TITLE: Continuing Disability Review Direct Mail Scannable Forms

ITEM NO. DESCRIPTION BOA UNIT RATE COST UNIT RATE COST UNIT RATE COST UNIT RATE 

I. COMPOSITION/CREATING CAMERA COPY: (a) Instruction Sheets..........................per page 1 50.00 $50.00 100.00 $100.00 75.00 $75.00 50.00 

 (b) Scannable Forms...........................per page 1 50.00 $50.00 100.00 $100.00 75.00 $75.00 50.00 

 (c) Envelopes................................per envelope 5 50.00 $250.00 75.00 $375.00 25.00 $125.00 40.00 

II. PRINTING, IMAGING, BINDING AND CONSTRUCTION(a) Scannable Form - includes folding... (1) Makeready and/or Setup 4 50.00 $200.00 272.00 $1,088.00 No Charge $0.00 25.00  (2) Running Per 1,000 Copies 1320 15.00 $19,800.00 40.41 $53,341.20 7.50 $9,900.00 59.00 

(b) Instruction Sheet - includes folding... (1) Makeready and/or Setup 4 50.00 $200.00 272.00 $1,088.00 No Charge $0.00 No Charge 

 (2) Running Per 1,000 Copies 1320 28.00 $36,960.00 40.41 $53,341.20 13.00 $17,160.00 25.00 

(c) BRM Return Envelope - includes construction/converting (1) Makeready and/or Setup 5 50.00 $250.00 No Charge $0.00 No Charge $0.00 50.00 

 (2) Running Per 1,000 Copies 1388 5.40 $7,495.20 76.28 $105,876.64 6.00 $8,328.00 6.63 

(d) Mail-Out Envelope - includes construction/converting (1) Makeready and/or Setup 5 50.00 $250.00 No Charge $0.00 No Charge $0.00 50.00 

 (2) Running Per 1,000 Copies 1385 8.04 $11,135.40 80.26 $111,160.10 5.00 $6,925.00 11.13 III. PAPER(a) ScannableForm - White Offset Book (50-lb.) or White Writing (20-lb) 1,320 6.00 $7,920.00 12.45 $16,434.00 9.00 $11,880.00 6.63 

(b) Instruction Sheet - White Offset Book (50-lb.) or White Writing (20-lb) 1,320 12.00 $15,840.00 23.90 $31,548.00 16.00 $21,120.00 13.27 

(c) BRM Return Envelope - White Writing (20-lb) or White Offset Book (50-lb.) 1,388 6.00 $8,328.00 No Charge $0.00 7.00 $9,716.00 7.48 

(d) Mail-Out Envelope - White Writing (24-lb) or White Offset Book (60-lb.) 1,385 6.00 $8,310.00 No Charge $0.00 7.00 $9,695.00 7.74 

IV. INSERTION, PACKAGING AND MAILING(a) Mailers: Inserting of required materials for each mailer 1,320 22.00 $29,040.00 43.00 $56,760.00 26.10 $34,452.00 52.00 

V. PREPRODUCTION TESTS(a) Wire Transmission Test 1 50.00 $50.00 50.00 $50.00 1,000.00 $1,000.00 No Charge 

(b) Pre-Production Validation Test 1 50.00 $50.00 50.00 $50.00 250.00 $250.00 854.00 

(c) Systems Change Validation Test 1 50.00 $50.00 50.00 $50.00 250.00 $250.00 100.00 

VI. ADDITIONAL OPERATIONS(a) Certified mail, When required - Includes manually filling out labels, affixing two matching labels and preparing for mailing (1) Programming - One time set-up charge for term of contract 1 250.00 $250.00 80.00 $80.00 250.00 $250.00 1,200.00 

 (2) Set-up for each order 4 50.00 $200.00 60.00 $240.00 100.00 $400.00 75.00  (3) Additional cost per mailer 2,227 0.50 $1,113.50 1.00 $2,227.00 1.00 $2,227.00 0.10 

CONTRACTOR SUBTOTALS $147,792.10 $433,909.14 $133,828.00 

DISCOUNT 0.00% $0.00 0.00% $0.00 2.00% $2,676.56 0.00% 

DISCOUNTED TOTALS $147,792.10 $433,909.14 $131,151.44 

PROGRAM NO. 895-STERM: May 10, 2013 to September 30, 2014

DATA INTEGRATORS

FREDERICKSBURG, VA

ABR SERVICES

WOODBRIDGE, VA 

COLOR PRESS

WALLA WALLA , WA

D

RECOGN

MAPLE G

Page 1 of 2
TITLE: Continuing Disability Review Direct Mail Scannable Forms

ITEM NO. DESCRIPTION BOAI. COMPOSITION/CREATING CAMERA COPY: (a) Instruction Sheets..........................per page 1 (b) Scannable Forms...........................per page 1 (c) Envelopes................................per envelope 5II. PRINTING, IMAGING, BINDING AND CONSTRUCTION(a) Scannable Form - includes folding... (1) Makeready and/or Setup 4

 (2) Running Per 1,000 Copies 1320(b) Instruction Sheet - includes folding... (1) Makeready and/or Setup 4

 (2) Running Per 1,000 Copies 1320(c) BRM Return Envelope - includes construction/converting (1) Makeready and/or Setup 5

 (2) Running Per 1,000 Copies 1388(d) Mail-Out Envelope - includes construction/converting (1) Makeready and/or Setup 5

 (2) Running Per 1,000 Copies 1385III. PAPER(a) ScannableForm - White Offset Book (50-lb.) or White Writing (20-lb) 1,320(b) Instruction Sheet - White Offset Book (50-lb.) or White Writing (20-lb) 1,320(c) BRM Return Envelope - White Writing (20-lb) or White Offset Book (50-lb.) 1,388(d) Mail-Out Envelope - White Writing (24-lb) or White Offset Book (60-lb.) 1,385IV. INSERTION, PACKAGING AND MAILING(a) Mailers: Inserting of required materials for each mailer 1,320V. PREPRODUCTION TESTS(a) Wire Transmission Test 1(b) Pre-Production Validation Test 1(c) Systems Change Validation Test 1VI. ADDITIONAL OPERATIONS(a) Certified mail, When required - Includes manually filling out labels, affixing two matching labels and preparing for mailing (1) Programming - One time set-up charge for term of contract 1 (2) Set-up for each order 4 (3) Additional cost per mailer 2,227

CONTRACTOR SUBTOTALS

DISCOUNT

DISCOUNTED TOTALS

PROGRAM NO. 895-STERM: May 10, 2013 to September 30, 2014

UNIT RATE COST UNIT RATE COST UNIT RATE COST UNIT RATE 

50.00 $50.00 500.00 $500.00 100.00 $100.00 75.00 

50.00 $50.00 500.00 $500.00 50.00 $50.00 75.00 

50.00 $250.00 No Charge $0.00 50.00 $250.00 100.00 

300.00 $1,200.00 No Charge $0.00 150.00 $600.00 200.00 

10.00 $13,200.00 12.00 $15,840.00 120.00 $158,400.00 11.57 

150.00 $600.00 No Charge $0.00 150.00 $600.00 200.00 

5.50 $7,260.00 26.00 $34,320.00 120.00 $158,400.00 8.35 

No Charge $0.00 No Charge $0.00 30.00 $150.00 200.00 

5.57 $7,731.16 No Charge $0.00 28.00 $38,864.00 4.76 

No Charge $0.00 No Charge $0.00 50.00 $250.00 200.00 

8.90 $12,326.50 No Charge $0.00 39.00 $54,015.00 6.72 

6.07 $8,012.40 6.00 $7,920.00 9.50 $12,540.00 7.60 

10.75 $14,190.00 14.00 $18,480.00 9.50 $12,540.00 12.52 

5.60 $7,772.80 14.00 $19,432.00 16.90 $23,457.20 7.14 

8.90 $12,326.50 14.00 $19,390.00 19.50 $27,007.50 10.09 

12.95 $17,094.00 10.00 $13,200.00 31.00 $40,920.00 19.54 

No Charge $0.00 No Charge $0.00 250.00 $250.00 No Charge No Charge $0.00 500.00 $500.00 300.00 $300.00 No Charge 

No Charge $0.00 No Charge $0.00 500.00 $500.00 No Charge 

100.00 $100.00 No Charge $0.00 1,200.00 $1,200.00 3,000.00 

50.00 $200.00 No Charge $0.00 80.00 $320.00 250.00 

0.46 $1,024.42 0.45 $1,002.15 1.00 $2,227.00 2.00 

$103,387.78 $131,084.15 $532,940.70 

0.25% $258.47 1.00% $1,310.84 1.00% $5,329.41 0.00% 

$103,129.31 $129,773.31 $527,611.29 

AWARD

CLAYSBURG, PA 

NPC, INC.

SOUR

DATA SYSTEM

NORCROSS, GA

PINNACLE

WBC INC, LITHEXCEL

ALBUQUERQUE, MN

OH

 MIAM

Page 2 of 2
Program 895-S (Formerly Program 889-S) Page 1 of 39 

Specifications by DLL 

U.S. GOVERNMENT PRINTING OFFICE 

Washington, DC 

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

For the Procurement of 

Continuing Disability Review Direct Mail Scannable Forms 

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

Social Security Administration (SSA) 

Single Award 

TERM OF CONTRACT: The base term of this contract is for approximately 18 months beginning Date of Award 

and ending September 30, 2014, 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. 

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 (or from date of 

installation of up to a T-1 line) through September 30, 2013, actual production begins October 1, 2013. 

BID OPENING: Bids shall be publicly opened at 11 a.m., prevailing Washington, DC time, on May 10, 2013

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

Printing Office, 732 North Capitol Street, NW, Mailstop: PPSB, Room C-161, Attn: Bid Section, 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. 

PLEASE NOTE: These specifications have been revised. Bidders are cautioned to familiarize themselves with all 

provisions of these specifications before bidding. 

