John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
REQUEST FOR PROPOSAL
FIXED PRICE GOODS OR SERVICES
(FIELD)
RFP NO: 14_045
PART A: COVER PAGE
ISSUED TO: USAID | DELIVER PROJECT website and a short list of transportation
vendors in Indonesia
SUBJECT: Request for Proposal for transportation services for TB MDR specimen from
district pick up points to the closest GeneXpert labs
The USAID | DELIVER PROJECT (herein referred to as “the Project”) under John Snow, Inc.
(JSI) is soliciting proposals for the provision of Subject services as described in the attached
Statement of Work. The Project is funded by the U.S. Agency for International Development
(USAID) and is subject to all applicable Federal Acquisition Regulation (FAR) and AID
Acquisition Regulations (AIDAR).
Please submit your most competitive proposal in accordance with the attached instructions, with
all required certifications. Any subcontract issued as a result of this RFP will be subject to all
instructions, certifications, terms and conditions, and specifications included in this RFP. This
solicitation document includes the following parts:
PART A: COVER PAGE .................................................................................................. 1
PART B: INSTRUCTIONS............................................................................................... 2
PART C: STATEMENT OF WORK ................................................................................. 5
This document is a request for proposals only, and in no way obligates the Project or USAID to
make any award. Award(s) made subsequent to this solicitation will be subject to the terms and
conditions described herein.
All proposals, inquiries, and correspondence, including the RFP number, pertaining to this
solicitation are to be directed to the attention of:
Dalia Al-Eryani
John Snow, Inc.
USAID | DELIVER PROJECT
1616 North Fort Myer Drive
Arlington, Virginia 22209, USA
Fax: 703/528-7480
Email: dalia_al-eryani@jsi.com
M. Vanden Bossche
Contract Administrator
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
PART B: INSTRUCTIONS
a) DEFINITIONS
Offeror: The individual or firm providing proposals for the supplies or services requested
under this RFP
Subcontractor: The individual or firm awarded the services requested under the RFP in the
form of a subcontract
b) PROPOSAL DEADLINE AND REQUIREMENTS
The Offeror shall submit a proposal addressing the terms and conditions of this RFP by 5:00
pm EST time on November 20, 2014 to the email address as provided in Part A on the cover
page. Please submit all questions by 5:00 pm EST November 6, 2014 to the email address
provided on the cover page. All questions and answers will be listed on the Deliver Website
by 5:00 pm EST on November 11, 2014.
The Technical and Cost Proposals should be submitted separately in two clearly marked
PDFs.
The written proposal should not be of excessive length and must contain the following
information:
i)
Technical Volume

A concise technical proposal on how the Offeror will carry out the activity with a detailed
work plan and schedule of tasks.

Also provide past performance references for the last three years, including the
following: name of firm, name of contact, address of firm, telephone number of firm,
email for firm, dollar amount of contract for each reference.

A set of relevant attachments to the proposal (optional) which further document or
explain the Offeror’s approach and qualification, e.g. institutional brochure, etc.

A description of the Offeror’s capability and experience in undertaking this task.
ii)
Cost Proposal

A fixed unit price for each pick and delivery charge in listed in table X in the
statement of work. The unit prices will need to include all costs.

Please provide financial statements for the last three fiscal years.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
 Please provide proof of business registration in Indonesia
JSI RESERVES THE RIGHT, IN ITS SOLE DISCRETION, TO MODIFY THE REQUEST,
TO ALTER THE SELECTION PROCESS IN ANY WAY, TO ASK FOR ADDITIONAL
INFORMATION FROM Offerors, TO REJECT ANY AND ALL PROPOSALS AND/OR
TO MODIFY OR AMEND THE SCOPE OF THE PROPOSALS SUBMITTED. THE
RELEASE OF THIS RFP IS NOT A COMMITMENT TO AWARD A CONTRACT.
