SEC.1: OVERVIEW

Section 1 requires no input from the applicant. Please review.

SEC.2: SUPPLIES OR SERVICES AND PRICES

The offeror (name of company): (CBE) certification # : hereby agrees to adopt the following: Federal Schedule Number: Federal Schedule Contract No.: Contractor Name:

SEC.3: DESCRIPTION/SPECIFICATION/WORK STATEMENT

Section 3 requires no input from the applicant. Please review.

SEC.4: DELIVERIES OR PERFORMANCE

Section 4 requires no input from the applicant. Please review.

SEC.5: CONTRACTOR PROPOSAL

a. Provide Written Offer b. Two Copies Required c. Required Contractor Information d. Where to Send Hardcopy or "Off-Line" Information

SEC.6: CONTRACTOR ADMINISTRATION DATA

4. Assignments Pursuant to instrument of assignment dated (mm/dd/yyyy): Make payment of this invoice to: Assignee Name: Street No.: Address: City: State: -State- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip:

SEC.7: LIST OF ATTACHMENTS

Section 7 requires the applicant to review and comply with attachments.

SEC.8: REPRESENTATION, CERTIFICATION AND OTHER STATEMENT OF OFFERORS

1. Employment Contract Complete and return Employment Contract*. 2. Certification As To Compliance With Equal Opportunity Obligations Complete and return Compliance with Equal Opportunity Obligations*. 3. Buy American Certification (Type "N/A" If Not Applicable) Country of Origin:   Excluded End Products:   4. Officers Not To Benefit Certification Each Offeror shall check one of the following: No person listed in Clause 17 of the Standard Contract Provisions will benefit from this contract. The following person(s) listed in Clause 17 may benefit from this contract. (For each       person attach the affidavit required by Clause 17 of the Standard Contract Provisions.)            Person 1: Person 3:      Person 2: Person 4: 5. Metropolitan Washington Council of Governments Rider Clause Complete and return COG Rider Clause*. 6. Type of Business Organization The Offeror, by checking the applicable box, represents that (a) It operates as: a corporation incorporated under the laws of the State of: -State- AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY an individual, a partnership, a nonprofit organization, or a joint venture (b) If the Offeror is a foreign entity, it operates as: an individual, a joint venture, or a corporation registered for business in (Country): 7. Authorized Negotiators List names, titles and telephone numbers of the authorized negotiators. Name1: Name2: Title1: Title2: Telephone1:   Telephone2: 8. Tax Certification Complete and return Tax Certification*. 9. Walsh-Healy Act If your offer is $10,000 or more, the following information MUST be furnished: (c) Regular Dealer: The Offeror is a Regular Dealer The Offeror is not a Regular Dealer (d) Manufacturer: The Offeror is a Manufacturer The Offeror is not a Manufacturer

SEC.9: INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

Section 9 requires no input from the applicant. Please review.

SEC.10: CLAUSES FOR PROCUREMENTS RESTRICTED TO THE CBE MARKET

Section 10 requires no input from the applicant. Please review.

SEC.11: AWARD

Section 11 requires no input from the applicant. Please review.

SEC.12: CONFIRMATION AND AGREEMENT

Section 12 requires no input from the applicant. Please review.