APPLICATION for APPOINTMENT as
General Agent of the National Shipping Authority
Maritime Administration
Department of Transportation
(Rev 3 - October 1997)
Instructions:
1. Any citizen of the United States, as defined here in Section 7, Part A, who is an operator of vessels (see below) may apply to the Director, National Shipping Authority (DNSA) to act as General Agent for vessels owned by the Maritime Administration (MARAD). Vessel is defined as:
Dry cargo: 450 feet LWL; 7500 DWT cargo capacity, or greater.
Tanker: 25,000 DWT cargo capacity or greater.
To be considered, the application should substantially follow the form indicated here.
2. Each application should contain at a minimum the information specifically requested here, in sufficient detail to enable MARAD to determine the qualifications of the applicant, including citizenship, ability, experience and financial resources.
3. If any information called for by the application is not furnished, an explanation of the omission should be given.
4. Those applicants determined qualified, will be sent a General Agent Agreement for signature. The representations and certifications contained in an offerors completed application will be made a part of the Agreement. It will be updated once each year, unless material changes occur in the ownership or organization of the applicant, including officers, executive management, citizenship, ship operating status, or financial resources, which require an interim notification by the General Agent.
5. Those applicants, who do not meet the criteria for this work, will be notified via certified mail.
6. Assignment of duties as General Agent will occur when MARAD has an urgent or compelling need for supplies and/or services on a government owned vessel(s) that can not be satisfied under existing contracts. MARAD will then issue an assignment order to the General Agent whose experience, geographic locale, and other predetermined factors, offers the highest probability of success. A point of contact will be established in the original assignment letter. Such selection decisions are solely MARAD's, and are not subject to dispute.
Section 1. Applicant :
1.1. Exact name of the company, corporation, or business entity.
1.2. Address of principal executive offices.
1.3. Contact person with address if different from B.
1.4. Telephone number with area code and extensions.
Section 2. Mailing Instructions :
2.1. Forward three (3) copies of the completed application, including all relevant information being submitted to:
DOT/Maritime Administration
ATTN: Office of Acquisition
MAR 383 Room 7310
400 Seventh Street SW
Washington, DC 20590
2.2. It will take approximately 45 days for MARAD to complete evaluation of your application. If you wish to check on its progress, please contact: Team Leader, Ship Manager Team at (202) 366-5757.
Section 3. Experience :
3.1. Brief history of the firm over the past five (5) years including:
3.1.1. List of all subsidiaries, parent companies, and/or affiliated interests
of the applicant. This may be submitted in the form of a chart clearly
indicating the relationships between the persons named and the nature and extent of control.
3.1.2. Years in business, type of operational experience, number, types
and registry of vessels operated and/or owned.
3.1.3 Facilities - type and location.
3.2. Size of firm, including number of employees in each department.
3.2.1. Include resumes on each Officer and Director to include:
a. Name and address.
b. Office.
c. Nationality.
d. Capitol shares owned.
e. Principal business experience over past 10 years.
3.2.2. Include resumes on those principal shoreside staff who are
anticipated to perform in the event of an assignment under a General
Agent Agreement.
3.3. Specialized experience in ship management.
3.3.1. Years of experience.
3.3.2. Details of management.
3.3.3. Experience operating oceangoing dry cargo vessels no less than 450 ft. LWL (length along waterline) or longer and a minimum of 7500
cargo DWT; or tanker(s) of 25,000 DWT cargo capacity or greater.
3.4. Experience on government contracts for operating vessels:
3.4.1. Contract number, date of award, date of completion.
3.3.2. Contact point in the government - name and telephone number.
3.4.3. Description of effort.
Section 4. Financial Records :
4.1. Financial capacity, working capital, what, if any assistance, would be
obtained from outside sources.
4.2. CPA certified balance sheet.
4.3. Profit/loss statement.
4.4. Statement of retained earnings.
Section 5. Area of Consideration :
Provide the geographic area of operation for which you wish to be considered. Describe the facilities and services you could provide in those areas.
Section 6. Union Agreements :
Submit current executed commercial union agreements.
Section 7. Representations and Certifications :
Carefully complete each of the following items.
7.1. Citizen of the United States
Citizen of the United States means a person (including receivers, trustees and successors or assignees of such persons as provided in 46 App. U.S.C. 802), including any person (stockholder, partner or other entity) who has a controlling interest in such person, any person whose stock or equity is being relied upon to establish the requisite U.S. citizen ownership, and any parent corporation, partnership or other entity of such person at all tiers of ownership, who, in both form and substance at each tier of ownership, satisfies the following requirements:
(1) An individual who is a Citizen of the United States, by birth, naturalization or as otherwise authorized by law;
(2) A corporation organized under the laws of the United States or of a State, the controlling interest of which is owned by and vested in Citizens of the United States and whose president or chief executive officer, chairman of the board of directors and all officers authorized to act in the absence or disability of such persons are Citizens of United States, and no more of its directors than a minority of the number necessary to constitute a quorum are noncitizens;
(3) A partnership organized under the laws of the United States or of a State, if all general partners are Citizens of the United States and a controlling interest in the partnership is owned by Citizens of the United States;
(4) An association organized under the laws of the United States or of a State, whose president or other chief executive officer, chairman of the board of directors (or equivalent committee or body) and all officers authorized to act in their absence or disability are Citizens of the United States, no more than a minority of the number of its directors, or equivalent, necessary to constitute a quorum are noncitizens, and a controlling interest in which is vested in Citizens of United States;
(5) A joint venture, if it is not determined by the Maritime Administrator to be in effect an association or partnership, which is organized under the laws of the United States or of a State, if each co-venturer is a Citizen of the United States. If a joint venture is in effect an association, it will be treated as is an association under paragraph (a)(4) of this section, or, if it is in effect a partnership, will be treated as is a partnership under paragraph (a)(3) of this section.