Each Offeror acknowledges and agrees that the preparation of all materials for submittal to
JSI and all presentations made by the Offeror are at the Offeror’s sole cost and expense, and
JSI shall not, under any circumstances, be responsible for any cost or expense incurred by an
Offeror. All documentation and/or materials submitted with a proposal shall become and
remain the property of JSI.
c) OFFER VALIDITY
The Offeror's technical and cost proposals must remain valid for not less than 60 calendar
days after the deadline specified above. Proposals must be signed by an official authorized to
bind the Offeror to its provisions.
d) FINANCIAL RESPONSIBILITY
Offerors which are firms and not individuals, must certify in the proposal submitted to the
Project that they have the financial viability and resources to complete the proposed activities
within the period of performance and under the terms of payment outlined in the Statement
of Work. The USAID | DELIVER PROJECT reserves the right to request and review the
latest financial statements and audit reports of the Offeror as part of the basis of the award.
e) NEGOTIATIONS
The Offeror's most competitive proposal is requested. It is anticipated that any award issued
will be made solely on the basis of an Offeror’s proposal. However, the Project reserves the
right to request responses to additional technical, management and cost questions which
would help in negotiating and awarding a subcontract. The Project also reserves the right to
conduct negotiations on technical, management, or cost issues prior to the award of a
subcontract. In the event that an agreement cannot be reached with an Offeror the Project
will enter into negotiations with alternate Offerors for the purpose of awarding a subcontract
without any obligation to previously considered Offerors.
f) REJECTION OF PROPOSALS
The Project reserves the right to reject any and all proposals received, or to negotiate
separately with any and all competing Offerors. Offerors whose proposals are not selected
will be notified in writing.
g) INCURRING COSTS
The Project is not liable for any cost incurred by Offerors during preparation, submission, or
negotiation of an award for this RFP. The costs are solely the responsibility of the Offeror.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
h) CANCELLATION
The Project may cancel this RFP without any cost or obligation at any time until issuance of
a Subcontract.
i) SUBCONTRACT AWARD
i)
Selection Criteria
Proposals will be evaluated first to ensure that they meet all mandatory requirements.
Proposals that fail to meet these requirements will receive no further consideration. A
non-responsive proposal to any element may be eliminated from consideration.
For the purpose of selection, the evaluation will be based on an integrated assessment of
the proposal, including, but not limited to, the following:





iii)
Technical capability and expertise
Responsiveness to the RFP
Cost/budget proposal
Ability to meet the deliverables requirements
Business status certification
Contract Type
The contracting document will be a Fixed Unit Price Blanket Purchase Agreement. Fixed
Price Purchase Orders will be issued for each pickup and delivery. Please be advised that
under a BPA and fixed price PO the work must be done within the specified total price.
Any expenses incurred in excess of the agreed upon amount in the purchase order will be
the responsibility of the Subcontractor and not that of JSI or USAID Therefore, the
Offeror is duly advised to provide its most competitive and realistic cost proposal to
cover all foreseeable expenses related to the tasks outlined in the Statement of Work.
j) REPRESENTATIONS AND CERTIFICATIONS
The proposal shall be accompanied by any requested representations or certifications signed
by an authorized official of the Offeror.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
PART C: STATEMENT OF WORK
The Statement of Work for this RFP is as described below:
a) BACKGROUND
The USAID | DELIVER PROJECT, a U.S. Agency for International Development (USAID)funded project, implemented by John Snow Inc., is issuing this RFP to obtain transportation
vendor bids for the transport of already properly packaged Tuberculosis (TB) specimens from
district collection sites to the nearest GeneXpert testing lab for a period of 9 months (November
2014 to June 2015) in 16 districts within 9 provinces. There are 75 district pick-up points and 10
GeneXpert lab drop-off point. Annex 1 below provides the detailed locations of pick-up and
drop-off points.
b) OBJECTIVES OF THIS WORK
1. Transportation and delivery of TB specimens from district sites to GeneXpert labs within
24 hours
2. Returning empty cold box packaging back from GeneXpert labs to the district site they
belong to within 48 hours
c) WORK PLAN
For laboratories to receive quality specimens to generate good quality results, the specimens
must be properly collected, handled and transported. Specimens must be transported and
delivered within 24 hours to the GeneXpert labs. They must be handled with great care.
