Program No 0412‐S Term 04/01/2017 To 03/31/2017

TITLE: Cable TV Statement of Account Forms SA1‐2 and SA3

BASIS OF UNIT RATE COST UNIT RATE COST UNIT RATE COST 

ITEM NO. DESCRIPTION AWARDI. PRINTING, VARIABLE IMAGING, AND BINDING:

(a) Saddle‐Stitched: Printing/imaging in black,

including binding............................per page..........

(1) Makeready and/or Setup ........................................ 104 $ 50.00 $ 5,200.00 $ 23.65 $ 2,459.60 $ 8.00 $ 832.00 

(2) Running Per 100 Copies ..................................... 1,475 $ 800.00 $ 1,180,000.00 $ 1.90 $ 2,802.50 $ 2.50 $ 3,687.50 

II. PACKING AND DISTRIBUTION:

Addressing single copies (self‐mailers)

(1) ........................per 100 copies...................... 62 $ 250.00 $ 15,500.00 $ 4.75 $ 294.50 $ 5.90 $ 365.80 

CONTRACTOR TOTALS $1,200,700.00 $5,556.60 $4,885.30 

DISCOUNT 0.00% $0.00 2.00% $111.13 1.00% $48.85 

DISCOUNTED TOTALS $1,200,700.00 $5,445.47 $4,836.45 

Diverse Imaging Inc.

Carmel, New York

WBC Inc, Lithexcel

Alburquerque, NM

GRC Enterprises Incorporated

Warrenton, VA
Program 412-S Page 1 of 14 

Specifications by RH 

Reviewed by JMcW 

 U.S. GOVERNMENT PUBLISHING OFFICE 

 Washington, DC 

 GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

 For the Procurement of 

Cable TV Statement of Account Forms SA1-2 and SA3 

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

 Library of Congress 

 Single Award 

TERM OF CONTRACT: The term of this contract is for the period beginning APRIL 1, 2017 and ending MARCH 

31, 2018, plus up to four (4) optional 12-month extension periods that may be added in accordance with the “OPTION 

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

BID OPENING: Bids shall be publicly opened at 11:00 a.m., prevailing Washington, DC time, on MARCH 3, 2017. 

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

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

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

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

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

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

of 8:00 a.m. and 4:00 p.m., prevailing Washington, DC, time, Monday through Friday. The contractor is to follow the 

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

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

For information of a technical nature, call Rose Hood at (202) 512-0310 or email rhood@gpo.gov . 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 2 of 14 

412-S (03/18) 

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. 8-02)). 

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 of this contract is printing and variable imaging. 

Bidders who must subcontract these operations will be declared nonresponsible. 

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 Prior to production samples/Proofs/ 

 Average type dimension/Electronic media 

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) 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 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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 3 of 14 

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

will extend from APRIL 1, 2017 to MARCH 31, 2018, 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 December 31, 2016, called the 

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

price adjustment for the period being considered for adjustment. 

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

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

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

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

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

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

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

award of a contract. 

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

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

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

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

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

Government. Orders may be issued under the contract from Date of Award through March 31, 2018, plus for such 

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

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

be “issued,” for purposes of the contract, when it is either deposited in the U.S. Postal Service mail or otherwise 

furnished to the contractor in conformance with the schedule. 

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 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 4 of 14 

412-S (03/18) 

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. 

WARNING: Proper control and handling must be maintained at all times to prevent any information or materials 

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

otherwise indicated herein, all extra copies, materials, waste, etc., must be destroyed upon fulfillment of the 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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 5 of 14 

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

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

other identifying particular assigned to the individual.

CRIMINAL 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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 6 of 14 

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SECTION 2. - SPECIFICATIONS 

SCOPE: These specifications cover the production of two different self-covered looseleaf publications requiring such 

operations as electronic prepress, printing and variable imaging, binding, packing, and distribution. 

TITLE: Cable TV Statement of Account Forms SA1-2 and SA3. 

Item 1: SA1-2. 

Item 2: SA3. 

NOTE: Both items will be ordered on a single print order, per the quantities listed below. 

