John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_043
REQUEST FOR PROPOSAL
FIXED PRICE GOODS OR SERVICES
(FIELD)
RFP NO: 14_043
DUE DATE EXTENDED – October 29, 2014
PART A: COVER PAGE
ISSUED TO: USAID | DELIVER PROJECT website and a short list of suitable vendors in
Nigeria
SUBJECT: Request for Proposal for Infrastructure Repairs to National Primary Health Care
Development Agency (NPHCDA) Warehouses in Nigeria
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 ................................................................................. 6
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:
Allison Ebrahimi Gold
John Snow, Inc.
USAID | DELIVER PROJECT
1616 North Fort Myer Drive
Arlington, Virginia 22209, USA
Fax: 703/528-7480.
allison_ebrahimi_gold@jsi.com
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_043
___________________________________________
Robert Schlink
Contract Administrator
John Snow, Inc.
__________________
Date
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
The Offeror shall submit a proposal addressing the terms and conditions of this RFP by 5:00
pm EST time on October 29, 2014 to the email address as provided in Part A on the cover
page. Please submit all questions by 5:00 pm EST October 25, 2014 to the email address
provided on the cover page. All questions and answers will be sent to all vendors who have
expressed an interest in the request by October 28, 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)
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Cost Proposal
A fixed unit price for each category of deliverable: The unit prices will need to
include all costs.
REQUEST FOR PROPOSAL
RFP NO: 14_043

Please provide financial statements for the last three fiscal years.

Please provide proof of business registration
John Snow, Inc.
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.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
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.
b) 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.
c) 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.
d) 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.
e) 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.
f) 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.
g) CANCELLATION
The Project may cancel this RFP without any cost or obligation at any time until issuance of
a Subcontract.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
h) 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:
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ii)
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 Price Purchase Order (PO) to be awarded once
a Subcontractor has been selected. The awarded PO will include a statement of the total
fixed price; the scope with stated deliverables and due dates; the guiding USAID FAR
and AIDAR clauses; and invoicing information. Please be advised that under a 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.
i) 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_043
John Snow, Inc.
PART C: STATEMENT OF WORK
I. Background
The USAID|DELIVER PROJECT is providing technical assistance to the Government of
Nigeria’s Subsidy Reinvestment and Empowerment Program (SURE-P) on Maternal and Child
Health (MCH), which is managed by the National Primary Health Care Development Agency
(NPHCDA). As part of the USAID | DELIVER PROJECT’s work to support the SURE-P MCH
in improving the availability of quality maternal and child health commodities at public health
facilities, the project is renovating four zonal warehouses in Minna, Enugu, Kano, and Warri.
These warehouses are expected to store and manage health commodities to be provided to about
1000 health facilities nationwide.
II. Objectives
The goal of this intervention is to provide infrastructural repairs to each of the 4 NPHCDA
warehouses, including floors, ramps, storm-water drainage, ceilings, louvres, and roof.
III. Statement of Work
The vendor shall follow all detailed specification for the repair of floor, ceiling, roof, ramps,
louvres, and storm water drainage trenches for National Primary Health Care Development
Agency (NPHCDA) Warehouses as indicated in this statement of work (SOW) described as:
a) Item #1: Repair of the floors for NPHCDA warehouses in Minna, Enugu, Kano, and
Warri
b) Item # 2: Repair of the ramps for NPHCDA warehouses in Enugu
c) Item # 3: Repair of the storm-water drainage system for NPHCDA warehouses
Enugu
d) Item #4: Repair of the ceiling for NPHCDA warehouses in Minna, Enugu, Kano,
and Warri
e) Item #5: Repair of the louvres for NPHCDA warehouses in Minna, Enugu, Kano,
and Warri
f) Item #6: Repair of the roof for NPHCDA warehouses in Minna, Enugu, Kano, and
Warri
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Item # 1: Repair of the floors for NPHCDA Warehouses in Minna, Enugu, Kano and
Warri
At all four (4) warehouses, there is need for repair to damaged cement floors.
Deliverables:

Repair of cracks, crevices and potholes as identified in the warehouses above are to be filed with
a 1:3 cement to sand aggregate mix ratio, allowing adequate drying time before allowing use of
the warehouse.
