Page 1 of 1

PROG# 6499-S........D.O.A. thru Sept 30, 2022

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

READINESS READER McDONALD & Print House

EUDY

BASIS Temple Hills Brooklyn

ITEM OF MD NYNUMBER ITEM DESCRIPTION AWARD UNIT RATE COST UNIT RATE COST

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

I.

COMPLETE PRODUCT:

 (a) Printing in 4-color ink (1) Makeready/Setup per page.................................. 92 50.00 4,600.00 10.00 920.00 (2) Run Per 100 Copies............................................ 666 1.90 1,265.40 10.60 7,059.60

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

TOTAL 5,865.40 7,979.60DISCOUNT 1.00% 58.65 0.25% 19.95NET TOTAL 20 days 5,806.75 7,959.65

AWARDED

Abstracted by: Bruce M. CanzanellaCertified by: Richard Gilbert
Program 6499-S Page 1 of 12 

Specifications by BMC 

Reviewed by MRN 

U.S. GOVERNMENT PUBLISHING OFFICE 

Charleston, SC 

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

For the Procurement of 

READINESS READER 

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

DLA Strategic Data Services (J67D South) 

Jacksonville, FL 

Single Award 

TERM OF CONTRACT: The term of this contract is for the period beginning October 1, 2021 and ending 

September 30, 2022, plus up to four optional 12-month extension periods in accordance with the “Option to 

Extend the Term of the Contract” clause in Section 1 of this contract. 

BID OPENING: Bids shall be opened at 11:00 a.m., prevailing Eastern Time, on September 15, 2021. Due to 

the COVID-19 pandemic, this will NOT be a public bid opening. 

BID SUBMISSION: Due to the COVID-19 pandemic, the physical office will NOT be open. Based on this, 

bidders MUST submit email bids to bidscharleston@gpo.gov for this solicitation. No other method of bid 

submission will be accepted at this time. The Program 6499-S and bid opening date must be specified in the 

subject line of the emailed bid submission. Bids received after 11:00 a.m. on the bid opening date specified above 

will not be considered for award. 

ADDITIONAL EMAILED BID SUBMISSION PROVISIONS: The Government will not be responsible for 

any failure attributable to the transmission or receipt of the emailed bid including, but not limited to, the 

following: 

 Illegibility of bid. 

 Emails over 75 MB may not be received by GPO due to size limitations for receiving emails. 

 The bidder’s email provider may have different size limitations for sending email; however, bidders are 

advised not to exceed GPO’s stated limit. 

 When the email bid is received by GPO, it will remain unopened until the specified bid opening time. 

Government personnel will not validate receipt of the emailed bid prior to bid opening. GPO will use the 

prevailing time (specified as the local time zone) and the exact time that the email is received by GPO’s 

server as the official time stamp for bid receipt at the specified location. 

Previous abstract available at: 

https://www.gpo.gov/docs/default-source/contract-pricing/contract-pricing/charleston/6499-s.pdf

Direct all questions concerning these specifications to Bruce Canzanella at (202) 679-3838, or email 

bcanzanella@gpo.gov. 
READINESS READER Page 2 of 12 

6499-S (09/22) 

SECTION 1. - GENERAL TERMS AND CONDITIONS 

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

Contract Terms (GPO Publication 310.2, effective December 1, 1987 (Rev. 01-18)) and GPO Contract Terms, 

Quality Assurance Through Attributes Program for Printing and Binding (GPO Publication 310.1, effective May 

1979 (revised 09-19)). 

GPO Contract Terms (GPO Publication 310.2) – https://www.gpo.gov/docs/default-source/forms-and-standardsfiles-for-vendors/contractterms2018.pdf

GPO QATAP (GPO Publication 310.1) – https://www.gpo.gov/docs/default-source/forms-and-standards-files-forvendors/qatap-rev-09-19.pdf

SUBCONTRACTING: Subcontracting is not allowed for this contract. 