FREQUENCY OF ORDERS: Approximately 2 orders per year. 

NOTE: The first order placed will be for the first mailing each of Item 1 and Item 2. The second order placed will be 

for the second mailing each of Item 1 and Item 2. 

QUANTITY: 

Item 1: Approximately 2,500 to 4,000 copies per order. 

Item 2: Approximately 1,000 to 1,200 copies per order. 

NUMBER OF PAGES: 

Item 1: Approximately 16 to 24 pages per order. 

Item 2: Approximately 32 to 40 pages per order. 

TRIM SIZE: 8-1/2 x 11”. 

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

 Platform: Macintosh 10.11 OR later. 

 Storage Media: FTP; Email. 

 Software: Adobe Acrobat PDF (Acrobat Pro DC). 

 

 (NOTE: Files may be created in Adobe InDesign CC 2015 or Later) 

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: All printer and screen fonts will be embedded. 

 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 archive 

immediately after completion of the contract. 

 Additional 

 Information: A separate file will be furnished for each item. 

 Files will be furnished in PDF format. 

 A visual of the furnished electronic files will be provided. 

 GPO Form 952 (Desktop Publishing – Disk Information) will be furnished. 

Distribution/Address lists will be furnished electronically via FTP or email in a Microsoft Word file. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 7 of 14 

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PS Form 3615 (Mailing Permit Application and Customer Profile). 

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 finished product. 

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “GOVERNMENT TO 

FURNISH,” necessary to produce the products in accordance with these specifications. 

Contractor must have the capability to transmit and receive files via FTP and/or email transmission. 

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 production image. Any errors, media 

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

agency as specified on the print order. 

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. 

When required by the Government, the contractor shall make minor revisions to the electronic files. It is anticipated 

that the Government will make all major revisions. 

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, unless otherwise 

specified. 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. 

(The Government will accept Adobe Acrobat Portable Document Format (PDF) files as digital deliverables when 

furnished by the Government.) 

PROOFS: One Adobe Acrobat (Acrobat Pro DC) PDF proof each for Item 1 and Item 2. Proofs will be transferred 

to the agency via email. The PDF proof will be evaluated for text flow and image position. 

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 these additional proofs. Such 

operations must be accomplished within the original production schedule allotted in the specifications. 

The contractor must not print prior to receipt of an “O.K. to print.” 

PRIOR TO PRODUCTION SAMPLES: Prior to the commencement of production of the contract production 

quantity, the contractor shall submit to the Government not less than 25 printed, imaged, and bound prior to 

production samples each of Item 1 and Item 2 (using the first 25 addresses from the furnished distribution file, unless 

otherwise specified). 

The container and accompanying documentation shall be marked “PRIOR TO PRODUCTION SAMPLES” and shall 

include the GPO Purchase Order, Jacket, Program, and Print Order numbers. 

All samples shall be printed, imaged, and bound as specified and must be of the size, kind, and quality that the 

contractor will furnish. Samples will be inspected and tested for conformance of materials and must comply with the 

specifications as to construction, kind, and quality of materials. 

Samples must be printed on the paper as specified herein. 
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The postnet barcode must be in accordance with MIL-STD-1189A with a range of 4.5 to 6.5 CPI and between 2” to 2-

1/2” in length. 

Contractor to submit samples to: Library of Congress, Landover Annex, Attn: Teresa McCall, 1701 Brightseat Road, 

Landover, MD 20785. (Telephone: (202) 707-8831) 

Contractor to submit samples within five (5) workdays of notification of availability of print order and furnished 

materials. 

The Government will approve, conditionally approve, or disapprove the samples within five (5) workdays of the 

receipt thereof. Approval or conditional approval shall not relieve the contractor from complying with the 

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

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

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

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

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

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

inspect and test any additional samples required. 

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

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

default, provided however, that the failure of the Government to terminate the contract for default in such event shall 

not relieve the contractor of the responsibility to deliver the contract quantities in accordance with the shipping 

schedule. 