Specifications: see pictures below showing the damaged floors that need to be repaired at the Kano and
Enugu warehouses. These pictures are also indicative of the type of damage that needs to be repaired at
the Minna and Warri warehouses.
Photographs 1. Kano Warehouses (from left to right)
1. Damaged floor at Dry Store entrance #1
2. Damaged floor at Dry Store entrance #2
3. Damaged floor near Cold Rooms
REQUEST FOR PROPOSAL
RFP NO: 14_043
Photographs 1. Enugu Warehouses (from left to right)
1. Damaged floor at Dry Store near ramp #1
2. Damaged floor near Cold rooms #2, #3 & #4
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Item # 2: Repair of the Ramps for NPHCDA Warehouse in Enugu
Specifications: see pictures showing damaged ramps below.
Photograph 3. Enugu Ramp inside the Dry Store Warehouse
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Photograph 3 above showing a ramp located in the middle of the Enugu Dry Store Warehouse.
The ramp will soon be used for the transportation of forklifts and inventory stacked on a pallet.
The total weight the forklift and pallet will be 2500kg (5511 Pounds).
The ramp has a loose surface which need to be repaired
Deliverables:
 Remove the loose cement and ¾ stone on the surface of the ramp
 Replace the material with a concrete mixture
 Finish off with a 1:3 cement to sand mix aggregate ratio, allowing adequate drying time before
allowing use of the warehouse.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Photograph 4. Enugu Warehouse ramps
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Photograph 4 above showing 2 external ramps leading to the Enugu Dry Store and Cold Chain
Warehouses respectively.
The ramps will soon be used for the transportation of forklifts and inventory stacked on a pallet,
and using the path marked by the blue lines in the photograph.
The total weight the forklift and pallet will be 2500kg (5511 Pounds).
Due to a combination of inadequate storm-water drainage system and wear and tear, both surfaces
need to be repaired.
Deliverables:
 Remove the loose cement and ¾ stone on the surface of the ramps
 Remove enough top soil to be able to repair the ramps.
 Replace the material with a concrete mixture
 Finish off with a 1:3 cement to sand mix aggregate ratio, allowing adequate drying time before
allowing use of the warehouse.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Item # 3: Repair of the Storm-water drainage system for NPHCDA Warehouse in Enugu
Specifications: See pictures below for damaged storm-water drainage system at Enugu warehouse.
Photograph 5. Enugu entrance to Dry Store Warehouses and Drainage System (from left to right)
1. Entrance to Dry Store showing ramp and storm-water drainage system
2. Entrance to Dry Store showing ramp and storm-water drainage system
3. Collapsed storm-water drainage system
4. Entrance to Dry Store showing ramp view from different angle.
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Photographs 5 above showing the external ramps leading to the Enugu Dry Store Warehouse, and
the collapsing /damaged storm-water drainage system surrounding it.
The damaged storm-water drainage system needs to be repaired.
Deliverables:
 Remove collapsing blocks and clear a good base
 Remove enough top soil to be able to make repairs.
 Replace the trenches which are damaged.
 Repair of damaged storm-water drainage system.
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Item # 4: Repair of the Ceiling for NPHCDA Warehouses in Minna, Enugu, Kano and
Warri
Specifications: See pictures below showing damage to ceiling and areas of repair at the Minna warehouse.
These pictures are also indicative of the type of repairs required at the other warehouses.
Photograph 6. Minna Warehouse (left to right)
1. Roof Minna Warehouse showing plant growth in the gutters
2. Damaged ceiling board under a blocked gutter or damaged roof panel.
Photograph 2 above shows water damage to a ceiling board. This damage is mainly caused by either
broken roof sheets, or by blocked gutters due to the accumulation of sand or debris.
Deliverables:
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Clean all gutters so that they are free of sand and debris
Identify water damaged ceiling boards in the warehouses and determine the cause.
If due to damaged roofing sheets, replace the roofing sheet
Replace and paint ceiling board with same color paint as identified
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Item # 5: Repair of the Louvres for NPHCDA Warehouses in Minna, Enugu, Kano, and
Warri
Specifications: see pictures below which are indicative of the type of louvre repairs required.