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. 

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

 Attribute Specified Standard 

P-7. Type Quality and Uniformity Electronic Media 

P-10. Process Color Match Electronic Media 

Prior to award, contractor may be required to provide information related to specific equipment that will be used 

for production. 

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 years 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 adjustments. 

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(s). 
READINESS READER Page 3 of 12 

6499-S (09/22) 

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 October 1, 2021 to September 30, 2022, and the second and any succeeding period(s) will 

extend for 12 months from 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 June 30, 2022, 

called the base index. The percentage change (plus or minus) of the variable index from the base index will be the 

economic price adjustment for the period being considered for adjustment. 

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

decrease to be applied to invoices for orders placed during the period indicated. The contractor shall apply the 

percentage increase or decrease against the total price of the invoice less reimbursable postage or transportation 

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

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

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

by an individual “Print Order” for each job placed with the contractor. The print order, when issued, will indicate 

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

PREAWARD SURVEY: In order to determine the responsibility of the contractor, the Government reserves the 

right to conduct an on-site preaward survey at the contractor facility or to require other evidence of technical, 

production, managerial, financial, and similar abilities to perform, prior to the award of a contract. As part of the 

financial determination, the contractor in line for award may be required to provide one or more of the following 

financial documents: 

1) Most recent profit and loss statement 

2) Most recent balance sheet 

3) Statement of cash flows 

4) Current official bank statement 

5) Current lines of credit (with amounts available) 

6) Letter of commitment from paper supplier(s) 

The documents will be reviewed to validate that adequate financial resources are available to perform the contract 

requirements. Documents submitted will be kept confidential, and used only for the determination of 

responsibility by the Government. Failure to provide the requested information in the time specified by the 
READINESS READER Page 4 of 12 

6499-S (09/22) 

Government may result in the Contracting Officer not having adequate information to reach an affirmative 

determination of responsibility. 

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

Government. Orders may be issued under the contract from October 1, 2021 through September 30, 2022, plus for 

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

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

“issued” upon notification by the Government for purposes of the contract when it is electronically transmitted or 

otherwise physically furnished to the contractor in conformance with the schedule. 

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

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

accordance with the clause entitled “Ordering.” The quantities of items specified herein are estimates only and are 

not purchased hereby. Except as may be otherwise provided in this contract, if the Government’s requirements for 

the items set forth herein do not result in orders in the amounts or quantities described as “estimated,” it shall not 

constitute the basis for an equitable price adjustment under this contract. 

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

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

The 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, 

except when the shipping/delivery schedule cannot be met. 

PAYMENT: Submitting invoices for payment via the GPO fax gateway (if no samples are required) utilizing the 

GPO barcode coversheet program application is the most efficient method of invoicing. Instruction for using this 

method can be found at the following web address: 

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

 

Invoices may also be mailed to: U.S. Government Publishing Office, Office of Financial Management, Attn: 

Comptroller, Stop: FMCE, Washington, DC 20401. 

For more information about the billing process refer to the General Information of the Office of Finance web page 

located at https://www.gpo.gov/how-to-work-with-us/vendors/how-to-get-paid. 

To check on the status of a payment, email invoice-inquiry@gpo.gov. 
READINESS READER Page 5 of 12 

6499-S (09/22) 

Contractor’s billing invoice must be itemized in accordance with the line items in the “Schedule of Prices.” 

MODIFICATIONS: If any additional costs are incurred during the production of any print order under this 

contract due to Government action (i.e., author’s alterations), contractor is REQUIRED to contact the publishing 

specialist in writing for approval BEFORE proceeding. 
READINESS READER Page 6 of 12 

6499-S (09/22) 

SECTION 2. – SPECIFICATIONS 

SCOPE: These specifications cover the production of a self-covered newsletter requiring such operations as 

electronic prepress, printing in four color-process, binding, packing, and distribution. 

TITLE: READINESS READER 

FREQUENCY OF ORDERS: Approximately 10 to 12 orders per year. 