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

For information of a technical nature call David Love (202) 512-0310 (No collect calls). 
SSA CDR Reports Page 2 of 39 

895-S (9/14) 

SECTION 1 - GENERAL TERMS AND CONDITIONS 

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

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

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

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

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

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

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

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

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

SUBCONTRACTING: The predominant production function is the laser/ion deposition imaging and inserting of data 

from electronically transmitted files. Any bidder who can not perform the imaging of variable data and the inserting 

portions of the mailing packet will be declared non-responsible. Contractor may subcontract any of the following: 

• The printing and converting of the envelopes 

• The printing of the instruction sheet 

• The presorting and mailing of the completed product 

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

If the Contractor wishes 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 sub-contractor is not approved by the Government then the 

contractor must submit a new subcontractor’s information to the Government for approval 30 calendar days prior to the 

start of production at that facility. 

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

requirements of this contract, they must comply with the terms and regulations as detailed in the Printing Procurement 

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

DISPLAY SAMPLES: Previously printed samples comparable to those to be produced on this contract will be 

available upon request. To arrange for supplied samples contact David Love at (202) 512-0310 between the hours of 

9:00 a.m. and 4:00 p.m., Monday through Friday, until the bid opening date. While these samples are representative of 

the printing, binding and other operations required for the major part of the work to be ordered on this contract, 

occasional orders may include additional requirements as provided for in these specifications. 

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. 
SSA CDR Reports Page 3 of 39 

895-S (9/14) 

(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. 

ANSI Standards may be obtained from the American National Standards Institute, 25 West 43rd Street, 4th Floor, 

New York, NY 10036. 

The forms produced under these specifications must be guaranteed to function properly when processed through an 

Integrated Image Based Data Capture System (IIBDCS). The bar coding must be easily readable by an Analog and/or 

Digital bar code scanning device. Forms require precision spacing, printing, trimming, and folding. 

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

Attribute Specified Standard

P-7. Type Quality and Uniformity Proofs / Camera Copy / Average Type Dimensions in Publication 

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

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

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

the total duration of the contract may not exceed five (5) months for setup of file transfer system and testing, and 

five (5) years for actual production as a result of, and including, any extension(s) added under this clause. Further 

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

ADJUSTMENT” for authorized pricing adjustment(s). 

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 September 30, 2014, and the second and any succeeding period(s) will extend for 12 

months from the end of the last preceding period, except that the length of the final period may vary. The first day of 

the second and any succeeding period(s) will be the effective date of the Economic Price Adjustment for that period. 

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

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

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

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

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

ending 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 January 31, 2013 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. 
SSA CDR Reports Page 4 of 39 

895-S (9/14) 

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 0913-01 for offset and text will apply to all paper required under this contract. 

2. The applicable index figures for the month of April, 2013 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(s) IV. (a) and (b) 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: 

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

Administration (SSA) in the performance of this contract to those employees and officials who need it to 

perform the contract. Employees and officials who need access to confidential information for performance of 

the contract will be determined at the post award conference between the Contracting Officer and the responsible 

Contractor representative. 

(b) The Contractor 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 Social 

Security Administration (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. 
SSA CDR Reports Page 5 of 39 

895-S (9/14) 

(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 assure that each Contractor employee with access to confidential information knows the 

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

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

When the Contractor employees are made aware of this information; they are required to sign Form SSA -301, 

Contractor Personnel Security Certification 

See Exhibit A – Form SSA -301, Contractor Personnel Security Certification 

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

Management Team, ATTN: Tina Johnson/Justin Smith, 1363 Annex Building and a copy must also be forwarded 

to: U.S. Government Printing Office, 732 North Capitol Street NW, Stop: CSAPS, Room C-838, AST-4, 

Washington, DC 20401. Attn: Contracting Officer 

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

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

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

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

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

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

26 U.S.C. Section 7213. 

(h) The Government reserves the right to conduct on-site visits to review the Contractor's documentation and in-house 

procedures for protection of confidential information. 

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

conform to all security requirements of the contract. 

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 personally 

identifiable information. Personally identifiable information 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 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. 
SSA CDR Reports Page 6 of 39 

895-S (9/14) 

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 within their department has occurred prior to any 

individual being authorized access to sensitive or critical applications. 

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

outlined by the contractor. 

• Contact the security officer within 24 hours whenever a systems security violation is discovered or suspected. 

Applicability - 

The responsibility to protect personally identifiable information 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 personally identifiable information. 

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. 

• 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 personally identifiable information 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 personally identifiable information 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’s employee has doubts about a specific situation involving their responsibilities for 

safeguarding personally identifiable information, they should consult the Contracting Officer or the Contract 

Administrator. 

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 as detailed 

in the Security Requirements. See Exhibit B: Security and Suitability Requirements

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

SSA site for any reason) or having access to Government programmatic or sensitive information. 

Upon award, the contractor must provide to SSA an applicant listing of all individuals for whom the contractor is 

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

• The contractor’s name 

• The contract number 
SSA CDR Reports Page 7 of 39 

895-S (9/14) 

• The name of the contractor’s point of contact (CPOC) 

• The CPOC contact information including email address 

• Each applicant’s full name 

• Each applicant’s Social Security Number (SSN) 

• Each applicant’s date of birth 

• Each applicant’s place of birth (must show city and state if born in the United States (U.S.) OR city and country if 

born outside of the U.S.) 

The contractor should submit the applicant listing upon contract award. The background investigation process will not 

start until the applicant listing is submitted. 

The applicant listing must be sent via Fax to: the CPSPM Suitability Team at (410) 966-0640 OR sent via U.S. Mail to: 

 SSA, CPSPM Suitability Team, Room 1260 Dunleavy Building, 6401 Security Boulevard, Baltimore, MD 21235. 

Once SSA receives and reviews the applicant listing, SSA will initiate the Electronic Questionnaire for Investigations 

Process (eQIP). SSA will email notification to the CPOC that each applicant has been invited into the eQIP website to 

electronically complete their background investigation form. The CPOC will provide the website to the applicants to 

complete their eQIP form. The applicant will have up to seven (7) calendar days to complete the eQIP form. The 7-

workday timeframe begins once SSA notifies the CPOC of the eQIP invitation(s). The applicant must print the 

signature pages of the form (pages 7 through 9 of SF 85P), sign the signature pages, and provide the signed originals to 

the CPOC.

See Exhibit C – Questionnaire for Public Trust Positions (SF-85P) 

The following is a list of forms each contractor employee is responsible to for completing: 

• Original signed and dated eQIP signature pages (pages 7 through 9 of SF 85P) as specified in the above 

paragraph. 

• Two (2) “Fingerprint Cards” (NOTE: The contractor will absorb the costs for obtaining fingerprints). 

See Exhibit D - Sample of Fingerprint Card (FD-258) 

• One (1) “Declaration for Federal Employment” 

See Exhibit E - Declaration for Federal Employment (OF-306) 

• One (1) “Fair Credit Reporting Act Authorization Form” 

See Exhibit F - Fair Credit Reporting Act Authorization Form 

• 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. For new contract employees hired during the contract term, forms must be submitted at least 15 workdays 

prior to working under the contract. The 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. It is the responsibility of the contractor to ensure fingerprint cards 

are processed through their local police departments or other authorized finger printers. SSA must receive forms within 

30 calendar days of signature and date. SSA will return forms not fully completed back to the contractor. 

Forms may be obtained by calling SSA Personnel Security Suitability Program Officer (SPO) Leslie Herman at (410) 

965-4426 or Joan DeAngelis at (410) 965-6845. 

The CPOC shall submit one (1) cover sheet to SSA 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 SSN, each applicant’s date of birth, and each applicant’s place of birth. 

Submit this cover sheet along with the completed paper forms and two FD-258 fingerprint charts for each applicant to: 

SSA, CPSPM Suitability Team, Room 1260 Dunleavy Building, 6401 Security Boulevard, Baltimore, MD 21235. 
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SSA will send a pre-screening notification within 15 workdays of receipt of properly completed forms and 

fingerprinting cards. Once a contractor employee is approved to work via the pre-screen notification, they are permitted 

to perform work under the contract. A final suitability determination can take up to 45 workdays. 

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 and subcontractor’s 

computer, printing, inserting, and 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. 

The Preaward Survey will include a review of: all subcontractors involved, along with their specific functions; and the 

contractor’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 to meet the file transmission 

requirements, the contractor must provide purchase order(s) with delivery date(s) at least 90 days prior to the start of live 

production, on October 1, 2013. 

NOTE: Due to PII issues, the Government cannot award the contract until all security requirements are met. If the 

contractor fails to meet these requirements within 60 workdays of the start of live production, the contractor will be 

declared non-responsible. 

Production Plans: The contractor shall present, in writing, to the Contracting Officer within five (5) workdays of being 

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

The workday after notification to submit will be the first day of the schedule. 

These proposed plans are subject to review and approval by the government and award will not be made prior to 

approval of same. 

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

Backup Facility: 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 locations for a period longer than five (5) workdays, contractor must have a backup 

facility with the capability of producing the notices/forms/publications. 

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, 

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

Part of the plan must also include the transportation of Government materials from one facility to another. SSA has 

the option to install a T1 line into the backup facility. 

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

Quality Control Plan – The contractor shall provide and maintain, within his own organization, an independent 

quality assurance organization of sufficient size and expertise to monitor the operations performed, and inspect the 

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

and acceptance provisions are met. The contractor shall 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 shall 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. The quality control plan must account for the number of pieces mailed daily. 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 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). 
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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, provide for back-up and re-running in the 

event of an unsatisfactory sample and contain control systems that will detect defective, missing, or mutilated pieces.

The plan should include the sampling interval the contractor intends to utilize. The contractor will be required to 

create two quality control samples to be drawn from the production stream at the same time – 

• 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 Social Security Administration and will be packed with the remaining 

samples associated with each print order and shipped to the Social Security Administration (address to be 

supplied at the Post-Award Conference). 

The plan shall detail the actions to be taken by the contractor when defective, 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 shall monitor all aspects of the job including material handling and mail flow, to assure that 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 page 11 of 39: “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 

calendar days subsequent to the date of the check tendered for final payment by the Government Printing 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 for electronic 

transmission of CIPA notice 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 shall demonstrate the contractor’s ability to provide complete hardware and software compatibility 

with SSA’s existing network (see “Wire Transmission Test” for additional information). The contractor must 

complete a System Plan. 