To ensure the correct packaging and biosafety, the transport vendor will not be involved with the
packing of the specimen but only with the transportation component. All the material required
for the safe packing and maintenance of cold chain will be provided by the district pick-up.
District TB officers and the technical staff of each TB specimen pick up sites (ARV hospitals,
prisons and district health offices) have been trained in packaging according to the WHO
recommended triple layer packing.
The pre-packed specimens will be in a cold box and sealed when picked up and should be never
opened by the transportation vendor’s workers. The specimens should never be exposed to
sources of contamination, such as rain/water. Incorrect handling of specimens may be dangerous
to workers and the public due to the infectious nature of the specimens and will also compromise
the quality of the specimen. The importance of a safe and reliable specimen transportation
system is fundamental for a national TB control program.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
The estimated number of pick-ups is two trips per week, on either Tuesday or Thursday, from
each pick up point. The pick-up point will telephone the transport vendor a day in advance when
a cold box is ready for transport. The transportation vendor will then have 24 hours to deliver
the cold box to the specified GeneXpert lab. There may be zero, one, or two trips per pick up
point per week, depending on the patient load.
In addition to delivering the TB specimens, the transportation vendor will also be responsible for
returning the empty cold box packaging back to the district site they belong to. During delivery
of the cold boxes containing the specimens, if there are empty cold boxes at the specific lab, the
vendor will be responsible for picking and returning the empty cold box’s to the specific district
site they came from.
The transportation of cold box containing SPECIMENS requirements are the following:
1. Collect cold boxes containing specimens on Tuesdays or Thursday following phone call
from district sites on preceding Monday or Wednesday.
2. Have Pick-Up section of form filled out and sign by District Site designee for each cold
box picked up. (see form in Annex 2)
3. Deliver cold boxes containing specimens to designated GeneXpert lab within 24 hours of
pick-up
4. Have delivery section of form filled out and sign by GeneXpert designee for each cold
box delivered.
The transportation of EMPTY cold box requirements is the following:
1. Collect and deliver the empty cold boxes within 3 working days.
2. Have Pick-Up section of form filled out and sign by GeneXpert Lab designee for each
cold box picked up. (see form in Annex 3)
3. Deliver cold boxes containing specimens to designated District site within 48 hours of
pick-up
4. Have delivery section of form filled out and sign by District site designee for each empty
cold box delivered.
Transportation Requirements / Details
1. The cold boxes should NEVER BE OPENED. They contain bio hazardous material and
may be infectious if they are open and exposed.
2. All cold boxes will be pre-packed and contain the appropriate hazard warning labels.
Vendor should not accept pick-up if the cold boxes are not packaged properly.
3. Each transport activity will be documented by pick-up and delivery signed documents.
4. Deliveries containing cold boxes containing specimens MUST be delivered within 24
hours to maintain cold chain and their quality for testing.
5. The method of delivery is only by land transport.
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
6. Each cold box to be delivered should weigh up to 3 kilogram per trip and the dimensions
are length 28 cm, height 20 cm, width 18 cm.
d) DELIVERABLES AND DUE DATES
1. The vendor will obtain a signed proof of receipt for each pick-up and delivery and
provide a copy to JSI for payment along with an invoice monthly.
2. Mode of Payment: By bank’s transfer/check within 30 days based upon the invoices
received for the ACTUAL no. of the cold box delivery completed, the weight of each
delivery and in accordance to the kilogram/location price quoted per trip.
3. Penalty: JSI may reject the payment for the delivery made beyond the stipulated time or
loss of the cold boxes except in some unavoidable circumstances. The reason of the delay
in delivery or loss of the box should be explain by the transport vendor clearly.
RFP Submission Details
The vendor will fill out the matrix below in Annex 1 and give costs for a shipment of 1 cold box
(measuring XX by XX) from each District Site to the GenXpert Lab specified.
The vendor will give a price for the return of 1 empty cold box (same measurements) from each
GeneXpert lab back to the District Site. We expect this cost to be slightly lower due to the
increased amount of time available to deliver (48 hours) and the less stringent handling
requirements (boxes are no longer hazardous).
