The contractor’s FTMS software shall be operational for the receipt of data files 24 hours a day, seven days 

a week, unless otherwise specified by the Government. (See “FILE TRANSFER MANAGEMENT SYSTEM (FTMS) 

REQUIREMENTS” for additional information). 

Regular Schedule - Monthly: 

Title II (Mailers 1-12), Title XVI (Mailers 13-18), Beneficiary Recontact (Mailers 25-28) - The following schedule 

begins the workday after notification of the availability of print order and furnished material; the workday after 

notification will be the first workday of the schedule. Complete production and mailing must be made within 

10 workdays. 

Regular Schedule - Weekly: 

Title II-Final Accounting (Mailers 19-24) - The following schedule begins the workday after notification of the 

availability of print order and furnished material; the workday after notification will be the first workday of the 

schedule. Complete production and mailing must be made within 5 workdays. 

SCHEDULING PRESS SHEET AND PRODUCTION INSPECTIONS: The contractor must notify the GPO of 

the date and time the Press Sheet OR Production Inspection can be performed. In order for proper arrangements to be 

made, notification must be given at least 72 hours prior to the inspection for orders placed on the regular schedule. 

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 am and 2:00 pm, 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. June 2001). 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. 

NOTE: If the backup facility is used for the production of these notices, the Government will require a product 

inspection. Prior to production, notification must be given at least 72 hours in advance of production start-up. 

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

with the 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. 

Upon completion of each order, the contractor is to notify the U.S. Government Publishing Office of the date of 

shipment (or delivery, if applicable). Call (202) 512-0516 or (202) 512-0517; callers outside the Washington, DC area 

may call toll free 800-424-9470 or 800-424-9471. 
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490-S (12/17) 

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 the first 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 under this contract for a like period of time. 

The following item designations correspond to those listed in the “SCHEDULE OF PRICES”.

I. (a) 26 

(b) 4 

(c) 16 

II. (a) 88 

 (b) 36,770 

(c) 36,634 

(d) 9,300 

(e) 9,274 

III. (a) 9,269 

(b) 14 

(c) 8,943 

(d) 9,159 

(e) 115 

(f) 566 

(g) 212 

(h) 9,269 

IV. (a) 9,269 

V. (a) 1 
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SECTION 4. – SCHEDULE OF PRICES 

Bids offered are f.o.b. contractor’s city for all mailing and f.o.b. destination to Baltimore, MD. 

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. 

Prices must be submitted for the entire term of the contract and bids qualified for a lesser period will not be 

considered. 

Fractional parts of 1,000 will be prorated at the per 1,000 rate. 

Cost of all required paper must be charged under Item III “PAPER”. 

I. COMPOSITION: Prices offered must be all-inclusive, and must include the cost of all materials, operations, 

programming, testing, and proofs in accordance with the terms of these specifications for all mailer components, 

consisting of Scannable Forms, Notices w/Micro-Perforated Payment Stub, Instruction Sheets, Flyer, and 

Envelopes. 

(a) Scannable Forms, Notices w/Micro-Perforated Payment Stub, 

Instruction Sheets & Flyer ................................................... per 8-1/2 x 11” page ........ $_____________ 

(b) Instruction Sheets ................................................................. per 17 x 11” page ............. $_____________ 

(c) Envelopes ............................................................................. per envelope ..................... $_____________ 

Any change in the format on any page, or on any envelope, will be charged under the respective component (a) 

or (b) above. 

II. PRINTING, IMAGING AND CONSTRUCTION/BINDING: Prices offered must be all-inclusive for 

printing, imaging, and construction/binding as required, and must include the cost of all required materials 

(except paper) and operations necessary for the complete production of the product listed in accordance with 

these specifications. Cost of all required paper must be charged under Item III. “PAPER”. 

(a) *Make-ready/setup charge ............................................................................................. $_____________ 

*Contractor will be allowed only one (1) make-ready/setup charge per order. This combined charge shall 

include all materials and operations necessary to make-ready and/or setup the contractor’s equipment for that 

run. Invoices submitted with more than one make-ready/setup charge per order will be disallowed. 

(b) Scannable Forms, Notices w/Micro-Perforated Payment Stub 

Instruction Sheets & Flyer (8-1/2 x 11”) ................................. per 1,000 pages ............. $_____________ 

 _____________ 
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 (Initials) 
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(c) Instruction Sheets (17 x 11”) ................................................... per 1,000 pages ............. $_____________ 

(d) BRM/CRM Return Envelopes (4 x 8-7/8”) ............................. per 1,000 envelopes ...... $_____________ 

(e) Mail-Out Envelope w/Window (4-1/4 x 9-1/2”) ..................... per 1,000 envelopes ...... $_____________ 

III. PAPER: Payment for all paper supplied by the contractor under the terms of these specifications, as ordered on 

the individual print order, will be based on the net number of leaves furnished for the product(s) ordered in the 

applicable “Trim Size” group. The cost of any paper required for make-ready or running spoilage must be 

included in the prices offered. 

Computation of the net number of leaves will be based on the following: 

Scannable Forms, Notices w/Micro-Perforated 

Payment Stub, Instruction Sheet, 

Single Page Flyer: 8-1/2 x 11” A charge will be allowed for each page-size leaf. 

Instruction Sheets: 17 x 11” A charge will be allowed for each page-size leaf. 

BRM/CRM Return Envelopes: 4 x 8-7/8” One leaf will be allowed for each envelope. 

Mail-Out Envelopes w/Window: 4-1/4 x 9-1/2” One leaf will be allowed for each envelope. 

Per 1,000 Leaves 

(a) Scannable Forms, White OCR Bond (20 lb.) ................................................................ $_____________ 

(b) Notices w/Micro-Perforated Payment Stub, White Offset Book (50 lb.)....................... $_____________ 

(c) Single Page Flyer, White Writing (20 lb.) ..................................................................... $_____________ 

(d) Instruction Sheets – 17 x 11”, White Offset Book (50 lb.) ............................................ $_____________ 

(e) Instruction Sheets – 8-1/2 x 11”, White Offset Book (50 lb.) ........................................ $_____________ 

(f) BRM/CRM Return Envelope, White Writing (20 lb.) ................................................... $_____________ 

(g) BRM Return Envelope, Colored Writing (20 lb.) .......................................................... $_____________ 

(h) Mail-Out Envelope w/Window, White Wove (24 lb.) or White Offset Book, (50 lb.) .. $_____________ 

IV. INSERTING AND MAILING: Prices offered must include the cost of all required materials and operations 

necessary for the mailing of Mailers 1 through 28, including cost of collating notice(s) (single or multiple 

leaves) in proper sequence and folding to required size in accordance with these specifications, insertion of all 

appropriate items as required (i.e. Scannable Forms, Notice w/Micro-Perforated Payment Stub, Instruction 

Sheets, Flyer, and Envelopes into mail-out envelope and mailing in accordance with these specifications. 

Per 1,000 Mailers 

(a) Inserting all required materials into mail-out envelope (Mailers 1-28) ......................... $_____________ 

 _____________ 

 (Initials) 
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V. TRANSMISSION TEST: Price offered must include all costs incurred in performing the Transmission Test as 

specified in these specifications. These costs shall cover but are not limited to: machine time, personnel, all 

required materials, transmissions, electronic pre-press, plates, paper, printing, imaging, collating, inserting, mail 

preparation, and any other operations necessary to produce the required quantities of the product in the time 

specified and in accordance with specifications. 

(a) Transmission Test .......................................................................................................... $_____________ 

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)