See Exhibit H – System Plan 

Included with the Computer System Plan shall 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(s) plans to use a 

consultant for either of these operations, a resume(s) must still be included. 

Mail Plan – This plan should include sufficient detail as to how the contractor will comply with all applicable U.S. 

Postal Service (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 – 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 pickup/delivery. 
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Personnel Plan – In conjunction with the required applicant listing, 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 be given to familiarize them with the 

requirements of this program. 

(See page 6 of 39: “PUBLIC TRUST SECURITY REQUIREMENTS”) 

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

• List of all production equipment and equipment capacities to be utilized on this contract; 

• The production capacity currently being utilized on this equipment; 

• The capacity that is available for these workloads; and, 

• If new equipment is to be utilized, documentation of the purchase order, source, delivery schedule and 

installation dates are required. 

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. 

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). 

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

for the CIPA 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) shall be limited to security-trained employees 

involved in the production of CIPA Notices.

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

walls, equipment to be used, and the printing and finishing locations. 

 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. 

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

production of sensitive SSA records will be definitively destroyed (ex., burning, pulping, shredding, macerating, 

or other suitable similar means). Electronic Records must be definitively destroyed in a manner that prevents 

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

inappropriate manner in violation of law and regulations. Sensitive records are records that are national security 

classified or exempted from disclosure by statue, including the Privacy Act or regulation. The contractor, at a 

minimum, must crosscut shred all documents into squares not to exceed one-quarter inch. All documents to be 

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. 
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UNIQUE IDENTIFICATION NUMBER: Unique identification 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. 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, or mutilated pieces 

detected are identified, reprinted and replaced. The contractor’s recovery system must use the unique alpha/numeric 

identifiers assigned to each piece (including quality control samples) to aid in the recovery and replacement of any 

defective, missing, 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 U.S. Postal Service (USPS) facility. An 

explanation of the contractor’s sequential numbering system is required to understand the audit trail required for each 

and 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 United 

States postal system. 

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

at least 90 calendar days prior to the start of live production on April 1, 2013. 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 shall be defined as follows: 

• Each notice shall 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 effected notices. 

Mailing integrity shall be defined as follows: 

• All notices received from SSA for each file date were printed, inserted and entered correctly into the United States 

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

capable of: 

(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 pieces that are 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, re-scanned 

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. 

(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 operator. 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. 

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

divert such as missing sequence number, missing leaves, mutilated, duplicate, pulled for inspection). 

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, and total completed. 

10. Audit report must contain the same information for all the reprints married with this 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). 

 See Exhibit G - 100% Accountability Summary Report 

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 and date that each was completed. 

NOTE: A PDF copy of the summary report(s) and matching GPO 712 form(s) must be submitted to: Justin Smith at 

justin.smith@ssa.gov for each file date within two (2) workdays of mailing. 

Contractor must submit a sample of their Audit and Summary reports with the required Pre-Award Production Plans for 

approval.

Contractor must generate an automated audit report when necessary showing the tracking of all notices throughout 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 email in 

MS word, MS Excel or PDF. 

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

made available to SSA for auditing of contractor performance upon request. 

The contractor must maintain quality control samples, inspection reports and records for a period of not less than 180 

calendar days subsequent to the date of the check tendered for final payment by the Government Printing Office. The 

Government will periodically verify that the contractor is complying with the approved quality control plan through onsite 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 that the contractor produce individual pieces in transit 

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

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

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 one private office of not less than 150 square feet, furnished with one desk, 

one swivel arm chair, two telephone lines (one for a PC and one for a telephone) and one facsimile machine. The 

Government will supply hookups and cover the cost of the telephone/facsimile machine service), two work tables, and 

two four-drawer letter-size files with combination padlock and pendaflex file folders or equal. 
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On-site representative(s) may be stationed at the contractor’s facility to: provide project coordination in receipt of wire 

transmissions; verify addresses; monitor the printing, imaging, 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 any and all 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: Unless waived by the Contracting Officer, the total requirements of the job as 

indicated in these specifications will be reviewed by Government representatives with the contractor’s representatives at 

the Social Security Administration, Baltimore, MD, immediately after award. NOTE: Person(s) that the contractor 

deems necessary for the successful implementation of the contract must be in attendance. 

PREPRODUCTION MEETING: A preproduction meeting covering the printing, imaging, folding, inserting, and 

mailing shall 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 Government Printing 

Office, Social Security Administration and the U.S. Postal Service. The contractor shall present and explain their final 

plan for the printing, imaging, folding, inserting, and mailing of the CIPA Notices. 

The contractor shall 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. 

In addition, the contractor shall be prepared to present detailed production plans, including such items as quality 

assurance, projected commencement dates, equipment loading, pallet needs, etc. The contractor is to provide the name of 

the representative responsible for the mailing operation and that individual’s backup. 

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

attendance. 

ASSIGNMENT OF JACKETS, PURCHASE, TASK ORDERS AND PRINT ORDERS: A GPO jacket number will 

be assigned and a purchase order issued to the contractor to cover work performed. The purchase order will be 

supplemented by an individual daily electronic “Task Order” for each job placed with the contractor. A print order will 

be issued weekly and will indicate the total number of task orders placed and the total number of notices produced that 

week. The print order will also indicate any other information pertinent to the particular order. 

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

supplemented by daily electronic task orders. Orders may be issued under the contract from Date of Award through 

September 30, 2014, plus for such additional period(s) as the contract is extended. All print orders and task orders 

issued hereunder are subject to the terms and conditions of the contract. The contract shall control in the event of 

conflict with any print order or task order. Task orders will be “issued” daily for purposes of the contract and shall detail 

the daily volume of notices required. A print order (GPO Form 2511) to be used for billing purposes will be issued 

weekly and will cover all daily task orders issued that week. 

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

effective period of this contract. 

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

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

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

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

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

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

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.
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CRIMINAL SANCTIONS: 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 an agency, 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 

thereunder, 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 

$10,000.00. 
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SECTION 2 - SPECIFICATIONS 

SCOPE: These specifications cover the production of English language mailers, consisting of an instruction sheet, a 

personalized scannable form, a return envelope (bilingual English and Spanish), and a mail-out envelope. The 

production of these forms will require such operations as the receipt and processing of wire transmitted or VPN Internet 

transmitted data, composition, printing/imaging (including computerized printing) in one ink color, duplex imaging (both 

sides of form), folding, inserting into envelopes, and distribution. 

Performance of Finished Product: The forms produced under these specifications must be guaranteed to function 

properly when processed through an Integrated Image Based Data Capture System (IIBDCS). The bar coding must be 

easily readable by an Analog and/or Digital bar code scanning device. 

IMPORTANT: Forms require precision spacing, printing, and trimming. 

FORM NUMBER: SSA-455-OCR-SM (7-2009) 

TITLE: Disability Update Report 

FREQUENCY OF ORDERS AND ESTIMATED QUANTITIES: 

(Based on the original term of the contract and the assumption that all option years are exercised) 

Mailer Type Mailing Date Est. Quantities

Mailer #1 October 11, 2013 300,000 

First Request, Title II February 14, 2014 250,000 

 June 6, 2014 250,000

 800,000 Total FY 2014 

 

 October 10, 2014 300,000 

 February 13. 2015 250,000 

 June 5, 2015 250,000

 800,000 Total FY 2015 

 October 16, 2015 300,000 

 February 12, 2016 250,000 

 June 10, 2016 250,000

 800,000 Total FY 2016 

October 14, 2016 300,000 

 February 10, 2017 250,000 

 June 9, 2017 250,000

 800,000 Total FY 2017 

 October 13, 2017 300,000 

 February 9, 2018 250,000 

 June 8, 2018 250,000

 800,000 Total FY 2018 

4,000,000* Total for Mailer 1 - FY 2014-2018 
SSA CDR Reports Page 18 of 39 

895-S (9/14) 

Mailer Type Mailing Date Est. Quantities 

Mailer #2 October 11, 2013 50,000 

Second Request February 14, 2014 45,000 

Title II June 6, 2014 40,000

 135,000 Total FY 2014 

 October 10, 2014 50,000 

 February 13. 2015 45,000 

 June 5, 2015 40,000

 135,000 Total FY 2015 

 October 16, 2015 50,000 

 February 12, 2016 45,000 

 June 10, 2016 40,000

 135,000 Total FY 2016 

 October 14, 2016 50,000 

 February 10, 2017 45,000 

 June 9, 2017 40,000

 135,000 Total FY 2017 

 October 13, 2017 50,000 

 February 9, 2018 45,000 

 June 8, 2018 40,000

 135,000 Total FY 2018 

 675,000* Total for Mailer 2 - FY 2014-2018 

Mailer Type Mailing Date Est. Quantities

Mailer #3 February 14, 2014 125,000 

First Request August 8, 2014 200,000

Title XVI 325,000 Total FY 2014 

 February 13, 2015 125,000 

 August 7, 2015 200,000

 325,000 Total FY 2015 

 February 12, 2016 125,000 

 August 12, 2016 200,000

 325,000 Total FY 2016 

 February 10, 2017 125,000 

 August 11, 2017 200,000

 325,000 Total FY 2017 

 February 9, 2018 125,000 

 August 10, 2018 200,000 

 325,000 Total FY 2018 

 1,625,000* Total for Mailer 3 - FY 2014-2018 
SSA CDR Reports Page 19 of 39 

895-S (9/14) 

Mailer Type Mailing Date Est. Quantities 

Mailer #4: February 14, 2014 35,000 

Second Request August 8, 2014 25,000

Title XVI 60,000 Total FY 2014 

 

 February 13. 2015 35,000 

 August 7, 2015 25,000

 60,000 Total FY 2015 

 February 12, 2016 35,000 

 August 12, 2016 25,000

 60,000 Total FY 2016 

 February 10, 2017 35,000 

 August 11, 2017 25,000

 60,000 Total FY 2017 

 February 9, 2018 35,000 

 August 10, 2018 25,000

 60,000 Total FY 2018 

 300,000* Total for Mailer 4 - FY 2014-2018 

The total mailer estimates per Fiscal Year (FY) is 1,320,000 with a grand total of 6,600,000 for FY 2014 through 

FY 2018. 