QUANTITY: Based on past performance, approximately 500 to 1,750 copies per order. 

NUMBER OF PAGES: Approximately 4 to 12 pages per order. 

TRIM SIZE: 8-1/2 x 11”. 

GOVERNMENT TO FURNISH: Electronic media will be furnished as follows – 

 Platform: IBM compatible Windows XP (or later). 

 

 Storage Media: Email or contractor-hosted FTP site 

 Software: Layout completed in Adobe InDesign CS6 and converted to Adobe PDF for 

printing. Orders will be provided as press-quality PDF files. 

 All platform system and software upgrades (for specified applications) which may 

occur during the term of the contract must be supported by the contractor. 

 Fonts: Fonts will be furnished embedded or embedded subsets of the PDF files. 

The contractor is cautioned that furnished fonts are the property of the Government 

and/or its originator. All furnished fonts are to be eliminated from the contractor’s 

archives immediately after completion of the contract. 

 

 Additional Operations: CMYK will be used for color identification. 

 

Identification markings such as register marks, commercial identification marks of any kind, etc., except GPO 

imprint, form number, and revision date, carried in the electronic files, must not print on the finished product. 

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. 

The contractor must be able to accept files electronically via their secure contractor-hosted FTP. Appropriate logon instructions and protocol shall be provided by the contractor at time of award. The contractor shall provide 

security, which at a minimum, shall require a unique user ID and password for access. 

ELECTRONIC PREPRESS: Prior to image processing, the contractor shall perform a basic check (preflight) of 

the furnished media and publishing files to assure correct output of the required reproduction image. Any errors, 

media damage, or data corruption that might interfere with proper file image processing must be reported to the 

DLA representative who submitted the print order, and the Charleston GPO at (843) 743-2036, ext 1. 

The contractor shall create or alter any necessary trapping, set proper screen angles and screen frequency, and 

define file output selection for the imaging device being utilized. Furnished files must be imaged as necessary to 

meet the assigned quality level. 
READINESS READER Page 7 of 12 

6499-S (09/22) 

Prior to making revisions, the contractor shall copy the furnished files and make all changes to the copy. 

Upon completion of each order, the contractor must furnish final production native application files (digital 

deliverables) with the furnished material. The digital deliverables must be an exact representation of the final 

printed product and shall be returned on the same type of storage media as was originally furnished. The 

Government will not accept, as digital deliverables, PostScript files, Adobe Acrobat Portable Document Format 

(PDF) files, or any proprietary file formats other than those supplied, unless specified by the Government. 

PROOFS: None required. The contractor will be responsible for performing all necessary proofreading to 

ensure that the final product is in conformity with the copy submitted. 

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. 13" dated 

September 2019. 

Government Paper Specification Standards No. 13 – https://www.gpo.gov/docs/default-source/forms-andstandards-files-for-vendors/vol_13.pdf. 

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

White Gloss Coated Text, basis weight: 80 lbs. per 500 sheets, 25 x 38", equal to JCP Code A180. 

PRINTING: Print head-to-head in four-color process. At contractor’s option, the product may be produced via 

conventional offset or digital printing provided that Quality Level III standards are maintained. Final output must 

be a minimum of 150-line screen and at a minimum resolution of 2400 x 2400 x 1 dpi or 600 x 600 x 8 bit depth 

technology. Digital device must have a RIP that provides an option for high quality color matching such as 

Device Links Technology and/or ICC Profiles. 

MARGINS: Page one may contain bleeds. The balance have adequate gripper. 

BINDING: Fold to 8-1/2 x 11”. Saddle-wire stitch in two places and trim three sides. Each product must contain 

complete 4-page signature after trimming. Single leaves connected with a lip (i.e., binding stub) to left or right 

side of stitches will not be allowed. 