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

specified, the Contracting Officer shall automatically extend the shipping schedule in accordance with article 12 

"Notice of Compliance With Schedules" of contract clauses in GPO Contract Terms (GPO Pub. 310.2, effective 

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

Manufacture of the final product prior to approval of the sample submitted is at the contractor’s risk. Samples will not 

be returned to the contractor. All costs, including the costs of all samples, shall be included in the contract price for the 

production quantity. 

All samples shall be manufactured at the facilities and on the equipment in which the contract production quantities 

are to be manufactured. 

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. 

Items 1 and 2: White Offset Book, basis weight: 60 lbs. per 500 sheets, 25 x 38”, equal to JCP Code A60. 

PRINTING AND VARIABLE IMAGING: At contractor’s option, digital printing using pigment-based ink, electro 

inks, or soy inks may be used to produce the products (inkjet and toner based inks are not acceptable) with a minimum 

of 812 x 812 resolution. 

Items 1 and 2: Print text head-to-head in black ink only. Printing consists of text matter, tables, and charts. Image 

variable data in black. Imaging consists of up to 5 lines of text matter (plus barcode, as specified) on pages throughout 

the publication. 
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Contractor must create and print a ZIP+4 postnet delivery point barcode in the appropriate area of the mailing page. 

Bar coding must range between 4.5 and 6.5 CPI. Postnet barcodes will be scanned with Barcode Industries “Minibar” 

and Caere Model B-33. 

LAYOUT/PRINTING INSTRUCTIONS: 

Two (2) FTP (file transfer protocol) files or e-mails will be provided for each Item. File LDS001 contains a file of fillin data for creating the SA1-2 forms. File LDS002 contains a file of fill-in data for creating the SA-3 forms. The 

record format of both files is identical. 

Print on page one the first 520 bytes of the record as eight print lines of 65 characters each. 

Print on the third line of the inside self-cover page the ACCOUNTING PERIOD INCLUSIVE DATES inserted 

between “... form for your” and “filing.” 

Print the ACCOUNTING PERIOD INCLUSIVE DATES in space A. 

Print in space B in the top left, a code 39 barcode of eleven digits (3/8” height and 2” to 2-1/2” in length), containing 

the SYSTEM ID (leading zeros as needed) , the 4-DIGIT YEAR, and the ACCOUNTING PERIOD. To the right of 

the barcode print the SYSTEM ID, one blank, the 4-DIGIT YEAR, the SLASH, the ACCOUNTING PERIOD, four 

blanks, and the FORM TYPE. Underneath the barcode print the two (2) 65-character SYSTEM NAME lines, then the 

3 ADDRESS lines. 

In Space D print the COMMUNITY CITY in the first line under “CITY OR TOWN” and COMMUNITY STATE 

centered under “STATE”. On the next line, beneath where COMMUNITY CITY was placed, print PROPERTY 

NAME. 

At the top of numbered pages 2-8 of Form SA1-2, and at the top of numbered pages 1B-9, 12-19, and two-thirds of the 

way down on page 11 of Form SA-3 (note that on this page ONLY all printing is within “LEGAL NAME OF 

OWNER OF CABLE SYSTEM” box), print the ACCOUNTING PERIOD HEADER adjacent to the binding edge in a 

manner similar to the placement of the form and page number data appearing at the opposite edge. In the area 

immediately below this, where there is space for the “LEGAL NAME OF OWNER OF CABLE SYSTEM” provided, 

print the SYSTEM NAME LINE 1, 2 blanks, and the SYSTEM ID. 

Records will be fixed length character format, with the following fields: 

1 – 21 Blank 192 – 195 Blank

22 – 27 System ID 196 – 260 System Name Line 1 

28 – 28 Blank 261 – 325 System Name Line 2 

29 – 32 4-digit year 326 – 390 Address Line 1 

33 – 33 Slash (“/”) 391 – 455 Address Line 2 

34 – 34 Accounting Period 456 – 520 Address Line 3 

35 – 61 Blank 521 – 560 Community City 

62 – 65 Form Type 561 – 562 Community State 

66 – 86 Blank 563 – 588 Accounting Period Inclusive Dates

87 – 130 Community Name 589 – 612 Accounting Period Header

131 – 151 Blank 613 - 622 Filler

152 – 191 Property Name 

MARGINS: Margins will be as indicated on the print order or furnished electronic media. 