*The above specified quantities represent estimated monthly amounts. Exact quantities will be furnished with the 

transmission. No shortages will be allowed. 

NOTE: During the term of this contract, the Government may develop one (1) to three (3) 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. 

The Government reserves the right to increase by up to 25% the total number of notices ordered annually. This 25% 

increase includes the additional notices occasioned by the one (1) to three (3) new notice workloads that may be 

developed during the term of this contract. 

ENVELOPE FULFILLMENT REQUIREMENT: 

Prior to the end of each contract year (around September), the Government will require a special fulfillment order for the 

envelopes shown below. 

ITEM EST. ANNUAL QTY

BRM Return Envelopes (CDR PO Box 4550) 28,000 

BRM Return Envelopes (CDR PO Box 4550) 17,600 

(not-LOW - with large 6-sided asterisk on front) 

BRM Return Envelopes (CDR PO Box 4556) 16,000 

BRM Return Envelopes (CDR PO Box 4556) 6,000 

(not-LOW - with large 6-sided asterisk on front) 

Mail-Out envelopes - Non-indicia 65,000 

The contractor will receive a print order detailing the total number of envelopes required. Complete production and 

fulfillment must be made within 30 business days. 
SSA CDR Reports Page 20 of 39 

895-S (9/14) 

Envelopes are to deliver f.o.b. destination to: Social Security Administration, Wilkes-Barre Data Operations Center, 

Attn: CDR Workload, Room 264, 1150 East Mountain Drive, Wilkes-Barre, PA 18702-7997. 

 

NOTE: Wilkes Barre, PA delivery hours are 6:00 AM to Midnight (Based on local prevailing times, on normal 

Government workdays). 

TRIM SIZES: 

Scannable Form: 8-1/2 x 11” 

Instruction sheet: 17 x 11” flat; folded to 8-1/2 x 11” 

BRM Return Envelope: 4 x 8-7/8” 

Mail-Out Envelope: 4-1/4 x 9-1/2” 

GOVERNMENT TO FURNISH: 

Camera copy for Facing Identification Mark (FIM) and for the Intelligent Mail Barcode (IMB) required for the reply 

envelopes. 

Manuscript copy for three (3) mail-out window envelopes, four (4) BRM return envelopes, scannable form, and 

instruction sheet 

Camera copy for the recycled logo and legend (both English and Spanish versions) 

Construction samples of envelopes and forms 

GPO Form 712 - Certificate of Conformance. 

GPO Form 892 - Proof label. 

PS Form 3615 - Mailing Permit Application and Customer Profile 

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

Exhibit B: Security and Suitability Requirements. 

Exhibit C: Questionnaire for Public Trust Positions (Standard Form 85P). 

Exhibit D: Sample of Fingerprint Card. 

Exhibit E: Declaration for Federal Employment (Optional Form 306). 

Exhibit F: Fair Credit Reporting Act Authorization Form. 

Exhibit G: 100% Accountability and Summary Report. 

Exhibit H: System Plan. 

Exhibit I: Vendor Record Specifications 

Mailing Indicia - “Postage and Fees Paid” 

Coding Accuracy Support System (CASS) Certification Certificate 

National Change of Address Certificate 

Vendor Record Specifications 

Wire transmission or VPN Internet transmission of test and production files. 

A data connection between the contractor’s specified location and the nearest available SSA network interface location 

or SSA’s National Computer Center in Baltimore, MD, if necessary. 

NOTE: Contractor’s equipment/software/system must be capable of supporting T-1 transmissions or an encrypted VPN 

tunnel through the Internet.
SSA CDR Reports Page 21 of 39 

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DATA SET NAMES: 

(Note – data set names are subject to change). 

The data set names for the TEST files are as follows: 

Title II, 1st request English: PUR3490.CSCDR.TSTE.RYYMMDD 

Title II, 2nd request English: PUR3490.CSCDR.SRTSTE.RYYMMDD 

Title II, 1st request Spanish: PUR3490.CSCDR.TSTS.RYYMMDD 

Title II, 2nd request Spanish: PUR3490.CSCDR.SRTSTS.RYYMMDD 

Title XVI, 1st request English: PUR3490.CSCDR.XVITSTE.RYYMMDD 

Title XVI, 2nd request English: PUR3490.CSCDR.SRSSTSTE.RYYMMDD 

Title XVI, 1st request Spanish: PUR3490.CSCDR.XVITSTS.RYYMMDD 

Title XVI, 2nd request Spanish: PUR3490.CSCDR.SRSSTSTS.RYYMMDD 

The data set names for the LIVE PRODUCTION files are:

Title II, 1st request English: PUR3490.CSCDR.FRE.RYYMMDD 

Title II, 2nd request English: PUR3490.CSCDR.SRE.RYYMMDD 

Title II, 1st request Spanish: PUR3490.CSCDR.FRS.RYYMMDD 

Title II, 2nd request Spanish: PUR3490.CSCDR.SRS.RYYMMDD 

Title XVI, 1st request English: PUR3490.CSCDR.XVIFRE.RYYMMDD 

Title XVI, 2nd request English: PUR3490.CSCDR.SSISRE.RYYMMDD 

Title XVI, 1st request Spanish: PUR3490.CSCDR.XVIFRS.RYYMMDD 

Title XVI, 2nd request Spanish: PUR3490.CSCDR.SSISRS.RYYMMDD 

NOTE: Even though the SSA provided files are divided into separate English and Spanish files, all Disability Update 

Report mailers (i.e., the instruction sheet, scannable form, and mail-out envelope) will print only in English except for 

bilingual BRM return envelopes which will print in both English and Spanish. 

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

certified mail. 

See Page 33 of 39: DISTRIBUTION 

The data set names for the Certified Notice Files are as follows:

TITLE II Initial Mailer 

OLBG.BTI.CDCI.CERTPRD.T02MLR1E.RYYMMDD English 

OLBG.BTI.CDCI.CERTPRD.T02MLR1S.RYYMMDD Spanish 

TITLE II Second Mailer 

OLBG.BTI.CDCI.CERTPRD.T02MLR2E.RYYMMDD English 

OLBG.BTI.CDCI.CERTPRD.T02MLR2S.RYYMMDD Spanish 

TITLE XVI Initial Mailer 

OLBG.BTI.CDCI.CERTPRD.T16MLR1E.RYYMMDD English 

OLBG.BTI.CDCI.CERTPRD.T16MLR1S.RYYMMDD Spanish 

TITLE XVI Second Mailer 

OLBG.BTI.CDCI.CERTPRD.T16MLR2E.RYYMMDD English 

OLBG.BTI.CDCI.CERTPRD.T16MLR2S.RYYMMDD Spanish 

The TEST files and LIVE PRODUCTION files correspond to the Scanning Form Identification Code or SFIC (see 

locations 1-5 of the Vendor Record Specifications) and use either PO Box 4550, Wilkes-Barre, PA 18767-4550 or PO 

Box 4556, Wilkes-Barre, PA 18767-4556 as follows: 
SSA CDR Reports Page 22 of 39 

895-S (9/14) 

TEST files: SFIC PO BOX

PUR3490.CSCDR.TSTE.RYYMMDD 11111 4550 

PUR3490.CSCDR.SRTSTE.RYYMMDD 22222 4550 

PUR3490.CSCDR.TSTS.RYYMMDD 33333 4550 

PUR3490.CSCDR.SRTSTS.RYYMMDD 44444 4550 

PUR3490.CSCDR.XVITSTE.RYYMMDD 55555 4556 

PUR3490.CSCDR.SRSSTSTE.RYYMMDD 66666 4556 

PUR3490.CSCDR.XVITSTS.RYYMMDD 77777 4556 

PUR3490.CSCDR.SRSSTSTS.RYYMMDD 88888 4556 

LIVE PRODUCTION files: SFIC PO BOX

PUR3490.CSCDR.FRE.RYYMMDD 11111 4550 

PUR3490.CSCDR.SRE.RYYMMDD 22222 4550 

PUR3490.CSCDR.FRS.RYYMMDD 33333 4550 

PUR3490.CSCDR.SRS.RYYMMDD 44444 4550 

PUR3490.CSCDR.XVIFRE.RYYMMDD 55555 4556 

PUR3490.CSCDR.SSISRE.RYYMMDD 66666 4556 

PUR3490.CSCDR.XVIFRS.RYYMMDD 77777 4556 

PUR3490.CSCDR.SSISRS.RYYMMDD 88888 4556 

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. 

WIRE TRANSMISSIONS: 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. At the 

Government’s option, the Government will either place an order for a dedicated circuit data connection under GSA's 

FTS 2001 contract to be installed within 60 to 90 calendar days between the contractor's location(s) and SSA's network 

interface location OR the connectivity method will be through the Internet using an encrypted VPN tunnel. 

The connection method is at the sole discretion of 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 VPN Internet connection method is deemed necessary, the contractor must have an Internet ready VPN IP security 

(IPsec) capable device. The Government will not be responsible for any cost associated with the VPN Internet 

connection that the Contractor may incur. 

If a dedicated circuit transmission is deemed necessary, SSA will determine the appropriate bandwidth for the 

connection. The cost of this connection will be borne by the Government. The contractor shall immediately provide a 

complete delivery address with nearest cross-street, contact name and phone number for installation of data transmission 

services and equipment. The contact person at the contractor’s site will 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 nonavailability of contact person at the delivery site. SSA will provide the necessary dedicated data connection, including 

a router, modem, and firewall at the contractor’s specified location(s). 

The contractor shall provide adequate rack space for securing the router and firewall; the contractor shall provide a 

dedicated analog dial-up line within eight (8) feet of the router. This dedicated 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 and equipment.

The contractor must provide capability to utilize the capacity of the connection(s) to fulfill the intended purposes of this 

contract. The contractor shall provide a suitable environment for installation of the equipment. 
SSA CDR Reports Page 23 of 39 

895-S (9/14) 

Power specifications for the router(s) are: AC Power Dissipation (280W maximum) and AC input voltage (100 to 

240VAC). 

