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To insure the submission of complete bids and to avoid omissions that could result in your bid being nonresponsive, please check each of the following:

1. Have you rechecked your estimate? Are all items and amounts included?

2. Is bid amount entered in proper space provided on the SF-21, Bid Form (Construction Contract)?

3. Have you completed all Alternates, Separated Prices and Unit Prices (if any) on the SF-21, Bid Form?

4. Have you acknowledged, on the SF-21, Bid Form, receipt of all amendments (if any) issued to the specifications?

5. Have you properly completed and checked the appropriate box of each bidder representation and certification on the SF 19-B, Representations and Certifications?

6. Have you properly completed the supplements to SF-21, Bid Form, including the List of Subcontractors and Competency of Bidder Certification (where required)?

7. Do your listed subcontractors meet all applicable qualifications requirements?

8. Does your bid guarantee conform to the requirements of SF-20, Invitation for Bids and SF-22, Instructions to Bidders?

9. Have you read the clause "Termination for Default - Damages for Delay Time Extensions," SF 23-A, General Provisions (Construction Contract), on delays and damages?

Submission and acceptance of your bid commits you to complete your contract within the time specified. The contract may provide for assessment of liquidated damages for each day's delay beyond the contract time, for which a time extension is not granted.

10. Have you read the "Equal Opportunity Clause," SF 23-A and do you fully understand your obligations regarding this requirement?

11. Have you familiarized yourself with the applicable contracting provisions covering Utilization of Small Business Concerns and the Small Business Subcontracting Program.

12. Have you properly complied with the appendixes to SF-21, Bid Form, including (if appended) the Notice of Requirements for Submission of Affirmative Action Plan to Ensure Equal Employment Opportunity?

13. Have you familiarized yourself with the regulations issued by the Secretary of Labor (see
Clause No. 2 of SF 19-A, as modified) pursuant to section 107 of the Contract Work Hours
and Safety Standards Act, entitled: "Safety and Health Regulations for Construction,"
(29 Code of Federal Regulations, Part 1518) published in 36 Federal Register 7340, April 17, 1971?

CAUTION-LATE BIDS See SF-22, Instructions to Bidders, clause entitled "Late Bids and
Modifications or Withdrawals" which provides that late bids and modifications or withdrawals
thereof sent through the mails ordinarily will be considered only if timely mailed by REGISTERED
MAIL or by CERTIFIED MAIL for which a POSTMARKED RECEIPT has been obtained.

GSA DC 71.14432

U.S. GOVERNMENT PRINTING OFFICE: 1972-515-868/85

GSA FORM 1903 (REV. 5-71)

SPECIAL ATTENTION - BIDDERS

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CAUTION LATE BIDS. See the clause entitled "Late Bids and Modifications or Withdrawals," Standard Form 22, Instructions to Bidders (Construction Contract), which provides that late bids and modifications or withdrawals thereof sent through the mails ordinarily will be considered only if timely mailed by REGISTERED MAIL or by CERTIFIED MAIL for which a POSTMARKED RECEIPT has been obtained as specified in such provision.

GSA-WASH DC 74-4935

76

FORM

GSA JUNTO 1888

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In negotiated procurements, "bid" and "bidder" shall be construed to mean "offer" and "offeror." The bidder makes the following representations and certifications as a part of the bid identified above. (Check appropriate boxes.)

1. SMALL BUSINESS

He is, is not, a small business concern. (For this purpose, a small business concern is a business concern, including its affiliates, which (a) is independently owned and operated, (b) is not dominant in the field of operation in which it is bidding on Government contracts, and (c) had average annual receipts for the preceding 3 fiscal years not exceeding $7,500,000. For additional information see governing regulations of the Small Business Administration.)

2. CONTINGENT FEE

(a) He has, has not, employed or retained any company or person (other than a full-time bona fide employee working solely for the bidder) to solicit or secure this contract, and (b) he has, has not, paid or agreed to pay any company or person (other than a full-time bona fide employee working solely for the bidder) any fee, commission, percentage or brokerage fee, contingent upon or resulting from the award of this contract; and agrees to furnish informa tion relating to (a) and (b) above as requested by the Contracting Officer. (For interpretation of the representation, includ ing the term "bona fide employee," see Code of Federal Regulations. Title 41, Subpart 1-1.5.)

3. TYPE OF ORGANIZATION

He operates as an individual, partnership, joint venture,

4. INDEPENDENT PRICE DETERMINATION

corporation, incorporated in State of

(a) By submission of this bid, each bidder certifies, and in the case of a joint bid each party thereto certifies as to his own organization, that in connection with this procurement:

(1) The prices in this bid have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor;

(2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, in the case of a bid, or prior to award, in the case of a proposal, directly or indirectly to any other bidder or to any competitor; and

(3) No attempt has been made or will be made by the bidder to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition.

(b) Each person signing this bid certifies that:

(1) He is the person in the bidder's organization responsible within that organization for the decision as to the prices being bid herein and that he has not participated, and will not participate, in any action contrary to (a)(1) through (4) (3) above; or

(2) (i) He is not the person in the bidder's organization responsible within that organization for the decision as to the prices being bid herein but that he has been authorized in writing to act as agent for the persons respon sible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to (a)(1) through (a) (3) above, and as their agent does hereby so certify; and (ii) he has not participated, and will not participate, in any action contrary to (a) (1) through (a)(3) above.

(c) This certification is not applicable to a foreign bidder submitting a bid for a contract which requires performance or delivery outside the United States, its possessions, and Puerto Rico.

(d) A bid will not be considered for award where (a)(1), (a)(3), or (b) above, has been deleted or modified. Where (a) (2) above, has been deleted or modified, the bid will not be considered for award unless the bidder furnishes with the bid a signed statement which sets forth in detail the circumstances of the disclosure and the head of the agency, or his designee, determines that such disclosure was not made for the purpose of restricting competition.

THE FOLLOWING NEED BE CHECKED ONLY IF BID EXCEEDS $10,000 IN AMOUNT.

5. EQUAL OPPORTUNITY

He has, has not, participated in a previous contract or subcontract subject to the Equal Opportunity Clause herein, the clause originally contained in Section 301 of Executive Order No. 10925, or the clause contained in Section 201 of Executive Order No. 11114; he has, has not, filed all required compliance reports; and representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained prior to subcontract awards. (The above representation need not be submitted in connection with contracts or subcontracts which are exempt from the clause.)

NOTE Bids must set forth full, accurate, and complete information as required by this imitation for bids (including attachments). The penalty for making false statements in bids is prescribed in 18 U.S.C. 1001. 19-302-01

(GSA OVERPRINT JUN 1970)

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