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
Annex 1: List of Pickup and delivery points per district
Location
A North Sumatera
1 Kota Medan to GeneXpert lab RS Adam Malik, Medan
1 HC Belawan, Medan to Adam Malik Hospital, Medan
2 HC Teladan, Medan to Adam Malik Hospital, Medan
3 HC Helvetia, Medan to Adam Malik Hospital, Medan
Pringadi Hospital, Medan to Adam Malik Hospital,
4 Medan
5 Prison Class I Medan to Adam Malik Hospital Medan
Prison II A Juvenile Medan to Adam Malik Hospital
6 Medan
Prison II A Women Medan to Adam Malik Hospital
7 Medan
Detention Center I Medan to Adam Malik Hospital
8 Medan
B DKI Jakarta
2 Kota Jakarta Barat to GeneXpert lab Mikro UI, Jakarta
Cengkareng Distric General Hospital, Jakarta to Mikro
9 UI, Jakarta
3 Kota Jakarta Pusat to GeneXpert lab Mikro UI, Jakarta
10 Tarakan General Hospital, Jakarta to Mikro UI, Jakarta
St. Carolus General Hospital, Jakarta to Mikro UI,
11 jakarta
12 Prison Salemba, Jakarta to Mikro UI, Jakarta
13 Detention Center Jakarta Pusat Mikro UI, Jakarta
Kota Jakarta Timur to GeneXpert lab RS Persahabatan,
4 Jakarta
Pengayoman Hospital Cipinang, Jakarta to Persahabatan
14 Hospital, Jakarta
Prison Class I Cipinang, Jakarta to Persahabatan
15 Hospital, Jakarta
Prison Narcotic, Jakarta to Persabahatan Hospital,
16 Jakarta
17 Detention Center Cipinang, Jakarta to Persahabatan
Cost in
IDR
to
Transport
1 Cold Box
from
District to
GeneXpert
Lab
Cost in IDR
to
Transport 1
EMPTY
Cold Box
from
GeneXpert
Lab to
District Site
REQUEST FOR PROPOSAL
RFP NO: 14_045
Hospital, Jakarta
Detention Center Jakarta Timur to Persahabatan
18 Hospital, Jakarta
C Banten
Kota Tangerang to GeneXpert lab RS Persahabatan,
5 Jakarta
Tangerang General Hospital to Persahabatan Hospital,
19 Jakarta
20 RSU Balaraja, Tangerang to RS Persahabatan, Jakarta
Prison Class I Tangerang to Persahabatan Hospital,
21 Jakarta
Prison Class II A Juvenile Man Tangerang to
22 Persahabatan Hospital, Jkt
Prison Class II A Pemuda Tangerang to Persahabatan
23 Hospital, Jakarta
Prison Class II A Women Tangerang to Persahabatan
24 Hospital, Jakarta
Prison Class II B Juvenile Women Tangerang to RS
25 Persahabatan Hospital, Jkt
Detention Center Class I Tangerang to Persahabatan
26 Hospital, Jakarta
D West Java
Kota Bandung to GeneXpert lab RS Hasan Sadikin,
6 Bandung
27 HC, Bandung to Hasan Sadikin Hospital, Bandung
28 HC, Bandung to Hasan Sadikin Hospital, Bandung
29 HC, Bandung to Hasan Sadikin Hospital, Bandung
Bandung City Gen Hospital to Hasan Sadikin Hospital,
30 Bandung
31 Prison Sukamiskin to Hasan Sadikin Prison, Bandung
Prison II A Banceuy, to Hasan Sadikin Hospital,
32 Bandung
Prison Narcotic Bandung to Hasan Sadikin Hospital,
33 Bandung
Prison II A Women Bandung to Hasan Sadikin Hospital,
34 Bandung
Prison Class III Juvenile Bandung to Hasan Sadikin
35 Hospital, Bandung
Detention Center I Bandung to Hasan Sadikin Hospital,
36 Bandung
7 Kota Bogor to GeneXpert lab RSP Goenawan, Bogor
37 HC, Bogor to Goenawan Hospital, Bogor