The cabinet specifications are: 36U enclosure; frame (72” H x 24” W x 36” D); 23-19 inch appropriate revsa rails (10-32 

tapped); louvered side panels; Plexiglas locking front door; solid locking rear door; heavy duty lockable dual width 

casters; top fan assembly (4 fans); 10- or 12-outlet 20-amp power strip; 19” width slide-out shelf; cable management 

(wire loops); appropriate cabinet grounding for installation; or equivalent to previous specifications. 

FILE TRANSFER MANAGEMENT SYSTEM (FTMS) REQUIREMENTS: 

The contractor shall provide the capability to interface with SSA’s national FTMS for electronic transmission of 

designated 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 (formally known as Cyberfusion Integration Suite) software from TIBCO Software. 

The Contractor may implement the Cyberfusion Platform Server that has embedded software encryption capable of being 

enabled. The personal computers/servers must have the capability to run Cyberfusion 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 

Cyberfusion 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 

Cyberfusion 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 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. 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. 

Wire 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. 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 provided to the contractor must be retained for 21 workdays after mailing. 
SSA CDR Reports Page 24 of 39 

895-S (9/14) 

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. 

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 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 must notify Justin Smith (410-966-2173) of any reprogramming and/or reformatting of data supplied by 

wire transmission necessitated due to the contractor’s method of production, with 2 hours of receipt of the data. 

In the event any wire transmission or VPN Internet transmission cannot be processed due to data line or other problems, 

the contractor must notify SSA within 24 hours of receipt. The contractor’s first point of contact at SSA for systems or 

data line problems shall be the HELP DESK at 877-697-4889. 

NOTE: the contractor must not compress files in processing data for this contract. 

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.

WIRE TRANSMISSION TEST, PRE-PRODUCTION VALIDATION TEST / SCANNABLE FORM DATA 

TEST, AND SYSTEM CHANGE VALIDATION TEST: Prior to the commencement of production of orders 

placed under this contract, the contractor will be required to demonstrate their ability to perform to the contract 

requirements. The Government will furnish electronic test files at the Post-Award Conference, or shortly thereafter, 

to be used in performing a Preproduction Validation Test / Scannable Forms Data Test for CDR Reports. 

NOTE: Failure of the contractor to perform any of the following tests (i.e., Wire Transmission Test, Pre-production 

Validation Test / Scannable Form Data Test, or System Change Validation Test) 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 Post-Award Conference if any test(s) will be waived. 

The contractor will be required to perform the following tests: 

Wire Transmission Test: The contractor will be required to receive within one workday approximately 300,000 

notices printing one page head to head. The contractor will be required to perform a Record Count Verification

the same day that the complete transmission of the test files are received. 

The contractor will be required to copy the files to their own system and provide to the SSA, Printing 

Management Branch, Baltimore, MD, , with the exact counts received (broken down by data set name), before 

proceeding with any other processing. SSA will respond within one (1) workday of receipt thereof. 

See Exhibit I – Vendor Record Specifications 

Pre –Production Validation Test (the first print order placed will be for testing): Within five (5) workdays of 

receipt of test files, the contractor shall conduct a validation test and furnish sample copies of the completed 

product as follows: 

100 1st request Title II records (50 English and 50 Spanish) 

100 2nd request Title II records (50 English and 50 Spanish) 

100 1st request Title XVI records (50 English and 50 Spanish) 

100 2nd request Title XVI records (50 English and 50 Spanish) 

In addition to providing validation records with bar coding and all data in the correct position, contractor must also 

run the transmission file through their Coding Accuracy Support System (CASS) to ensure that no problems exist 

with the reading of the address data. Contractor must notify SSA with the results of this test. 
SSA CDR Reports Page 25 of 39 

895-S (9/14) 

The sample copies must be complete and include all variable data from Government furnished files, inserted into 

envelopes. Seal envelopes. The container and accompanying documentation shall include the GPO jacket, purchase 

order, and program number. Test samples should be sent to: SSA, WBDOC, Room 341, 1150 E Mountain Drive, 

Wilkes Barre, PA 18702 Attn: CDR Analyst. 

The Government will approve, conditionally approve, or disapprove the sample copies within 7 workdays of the 

receipt thereof. Agency will test these sample copies on their scanner and bar code reading device(s) 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 sample copies are disapproved by the Government due to printer's errors, the Government at its option may 

require the contractor to submit additional sample copies for inspection and testing, in the time and under the terms 

and conditions specified in the notice of rejection. Such additional sample copies shall be furnished, and necessary 

changes made, at no additional cost to the Government. In the event the additional sample copies are disapproved by 

the Government due to printer's 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 sample copies, if necessary due to author's alterations by the Government, within 5 workdays after 

receipt of furnished materials. Revised sample copies will be available for pick up within 3 workdays. 

Using the test files, SSA will also require the contractor to provide one complete set of PDF files for the scannable 

form test samples listed above. PDF samples should be password coded with a password provided in a separate 

email for any samples containing Personal Identifiable Information (PII). Send PDF test samples to Don Harvey

Don.Harvey@ssa.gov and Justin Smith Justin.Smith@ssa.gov. 

Systems Change Validation Test: When appropriate, the Government will furnish test files for wire transmission 

that are to be used in performing a Systems Change Validation Test. This test is required whenever SSA or the 

Contractor initiates a systems/programming change. See quantities under Pre-Production Validation Test. 

Contractor must provide the Government with 50 complete notices of each of the four versions printed and 

constructed in accordance with the contract within 10 workdays after completion of the order. Deliver copies to 

SSA, 1363 Annex Building, 6401 Security Blvd, Baltimore, MD 21235 Attn; Justin Smith 1363 Annex, 

Contractor is not to implement change until authorized by SSA. Prior to systems/programming changes, the 

Contractor must execute a self-certification statement and schedule the validation test with SSA. The contractor shall 

furnish SSA samples within two days of receipt of the requested change. The Government will approve, 

conditionally approve or disapprove the samples from the Systems Change Validation Test within five workdays of 

receipt thereof. 

Submit revised samples, if necessary due to author's alterations by the Government, within 5 workdays after receipt 

of furnished materials. Revised samples will be available for pick up within 3 workdays. 

NOTE: The Government may require the contractor to make changes to the formats of the scannable forms, instruction 

sheets, 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. 

COMPOSITION: 

Text and form work will be required utilizing Century Schoolbook, or similar serif typeface, and OCR hand printed 

characters typeface. Helvetica, or similar typeface, will be utilized for the envelopes. 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. 

Contractor will be required to typeset the scannable form. Exact spacing of scan boxes and variable data must be 

maintained for readability on pre-programmed scanning equipment. 
SSA CDR Reports Page 26 of 39 

895-S (9/14) 

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. A disk will be provided at post award that will show all the above. 

Composition may be produced by photocomposition or by laser imaging. The entirety of each category of composition 

(text, tabular, and display) must be identical throughout the product(s) ordered under these specifications. 

Photocomposition includes all typesetting produced by photographically creating the characters on sensitized film or 

paper. If laser imaging is used, the images must not be conspicuously different in quality from images produced by 

photocomposition, and must have a density of 300 or more dots per square inch. 

NOTE: The Government may require the contractor to make changes to the formats of the instruction sheet, forms, or 

envelopes at any time during the term of the contract. Therefore pre-printing or stock piling of any or all of the 

components is at the contractor's own risk. The Government shall not be required to purchase from the contractor any of 

the above listed components on hand when a format change is ordered.

PROOFS: Three sets of digital content proofs of all components (All envelopes, scannable form, and instruction sheet) 

will be required. Proofs must be created using the same Raster Image Processor (RIP) that will be used in live 

production. Proofs shall be collated with all elements in proper position (not pasted up), imaged face and back, trimmed 

and folded to the finished size as required for each item. 

All proofs must be clean on white paper, free of ink smudges, with all images clearly legible. All proofs must be collated 

in sets, numbered sequentially, and have a one-inch clear margin on all sides. Proofs must be identified with the jacket 

number, program number, print order number, and proof date, at least 13 mm (1/2") from the type area. The contractor's 

firm name must not appear on any proofs. 

SSA reserves the right to make changes to all proofs. The government may require one or more sets of revised proofs 

before rendering an "OK to print". 

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

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

accomplished within the original production schedule allotted in the specifications. 

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. 

Government Paper Specification Standards No. 12 – http://www.gpo.gov/pdfs/customers/sfas/vol12/vol_12.pdf. 

All paper used in each copy must be of a uniform shade. 

Personalized Scannable Form and Instruction Sheet: White Offset Book, basis weight: 50 lbs. per 500 sheets, 25 x 38", 

equal to JCP Code A60; or, at contractor's option, White Writing, basis weight: 20 lbs. per 500 sheets, 17 x 22", equal to 

JCP Code D10. 

Mail-Out Envelopes: White Writing, wove-finish, basis weight: 24 lbs. per 500 sheets, 17 x 22"; equal to JCP Code V20 

or, at contractor's option, White Offset Book, basis weight: 60 lbs. per 500 sheets, 25 x 38", equal to JCP Code A60. 

BRM Return Envelopes: White Writing, basis weight: 20 lbs. per 500 sheets, 17 x 22", equal to JCP Code D10. 

Total weight of complete mailer MUST NOT exceed 1 ounce. With the exception of the paper being used for the 

scannable form, contractor may substitute paper and/or adjust weight of paper in order to limit weight of mailing unit. 

NOTE: All changes to stock requirements are subject to approval from the Contracting Officer 
SSA CDR Reports Page 27 of 39 

895-S (9/14) 

PRINTING: 

Scannable Form - Print face and back, head-to-head in black ink. 

Instruction Sheet – Print face and back, head-to-head in black ink. 

NOTE: At contractor's option, the entire black ink portion of the face and back of the scannable form may be imaged 

provided that the images produced meet the quality requirements described under “COMPOSITION.” 

BRM Return Envelopes and Mail-Out Envelopes - Print face and back after manufacture in black ink 

There are two different mail-out envelopes and four different BRM return envelopes. Printing shall be in accordance 

with the requirements for the style envelope ordered. All printing shall comply with all applicable U.S. Postal Service 

regulations. The envelope shall accept printing without feathering or penetrating to the reverse side. 

