As prescribed in 1515.408(a)(2), insert the following provision:
General Financial and Organizational Information: (AUG 1999)
Offerors or quoters are requested to provide information regarding the following items in sufficient detail to allow a full and complete business evaluation. If the question indicated is not applicable or the answer is none, it should be annotated. If the offeror has previously submitted the information, it should certify the validity of that data currently on file at EPA and to whom and where it was submitted or update all outdated information on file.
(a) Contractor's Name:____________________
(b) Address (If financial records are maintained at some other location, show the address of the place where the records are kept):
____________________
____________________
(c) Telephone Number:____________________
(d) Individual(s) to contact re. this proposal:____________________
____________________
(e) Cognizant Government:
Audit Agency:____________________
Address:____________________
Auditor:____________________
(f)(1) Work Distribution for the Last Completed Fiscal Accounting Period:
Sales:
Government cost-reimbursement type prime contracts $____
and subcontracts.................................
Government fixed-price prime contracts and $____
subcontracts.....................................
Commercial Sales.................................. $____
Total Sales..................................... $____
(2) Total Sales for first and second fiscal years
immediately preceding last completed fiscal year.
Total Sales for First Preceding Fiscal Year......... $____
Total Sales for Second Preceding Fiscal Year........ $____
(g) Is company a separate rate entity or division?..
Yes____
No____
If a division or subsidiary corporation, name parent company:
____________________
(h) Date Company Organized: ____________________
(i) Manpower:
Total Employees: ____________________
Direct: ____________________
Indirect: ____________________
Standard Work Week (Hours): ____________________
(j) Commercial Products: ____________________
(k) Attach a current organizational chart of the company.
(l) Description of Contractor's system of estimating and accumulating costs under Government contracts. (Check appropriate blocks.)
------------------------------------------------------------------------
Estimated/ Standard
actual cost cost
------------------------------------------------------------------------
Estimating System:
Job Order................................... ___ ___
Process..................................... ___ ___
Accumulating System:
Job Order................................... ___ ___
Process..................................... ___ ___
------------------------------------------------------------------------
Has your cost estimating system been approved by any Government agency?
Yes ____ No ____
If yes, give name, date or approval, and location of agency:
____________________
____________________
Has your cost accumulation system been approved by any Government agency?
Yes ____ No ____
If yes, give name, date of approval, and address of agency:
____________________
____________________
(m) What is your fiscal year period? (Give month-to-month dates):
____________________
____________________
What were the indirect cost rates for your last completed fiscal year?
------------------------------------------------------------------------
Indirect Basis of
Fiscal year cost rate allocation
------------------------------------------------------------------------
Fringe Benefits................................. ___ ___
Overhead........................................ ___ ___
G&A Expense................................. ___ ___
Other........................................... ___ ___
------------------------------------------------------------------------
(n) Have the proposed indirect cost rate(s) been evaluated and accepted by any Government agency?
Yes ____ No ____
If yes, give name, date of approval, and location of the Government agency:
____________________
Date of last preaward audit review by a Government agency:
____________________
If the answer is no, data supporting the proposed rates must accompany the cost or price proposal. A breakdown of the items comprising overhead and G&A must be furnished.
(o) Cost estimating is performed by:
Accounting Department____________________
Contracting Department____________________
Other (describe)____________________
(p) Has system of control of Government property been approved by a Government agency?
Yes ____ No ____
If yes, give name, date of approval, and location of the Government agency:
____________________
____________________
(q) Purchasing System: FAR 44.302 requires EPA, where it is the cognizant Government agency, to conduct a Contractor Purchasing System Review for each contractor whose sales to the Government, using other than sealed bid procedures, are expected to exceed $25 million (annual billings) during the next twelve months. The $25 million sales threshold is comprised of prime contracts, subcontractors under Government prime contracts, and modifications (except when the negotiated price is based on established catalog or market prices or is set by law or regulation).
Has your purchasing system been approved by a Government agency?
Yes ____ No ____
If yes, name and location of the Government agency:
____________________
Period of Approval: ____________________
If no, do you estimate that your negotiated sales to the Government during the next twelve months will meet the $25 million threshold? Yes ____ No ____
If you responded yes to the $25 million threshold question, is EPA the cognizant agency for your organization based on the preponderance of Government contract dollars?
Yes ____ No ____
If EPA is not your cognizant Government agency, provide the name and location of the cognizant agency ______
____________________
Are your purchasing policies and procedures written?
Yes ____ No ____
(r) Does your firm have an established written incentive compensation or bonus plan?
Yes ____ No ____
(s) Additionally, offerors shall submit current financial statements, including a Balance Sheet, Statement of Income (Loss), and Cash Flow for the last two completed fiscal years. Specify resources available to perform the contract without assistance from any outside source. If sufficient resources are not available, indicate in proposal the amount required and the anticipated source (i.e., bank loans, letter or lines of credit, etc.).
(End of provision)
[64 FR 47417, Aug. 31, 1999]