38 HC, Bogor to Goenawan Hospital, Bogor
39 Marzoeki Makhdi Hospital, Bogor to Goenawan
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
8
E
9
10
F
11
12
G
13
Hospital, Bogor
40 Prison Class II A Bogor to Goenawan Hospital Bogor
Kabupaten Bogor to GeneXpert lab RSP Goenawan,
Bogor
41 HC, kab Bogor Goenawan Hospital, Bogor
42 HC, Kab Bogor to Goenawan Hospital, Bogor
Prison Class II A Cibinong to Goenawan Hospital,
43 Bogor
Central Java
Kota Surakarta to GeneXpert lab RS Karyadi, Semarang
Detention Center I Surakarta to Karyadi Hospital,
44 Semarang
Kota Semarang to GeneXpert lab RS Karyadi, Semarang
Pantiwilasa Citarum Hospital, Semarang to Karyadi
45 Hospital, Semarang
46 Karyadi Hospital Semarang to BLK Semarang
47 Prison Class I Semarang to Karyadi Hospital Semarang
Prison Class II A Semarang to Karyadi Hospital,
48 Semarang
East Java
Kota Surabaya to GeneXpert lab RS Soetomo, Surabaya
Karang Tembok Hospital, Surabaya to Soetomo
49 Hospital, Surabaya
Suwandi Hospital, Surabaya to Soetomo Hospital,
50 Surabaya
HC Krembangan Timur, Surabaya to Soetomo
51 Hospital, Surabaya
Prison Surabaya located Sidoarjo to RS Soetomo,
52 Surabaya
Detention Center I, Surabaya located Sidoarjo to
53 Soetomo Hospital, Surabaya
Kota Malang to GeneXpert lab RS Saiful Anwar, Malang
HC Arjuno, Malang to RS Saiful Anwar Hospital,
54 Malang
55 HC Janti, Malang to Saiful Anwar Hospital, Malang
56 HC Dinoyo, Malang to Saiful Anwar Hospital, Malang
57 Prison I Malang to Saiful Anwar Hospital, Malang
Prison II A Women Malang to Saiful Anwar Hospital,
58 Malang
Bali
Kota Denpasar to GeneXpert lab RS Sanglah, Denpasar
HC Denpasar Selatan, Denpasar to Sanglah Hospital,
59 Denpasar
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
HC Denpasar Utara, Denpasar to Sanglah Hospital,
60 Denpasar
61 Wangaya City Hospital to Sanglah Hospital, Denpasar
62 Prison Denpasar to Sanglah Hospital, Denpasar
14 Kota Singaraja to GeneXpert lab RS Sanglah, Denpasar
63 HC Seririt 1, Singaraja to Sanglah Hospital, Denpasar
HC Kututambahan 1, Singaraja to Sanglah Hospital,
64 Denpasar
RSUD Buleleng, Singaraja to Sanglah Hospital,
65 Denpasar
H North Sulawesi
15 Kota Manado to GeneXpert lab NHCR, Makassar
66 HC to NHCR, Makassar
67 HC to NHCR, Makassar
68 Prison Manado to NHCR, Makassar
69 Detention Center, Manado to NHCR, Makassar
I
South Sulawesi
16 Kota Makassar to GeneXpert lab NHCR, Makassar
70 HC Sudiang Raya, Makassar to NHCR Makassar
71 HC Batua, Makassar to NHCR Makassar
72 HC Tabaraningan, Makassar to NHCR Makassar
73 Labuang Baji Hospital, Makassar to NHCR, Makassar
74 Prison Makassar to NHCR Makassar
75 detention Center Makassar to NHCR Makassar
John Snow, Inc.
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
Annex 2
TB Transport/Cold Chain Pilot Project
SPECIMEN TRANPORT FROM PICK UP POINT TO GENEXPERT (A)
Pick-up Action
Movement #
Date of Pick-up
:
Time of Pick-up
:
Location of Pick-up
:
Items Picked-up
:
Weight of Item(s)
:
Vendor Representative :
Pick-up Points Rep.