BINDING: Items 1 and 2: Saddle-wire stitch in two places and trim three sides. Each product must contain 

complete four-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. 
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Contractor to apply wafer seals (Seal-O-Matic or similar) to each copy in accordance with the USPS regulations. 

Wafer seals must not cover/conceal any text matter. 

PACKING: 

Mailed Shipments – Single copies must be mailed as self-mailers. 

NOTE: Contractor must deliver the publications, segregated by form type (item) and in ZIP+4 sequence. Each 

mailing (both items) must be delivered as a single shipment to the post office. 

LABELING AND MARKING: Address each self-mailer with mailing address and barcode (in accordance with 

“PRINTING AND VARIABLE IMAGING”), and with the furnished mailing indicia. 

DISTRIBUTION: Mail f.o.b. contractor’s city each individual form to addresses nationwide. 

Complete addresses and quantities will be furnished with the print orders. 

All mailing shall be made at the Presorted First Class Mail rate. 

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

material produced under this contract. 

Orders which result in mailings of less than 200 pieces or less than 50 pounds will require the contractor to apply the 

appropriate postage to each mailing. Contractor will be reimbursed for postage by submitting a properly completed 

Postal Service Certificate of Mailing with the voucher for billing. 

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. 

All copies mailed must conform to the appropriate regulations in the U.S. Postal Service manuals for “Domestic Mail” 

or “International Mail” as applicable. 

Upon immediate completion of each order, contractor must email the list of all incomplete addresses (with the 

corresponding number of printed items) to: Library of Congress, Copyright Office, Attn: Teresa McCall at: 

temc@loc.gov. 

Within 10 workdays of complete distribution, the contractor must return a copy of the U.S. Postal Service Certificate 

of Mailing (PS Form 3602-G, or its equivalent) to: Library of Congress, Copyright Office, Attn: Teresa McCall, 

1701 Brightseat Road, Landover, MD 20785; or email to: temc@loc.gov. 

All expenses incidental to submitting proofs and prior to production samples and furnishing sample copies must be 

borne by the contractor. 

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). 

Proofs must be emailed to the email address specified on the print order. 

No definite schedule for pickup of material can be predetermined; however, it is anticipated that the first order will be 

placed immediately after award (late April/early May); the second order will be placed in October. 

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. 

 Contractor must submit proofs within five (5) workdays of notification of availability of print order and 

furnished material. 
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 Proofs will be withheld no more than three (3) workdays from their receipt at the ordering agency 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.) 

 Contractor must submit prior to production sample within five (5) workdays of receipt of “OK to print” on 

proofs. 

 The Government will approve, conditionally approve, or disapprove the samples within five (5) workdays of 

the receipt thereof. 

 Contractor must complete production and distribution within five (5) workdays of receipt of approval on prior 

to production samples. 

The ship/deliver date indicated on the print order is the date products ordered for mailing f.o.b. contractor’s city must 

be delivered to the U.S. Postal Service. 

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.

Upon completion of each order, the contractor is to notify the U.S. Government Publishing Office of the date of 

shipment or delivery. Call (202) 512-0516 or (202) 512-0520; or email compliance@gpo.gov. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 12 of 14 

412-S (03/18) 

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 (1) 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. 104 1475 

II. 62 
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SECTION 4. - SCHEDULE OF PRICES 

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

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

specifications. 

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

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

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

Government. 

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

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

(whether or not such items are included in the DETERMINATION OF AWARD) that are inconsistent or unrealistic in 

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

interest of the Government. 

All 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. 

A charge will be allowed for each page, whether printed or blank. 

Unless otherwise specified, no more than three blank pages shall be permitted at the end of the text. 