Photograph 7. Louvres placed at very low levels in the warehouses (from left to right)
1. The side of a typical NPHCDA warehouse wall with louvre placed 300mm (12 inches) on a wall above
ground level
2. Very wide mesh wire used to block vents in warehouse walls (with plug top inserted to show relative
size of louvre opening)
3. An attempt made to deter burglary, but using wire with very wide apertures in the opening in some
warehouses.
4. Chicken run mesh wire frames installed over louvres on the outside wall of some warehouses
5. Showing lizard that has gained access to the warehouse
6. Showing tail of lizard that has gained access to the warehouse.
REQUEST FOR PROPOSAL
RFP NO: 14_043
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John Snow, Inc.
Photographs 7 above shows vents which have been placed at a very low level from the ground
level
In some of the warehouses, a frame with chicken run size mesh wire has been installed.
However, the louvre openings are too large allowing rodents, lizards, and (reportedly) snakes into
the warehouses.
All the warehouses are going to be air-conditioned soon, and the vents can be sealed off.
Deliverables:
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Provision must be made for 16 wooden boards per site, of dimensions listed below:
o Length: 2500mm (98.5 in)
o Width: 920mm (36 in).
o Thickness: 19mm (3/4 in)
These boards are to be fastened against each of the louvres on the inside wall of each warehouse.
Each board is to be fastened onto the wall using a minimum of 6 off size M6 bolts with nuts.
The boards are to be painted in the color that matches the internal décor of the warehouses.
Item # 6: Repair of the Roof for NPHCDA Warehouses in Minna, Enugu, Kano, and Warri
Specifications: See pictures below for damage to roof.
Photograph 8. Damaged warehouses roofing sheets (from left to right)
1. Damaged (marked) corner of roof (Minna)
2. Damaged roofing sheets and gutters (Kano)
3. Open roof ridge which is damaged (Enugu)
4. Damaged (marked) roof ridge (Enugu)
5. Damaged (marked) roof ridge (Warri).
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
In all warehouses, there is evidence of damaged roofing sheets as indicated on the photographs above.
Deliverables:
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Replace all damaged roofing sheets as identified
Check all ridge components and repair accordingly
Check and repair all gutters, ensuring that they are free of plant growth, sand and debris
REQUEST FOR PROPOSAL
RFP NO: 14_043
John Snow, Inc.
Information to Be Provided By The Vendor Bidding
1) Profile of Company to include
a) Number of years in business
b) Type of organization
c) Name of directors and senior management personnel
d) Brief history of company
e) Total number of employees
2) Certificate of Insurance
3) References of similar work carried out in Nigeria.
4) The proposal must demonstrate that they have adequate knowledge building and construction
by providing the following:
a) The names of businesses/institutions in Nigeria or the region that have, or have had,
contracts with your firm of a similar size and scope as described herein. For each
customer named, indicate:
i) number of years as a customer;
ii) contact names and numbers
iii) general type of business and pest control services provided
iv) name of your firm’s account representative for each contract location.
5) Bidders shall provide a description of your staffing plan for the entire scope of work.
6) Provide the following for this Inquiry
a) Cost of inputs/material separate from labor costs
b) Provide estimated time required to completion (this is necessary to enable National
Primary Health Care Development Agency (NPHCDA) to plan inventory re-location
effectively if deemed necessary).
IV. Deliverables and Schedule
An initial facility assessment is to be carried out and a report provided to facility managers
within 7-10 business days from contract signing. The assessment report should outline a
schedule of work to be conducted within the specified timeline.
REQUEST FOR PROPOSAL
RFP NO: 14_043
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 (Feb 2012)
4. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (Sep
2007)
5. Certification Regarding Debarment, Suspension, or Proposed Debarment (December 2010)
John Snow, Inc.
REQUEST FOR PROPOSAL
RFP NO: 14_043
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_043
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_043
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_043
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 (FEB 2012)
(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_043
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_043
ATTACHMENT 4
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_043
ATTACHMENT 5
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