Name
Signature
Name
Signature
Name
Signature
Name
Signature
:
Delivery Action
Date of Delivery
:
Time of Delivery
:
Location of Delivery
:
Items of Delivery
:
Condition of Item (s) :
Vendor Representative :
Pick-up Points Rep.
:
:
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
Annex 3
TB Transport/Cold Chain Pilot Project
COLD BOX RETURN FROM GENEXPERT LAB TO PICK UP POINTS (B)
Pick-up Action
Movement #
Date of Pick-up
:
Time of Pick-up
:
Location of Pick-up
:
Items Picked-up
:
Weight of Item(s)
:
Vendor Representative :
Pick-up Points Rep.
Name
Signature
Name
Signature
Name
Signature
Name
Signature
:
Delivery Action
Date of Delivery
:
Time of Delivery
:
Location of Delivery
:
Items of Delivery
:
Condition of Item (s) :
Vendor Representative :
Pick-up Points Rep.
:
:
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
PART D: ATTACHMENTS TO THE RFP
1. Certification Regarding: Prohibition on the Promotion or Advocacy of the Legalization or
Practice of Prostitution or Sex Trafficking (Acquisition) (June 2010)
2. Contractor Code of Business Ethics (April 2010)
3. Information Regarding Responsibility Matters (April 2010)
4. Certification of Toxic Chemical Release Reporting (August 2003)
5. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (Sep
2007)
6. Certification Regarding Debarment, Suspension, or Proposed Debarment (December 2010)
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 1
REQUIRED CERTIFICATION
As a condition of accepting a subcontract under this RFP, the selected vendor is required to
certify to the following mandatory clause:
Prohibition on the Promotion or Advocacy of the Legalization or Practice of Prostitution or Sex
Trafficking (Acquisition) (June 2010)
(a) This contract is authorized under the United States Leadership Against HIV/AIDS, Tuberculosis, and
Malaria Act of 2003 (Pub.L. No. 108-25), as amended. This Act enunciates that the U.S. Government is
opposed to prostitution and related activities, which are inherently harmful and dehumanizing, and
contribute to the phenomenon of trafficking in persons. The contractor shall not use any of the funds
made available under this contract to promote or advocate the legalization or practice of prostitution or
sex trafficking. Nothing in the preceding sentence shall be construed to preclude the provision to
individuals of palliative care, treatment, or post-exposure pharmaceutical prophylaxis, and necessary
pharmaceuticals and commodities, including test kits, condoms, and, when proven effective,
microbicides.
(b)(I) Except as provided in (b)(2) and (b)(3), by its signature of this contract or subcontract for HIV I
AIDS activities, a non-governmental organization or public international organization awardee/sub
awardee agrees that it is opposed to the practices of prostitution and sex trafficking because of the
psychological and physical risks they pose for women, men, and children. [1 0]
10 The following footnote should only be included in awards to Alliance for Open Society International
(AOSI), Pathfinder, or a member of GHC or InterAction (with the exception of DKT International, Inc.):
(b)(2) The following organizations are exempt from (b)(I): the Global Fund to Fight AIDS, Tuberculosis
and Malaria; the World Health Organization; the International AIDS Vaccine Initiative; and any United
Nations agency. (b)(3) Contractors and subcontractors are exempt from (b)(I) if the contract or
subcontract is for commercial items and services as defined in FAR 2.101, such as pharmaceuticals,
medical supplies, logistics support, data management, and freight forwarding.
(b)(4)Notwithstanding section (b)(3), not exempt from (b)(I) are contractors and subcontractors that
implement HIV I AIDS programs under this contract or subcontract by: (i) providing supplies or services
directly to the final populations receiving such supplies or services in host countries;
(ii) providing technical assistance and training directly to host country individuals or entities on the
provision of supplies or services to the final populations receiving such supplies and services; or
(iii) providing the types of services listed in FAR 37 .203(b)( 1 )-( 6) that involve giving advice about
substantive policies of a recipient, giving advice regarding the activities referenced in (i) and (ii), or
making decisions or functioning in a recipient's chain of command (e.g., providing managerial or
supervisory services approving financial transactions, personnel actions).