I. PRINTING, VARIABLE IMAGING, AND BINDING: Prices offered shall include the cost of all required 

materials and operations necessary (including proofs and prior to production samples) for the printing, variable 

imaging, and binding of the product listed in accordance with these specifications. 

 

 Makeready Running Per 

 and/or Setup 100 Copies 

 (1) (2) 

Saddle-Stitched: Printing/imaging in black, 

including binding .................................................................... per page ...... $___________ $___________ 

II. PACKING AND DISTRIBUTION: Prices offered must be all-inclusive, as applicable, and must include the 

cost of labeling and marking and complete distribution, in accordance with these specifications. 

 Addressing single copies (self-mailers) ......................................................... per 100 copies ...... $___________ 

_____________ 

(Initials) 
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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) 
Program 412-S Page 1 of 14 

Specifications by RH 

Reviewed by JMcW 

 U.S. GOVERNMENT PUBLISHING OFFICE 

 Washington, DC 

 GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS 

 For the Procurement of 

Cable TV Statement of Account Forms SA1-2 and SA3 

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

 Library of Congress 

 Single Award 

TERM OF CONTRACT: The term of this contract is for the period beginning APRIL 1, 2017 and ending MARCH 

31, 2018, plus up to four (4) optional 12-month extension periods that may be added in accordance with the “OPTION 

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

BID OPENING: Bids shall be publicly opened at 11:00 a.m., prevailing Washington, DC time, on MARCH 3, 2017. 

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

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

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

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

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

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

of 8:00 a.m. and 4:00 p.m., prevailing Washington, DC, time, Monday through Friday. The contractor is to follow the 

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

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

For information of a technical nature, call Rose Hood at (202) 512-0310 or email rhood@gpo.gov . 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 2 of 14 

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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. 8-02)). 

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 of this contract is printing and variable imaging. 

Bidders who must subcontract these operations will be declared nonresponsible. 

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 Prior to production samples/Proofs/ 

 Average type dimension/Electronic media 

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) 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 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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 3 of 14 

412-S (03/18) 

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

will extend from APRIL 1, 2017 to MARCH 31, 2018, 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 December 31, 2016, called the 

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

price adjustment for the period being considered for adjustment. 

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

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

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

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

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

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

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

award of a contract. 

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

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

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

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

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

Government. Orders may be issued under the contract from Date of Award through March 31, 2018, plus for such 

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

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

be “issued,” for purposes of the contract, when it is either deposited in the U.S. Postal Service mail or otherwise 

furnished to the contractor in conformance with the schedule. 

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 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 4 of 14 

412-S (03/18) 

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. 

WARNING: Proper control and handling must be maintained at all times to prevent any information or materials 

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

otherwise indicated herein, all extra copies, materials, waste, etc., must be destroyed upon fulfillment of the 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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 5 of 14 

412-S (03/18) 

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

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

other identifying particular assigned to the individual.

CRIMINAL 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 two different self-covered looseleaf publications requiring such 

operations as electronic prepress, printing and variable imaging, binding, packing, and distribution. 

TITLE: Cable TV Statement of Account Forms SA1-2 and SA3. 

Item 1: SA1-2. 

Item 2: SA3. 

NOTE: Both items will be ordered on a single print order, per the quantities listed below. 

FREQUENCY OF ORDERS: Approximately 2 orders per year. 

NOTE: The first order placed will be for the first mailing each of Item 1 and Item 2. The second order placed will be 

for the second mailing each of Item 1 and Item 2. 

QUANTITY: 

Item 1: Approximately 2,500 to 4,000 copies per order. 

Item 2: Approximately 1,000 to 1,200 copies per order. 

NUMBER OF PAGES: 

Item 1: Approximately 16 to 24 pages per order. 

Item 2: Approximately 32 to 40 pages per order. 

TRIM SIZE: 8-1/2 x 11”. 

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

 Platform: Macintosh 10.11 OR later. 

 Storage Media: FTP; Email. 

 Software: Adobe Acrobat PDF (Acrobat Pro DC). 

 

 (NOTE: Files may be created in Adobe InDesign CC 2015 or Later) 

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: All printer and screen fonts will be embedded. 

