PAGE 1 OF 1. REQUISITION NO. 2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL TIME 9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR: SMALL BUSINESS HUBZONE SMALL BUSINESS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM EDWOSB 8(A) NAICS: SIZE STANDARD: 11. DELIVERY FOR FOB DESTINA- TION UNLESS BLOCK IS MARKED SEE SCHEDULE 12. DISCOUNT TERMS 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) 13b. RATING 14. METHOD OF SOLICITATION RFQ IFB RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE 17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE TELEPHONE NO. DUNS: DUNS+4: PHONE: FAX: 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED SEE ADDENDUM 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT (Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED. 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS: 30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012) PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 7. FOR SOLICITATION INFORMATION CALL: STANDARD FORM 1449 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 14 621-21-3-5091-0060 36C24921Q0272 05-03-2021 ELISHIA LANNOM 615-400-6858 05-14-2021 8:00AM CDT 90C Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 X 100 X 336999 1000 Employees N/A X Department of Veterans Affairs James H. Quillen VAMC Corner of Lamont and Veterans Way Dogwood Avenue, Building 205 Mountain Home TN 37684 90C Department of Veterans Affairs Network Contracting Office - 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 90C FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically Setup 1-877-489-6135 See CONTINUATION Page This is a brand name requirement for three Polaris ATVs. The solicitation is 100% set aside for small business opportunities. Responses to this solicitation will only be accepted through Email: [email protected] POC: Elishia Lannom, Contract Specialist 615-225-5623, [email protected] Quotes are due no later than 5/28/2021 8:00AM CST See CONTINUATION Page 621-3610162-5091-850100-3151 0100C6075 X X COREY A. MALIK CONTRACTING OFFICER 36C24921Q0272 Page 1 of Page 2 of 16 Page 1 of Table of Contents SECTION A 1 A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1 SECTION B - CONTINUATION OF SF 1449 BLOCKS 3 B.1 CONTRACT ADMINISTRATION DATA 3 B.2 PRICE/COST SCHEDULE 4 ITEM INFORMATION 4 B.3 DELIVERY SCHEDULE 4 SECTION C - CONTRACT CLAUSES 5 C.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020) 5 C.3 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) 7 C.4 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING MONITORING AND COMPLIANCE (JUL 2018) 9 C.5 VAAR 852.247-71 DELIVERY LOCATION (OCT 2018) 10 SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS 11 SECTION E - SOLICITATION PROVISIONS 12 E.1 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018) 12 E.3 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018) 12 E.4 VAAR 852.246-71 REJECTED GOODS (OCT 2018) 13 E.5 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) 13 36C24921Q0272 Page 1 of Page 4 of 16 Page 1 of SECTION B - CONTINUATION OF SF 1449 BLOCKS INTENTIONALLY BLANK B.1 CONTRACT ADMINISTRATION DATA 1. Contract Administration: All contract administration matters will be handled by the following individuals: a. CONTRACTOR: b. GOVERNMENT: Contracting Officer 36C249 Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with: [X] 52.232-33, Payment by Electronic Funds Transfer System For Award Management, or [] 52.232-36, Payment by Third Party 3. INVOICES: Invoices shall be submitted in arrears: a. Quarterly [] b. Semi-Annually [] c. Other [X] In arrears 4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests. FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows: AMENDMENT NO DATE B.2 PRICE/COST SCHEDULE ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 3.00 EA __________________ __________________ 3- New 2021 Polaris Ranger XP 1000 Northstar Edition Premium (Burgundy Metallic) 1 YEAR WARRAMTY LOCAL STOCK NUMBER: RANGER XP 1000 GRAND TOTAL __________________ B.3 DELIVERY SCHEDULE ITEM NUMBER QUANTITY DELIVERY DATE 0001 SHIP TO: James H. Quillen VAMC Bldg 205 Bradford Pear Lane Warehouse Dock 1 or 2 Mountain Home, TN 37684 USA 3.00 5/30/2021 MARK FOR: SYLVIA GOUGE 423-926-1171 ext 7727 [email protected] 36C24921Q0272 Page 1 of Page 10 of 16 Page 1 of SECTION C - CONTRACT CLAUSES C.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (OCT 2020) The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument in paragraph (c)(1) in the provision at 52.204 26, Covered Telecommunications Equipment or Services Representation, or in paragraph (v)(2)(i) of the provision at 52.212 3, Offeror Representations and Certifications Commercial Items. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services in paragraph (c)(2) of the provision at 52.204 26, or in paragraph (v)(2)(ii) of the provision at 52.212 3. (a) Definitions. As used in this provision Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204 25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (b) Prohibition. (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115 232) prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall be construed to (i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles. (2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115 232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a Federal contract. Nothing in the prohibition shall be construed to (i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into any user data or packets that such equipment transmits or otherwise handles. (c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) (https://www.sam.gov) for entities excluded