(c) The following definitions apply for purposes of this provision:
"Commercial sex act" means any sex act on account of which anything of value is given to or received by
any person.
"Prostitution" means procuring or providing any commercial sex act and the "practice of prostitution" has
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
the same meaning.
"Sex trafficking" means the recruitment, harboring, transportation, provision, or obtaining of a person for
the purpose of a commercial sex act. 22 U.S.C. 7102(9).
(d) The contractor shall insert this provision in all subcontracts.
(e) Any violation of this provision will result in the immediate termination of this award by USAID.
(f) This provision does not affect the applicability of FAR 52.222-50 to this contract.
The Offeror (below named organization or firm) certifies that it has ( ) has not ( ) instituted a policy
explicitly opposing prostitution and sex trafficking as required under this Request for Proposal and any
possible subsequent subcontract.
Offeror:
_______________________________________
Authorized Signatory: _______________________________________
Print Signatory Name: _______________________________________
Title:
_______________________________________
Date:
__________________
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 2
REQUIRED CERTIFICATION
As a condition of accepting a subcontract under this RFP, the selected vendor is required to
certify to the following mandatory clause:
CONTRACTOR CODE OF BUSINESS ETHICS (APR 2010)
In accordance with FAR 52.203-13, CONTRACTOR CODE OF BUSINESS ETHICS (APR 2010)
the subcontractor ____ has ____ does not have current active Federal contracts and grants with total
value greater than $5,000,000. The subcontractor ____ is____is not a small business. The duration of the
subcontract is____is not____ less than 120 days. The subcontractor has____does not have___ a Code
of Business Ethics which has been provided to employees. The subcontractor is ___ is not___
exempt from the Code of Business Ethics. In accordance with the subcontractor’s Code of Business
Ethics the contractor has ____does not have____a Business Ethics Awareness and Compliance
Program that encourages and otherwise promotes a culture of ethical conduct and commitment to
comply with the law and an internal control system that prevents and detects criminal conduct. In
accordance with the Business Ethics Awareness and Compliance Program the subcontractor
does___does not____ provide effective training to employees in this area.
The subcontractor shall disclose, in writing, to the prime contractor and the agency office of the
Inspector General (OIG), with a copy to the Contracting Officer, whenever, in connection with the
award, performance, or closeout of this contract or any subcontract thereunder, the subcontractor has
credible evidence that a principal, employee, agent, or subcontractor of the subcontractor has
committed a violation of Federal Criminal law involving fraud, conflict of interest, bribery, or
gratuity violations in Title 18 of the US Code or a violation of the civil False Claims Act.
_____________________________________
Signature
_____________________________________
Printed Name
_____________________________________
Company Name
_____________________________________
Date
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 3
REQUIRED CERTIFICATON
As a condition of accepting a subcontract under this RFP, the selected vendor is required to
certify to the following mandatory clause:
52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (APR 2010)
(a) The offeror [ ] has [ ] does not have current active Federal contracts and grants with total value
greater than $10,000,000.
(b) If the offeror checked "has" in paragraph (b) of this provision, the offeror represents, by submission of
this offer, that the information it has entered in the Federal Awardee Performance and Integrity
Information System (F APIIS) is current, accurate, and complete as of the date of submission of this offer
with regard to the following information:
(l) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in
connection with the award to or performance by the offeror of a Federal contract or grant, been the
subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:
(i) In a criminal proceeding, a conviction.
(ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine,
penalty, reimbursement, restitution, or damages of $5,000 or more.
(iii) In an administrative proceeding, a finding of fault and liability that results in(A) The payment of a monetary fine or penalty of $5,000 or more; or
(B) The payment of a reimbursement, restitution, or damages in excess of $100,000.
(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or
compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any
of the outcomes specified in paragraphs (c)(1 )(i), (c)(1 )(ii), or (c)(1 )(iii) of this provision.
(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this
provision, whether the offeror has provided the requested information with regard to each occurrence.
(d) The offeror shall enter the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in F
APIIS as required through maintaining an active registration in the Central Contractor Registration
database at http://www.ccr.gov (see 52.204-7).