PACKING: Pack suitable in shipping containers not to exceed 40 pounds when fully packed. All shipments 

which fill less than a shipping container must be packaged with materials of sufficient strength and durability and 

in such a manner which will guarantee that the product will not be damaged and the package will not open nor 

split during the delivery process. 

LABELING AND MARKING: Contractor to download the Labeling and Marking Specifications form (GPO 

Form 905, R. 7-15) from gpo.gov, fill in appropriate blanks, and attach to shipping containers. 

DEPARTMENTAL RANDOM COPIES (BLUE LABEL): All orders must be divided into equal sublots in 

accordance with the chart below. A random copy must be selected from each sublot. Do not choose copies from 

the same general area in each sublot. The contractor will be required to certify that copies were selected as 

directed using GPO Form 917-Certificate of Selection of Random Copies (located on GPO.gov). The random 

copies constitute a part of the total quantity ordered, and no additional charge will be allowed. 

 Quantity Number of 

 Ordered Sublots 

 500 - 3,200 50 

 
READINESS READER Page 8 of 12 

6499-S (09/22) 

These randomly selected copies must be packed separately and identified by a special label (GPO Form 2678-

Departmental Random Copies (Blue Label) that must be printed on blue paper and affixed to each affected 

container. This form can be downloaded from GPO.gov. The container and its contents shall be recorded 

separately on all shipping documents and sent in accordance with the distribution list to the Cherry Point, NC 

address listed under "Distribution". 

A copy of the print order/specification and a signed Certificate of Selection of Random Copies must be included. 

QUALITY ASSURANCE RANDOM COPIES: In addition to the Departmental Random Copies (Blue Label), 

the contractor may be required to submit quality assurance random copies to test for compliance against 

specifications. The print order will indicate the number required, if any. When ordered, the contractor must 

divide the entire order into equal sublots and select a copy from a different general area of each sublot. The 

contractor will be required to certify that copies were selected as directed using GPO Form 917-Certificate of 

Selection of Random Copies (located on GPO.gov). Copies will be paid for at the running rate offered in the 

contractor's bid and their cost will not be a consideration for award. A copy of the Print Order must be included 

with the samples. 

Business Reply Mail labels will be furnished for mailing the quality assurance random copies. The copies are to 

be mailed at the same time as the first scheduled shipment. A U.S. Postal Service approved Certificate of 

Mailing, identified by Program, Jacket and Print Order numbers must be furnished with billing as evidence of 

mailing. 

DISTRIBUTION: Deliver f.o.b. destination to: 

 FLEET READINESS CENTER EAST 

 Building 137, MCAS Cherry Point, NC 28533-0021 

 Attention: Corporate Communication Department 

 Telephone: 252.464.7353 

For each order placed, contractor must notify the ordering agency on the same day that the product delivers via 

email sent to the address furnished on the print order AND infocharleston@gpo.gov. The subject line of this 

message shall be “Distribution Notice for Program 6499-S, P.O. XXXXX, Print Order XXXXX”. The notice 

must provide all applicable tracking numbers, delivery method, and Title. Contractor must be able to provide 

copies of all delivery receipts upon agency request. 

RECEIPT FOR DELIVERY: Contractor must furnish their own receipts for delivery. These receipts must 

include the GPO jacket, program, and print order numbers; total quantity delivered, number of cartons, and 

quantity per carton; date delivery made; and signature of the Government agent accepting delivery. The original 

copy of this receipt must accompany the contractor’s voucher for 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). 

Print orders and furnished materials will be emailed or sent via contractor-hosted FTP site. 

No definite schedule for placement of orders can be predetermined. 

The following schedule begins upon notification of the availability of print order and furnished material. 

Contractor must make complete production and distribution within four workdays of notification of availability of 

print order and furnished material. 

 

Complete delivery must be made by 1:00 p.m. . on the delivery date requested. 
READINESS READER Page 9 of 12 

6499-S (09/22) 

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. 