Envelopes require a security tint (straight-line tint is not acceptable) printed on the inside (back - before manufacture) in 

black ink. Contractor may use his own design but must guarantee the product will ensure complete opacity and prevent 

show through of any material contained therein. 

NOTE: Inside BRM return envelopes must contain a clear area, approximate area of 3-1/2 x 5/8" behind the barcode to 

ensure the readability of the barcode by the U. S. Postal Service equipment. 

RECYCLED PAPER LOGO AND LEGEND: 

See Government Paper Specification Standards No. 12 for recycled content requirements 

The English recycled paper logo and English legend, “Printed on recycled paper”, must be printed in black on the last 

page of the instruction sheet and all envelopes. In addition, the Spanish recycled logo and the Spanish legend, "Impreso 

en papel reciclado", must be printed on the back of the four BRM return envelopes. 

IMAGING: 

Contractor will be required to print/image using either laser or ion deposition printing, in black ink, minimum resolution 

of 300 x 300 dpi, utilizing Century Schoolbook or similar serif typeface, on the scannable forms in accordance with the 

following: 

Variable Data 

Face of scannable form - Maximum 20 type lines of alpha-numeric characters, plus contractor created Intelligent Mail 

Barcode (IMB). (See manuscript copy- Face) 

Back of scannable form - 4 type lines of alpha-numeric characters with 2 of the 4 type lines matching the barcodes. 

(See manuscript copy- Back). 

NOTE: The scanning form identification code will consist of a 5-digit number printed using the OCR A font. Print all 

variable data in the “Report Period,” “Beneficiary,” “Telephone Number,” and “Claim Number” areas using the OCR A 

font. 

For those fields that will contain data of varying length (PNA 1 - 6, Beneficiary's Name, and Reporting Period), the 

contractor must make the adjustment (i.e., close up the extra space) in the printing of those fields on the scannable form. 

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: 

Scan Line 1 – Variable up to 32 characters maximum, OCR A font. 

Scan Line 2 – Variable up to 32 characters maximum, OCR A font. 

Scan Line 3 – Variable up to 32 characters maximum, OCR A font. 
SSA CDR Reports Page 28 of 39 

895-S (9/14) 

Variable data for the Scanning Form Identification Code, Report Period, Beneficiary, Telephone Number, Claim 

Number, and Scan Lines shall be printed using the OCR A font. The OCR printing shall 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 shall be based on the number of rejected items in a sample of the size specified in MIL-STD 105, General 

Inspection Level I, with AQL equal to .65 percent. For OCR evaluation, the sampling unit of production shall 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. 

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, 1430 Broadway, New York, NY 

10018. 

Non-variable data may also be printed by laser imaging (or ion-deposition), provided that the images meet the quality 

requirements described under "COMPOSITION". 

not-LOW Personalized Scannable Mailer - Contractor is required to review the ORB field (location 285, Scanline 2, 

Field 3) for all records. For every record containing an “M” or “H” in the ORB field, the contractor must print/image a 

large (48 point) 6-sided asterisk in Times New Roman on the front side of the scannable form. This 6-sided asterisk 

must be positioned in the top left-hand portion of the form starting 2-3/4” from the left margin and ending 9/16” left of 

the Scanning Form Identification Code (SFIC) box. (See “not-LOW” variation in Exhibit ?? for asterisk positioning.) 

Forms printed with the 6-sided asterisk are described as “not-LOW” personalized scannable mailer forms. 

When an asterisk is printed on a not-LOW scannable form, the BRM return envelope included with the form must also 

have a large (48 point) 6-sided asterisk in Times New Roman printed on it and positioned below the return address lines. 

If the value for location 285 (Scanline 2, Field 3, the ORB field) is “L” or blank, the 6-sided asterisk will not be printed 

on either the scannable form or on the BRM return envelope. 

It is expected that all scheduled mailings will include some not-LOW mailers. Upon selection of records for a scheduled 

printing, the contractor will be advised of the amount of not-LOW mailers in the selection by type (Title II and/or Title 

XVI) and by whether they are first-time or second-time mailers. When and where possible, the contractor will be 

notified in advance of approximate amounts for not-LOW future mailings. 

BARCODE REQUIREMENTS: 

The scannable form containsthree barcodes; two data matrix 2D barcodes and one standard 3 of 9 barcode. The standard 

3 of 9 barcode is located on the back of the form. The standard 3 of 9 barcode consist of a maximum 16 characters. The 

barcode 3 of 9 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. A data matrix 2D barcode is located 

on the front and back of the form. See manuscript copy for precise placement and size of barcodes. 

All encoded data is to be preceded and followed by the Standard Barcode 3 of 9 start/stop (*) code. Additionally, where 

blanks occur in the fields identified for conversion to bar code, these blanks should be expressed as barcoded blanks. 

Carbon black ink must be used to image barcodes. Barcodes must not fall on a fold. Contractor will be required to have 

necessary equipment to perform all quality assurance tests and to verify the accuracy of the barcodes during the term of 

this contract. 
SSA CDR Reports Page 29 of 39 

895-S (9/14) 

Standard 3 of 9 barcode

 (Social Security Number, 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 (Font C3901J). 

Note: A standard 1/2" white space for "quiet zone" is required before and after each barcode. 

 Position Field/Entry

 1 Start (*) 

 2-10 SSN 

 11 PC Code 

 12 0 

 13 1 

 14 8 

 15 9 

 16 Stop (*) 

Data Matrix 2D barcodes 

Two Data Matrix 2D barcodes will be required on all scannable forms as follows: 

Front: Located at question 1.b, 5/16” to the left of 1.b2 and 1.b3. Height is 5/8” plus or minus 1/16”; length/width is 

5/8” plus or minus 1/16”. 

Back: Located in the top margin, 1/4” down from the leading edge of the form, and 1-1/2” in from the left edge of the 

form. Height is 5/8” plus or minus 1/16”; length/width is 5/8” plus or minus 1/16” centered in the margin. 

NOTE: At least 1/8” margin (quiet zone) is required top, bottom, left, and right of each 2D barcode. 

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. 

The Data Matrix 2D barcodes should contain the following data elements with a delimited character (comma) inserted 

between each data element: 

Form #: SSA-455 

Revision Date: 072009 (month & year) *subject to change 

Form side: “F” or “B” (Front or Back) 

Request Type: “1” or “2” (First or Second Request) 

Mail Date: MMDDYYYY (Month/Day/Year) 

ScanLine #1: 123456789/C1/1952/0000/12345678/ 

ScanLine #2: 3/---/L/0012/022009/1/8/S11/123/ 

ScanLine #3: ANYCITY /PA/1234567890/ 

End: EOD (End of Data) 

Total of 130 characters 

Example

SSA-455,102003,F,1,02102011,123456789/C1/1952/0000/12345678/,3/---/L/0012/022009/1/8/S11/123/, 

ANYCITY /PA/1234567890/, EOD 

The Data Matrix 2D barcodes must be in accordance with the requirements of ANSI MH 10.8.3M, unless otherwise 

specified. 
SSA CDR Reports Page 30 of 39 

895-S (9/14) 

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. 

Carbon black ink must be used to image barcodes. Barcodes must not fall on a fold. Contractor will be required to have 

necessary equipment to perform all quality assurance tests and to verify the accuracy of the barcodes during the term of 

this contract 

Type of Event Visual Display 

The TOE Code will not be shown on the back of the scannable form in a bar code format. The letters "TOE" and the 

numbers "290", "790", and "990" should be displayed on the back of the scannable form as follows: 

A. If the file contains Title XVI records, Processing Center Code (PC) 0 through 6, then the TOE Code Visual 

Display should read: TOE 290

B. If the file contains Title II records, Processing Center Code (PC) 0 through 6, then the TOE Code Visual Display 

should read: TOE 790

C. If the file contains Title II records, Processing Center Code (PC) 7 or 8, then the TOE Code Visual Display 

should read: TOE 990

PRODUCTION INSPECTION: Production inspection(s) may be required at the contractor’s/subcontractor’s plant for 

the purpose of establishing that the receipt of transmitted files, the printing of notices, the imaging, collating, folding, 

inserting, and mailing is being accomplished in accordance with contract quality attributes and requirements. 

A production 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. 

When a production inspection is required, the Government will notify the contractor. 

MARGINS: 

Scannable Form - Minimum of 1/4" all sides. 

Instruction Sheet and Envelopes – adequate gripper 

BINDING: 

Scannable Form: Fold from flat size of 8-1/2 x 11" to 8-1/2 x 3-2/3" with 2 parallel folds, title out (accordion fold). 

Barcodes on front and back of the scannable form must not fall on a fold. 

Instruction Sheet: Fold from overall flat size of 17 x 11" to 8-1/2 x 11" then fold to 8-1/2 x 3-2/3" . 

CONSTRUCTION: 

BRM return envelope (4 x 8-7/8”): Open side, side seams, with suitable remoisten able glue the entire length of flap that 

will securely seal the return material for mailing. The BRM return envelopes must accommodate the scannable form 

with only those manufactured folds as specified above. 

Mail-out envelope (4-1/4 x 9-1/2”): Open side, with gummed fold-over flap for sealing, and side seams or diagonal 

seams. Face of envelope must contain a 3-3/4 x 1-1/2" die-cut address window with slightly rounded corners, positioned 

1/2" from the bottom edge of envelope and 5/8" from left edge of envelope. Window should be a suitable poly-type, 

transparent and low gloss material (must be clear of smudges, lines, and distortion), securely glued to inside of envelope. 

 The window material must pass USPS readability on its OCR scanner. At contractor's option, opening size of window 

may be adjusted (subject to SSA approval), provided that visibility of the mailing address on the scannable form is not 

obscured, and other extraneous information is not visible when material is folded and inserted in the envelope. 
SSA CDR Reports Page 31 of 39 

895-S (9/14) 

Flap depth must be at least 1-1/2" and flap must be coated with a suitable remoistenable glue that will securely seal the 

envelope for mailing, permit easy opening by recipient, but will not permit resealing of the envelope. Mail-out envelope 

to be securely sealed on all sides and must remain sealed under normal mailing conditions. (Adhesive must not adhere to 

the contents of the envelope.) 