 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 archive 

immediately after completion of the contract. 

 Additional 

 Information: A separate file will be furnished for each item. 

 Files will be furnished in PDF format. 

 A visual of the furnished electronic files will be provided. 

 GPO Form 952 (Desktop Publishing – Disk Information) will be furnished. 

Distribution/Address lists will be furnished electronically via FTP or email in a Microsoft Word file. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 7 of 14 

412-S (03/18) 

PS Form 3615 (Mailing Permit Application and Customer Profile). 

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 finished product. 

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “GOVERNMENT TO 

FURNISH,” necessary to produce the products in accordance with these specifications. 

Contractor must have the capability to transmit and receive files via FTP and/or email transmission. 

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 production image. Any errors, media 

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

agency as specified on the print order. 

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. 

When required by the Government, the contractor shall make minor revisions to the electronic files. It is anticipated 

that the Government will make all major revisions. 

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, unless otherwise 

specified. 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. 

(The Government will accept Adobe Acrobat Portable Document Format (PDF) files as digital deliverables when 

furnished by the Government.) 

PROOFS: One Adobe Acrobat (Acrobat Pro DC) PDF proof each for Item 1 and Item 2. Proofs will be transferred 

to the agency via email. The PDF proof will be evaluated for text flow and image position. 

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 these additional proofs. Such 

operations must be accomplished within the original production schedule allotted in the specifications. 

The contractor must not print prior to receipt of an “O.K. to print.” 

PRIOR TO PRODUCTION SAMPLES: Prior to the commencement of production of the contract production 

quantity, the contractor shall submit to the Government not less than 25 printed, imaged, and bound prior to 

production samples each of Item 1 and Item 2 (using the first 25 addresses from the furnished distribution file, unless 

otherwise specified). 

The container and accompanying documentation shall be marked “PRIOR TO PRODUCTION SAMPLES” and shall 

include the GPO Purchase Order, Jacket, Program, and Print Order numbers. 

All samples shall be printed, imaged, and bound as specified and must be of the size, kind, and quality that the 

contractor will furnish. Samples will be inspected and tested for conformance of materials and must comply with the 

specifications as to construction, kind, and quality of materials. 

Samples must be printed on the paper as specified herein. 
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412-S (03/18) 

The postnet barcode must be in accordance with MIL-STD-1189A with a range of 4.5 to 6.5 CPI and between 2” to 2-

1/2” in length. 

Contractor to submit samples to: Library of Congress, Landover Annex, Attn: Teresa McCall, 1701 Brightseat Road, 

Landover, MD 20785. (Telephone: (202) 707-8831) 

Contractor to submit samples within five (5) workdays of notification of availability of print order and furnished 

materials. 

The Government will approve, conditionally approve, or disapprove the samples within five (5) workdays of the 

receipt thereof. Approval or conditional approval shall not relieve the contractor from complying with the 

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

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

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

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

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

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

inspect and test any additional samples required. 

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

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

default, provided however, that the failure of the Government to terminate the contract for default in such event shall 

not relieve the contractor of the responsibility to deliver the contract quantities in accordance with the shipping 

schedule. 

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

specified, the Contracting Officer shall automatically extend the shipping schedule in accordance with article 12 

"Notice of Compliance With Schedules" of contract clauses in GPO Contract Terms (GPO Pub. 310.2, effective 

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

Manufacture of the final product prior to approval of the sample submitted is at the contractor’s risk. Samples will not 

be returned to the contractor. All costs, including the costs of all samples, shall be included in the contract price for the 

production quantity. 

All samples shall be manufactured at the facilities and on the equipment in which the contract production quantities 

are to be manufactured. 

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. 

Items 1 and 2: White Offset Book, basis weight: 60 lbs. per 500 sheets, 25 x 38”, equal to JCP Code A60. 

PRINTING AND VARIABLE IMAGING: At contractor’s option, digital printing using pigment-based ink, electro 

inks, or soy inks may be used to produce the products (inkjet and toner based inks are not acceptable) with a minimum 

of 812 x 812 resolution. 

