01. W912LP26Q4005_Attch 01 Contractor Information & Pricing Table.pdf
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- Solicitation number
- W912LP-26-Q-4005
About this file
This is a Request for Quote (RFQ) attachment for medical surveillance examination services. RFQ # W912LP-26-Q-4005 solicits medical surveillance examination services in Des Moines and Boone, Iowa. Contractors must complete the Contractor Information Table with company details, point of contact information, CAGE code, SAM Unique Entity ID, tax identification number, payment discount terms, business size/socio-economic classifications, and period of performance.
The Pricing Table requires unit pricing and extended pricing for seven line items totaling 404 examination units: 71 Physical/Dermatological Exams, 71 Complete Lab Draws, 71 Vision Screenings, 26 Chromium Blood Level tests, 71 Lead Blood Level tests, 23 Cadmium Blood Level tests, and 71 Zinc Protoporphyrin tests. Contractors must submit this attachment as their official quote, with the option to submit additional documentation. Business size and socio-economic classifications must correspond with FAR 52.212-3 Representations and Certifications completed within SAM. Payment terms default to Net 30 unless otherwise specified.
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Attachment 01 – Contractor Information and Pricing Tables
RFQ # W912LP-26-Q-4005
Medical Surveillance Examination Services (Des Moines & Boone, Iowa)
Contractor shall complete the Contractor Information Table and the Pricing Table and include this page as their official quote. If the contractor submits an additional quote document, this attachment shall still be completed and submitted with their other documents.
CONTRACTOR INFORMATION TABLE
Company Name:
Point of Contact (POC) Name:
POC Phone:
POC Email:
CAGE Code:
SAM Unique Entity ID:
Tax ID Number:
Prompt Payment Discount Terms (Net 30 unless otherwise noted)
Business Size/Socio-economic Group(s) (Must correspond with FAR 52.212-3 Representations and Certifications completed within SAM)
Period of Performance
PRICING TABLE
Item # Description Qty Unit Unit Price Extended Price
0001 Physical / Dermatological Exam 71 EA
0002 Complete Lab Draw 71 EA
0003 Vision Screening 71 EA
0004 Chromium Blood Level 26 EA
0005 Lead Blood Level 71 EA
0006 Cadmium Blood Level 23 EA
0007 Zinc Protoporphyrin 71 EA
Total
File details come from the government source that posted it. Updated .