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(7/08 DCM)
(FAC 2005-25




This contract incorporates the following 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 address:


FAR Clause No. Title and Date
52.203-3Gratuities (APR 1984)
52.203-5Covenant Against Contingent Fee (APR 1984)
52.203-6Restrictions on Subcontractor Sales to The Government (SEPT 2006)
52.203-7Anti-Kickback Procedures (JUL 1995)
52.203-10Price or Fee Adjustment for Illegal or Improper Activity (JAN 1997)
52.203-12Limitation on Payments to Influence Certain Federal Transactions (SEP 2007)
52.203-14Display of Hotline Poster(s) (DEC 2007)

(Dept. of Health and Human Services Poster at:

52.204-4Printing/Copying Double-Sided on Recycled Paper (AUG 2000)
52.204-7Central Contractor Registration. (APR 2008)
52.209-6Protecting the Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (SEPT 2006)
52.215-2Audit and Records—Negotiation (JUN 1999)
52.215-8Order of Precedence Uniform Contract Format (OCT 1997)
52.215-17Waiver of Facilities Capital Cost of Money (OCT 1997)
52.217-9Option to Extend the Term of the Contract (MAR 2000)
52.219-8Utilization of Small Business Concerns (MAY 2004)
52.219-28Post-Award Small Business Program Representation (JUNE 2007)
52.222-3Convict Labor (JUNE 2003)
52.222-26 Equal Opportunity (APR 2002)
52.222-35 Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans. (SEPT 2006)
52.222-36 Affirmative Action for Workers With Disabilities (JUNE 1998)
52.222-37 Employment Reports on Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans. (SEPT 2006)
52.222-39 Notification of Employee Rights Concerning Payment of Union Dues or Fees (DEC 2004)
52.223-6 Drug Free Workplace (MAY 2001)
52.223-14 Toxic Chemical Release Reporting (AUG 2003)
52.225-13 Restrictions on Certain Foreign Purchases (JUNE 2006)
52.227-1 Authorization and Consent (DEC 2007)
52.229-4Federal, State and Local Taxes (Noncompetitive Contract (APRIL 2003)
52.232-1Payments (APR 1984)
52.232-8Discounts for Prompt Payment (FEB 2002)
52.232-9Limitation on Withholding of Payments (APRIL 1984)
52.232-11Extras (APR 1984)
52.232-17 Interest (JUNE 1996)
52.232-23 Assignment of Claims (JAN 1986)
52.232-25Prompt Payment (OCT 2003)
52.233-1Disputes (JULY 2002)
52.233-3Protest After Award (AUG 1996)
52.233-4Applicable Law for Breach of Contract Claim (OCT 2004)
52.242-13 Bankruptcy (JUL 1995)
52.243-1Changes—Fixed Price (AUG 1987)

Alternate I (APRIL 1984)
52.246-4 Inspection of Services—Fixed Price (AUG 1996)
52.246-25 Limitation of Liability—Services (FEB 1997)
52.249-4Termination for Convenience of the Government (Services) (Short Form) (APRIL 1984)
52.249-8 Default (Fixed-Price Supply and Service) (APRIL 1984)



HHSAR Clause No. Title and Date
352.202-1 Definitions (JAN 2006)
352.232-9Withholding of Contract Payments (JAN 2006)
352.270-1Accessibility of Meetings, Conferences, Seminars to Persons with Disabilities (DEC 2006)
352.270-4 Pricing of Adjustments (JAN 2001)
352.270-7 Paperwork Reduction Act (JAN 2006)

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1. Past Performance Questionnaire and Contractor Performance Form
2. Proposal Intent Form


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(FAC 2005-03)



Section Clause No. Title and Date
K.1 HHSAR 315.204-5 Representations and Instructions
K.2. FAR 52.204-8 Annual Representations and Certifications (JAN 2006)
K.3. FAR 52.222-21 Prohibition of Segregated Facilities (FEB 1999)
K.4. FAR 52.230-1 Cost Accounting Standards Notices and Certification (JUNE 2000)    
K.5. FAR 15.406-2 Certificate of Current Cost and Pricing  Data
K.6. P.L. 103-227 Certification Regarding Environmental Tobacco Smoke


  1. Section K, Representations, certifications, and other statements of offerors.
    1. This section shall begin with the following and continue with the applicable representations and certifications:

TO BE COMPLETED BY THE OFFEROR:  (The Representations and Certifications must be executed by an individual authorized to bind the Offeror.) The Offeror makes the following Representations and Certifications as part of its proposal.  (Check or complete all appropriate boxes or blanks on the following pages.)