INSERTION: 

Each constructed mailer consists of a folded instruction sheet, a folded personalized scannable form, and a BRM return 

envelope, inserted loose into mail-out envelope so that the payee's name and address on the scannable form appear 

through window. 

Contractor is to follow construction sample for proper insertion. 

DISTRIBUTION: f.o.b. contractor's city. 

Contractor is responsible for all costs incurred in transporting this product to the post office. 

Domestic First-Class Letter-Size Mail

The contractor is required to prepare 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 

SSA requires the use of Permit Imprint. The contractor must use SSA’s “Postage and Fees Paid First Class Mail” 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. 

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 post award conference. 

Permit imprint may not be used if the mailing is less than 200 pieces or pieces that are not identical. Instead, the mail 

must be metered and any permit imprint must be covered/concealed by a meter strip. The contractor will be reimbursed 

for the metered postage by submitting a properly completed Postal Service form (or equivalent). All meter supplies will 

be borne by the contractor 

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) Non- automation 

(Single Piece). 

NOTE: 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 notices/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. 

All mailing must be presorted to the maximum extent possible. 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 CDR Reports Page 32 of 39 

895-S (9/14) 

SSA has the right to inspect the subcontractor for the security of the mailing operation and compliance with the contract. 

 

All of the pieces without a barcode must be separated and mailed as a non-automation rate single piece mailing. 

NOTE: Mail addressed to United States possessions (e.g., American Samoa, Federated States of Micronesia, Guam, 

Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, Virgin Islands, Wake Island, and Military Overseas 

Addresses (APO/FPO mail) is considered Domestic Mail, not International Mail. 

In addition, USPS has 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 (1/8) inch between the left and right edges of the window, and at least 

0.028 inch 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 USPS uses the Mail Evaluation Readability Look-up 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. 

The delivery addresses for this workload will emanate from SSA's Master Beneficiary Record (MBR) Title II and SSA's 

Supplemental Security Record (SSR) Title XVI files. SSA will provide the latest Coding Accuracy Support System 

(CASS) certification and USPS National Change of Address (NCOA) move update service for addresses from the MBR. 

SSA will provide only the CASS certificate for addresses from the SSR. SSA does not match SSR addresses against 

USPS' NCOA. Therefore, when required, the contractor may be required to print an ancillary service endorsement on the 

envelope such as “Address Service Requested” in lieu of the NCOA, in one of the locations approved by USPS. The 

contractor is required to furnish USPS with any required NCOA certificates. 

NOTE: The contractor shall NOT, at any time, perform move updates or address corrections on the notice addresses 

supplied from the SSR. 

Printing of address, barcode, etc. make-up and processing of all mail pieces must comply with the Domestic Mail 

Manual and current issues of the USPS Postal Bulletin. 

To maximize automation discounts, the IMB, delivery address placement and envelopes used for the mailing are among 

the items that must comply with USPS requirements for automation compatible-mail in effect at the time of the mailing. 

It is the contractor's responsibility to assure that only the computer generated address on the personalized scannable form 

will be visible through the window in the envelope and that only one form is inserted into each envelope. 

The contractor will be required to insert behind the form (when viewed from the window side of the envelope) the BRM 

return envelope, and the folded instruction sheet (see construction sample). 

The contractor is required to fill in all applicable items on USPS form(s) and submit in duplicate to the entry post office. 

The contractor is required to use agency cost code 276-00031 on all mailing statements. 

The post office will return a verified copy of USPS form(s) to the contractor. The contractor must immediately forward 

a copy to the ordering agency identifying the Program Number, Print Order, Jacket Number as appropriate. The mail-out 

envelopes will contain the SSA's official First Class permit imprint indicia (G-11). 

The contractor is cautioned that "Postage and Fees Paid" indicia may be used only for the purpose of mailing material 

produced under this contract. 
SSA CDR Reports Page 33 of 39 

895-S (9/14) 

Certificate of Conformance: When using Permit Imprint Mail the contractor must complete GPO Form 712 - Certificate 

of Conformance (Rev. 2/91), supplied by GPO and the appropriate mailing statement or statements, supplied by USPS. 

Within 72 hours after completion of mailing, contractor must deliver (via overnight carrier), copies of Postal Service 

documentation and GPO Form 712 to: Social Security Administration, Printing Management Team, Attn: Justin Smith, 

1363 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 

CERTIFIED MAIL: 

Contractor will be required to process Special Notice Option (SNO) mail pieces 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 Postal Service 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 Postal Service mailing statement. 

The contractor will be reimbursed for the postage costs of certified mail by submitting a properly completed Postal 

Service form (or equivalent). 

MAILING / SHIPPING DOCUMENTATION: 

Upon completion of each order, contractor must notify the ordering agency (on the same day the order delivers) via 

email to justin.smith@ssa.gov and tina.johnson@ssa.gov. The subject line of the email shall be “Distribution Notice for 

Program 895-S, Print Order XXXXX, Jacket Number XXX-XXX.” The notice must provide all applicable tracking 

numbers, delivery method, and title of publication. 

Within 72 hours of completion of the order, all supporting delivery documentation (i.e. shipping receipts and / mailing 

documentation) for each print order is required to be scanned and e- mailed as a PDF to: justin.smith@ssa.gov and 

tina.johnson@ssa.gov

NOTE: Contractor must identify the Program and Print Order number in the subject line of all emails. 

Within 10 working days of completion of the order, one copy of the GPO billing invoice is to be scanned and emailed as a PDF to: justin.smith@ssa.gov and tina.johnson@ssa.gov

PAYMENTS ON PURCHASE ORDER: Processing vouchers for payment, FAX the completed invoice to us by 

utilizing the GPO barcode coversheet program application. Access the following hyperlink and follow the instructions as 

indicated: 

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 will be 

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

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

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

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

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

receipt of the individual print order (GPO Form 2511). 

Furnished material will be available for pick-up at the Post Award Conference or shortly thereafter. 

All furnished material and proofs must be picked up from and delivered to: Social Security Administration, Printing 

Management Team, Attn: Justin Smith, 1363 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 

NOTE: All expenses incidental to returning materials, submitting and picking up proofs, and furnishing proofs 

and samples must be borne by the contractor. 
SSA CDR Reports Page 34 of 39 

895-S (9/14) 

Proofing

Contractor must submit proofs within five (5) workdays after receiving furnished material. 

Proofs will be withheld no more than seven (7) workdays from their receipt at SSA until they are made available for 

pickup. (The first workday after receipt of proofs at the ordering agency is day one (1) of the hold time.) 

If required due to author’s alterations, the contractor must submit revised proofs within five (5) workdays of 

notification. Revised proofs will be withheld no more than three (3) workdays from receipt at the ordering agency until 

they are made available for pickup. 

Schedule for Preproduction Tests

Prior to receiving wire transmission of live production data files, the contractor will be required to perform the following 

tests: 

Wire Transmission Test 

 This test is to be performed after the contract is awarded and the process is ready. The Government will notify the 

contractor when the test will be performed. 

 The contractor will be required to receive approximately 300,000 notices within one (1) workday. 

 The contractor will be required to perform a Record Count Verification same workday as receipt of complete 

transmission of the test files and furnish the Government with the exact counts. 

 The Government will approve, conditionally approve, or disapprove within one (1) workday of receipt thereof. 

Pre-Production Validation Test 

 Contractor must submit required samples from test files within five (5) workdays of receipt of test files. 

 The Government will approve, conditionally approve, or disapprove the preproduction validation test samples 

within seven (7) workdays of receipt thereof. 

 If required due author’s alterations or contractor’s error, the contractor must submit revised samples within five 

(5) workdays of notification. The Government will approve, conditionally approve, or disapprove the 

preproduction validation test samples within three (3) workdays of receipt thereof. 

Systems Change Validation Test 

 When required, contractor must submit required notice samples within two (2) workdays of receipt of test files. 

 Samples will be withheld no more than five (5) workdays from their receipt at SSA until they are made available 

for pickup. 

 If required due to author’s alterations or contractor’s error, the contractor must submit additional samples within 

five (5) workdays of notification. The additional samples will be withheld no more than three (3) workdays 

from their receipt at SSA until they are made available for pickup. 

Initial Start-Up Requirements 

Notices - During the initial start-up (on the first regular production Print Order, in addition to requirements on page 

17 of 40 under FREQUENCY OF ORDERS AND ESTIMATED QUANTITIES) the contractor must provide the 

Government with 50 complete mailers of each of the four versions (200 total complete mailers) printed and 

constructed in accordance with the contract. 

Contractor will be required to ship these samples to: the Social Security Administration, Printing Management 

Team, Attn: Justin Smith, 1363 Annex Building, 6401 Security Boulevard, Baltimore, MD 21235-6401. 
SSA CDR Reports Page 35 of 39 

895-S (9/14) 

Envelopes - Delivery of the following envelope samples must be accomplished within 15 workdays after proof 

approval, printing and converting. 

The contractor must submit 25 samples of each of the seven envelopes to: SSA, WBDOC, Room 341, 1150 E 

Mountain Drive, Wilkes Barre PA, 18702 Attn: CDR Analyst 

The contractor must submit 5 samples of each of the seven envelopes to: SSA,6401 Security Blvd, Baltimore, MD 

21235 Attn: Justin Smith, 1363 Annex. 

Deliver f.o.b. destination with the first order, and whenever copy changes are required, 10 production samples of 

each BRM return envelope to: SSA, Mail and Postage Policy Team, 1333 Annex Building, 6401 Security Boulevard, 

Baltimore, MD 21235-6401 

Regular Production Schedule 

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. 

Accelerated Schedule 

On occasion, the SSA may require an order to be accelerated (estimated 5% of the total orders) requiring complete 

production and mailing within 5 workdays after receipt of files. Orders requiring this accelerated schedule will 

receive a “Premium Payment” of 20% on the bid prices offered for line items II and IV; as specified in the 

“SCHEDULE OF PRICES.” 

