/ REPRESENTATIONS AND CERTIFICATIONS
CONSTRUCTION

This part to be completed by all offerors and submitted with offer.

The full text of the representations and certifications made below, as referenced by the provision number and title, is available in the Federal Acquistion Regulation (FAR) or can be supplied by Fluor Federal Petroleum Operations (FFPO).

When stated in these provisions, "Contractor" means the party to whom this Subcontract is awarded; "Government" means United States Government and/or FFPO; "Contracting Officer" means Department of Energy Contracting Officer and/or FFPO Subcontract Administrator/Buyer, and “Contract” is synonymous with “Subcontract.”

1.  52.219-1, Small Business Program Representations (OCT 2014)

This provision applies to solicitations where the contract value is expected to exceed the micro-purchase acquisition threshold.

(a) The North American Industry Classification System (NAICS) code for this acquisition is ______[insert NAICS code].

(b) The small business size standard is ______[insert size standard].

(c) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

2.  Business size representations. The offeror represents:

It IS , IS NOT a small business.

It IS , IS NOT a veteran-owned small business concern.

It IS , IS NOT a service-disabled veteran-owned small business concern

It IS , IS NOT a woman-owned small business.

It IS , IS NOT an 8A firm.

It IS , IS NOT an 8A firm joint venture.

It IS , IS NOT a woman-owned small business under the WOSB Program

It IS , IS NOT an economically disadvantage woman-owned small business under the WOSB Program

It IS , IS NOT a HUBZone small business concern.

It IS , IS NOT a HUBZone small business joint venture.

3.  It IS , IS NOT a small and disadvantaged business,

If, YES:

Alaskan-Native Corporation Hispanic American Owned

American Indian Owned Native American Owned

Asian-Pacific American Owned Native Hawaiian Organization

Black American Owned Subcontinent Asian-American Owned

4.  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 foreign government;

Offeror is an agency or instrumentality of the Federal Government;

5.  Type of organization.

Sole proprietorship; Partnership;

Corporate entity (not tax-exempt); Corporate entity (tax-exempt);

Government entity (Federal, State, or local); Foreign government;

International organization per 26 CFR 1.6049-4;

Other ______.

6.  DUNS#______(unique nine-character identification number provided by Dun and Bradstreet (D&B) that is assigned to your entity)

7.  Annual Revenue: ______(average receipts over the last three complete fiscal years, including receipts of the parent organization, all branches, and all affiliates worldwide)

8.  Number of Employees:______(average number of employees, including all affiliates. This is the average number of persons employed for each pay period over the firm's latest 12 months, including persons employed by the parent organization, all branches, and all affiliates worldwide.)

DO NOT release Annual Revenue and Number of Employees to the public.

9.  Common parent.

Offeror is not owned or controlled by a common parent:

Name and TIN of common parent:

Name ______

TIN ______

DUNS Number of Common Parent ______

10.  52.203-2, Certificate of Independent Price Determination (Apr 1985)

Applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is

contemplated.

(a) The offeror certifies that –

(1) The prices in this offer have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other offeror or competitor relating to --

(i) Those prices;

(ii) The intention to submit an offer; or

(iii) The methods or factors used to calculate the prices offered.

(2) The prices in this offer have not been and will not be knowingly disclosed by the offeror, directly or indirectly, to any other offeror or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a negotiated solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the offeror to induce any other concern to submit or not to submit an offer for the purpose of restricting competition.

(b) Each signature on the offer is considered to be a certification by the signatory that the signatory –

(1) Is the person in the offeror’s organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; or

(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) of this

provision ______[insert full name of person(s) in the offeror’s organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the offeror’s organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) of this provision have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision; and

(iii) As an agent, has not personally participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) of this provision.

(c) If the offeror deletes or modifies subparagraph (a)(2) of this provision, the offeror must furnish with its offer a signed statement setting forth in detail the circumstances of the disclosure.

11.  52.204-10, Reporting Executive Compensation and First-Tier Subcontract Awards (Oct 2015)

(Applicable clause certifications are attached below – reference clause for full text.)

This provision applies to solicitations where the contract value is expected to be $30,000 or more.

In accordance with Public Law 109-282 and FAR 52.204-10, Reporting Executive Compensation for First-Tier Subcontract Awards (JUL 2010), you are required to provide certain information pertaining to compensation of executives in order to be eligible for this subcontract award. Please answer the following question(s) in connection with this requirement:

1) Did your organization in the previous tax year have gross income from all sources over $300,000?

YES NO

If you answered “No” to question 1 above, you are exempt from this reporting requirement. Please sign in the spaces indicated below and return this certification to the cognizant APL procurement representative. If you answered “Yes,” please answer the following questions:

2) Did your company receive 80% or more of its annual gross revenues from Federal contracts (and subcontracts), loans, grants (and subgrants) and cooperative agreements in the preceding fiscal year?