(Name of Offeror)                                                                                                 (RFP No.)

(Signature of Authorized Individual)                                                                       (Date)

(Typed Name of Authorized Individual)

NOTE:  The penalty for making false statements in offers is  prescribed in 18 U.S.C. 1001.


  1. (1) If the clause at 52.204-7, Central Contractor Registration, is included in this solicitation, paragraph (c) of this provision applies.

    (2) If the clause at 52.204-7 is not included in this solicitation, and the offeror is currently registered in CCR, and has completed the ORCA electronically, the offeror may choose to use paragraph (b) instead of completing the corresponding individual representations and certifications in the solicitation.  The offeror shall indicate which option applies by checking one of the following boxes:

    [  ] (i) Paragraph (b) applies.

    [  ] (ii) Paragraph (b) does not apply and the offeror has completed the individual representations and certification in the solicitation.

  2. The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) Web site at  After reviewing the ORCA database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below (offeror to insert changes, identifying change by clause number, title, date).  These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.
FAR Clause# Title Date Change

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on ORCA.

(End of provision)


(FEB 1999) (FAR 52.222-21)

  1.   "Segregated facilities," as used in this clause, means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees, that are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin because of written or oral policies or employee custom. The term does not include separate or single-user rest rooms or necessary dressing or sleeping areas provided to assure privacy between the sexes.
  2.   The Contractor agrees that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location under its control where segregated facilities are maintained.  The Contractor agrees that a breach of this clause is a violation of the Equal Opportunity clause in this contract.
  3.    The Contractor shall include this clause in every subcontract and purchase order that is subject to the Equal Opportunity clause of this contract.

(End of Clause)


(FAR 52.230-1) (JUNE 2000)

NOTE: This notice does not apply to small businesses or foreign governments.  This notice is in three parts, identified by Roman numerals I through III.

Offerors shall examine each part and provide the requested information in order to determine Cost Accounting Standards (CAS) requirements applicable to any resultant contract.

If the offeror is an educational institution, Part II does not apply unless the contemplated contract will be subject to full or modified CAS-coverage pursuant to 48CFR 9903.201-2(c)(5) or 9903.201-2(c)(6),respectively.

  1. Disclosure Statement—Cost Accounting Practices and Certification

    1. Any contract in excess of $500,000 resulting from this solicitation, will be subject to the requirements of the Cost Accounting Standards Board (48 CFR, Chapter 99), except for those contracts which are exempt as specified in 48 CFR 9903.201-1.
    2. Any offeror submitting a proposal which, if accepted, will result in a contract subject to the requirements of 48 CFR Chapter 99 must, as a condition of contracting, submit a Disclosure Statement as required by 48 CFR 9903.202.  When required, the Disclosure Statement must be submitted as a part of the offeror's proposal under this solicitation unless the offeror has already submitted a Disclosure Statement disclosing the practices used in connection with the pricing of this proposal.  If an applicable Disclosure Statement has already been submitted, the offeror may satisfy the requirement for submission by providing the information requested in paragraph (c) of Part I of this provision. Caution:  In the absence of specific regulations or agreement, a practice disclosed in a Disclosure Statement shall not, by virtue of such disclosure, be deemed to be a proper, approved, or agreed-to practice for pricing proposals or accumulating and reporting contract performance cost data.
    3. Check the appropriate box below:

      [  ] (1) Certificate of Concurrent Submission of Disclosure Statement.

      The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows: (i) original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity, as applicable, and (ii) one copy to the cognizant Federal auditor.

      (Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable.  Forms may be obtained from the cognizant ACO or Federal official and/or from the loose-leaf version of the Federal Acquisition Regulation.)

      Date of Disclosure Statement: __________________________

      Name and Address of Cognizant




      ACO or Federal official where filed: __________________________

      The offeror further certifies that practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

      [  ] (2) Certificate of Previously Submitted Disclosure Statement.

      The offeror hereby certifies that the required Disclosure Statement was filed as follows:

      Date of Disclosure Statement:__________________________

      Name and Address of Cognizant




       ACO or Federal official where filed:__________________________

      The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

      [  ] (3) Certificate of Monetary Exemption.