Production Inspection 

The contractor must notify the GPO of the date and time the 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. Notify the U.S. 

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

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

Monday through Friday. 

NOTE: See contract clauses, paragraph 14(e) (1), Inspections and Tests in GPO Contract Terms (GPO Publication 

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

The ship/deliver date indicated on the print order is the date products ordered for delivery f.o.b. destination must be 

delivered to the destination(s) specified, and products ordered for mailing f.o.b. contractor’s city must be delivered to the 

post office. 

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

Contractors are to report information regarding each order for compliance reporting purposes and include date of 

delivery (or shipment if applicable) for proofs and delivery schedules in accordance with the contract requirements by 

contacting Shared Support Services Compliance Section via e-mail to compliance@gpo.gov or by calling (202) 512-

0520 or faxing to (202) 512-1364. Personnel receiving the e-mail or call will be unable to respond to questions of a 

technical nature or transfer any inquiries. 

 
SSA CDR Reports Page 36 of 39 

895-S (9/14) 

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 fourteen month's production under this 

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

ordered for a like period under this contract. 

PREMIUM PAYMENTS: Orders requiring an accelerated schedule in order to meet delivery requirements will be paid 

for at the premium payment rate of 20%. 

All other orders will be placed with the required schedule and paid for at the basic prices offered. 

Failure of the contractor to deliver work at the time specified will result in disallowance of premium payments that were 

anticipated and the contractor will not list such items on his voucher.

NOTE: Premium payments, when authorized, will apply to item III only. 

It is estimated that 5% of the orders placed on this contract will require an accelerated schedule. Premium payments 

for an accelerated schedule will be evaluated for award. Evaluation will be effected by applying the premium 

payment rate of 20% to 5% of the abstract cost for line items II and IV; as specified in the “SCHEDULE OF 

PRICES.” 

 

The following item designations correspond to those listed in the "Schedule of Prices". 

 I. (a) 1 

 (b) 1 

 (c) 5 

 II. (a) (1) 4 

 (2) 1,320 

 (b) (1) 4 

 (2) 1,320 

 (c) (1) 5 

 (2) 1,388 

 (d) (1) 5 

 (2) 1,385 

III. (a) 1,320 

 (b) 1,320 

 (c) 1,388 

 (d) 1,385 

 IV. (a) 1,320 

V. (a) 1 

 (b) 1 

 (c) 1 

VI. (a) (1) 1 

 (2) 4 

 (3) 2,227 
SSA CDR Reports Page 37 of 39 

895-S (9/14) 

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 and Wilkes-Barre, PA. 

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

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

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

Government. 

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

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

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

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

Government. 

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

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 must include the cost of all proofs 

(a) Scannable Forms............................................per page................................................................$ ________ 

(b) Instruction Sheets...........................................per 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), (b), 

or (c) above. 

II. PRINTING, IMAGING, BINDING AND CONSTRUCTION: Prices offered must include the cost of all 

materials and operations necessary for the printing/imaging and binding/construction of the product listed in 

accordance with these specifications. 

 Makeready Running Per 

 and /or Setup 1,000 Copies

 (1) (2) 

(a) Scannable form ..............................................per 1000 leaves ..........................$ _________ $ ________ 

Price includes folding from flat size of 

8-1/2 x 11" to 8-1/2 x 3-2/3" 

(b) Instruction Sheet ............................................per 1000 forms ...........................$ _________ $ ________ 

Price includes folding from flat size of 

17 x 11" to 8-1/2 x 3-2/3" 

(c) BRM Return Envelope ..................................per 1000 envelopes ....................$ _________ $ ________ 

Price includes any required 

construction/converting 

(d) Mail-out Envelope .........................................per 1000 envelopes ....................$ _________ $ ________ 

Price includes any required 

construction/converting 

____________ 

(Initials) 
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895-S (9/14) 

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 makeready 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: 8-1/2 x 11" A charge will be allowed for one page-size leaf. 

 Instruction Sheet: 11 x 17” A charge will be allowed for each form 

 BRM Return Envelopes: 4 x 8-7/8" One leaf will be allowed for each envelope. 

 Mail out Envelopes: 4-1/4 x 9-1/2" One leaf will be allowed for each envelope. 

 

Per 

1,000 Leaves

 

(a) Scannable Form:

White Offset Book (50-lb.), or, at contractor’s option, White Writing (20-lb.) ..........................$ ________ 

(b) Instruction Sheet: 

White Offset Book (50-lb.), or, at contractor’s option, White Writing (20-lb.) ..........................$ ________ 

(c) BRM Return Envelope: 

White Writing (20-lb.), or, at contractor’s option, White Offset Book (50-lb.) ..........................$ ________ 

(d) Mail-out Envelope (9 x 12”): 

White Writing (24-lb.), or, at contractor’s option, White Offset Book (60-lb.) ..........................$ ________ 

IV. INSERTION, PACKAGING AND MAILING: Prices offered must include the cost of all required materials 

and operations necessary for the mailing of the notice(s) including cost of collating in proper sequence, insertion 

of Scannable form, Instruction Sheet, and BRM return envelope into mail-out envelope and mailing in accordance 

with these specifications. 

 

 Per 

 1000 Mailers

 (a) Mailers: Inserting of required materials for each mailer ....................................................$___________ 

V. PREPRODUCTION TESTS: Price offered must include all costs incurred in performing the tests as specified in 

these specifications. These costs shall cover but are not limited to: machine time, personnel, all required materials, 

wire transmissions, electronic prepress, 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) Wire Transmission Test...................................................................................... per test ..... $___________ 

 (b) Pre-Production Validation Test .......................................................................... per test ..... $___________ 

 (c) Systems Change Validation Test ........................................................................ per test ..... $___________ 

____________ 

(Initials) 
SSA CDR Reports Page 39 of 39 

895-S (9/14) 

VI. ADDITIONAL OPERATIONS 

(a) Certified mail, when required 

 Includes manually filling out labels, affixing two (2) matching labels and preparing for mailing 

(1) Programming - One time set-up charge for term of contract ............................................. $__________ 

(2) Set-up for each order......................................................................................................... $__________ 

(3) Additional cost per mailer................................................................................................. $__________ 

LOCATION OF POST OFFICE: All mailing will be made from the__________________________________ 

Post Office located at Street Address_____________________________________________________________, 

City__________________, State________________, ZIP Code________________. 

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) 

CIPA Notices Page 36 of 35 

817-S (03/14) EXHIBIT A Page 1 of 3 

CONTRACTOR PERSONNEL SECURITY CERTIFICATION 
CIPA Notices Page 37 of 35 

817-S (03/14) EXHIBIT A Page 2 of 3 

CONTRACTOR PERSONNEL SECURITY CERTIFICATION 
CIPA Notices Page 38 of 35 

817-S (03/14) EXHIBIT A Page 3 of 3 

CONTRACTOR PERSONNEL SECURITY CERTIFICATION 
CIPA Notices Page 39 of 35 

817-S (03/14) EXHIBIT B Page 1 of 4 

SECURITY AND SUITABILITY REQUIREMENTS 
CIPA Notices Page 40 of 35 

817-S (03/14) EXHIBIT B Page 2 of 4 

SECURITY AND SUITABILITY REQUIREMENTS 
CIPA Notices Page 41 of 35 

817-S (03/14) EXHIBIT B Page 3 of 4 

SECURITY AND SUITABILITY REQUIREMENTS 
CIPA Notices Page 42 of 35 

817-S (03/14) EXHIBIT B Page 4 of 4 

SECURITY AND SUITABILITY REQUIREMENTS 
CIPA Notices Page 43 of 35 

817-S (03/14) EXHIBIT C Page 1 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 44 of 35 

817-S (03/14) EXHIBIT C Page 2 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 45 of 35 

817-S (03/14) EXHIBIT C Page 3 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 46 of 35 

817-S (03/14) EXHIBIT C Page 4 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 47 of 35 

817-S (03/14) EXHIBIT C Page 5 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 48 of 35 

817-S (03/14) EXHIBIT C Page 6 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 49 of 35 

817-S (03/14) EXHIBIT C Page 7 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 50 of 35 

817-S (03/14) EXHIBIT C Page 8 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 51 of 35 

817-S (03/14) EXHIBIT C Page 9 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 52 of 35 

817-S (03/14) EXHIBIT C Page 10 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 53 of 35 

817-S (03/14) EXHIBIT C Page 11 of 11 

QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS 
CIPA Notices Page 54 of 35 

817-S (03/14) EXHIBIT D Page 1 of 1 

SAMPLE OF FINGERPRINT CARD 
CIPA Notices Page 55 of 35 

817-S (03/14) EXHIBIT E Page 1 of 3 
CIPA Notices Page 56 of 35 

817-S (03/14) EXHIBIT E Page 2 of 3 
CIPA Notices Page 57 of 35 

817-S (03/14) EXHIBIT E Page 3 of 3 
CIPA Notices Page 58 of 35 

817-S (03/14) EXHIBIT F Page 1 of 4 

FAIR CREDIT REPORTING ACT 

AUTHORIZATION FORM
CIPA Notices Page 59 of 35 

817-S (03/14) EXHIBIT F Page 2 of 4 

FAIR CREDIT REPORTING ACT 

AUTHORIZATION FORM 
CIPA Notices Page 60 of 35 

817-S (03/14) EXHIBIT F Page 3 of 4 

FAIR CREDIT REPORTING ACT 

AUTHORIZATION FORM 
CIPA Notices Page 61 of 35 

817-S (03/14) EXHIBIT F Page 4 of 4 

FAIR CREDIT REPORTING ACT 

AUTHORIZATION FORM 
CIPA Notices Page 62 of 35 

817-S (03/14) EXHIBIT G Page 1 of 2 

100% ACCOUNTABILITY AND SUMMARY REPORTS 
CIPA Notices Page 63 of 35 

817-S (03/14) EXHIBIT G Page 2 of 2 

100% ACCOUNTABILITY AND SUMMARY REPORTS 
CIPA Notices Page 64 of 35 

817-S (03/14) EXHIBIT H Page 1 of 1 

SYSTEM PLAN