Items 1 and 2: Print text head-to-head in black ink only. Printing consists of text matter, tables, and charts. Image 

variable data in black. Imaging consists of up to 5 lines of text matter (plus barcode, as specified) on pages throughout 

the publication. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 9 of 14 

412-S (03/18) 

Contractor must create and print a ZIP+4 postnet delivery point barcode in the appropriate area of the mailing page. 

Bar coding must range between 4.5 and 6.5 CPI. Postnet barcodes will be scanned with Barcode Industries “Minibar” 

and Caere Model B-33. 

LAYOUT/PRINTING INSTRUCTIONS: 

Two (2) FTP (file transfer protocol) files or e-mails will be provided for each Item. File LDS001 contains a file of fillin data for creating the SA1-2 forms. File LDS002 contains a file of fill-in data for creating the SA-3 forms. The 

record format of both files is identical. 

Print on page one the first 520 bytes of the record as eight print lines of 65 characters each. 

Print on the third line of the inside self-cover page the ACCOUNTING PERIOD INCLUSIVE DATES inserted 

between “... form for your” and “filing.” 

Print the ACCOUNTING PERIOD INCLUSIVE DATES in space A. 

Print in space B in the top left, a code 39 barcode of eleven digits (3/8” height and 2” to 2-1/2” in length), containing 

the SYSTEM ID (leading zeros as needed) , the 4-DIGIT YEAR, and the ACCOUNTING PERIOD. To the right of 

the barcode print the SYSTEM ID, one blank, the 4-DIGIT YEAR, the SLASH, the ACCOUNTING PERIOD, four 

blanks, and the FORM TYPE. Underneath the barcode print the two (2) 65-character SYSTEM NAME lines, then the 

3 ADDRESS lines. 

In Space D print the COMMUNITY CITY in the first line under “CITY OR TOWN” and COMMUNITY STATE 

centered under “STATE”. On the next line, beneath where COMMUNITY CITY was placed, print PROPERTY 

NAME. 

At the top of numbered pages 2-8 of Form SA1-2, and at the top of numbered pages 1B-9, 12-19, and two-thirds of the 

way down on page 11 of Form SA-3 (note that on this page ONLY all printing is within “LEGAL NAME OF 

OWNER OF CABLE SYSTEM” box), print the ACCOUNTING PERIOD HEADER adjacent to the binding edge in a 

manner similar to the placement of the form and page number data appearing at the opposite edge. In the area 

immediately below this, where there is space for the “LEGAL NAME OF OWNER OF CABLE SYSTEM” provided, 

print the SYSTEM NAME LINE 1, 2 blanks, and the SYSTEM ID. 

Records will be fixed length character format, with the following fields: 

1 – 21 Blank 192 – 195 Blank

22 – 27 System ID 196 – 260 System Name Line 1 

28 – 28 Blank 261 – 325 System Name Line 2 

29 – 32 4-digit year 326 – 390 Address Line 1 

33 – 33 Slash (“/”) 391 – 455 Address Line 2 

34 – 34 Accounting Period 456 – 520 Address Line 3 

35 – 61 Blank 521 – 560 Community City 

62 – 65 Form Type 561 – 562 Community State 

66 – 86 Blank 563 – 588 Accounting Period Inclusive Dates

87 – 130 Community Name 589 – 612 Accounting Period Header

131 – 151 Blank 613 - 622 Filler

152 – 191 Property Name 

MARGINS: Margins will be as indicated on the print order or furnished electronic media. 

BINDING: Items 1 and 2: Saddle-wire stitch in two places and trim three sides. Each product must contain 

complete four-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. 
Cable TV Statement of Account Forms SA1-2 and SA3 Page 10 of 14 

412-S (03/18) 

Contractor to apply wafer seals (Seal-O-Matic or similar) to each copy in accordance with the USPS regulations. 

Wafer seals must not cover/conceal any text matter. 

PACKING: 

Mailed Shipments – Single copies must be mailed as self-mailers. 