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

delivery in accordance with the contract requirements by contacting the Charleston Regional Procurement Office 

via e-mail to infocharleston@gpo.gov or by calling (843) 743-2036, ext 1. Personnel receiving the e-mail or call 

will be unable to respond to questions of a technical nature or transfer any inquiries. 
READINESS READER Page 10 of 12 

6499-S (09/22) 

SECTION 3. - DETERMINATION OF AWARD 

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

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

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

may be ordered for a like period of time. 

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

 (1) (2) 

I. 92 666 
READINESS READER Page 11 of 12 

6499-S (09/22) 

SECTION 4. - SCHEDULE OF PRICES 

Bids offered are f.o.b. destination. 

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

specifications. 

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

alteration of the order and manner of submitting bids may be declared non-responsive. 

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), N/A (Not Applicable), 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 invoices submitted to the GPO shall be based on the most economical method of production. 

Fractional parts of 100 will be prorated at the per-100 rate. 

I. COMPLETE PRODUCT: Prices offered shall include the cost of all required and operations necessary for 

the complete production and distribution of the product listed in accordance with these specifications. 

 

 

 Makeready Running Per 

Charges 100 Copies 

(1) (2) 

Printing in 4-color process ...................................................... per page ...... $___________ $___________ 

____________________ 

 (Initials)
READINESS READER Page 12 of 12 

6499-S (09/22) 

SHIPMENTS: Shipments will be made from: City ________________________ State____________________.

The city(ies) indicated above will be used for evaluation of transportation charges when shipment f.o.b. 

contractor’s city is specified. If no shipping point is indicated above, it will be deemed that the bidder has selected 

the city and state shown below in the address block, and the bid will be evaluated and the contract awarded on 

that basis. If shipment is not made from evaluation point, the contractor will be responsible for any additional 

shipping costs incurred. 

DISCOUNTS: Discounts are offered for payment as follows: ___________ Percent ___________ Calendar 

Days. See Article 12 “Discounts” of Solicitations Provisions in GPO Contract Terms (Publication 310.2). 

AMENDMENT(S): Bidder hereby acknowledges amendment(s) number(ed) ____________________________. 

BID ACCEPTANCE PERIOD: In compliance with the above, the undersigned agree, if this bid is accepted 

within ____________ calendar days (60 calendar days unless a different period is inserted by the bidder) from the 

date for receipt of bids, to furnish the specified items at the price set opposite each item, delivered at the 

designated point(s), in exact accordance with specifications. 

NOTE: Failure to provide a 60-day bid acceptance period may result in expiration of the bid prior to award. 

BIDDER’S NAME AND SIGNATURE: Unless specific written exception is taken, the bidder, by signing and 

submitting a bid, agrees with and accepts responsibility for all certifications and representations as required by the 

solicitation and GPO Contract Terms - Publication 310.2. When responding by email, fill out and return one copy 

of all pages in “SECTION 4. – SCHEDULE OF PRICES,” including initialing/signing where indicated. Valid 

electronic signatures will be accepted in accordance with the Uniform Electronic Transactions Act, §2. Electronic 

signatures must be verifiable of the person authorized by the company to sign bids. Failure to sign the signature 

block below may result in the bid being declared non-responsive. 

Bidder________________________________________________________________________________________________

 (Contractor Name) (GPO Contractor’s Code) 

 ___________________________________________________________________________________________ 

(Street Address) 

 ___________________________________________________________________________________________ 

(City – State – Zip Code) 

By _________________________________________________________________________________________ 

 (Signature and Title of Person Authorized to Sign this Bid) (Date) 

 ___________________________________________________________________________________________ 

 (Printed Name) (Telephone Number) 

___________________________________________________________________________________________ 

 (Email) (Fax Number) 

___________________________________________________________________________________________ 

THIS SECTION FOR GPO USE ONLY 

Certified by: __________ Date: __________ Contracting Officer: __________ Date: __________ 

 (Initials) (Initials) 

___________________________________________________________________________________________