from receiving federal awards for covered telecommunications equipment or services. (d) Representations. The Offeror represents that (1) It [ ] will, [ ] will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (e)(1) of this section if the Offeror responds will in paragraph (d)(1) of this section; and (2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that It [ ] does, [ ] does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (e)(2) of this section if the Offeror responds does in paragraph (d)(2) of this section. (e) Disclosures. (1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded will in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer: (i) For covered equipment (A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known); (B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and (C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision. (ii) For covered services (A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or (B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision. (2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded does in the representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer: (i) For covered equipment (A) The entity that produced the covered telecommunications equipment (include entity name, unique entity identifier, CAGE code, and whether the entity was the OEM or a distributor, if known); (B) A description of all covered telecommunications equipment offered (include brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and (C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision. (ii) For covered services (A) If the service is related to item maintenance: A description of all covered telecommunications services offered (include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); or (B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision. (End of Provision) C.3 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) (a) The Contractor agrees to comply with any provision or clause that is incorporated herein by reference to implement agency policy applicable to acquisition of commercial items or components. The following provisions and clauses that have been checked by the Contracting Officer are incorporated by reference. [X] 852.203 70, Commercial Advertising. [] 852.209 70, Organizational Conflicts of Interest. [] 852.211 70, Equipment Operation and Maintenance Manuals. [] 852.214 71, Restrictions on Alternate Item(s). [] 852.214 72, Alternate Item(s). [Note: this is a fillable clause.] [] 852.214 73, Alternate Packaging and Packing. [] 852.214 74, Marking of Bid Samples. [] 852.215 70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors. [] 852.215 71, Evaluation Factor Commitments. [] 852.216 71, Economic Price Adjustment of Contract Price(s) Based on a Price Index. [] 852.216 72, Proportional Economic Price Adjustment of Contract Price(s) Based on a Price Index. [] 852.216 73, Economic Price Adjustment State Nursing Home Care for Veterans. [] 852.216 74, Economic Price Adjustment Medicaid Labor Rates. [] 852.216 75, Economic Price Adjustment Fuel Surcharge. [] 852.219 9, VA Small Business Subcontracting Plan Minimum Requirements. [X] 852.219 10, VA Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside. [] 852.219 11, VA Notice of Total Veteran-Owned Small Business Set-Aside. [] 852.222 70, Contract Work Hours and Safety Standards Nursing Home Care for Veterans. [] 852.228 70, Bond Premium Adjustment. [] 852.228 71, Indemnification and Insurance. [] 852.228 72, Assisting Service-Disabled Veteran-Owned and Veteran-Owned Small Businesses in Obtaining Bonds. [X] 852.232 72, Electronic Submission of Payment Requests. [] 852.233 70, Protest Content/Alternative Dispute Resolution. [] 852.233 71, Alternate Protest Procedure. [] 852.237 70, Indemnification and Medical Liability Insurance. [X] 852.246 71, Rejected Goods. [] 852.246 72, Frozen Processed Foods. [] 852.246 73, Noncompliance with Packaging, Packing, and/or Marking Requirements. [] 852.270 1, Representatives of Contracting Officers. [] 852.271 72, Time Spent by Counselee in Counseling Process. [] 852.271 73, Use and Publication of Counseling Results. [] 852.271 74, Inspection. [] 852.271 75, Extension of Contract Period. [] 852.273 70, Late Offers. [] 852.273 71, Alternative Negotiation Techniques. [] 852.273 72, Alternative Evaluation. [] 852.273 73, Evaluation Health-Care Resources. [] 852.273 74, Award without Exchanges. (b) All requests for quotations, solicitations, and contracts for commercial item services to be provided to beneficiaries must include the following clause: [] 852.237 74, Nondiscrimination in Service Delivery. (End of Clause) C.4 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING MONITORING AND COMPLIANCE (JUL 2018) (a) This solicitation includes VAAR 852.219-10 VA Notice of Total Service- Disabled Veteran-Owned Small Business Set-Aside. (b) Accordingly, any contract resulting from this solicitation is subject to the limitation on subcontracting requirements in 13 CFR 125.6, or the limitations on subcontracting requirements in the FAR clause, as applicable. The Contractor is advised that in performing contract administration functions, the Contracting Officer may use the services of a support contractor(s) retained by VA to assist in assessing the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to Contractor's offices where the Contractor's business records or other proprietary data are retained and to review such business records regarding the Contractor's compliance with this requirement. (c) All support contractors conducting this review on behalf of VA will be required to sign an Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement to ensure the Contractor's business records or other proprietary data reviewed or obtained in the course of assisting the Contracting Officer in assessing the Contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. (d) Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the Contractor to protect proprietary information as required by FAR 9.505-4, Obtaining access to proprietary information, paragraph (b). The Contractor is required to cooperate fully and make available any records as may be required to enable the Contracting Officer to assess the Contractor's compliance with the limitations on subcontracting or percentage of work performance requirement. (End of Clause) C.5 VAAR 852.247-71 DELIVERY LOCATION (OCT 2018) Shipment of deliverable items, other than reports, shall be to: Department of Veterans Affairs James H. Quillen VAMC Corner of Lamont and Veterans Way Dogwood Avenue, Building 205 Mountain Home TN 37684 (End of Clause) 36C24921Q0272 Page 1 of Page 11 of 16 Page 1 of SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS INTENTIONALLY BLANK 36C24921Q0272 Page 1 of Page 16 of 16 Page 1 of SECTION E - SOLICITATION PROVISIONS E.1 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018) The Contractor shall not make reference in its commercial advertising to Department of Veterans Affairs contracts in a manner that states or implies the Department of Veterans Affairs approves or endorses the Contractor s products or services or considers the Contractor s products or services superior to other products or services. (End of Clause) E.3 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018) (a) Definitions. As used in this clause (1) Contract financing payment has the meaning given in FAR 32.001; (2) Designated agency office means the office designated by the purchase order, agreement, or contract to first receive and review invoices. This office can be contractually designated as the receiving entity. This office may be different from the office issuing the payment; (3) Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods and formats identified in paragraph (c) of this clause. Facsimile, email, and scanned documents are not acceptable electronic forms for submission of payment requests; (4) Invoice payment has the meaning given in FAR 32.001; and (5) Payment request means any request for contract financing payment or invoice payment submitted by the contractor under this contract. (b) Electronic payment requests. Except as provided in paragraph (e) of this clause, the contractor shall submit payment requests in electronic form. Purchases paid with a Government-wide commercial purchase card are considered to be an electronic transaction for purposes of this rule, and therefore no additional electronic invoice submission is required. (c) Data transmission. A contractor must ensure that the data transmission method and format are through one of the following: (1) VA s Electronic Invoice Presentment and Payment System at the current website address provided in the contract. (2) Any system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) and chartered by the American National Standards Institute (ANSI). (d) Invoice requirements. Invoices shall comply with FAR 32.905. (e) Exceptions. If, based on one of the circumstances in this paragraph (e), the Contracting Officer directs that payment requests be made by mail, the Contractor shall submit payment requests by mail through the United States Postal Service to the designated agency office. Submission of payment requests by mail may be required for (1) Awards made to foreign vendors for work performed outside the United States; (2) Classified contracts or purchases when electronic submission and processing of payment requests could compromise the safeguarding of classified or privacy information; (3) Contracts awarded by contracting officers in the conduct of emergency operations, such as responses to national emergencies; (4) Solicitations or contracts in which the designated agency office is a VA entity other than the VA Financial Services Center in Austin, Texas; or (5) Solicitations or contracts in which the VA designated agency office does not have electronic invoicing capability as described above. (End of Clause) E.4 VAAR 852.246-71 REJECTED GOODS (OCT 2018) (a) Supplies and equipment. Rejected goods will be held subject to Contractor s order for not more than 15 days, after which the rejected merchandise will be returned to the Contractor s address at the Contractor s risk and expense. Expenses incident to the examination and testing of materials or supplies that have been rejected will be charged to the Contractor. (b) Perishable supplies. The Contractor shall remove rejected perishable supplies within 48 hours after notice of rejection. Supplies determined to be unfit for human consumption will not be removed without permission of the local health authorities. Supplies not removed within the allowed time may be destroyed. The Department of Veterans Affairs will not be responsible for, nor pay for, products rejected. The Contractor will be liable for costs incident to examination of rejected products. (End of Clause) E.5 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/index.asp (End of Clause) FAR Number Title Date 52.204-7 SYSTEM FOR AWARD MANAGEMENT OCT 2018 52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE OCT 2018 52.232-18 AVAILABILITY OF FUNDS APR 1984 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER OCT 2020 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS DEC 2013

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