YES NO

3) Did your company receive $25,000,000 or more in annual gross revenues from Federal contracts (and subcontract), loans, grants (and subgrants) and cooperative agreements in the preceding fiscal year?

YES NO

4) Does the public NOT have access to information about the compensation of your company’s executives through periodic reports filed under 13(a) or 15(d) of the Securities Exchange Act 0f 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the Internal Revenue Code of 1986? (To determine if the public has access to the compensation information, see the U.S. Security and Exchange Commission total compensation filing at http://www.sec.gov/answers/execomp.htm.)

YES NO

If the answers to questions 2, 3 and 4 are all “Yes,” you are required to provide the names and total compensation of each of the five most highly compensated executives in your organization as part of this certification, and on an annual basis for the life of this subcontract. Please note that as required by public law and FAR 52.204-10(b), FFPO will report this information to the government, and this information will be made public. Further, please note your continuing obligation to immediately notify FFPO in writing of any changes to previously reported data.

12.  52.209-2, Prohibition on Contracting with Inverted Domestic Corporations-Representation (Nov 2015).

This provision applies to acquisitions of products or services (including construction).

The offeror represents that—

(1) It IS, IS NOT an inverted domestic corporation; and

(2) It IS, IS NOT a subsidiary of an inverted domestic corporation.

13. 52.209-5, Certification Regarding Responsibility Matters (Apr 2010).

This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.

The Offeror certifies, to the best of its knowledge and belief, that –

(i) The Offeror and/or any of its Principals –

(A) ARE ARE NOT presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) 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, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if offeror checks “have”, the offeror shall also see 52.209-7, if included in this solicitation); and

(C) ARE ARE NOT presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision; and

(D) HAVE , HAVE NOT , within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,000 for which the liability remains unsatisfied.

(ii) 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.

(e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Offeror knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may terminate the contract resulting from this solicitation for default.

14. 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (Sep 2007)

This provision applies to solicitations expected to exceed $150,000.

By submission of its offer, the offeror certifies to the best of its knowledge and belief that no Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress on his or her behalf in connection with the award of any resultant contract. If any registrants under the Lobbying Disclosure Act of 1995 have made a lobbying contact on behalf of the offeror with respect to this contract, the offeror shall complete and submit, with its offer, OMB Standard Form LLL, Disclosure of Lobbying Activities, to provide the name of the registrants. The offeror need not report regularly employed officers or employees of the offeror to whom payments of reasonable compensation were made.

15. 52.215-6, Place of Performance (Oct 1997)

This provision applies to solicitations unless the place is specified.

(a) The offeror or respondent, in the performance of any contract resulting from this solicitation, INTENDS, DOES NOT INTEND [check applicable block] to use one or more plants or facilities located at a different address from the address of the offeror or respondent as indicated in this proposal or response to request for information.

(b) If the offeror or respondent checks “intends” in paragraph (a) of this provision, it shall insert in the following spaces the required information:

Place of Performance(Street Address, City, State, County, Zip Code) / Name and Address of Owner and Operator of the Plant or Facility if Other Than Offeror or Respondent

16. 52.222.22 Previous Contracts and Compliance Reports (Feb 1999)

This provision applies to solicitations expected to exceed $10,000, or the aggregate value of subcontracts awarded in any 12 month period exceeds, or can be reasonably expected to exceed, $10,000.

The offeror represents that

(a) It HAS, HAS NOT, participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; and

(b) HAS, HAS NOT, filed all required compliance reports; and

17. 52.222.25 Affirmative Action Compliance (Apr 1984)

This provision applies to solicitation, other than those for construction, expected to exceed $10,000, or the aggregate value of subcontracts awarded in any 12 month period exceeds, or can be reasonably expected to exceed, $10,000.

The offeror represents that –

(a)  It HAS developed and has on file, HAS NOT developed and does not have on file, at each establishment, affirmative action programs by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or

(b)  It HAS NOT previously had contracts subject to the written affirmative action programs requirements of the rules and regulations of the Secretary of Labor.

18. 52.225-2 Buy American Act Certificate (May 2014).

This provision applies to solicitations containing the clause at 52.225-1, Buy American Act-Supplies.

(a) The offeror certifies that each end product, except those listed in paragraph (b) of this provision, is a domestic end product and that for other than COTS items, the offeror has considered components of unknown origin to have been mined, produced, or manufactured outside the United States. The offeror shall list as foreign end products those end products manufactured in the United States that do not qualify as domestic end products, i.e., an end product that is not a COTS item and does not meet the component test in paragraph (2) of the definition of “domestic end product.” The terms “commercially available off-the-shelf (COTS) item,” “component,” “domestic end product,” “end product,” “foreign end product,” and “United States” are defined in the clause of this solicitation entitled “Buy American—Supplies.”