Certification of United States Citizenship
The offeror certifies that it [ ] is, [ ] is not a citizen of the United States within the meaning of citizenship as set forth here.
NOTE: Any offeror who is not a United States citizen, within the meaning stated above, will be found non-responsive, and their application will not be considered further.
(End of Provision)
7.2. Owner/Owner Operator Certification (MARAD) (July 1990)
The offeror certifies that it is currently an [ ] owner- operator, [ ] operator of a government owned or an [ ] operator of commercial vessels, and warrants that they shall notify MARAD of any change to this status.
Vessel is defined as:
Dry cargo - 450 feet LWL; 7500 DWT cargo capacity, or greater.
Tanker - 25,000 DWT cargo capacity or greater.
Please identify the size, weight (dead weight tons), type/purpose (RO/RO, tanker, barge, etc) and normal shaft horsepower of the vessels you are certifying in the space below ________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
(End of Provision)
7.3. Contingent Fee Representation and Agreement (FAR 52.203-4) (APR 1984)
(1) Representation. The offeror represents that, except for full-time bona fide employees working solely for the offeror, the offeror--
(NOTE: The offeror must check the following appropriate boxes. For interpretation of the representation, including the term "bona fide employee," see Subpart 3.4 of the Federal Acquisition Regulation.)
(a) Has [ ], has not [ ] employed or retained any person or company to solicit or obtain this contract; and
(b) Has [ ], has not [ ] paid or agreed to pay to any person or company employed or retained to solicit or obtain this contract any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.
(2) Agreement. The offeror agrees to provide information relating the above Representation as requested by the Contracting Officer and, when
subparagraph (a) or (b) is answered affirmatively, to promptly submit to the Contracting Officer --
(a) A completed Standard Form 119, Statement of Contingent or Other Fees, (SF 119); or
(b) A signed statement indicating that SF 119 was previously submitted to the same contracting office, including the date and applicable solicitation or contract number, and representing that the prior SF 119 applies to this offer or quotation.
(End of Provision)
7.4. Taxpayer Identification (FAR 5.204-3) (SEP 1989)
(1) Definitions.
"Common parent," as used in this solicitation provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member.
"Corporate status," as used in this solicitation provision, means a designation as to whether the offeror is a corporate entity, an unincorporated entity (e.g., sole proprietorship or partnership), or a corporation providing medical and health care services.
"Taxpayer Identification Number (TIN)," as used in this solicitation provision, means the number required by the IRS to be used by the offeror in reporting income tax and other returns.
(2) The offeror is required to submit the information required in paragraphs (3) through (5) of this solicitation provision in order to comply with reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M and implementing regulations issued by the Internal Revenue Service (IRS). If the resulting contract is subject to the reporting requirements described in 4.902(a), the failure or refusal by the offeror to furnish the information may result in a 20 percent reduction of payments otherwise due under the contract.
(3) Taxpayer Identification Number (TIN).
[ ] TIN:
[ ] TIN has been applied for.
[ ] TIN is not required because:
[ ] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States;
[ ] Offeror is an agency or instrumentality of a Federal, State, or local government;
[ ] Other, state basis.
(4) Corporate Status.
[ ] Corporation providing medical and health care service, or engaged in the billing and collecting of payments for such services;
[ ] Other corporate entity;
[ ] Not a corporate entity;
[ ] Sole proprietorship;
[ ] Partnership;
[ ] Hospital or extended care facility described in 26 CFR 501 (c)(3) that is exempt from taxation under 26 CFR 501(a).
(5) Common Parent.
[ ] Offeror is not owned or controlled by a common parent as
defined in paragraph (1) of this clause.
[ ] Name and TIN of common parent:
Name _______________________________________
TIN _______________________________________ (End of Provision)
7.5. Certification Regarding Debarment, Suspension, Proposed Debarment, and other Responsibility Matters (FAR 52.209-5)
(May 1989)
The offeror certifies, to the best of its knowledge and belief; the offeror and/or any of its Principals;
(1) Are [ ], are not [ ] presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency; and
(2) Have [ ], have not [ ] within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; and
(3) Are [ ], are not [ ] presently indicted for, or otherwise criminally or civilly moved by a governmental entity with, commission of any of the offenses enumerated in subdivision (E) (2) of this provision.
(4) The offeror has [ ], has not [ ] within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.
(5) "Principals," for the purposes of this certification, means officers, directors, owners, partners, and, persons having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a subsidiary, division, or business segment, and similar positions).
(6) The offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the offeror learns that its certifications was erroneous when submitted or has become erroneous by reason of changed circumstances.
(7) A certification that any of the items in paragraph (1) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the offeror's responsibility. Failure of the offeror to furnish a certification or provide such additional information as requested by the Contracting Officer may render the offeror nonresponsible.
(8) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (1) of this provision. The knowledge and information of an offeror is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.