REQUEST FOR PROPOSAL
RFP NO: 14_045
John Snow, Inc.
"Principal" means an officer, director, owner, partner, or a person having primary management or
supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a
division or business segment; and similar positions).
___________________________________________
Signature
___________________________________________
Printed Name
___________________________________________
Company Name
___________________________________________
Date
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 4
REQUIRED CERTFICATION
As a condition of accepting a subcontract under this RFP, the selected vendor is required to certify to the
following mandatory clause:
52.223.13 CERTIFICATION OF TOXIC CHEMICAL RELEASE REPORTING (AUG 2003)
By signing this offer, the offeror certifies that:
1) As the owner or operator of facilities that will be used in the performance of this contract that are
subject to the filing and reporting requirements described in section 313 of the Emergency
Planning and Community Right-to-Know Act of 1986, (EPCRA) and requirement section 6607 of
the Pollution Prevention Act of 1990 (PPA) (42 U.S.C. 13106), the offeror will file and continue
to file for such facilities for the life of the contract the Toxic Chemical Release Inventory Form
(Form R) as described in sections 313(a) and (g) of EPCRA and section 6607 of EPA; or
2) None of its owned or operated facilities to be used in the performance of this contract is subject to
the Form R filing and reporting requirements because each such facility is exempt for at least one
of the following reasons: (check each block that is applicable)
3) ( ) (i) The facility does not manufacture, process, or otherwise use any toxic chemicals listed in
40 CFR 372.65;
4) ( ) (ii) The facility does not have 10 or more full-time employees as specified in section
313(b)(1)(A) of EPCRA, 42 U.S.C. 11023(b)(1)(A);
5) ( ) (iii) The facility does not meet the reporting thresholds of toxic chemicals established under
section 313(f) of EPCRA, 42 U.S.C. 11023(f) (including the alternate thresholds at 40 CFR
372.27, provided an appropriate certification from has been filed with EPA);
6) ( ) (iv) The facility does not fall within the following Standard Industrial Classification
(SIC)codes or their corresponding North American Industry Classification System sectors:
(A) Major group code 10 (except 1011, 1081, and 1094,
(B) Major group code 12 (except 1241)
(C) Major group codes 20 through 39.
(D) Industry code 4911, 4931, or 4939 (limited to facilities that combust coal and/or oil
for the purpose of generating power for distribution in commerce).
(E) Industry code 4953 (limited to facilities regulated under the Resource Conservation
and Recovery Act, Subtitle C (41 U.S.C 6921 et seq.), or 5169, or 5171, or 7389
(limited to facilities primarily engaged in solvent recovery services on a contract or
fee basis); or
( ) (v) The Facility is not located in the United States or its outlying areas.
______________________________________
Signature
______________________________________
Printed Name
______________________________________
Organization and Date
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 5
REQUIRED CERTIFICATON
As a condition of accepting a subcontract under this RFP, the selected vendor is required to certify to the
following mandatory clause:
52.203-11Certification and Disclosure Regarding Payments to Influence Certain Federal
Transactions (SEP 2007)
Please complete OMB Standard Form LLL which is attached and the certification below:
The offeror, by signing its offer, herby 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, and officer
or employee of Congress, or an employee of a Member of Congress on its behalf in connection
with the awarding of this 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 who payments of reasonable compensation were made.
___________________________________
Signature
___________________________________
Printed Name
___________________________________
Company
___________________________________
Date
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_045
ATTACHMENT 6
REQUIRED CERTIFICATION
As a condition of accepting a subcontract under this RFP, the selected vendor is required to certify to the
following mandatory clause:
Protecting the Government’s Interest When Subcontracting with Contractors Debarred,
Suspended, or Proposed for Debarment (DEC 2010)
This is___is not___ a commercial subcontract. This subcontract is ___ is not___ for the
procurement of off-the-shelf items. The total price of the subcontract is___is not___greater
$30,000.
The subcontractor or its principals have ____ or have not ____ been debarred, suspended, or
proposed for debarment.
______________________________________
Signature
______________________________________
Printed Name
______________________________________
Company Name
______________________________________
Date