      The offeror hereby certifies that the offeror together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling more than $25 million in the cost accounting period immediately preceding the period in which this proposal was submitted.  The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.   

      [  ] (4) Certificate of Interim Exemption.

      The offeror hereby certifies that (i) the offeror first exceeded the monetary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR, Subpart 9903.202-1, the offeror is not yet required to submit a Disclosure Statement.  The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a review certificate to the Contracting Officer, in the form specified under subparagraph (c)(1) or (c)(2) of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

      Caution:  Offerors currently required to disclose because they were awarded a CAS-covered prime contract or subcontract of $25 million or more in the current cost accounting period may not claim this exemption (4).  Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

  2. Cost Accounting Standards—Eligibility for Modified Contract Coverage

    If the offeror is eligible to use the modified provisions of 48 CFR, Subpart 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below.  Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause.

    [  ]   The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR, Subpart 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $25 million in awards of CAS-covered prime contracts and subcontracts or the offeror did not receive a single CAS-covered award exceeding $1 million.  The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately.

    Caution:  An offeror may not claim the above eligibility for modified contract coverage if this proposal is expected to result in the award of a CAS-covered contract of $25 million or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $25 million or more.

  3. Additional Cost Accounting Standards Applicable to Existing Contracts

    The offeror shall indicate below whether award of the contemplated contract would, in accordance with subparagraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts. [  ] Yes     [  ] No

    (End of Provision)

    ALTERNATE I (APR 1996)

    [  ] (5) Certificate of Disclosure Statement Due Date by Educational Institution. 

    If the offeror is an educational institution that, under the transition provisions of 48 CFR 9903.202-1(f), is or will be required to submit a Disclosure Statement after receipt of this award, the offeror hereby certifies that (check one and complete):

    [  ] (a) A Disclosure Statement filing Due Date of ___________ has been established with the cognizant Federal agency.

    [  ] (b) The Disclosure Statement will be submitted within the six month period ending ___________ months after receipt of this award.

    Name and Address of cognizant ACO or Federal Official where Disclosure Statement is to be filed:






(FAR 15.406-2)

When cost or pricing data are required, the contracting officer shall require the contractor to execute a Certificate of Current Cost or Pricing Data using the format in this paragraph, and shall include the executed certificate in the contract file.

This is to certify that, to the best of my knowledge and belief, the cost or pricing data (as defined in Section 15.401 of the Federal Acquisition Regulation (FAR) and required under FAR subsection 15.403-4) submitted, either actually or by specific identification, in writing, to the contracting officer or the contracting officer's representative in support of _______________________* are accurate, complete, and current as of _______________________**.

This certification includes the cost or pricing data supporting any advance agreements and forward pricing rate agreements between the offeror and the Government that are part of the proposal.

FIRM   _____________________________________________________

NAME   ____________________________________________________ 

TITLE  _____________________________________________________

DATE OF EXECUTION*** ______________________________________

* Identify the proposal, request for price adjustment, or other submission involved, giving the   appropriate identifying number (e.g., Request for Proposal number).

** Insert the day, month, and year when price negotiations were concluded and price agreement was reached or, if applicable, an earlier date agreed upon between the parties that is as    close as practicable to the date of agreement on price.

*** Insert the day, month, and year of signing, which should be as close as practicable to the date when the price negotiations were concluded and the contract price agreed to.

End of Certificate


The Public Health Service strongly encourages all grant and contract recipients to provide a smoke-free workplace and to promote the nonuse of all tobacco products.  In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care or early childhood development services are provided to children.


Public Law 103-227, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, early childhood development services, education or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee.  The law also applies to children's services that are provided in indoor facilities that are constructed, operated, or maintained with such Federal funds.  The law does not apply to children's services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment; service providers whose sole source of applicable Federal funds is Medicare or Medicaid; or facilities where WIC coupons are redeemed.  Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1000 for each violation and/or the imposition of an administrative compliance order on the responsible entity.

By signing this certification, the offeror/contractor certifies that the submitted organization will comply with the requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision of services for children as defined by the Act.

The submitting organization agrees that it will require that the language of this certification be included in any subawards which contain provisions for children's services and that all subrecipients shall certify accordingly.


Signature: _________________________ Title: _____________________

Date: ________________________________

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