NOTE: Contractor must deliver the publications, segregated by form type (item) and in ZIP+4 sequence. Each 

mailing (both items) must be delivered as a single shipment to the post office. 

LABELING AND MARKING: Address each self-mailer with mailing address and barcode (in accordance with 

“PRINTING AND VARIABLE IMAGING”), and with the furnished mailing indicia. 

DISTRIBUTION: Mail f.o.b. contractor’s city each individual form to addresses nationwide. 

Complete addresses and quantities will be furnished with the print orders. 

All mailing shall be made at the Presorted First Class Mail rate. 

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

material produced under this contract. 

Orders which result in mailings of less than 200 pieces or less than 50 pounds will require the contractor to apply the 

appropriate postage to each mailing. Contractor will be reimbursed for postage by submitting a properly completed 

Postal Service Certificate of Mailing with the voucher for billing. 

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. 

All copies mailed must conform to the appropriate regulations in the U.S. Postal Service manuals for “Domestic Mail” 

or “International Mail” as applicable. 

Upon immediate completion of each order, contractor must email the list of all incomplete addresses (with the 

corresponding number of printed items) to: Library of Congress, Copyright Office, Attn: Teresa McCall at: 

temc@loc.gov. 

Within 10 workdays of complete distribution, the contractor must return a copy of the U.S. Postal Service Certificate 

of Mailing (PS Form 3602-G, or its equivalent) to: Library of Congress, Copyright Office, Attn: Teresa McCall, 

1701 Brightseat Road, Landover, MD 20785; or email to: temc@loc.gov. 

All expenses incidental to submitting proofs and prior to production samples and furnishing sample copies must be 

borne by the contractor. 

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). 

Proofs must be emailed to the email address specified on the print order. 

No definite schedule for pickup of material can be predetermined; however, it is anticipated that the first order will be 

placed immediately after award (late April/early May); the second order will be placed in October. 

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. 

 Contractor must submit proofs within five (5) workdays of notification of availability of print order and 

furnished material. 
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412-S (03/18) 

 Proofs will be withheld no more than three (3) workdays from their receipt at the ordering agency 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.) 

 Contractor must submit prior to production sample within five (5) workdays of receipt of “OK to print” on 

proofs. 

 The Government will approve, conditionally approve, or disapprove the samples within five (5) workdays of 

the receipt thereof. 

 Contractor must complete production and distribution within five (5) workdays of receipt of approval on prior 

to production samples. 

The ship/deliver date indicated on the print order is the date products ordered for mailing f.o.b. contractor’s city must 

be delivered to the U.S. Postal Service. 

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.

Upon completion of each order, the contractor is to notify the U.S. Government Publishing Office of the date of 

shipment or delivery. Call (202) 512-0516 or (202) 512-0520; or email compliance@gpo.gov. 
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412-S (03/18) 

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 (1) 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. 104 1475 

II. 62 
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412-S (03/18) 

SECTION 4. - SCHEDULE OF PRICES 

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

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

specifications. 

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

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

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

Government. 

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

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

(whether or not such items are included in the DETERMINATION OF AWARD) that are inconsistent or unrealistic in 

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

interest of the Government. 

All 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. 

A charge will be allowed for each page, whether printed or blank. 

Unless otherwise specified, no more than three blank pages shall be permitted at the end of the text. 

I. PRINTING, VARIABLE IMAGING, AND BINDING: Prices offered shall include the cost of all required 

materials and operations necessary (including proofs and prior to production samples) for the printing, variable 

imaging, and binding of the product listed in accordance with these specifications. 

 

 Makeready Running Per 

 and/or Setup 100 Copies 

 (1) (2) 

Saddle-Stitched: Printing/imaging in black, 

including binding .................................................................... per page ...... $___________ $___________ 

II. PACKING AND DISTRIBUTION: Prices offered must be all-inclusive, as applicable, and must include the 

cost of labeling and marking and complete distribution, in accordance with these specifications. 

 Addressing single copies (self-mailers) ......................................................... per 100 copies ...... $___________ 

_____________ 

(Initials) 
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412-S (03/18) 

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)