10-236-SOL-00031_CRC_SOL_PG1_2_08022010.pdf

r. THIS CONTRACT ISA RATED ~IRATING rAGE OF PAGES

SOLICITATION, OFFER AND AWARD ORDER UNDER DPAS (15 CFR 700) 1 1 31

2. CONTRACT NUMBER 3. SOLICITATION NUMBER 4. TYPE OF SOLICITATION 5. DATE ISSUED 6. REQUISITIONIPURCHASE NUMBER

10-236-S0L-00031 o SEALED BID (IFB) 08/02/2010 !Xl NEGOTIATED (RFP)

7. ISSUED BY CODE 1196 8. ADDRESS OFFER TO (If olher Ihan Item 7)

Indian Health Service INDIAN HEALTH SERVICE 801 Thompson Ave ATTN: SONIA NELSON, DIV OF ACQ POLICY Rockville MD 20852 5300 HOMESTEAD ROAD NE, RM 3066

ALBUQUERQUE, NM 87110

NOTE: In sealed bid soticitattcns "offer" and "offeror" mean "bid" and "bidder".

SOUCITATION

9. Sealed offers in original and ~2,=-- copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the depository located in until local time 08/27/2010 (Hour)

CAUTION- LATE Submissions Modifications and Withdrawals· See Section L Provision No 52214-7 or 52 215-1 All offers are subject to all terms and conditions contained in this solicitation (Date)

10. FOR

A.NAME B. TELEPHONE (NO COLLECT CALLS) C. E-MAIL ADDRESS

INFORMATION

AREA CODE 1NUMBER 1EXT sonia.nelson@ihs.gov

CALL, SONIA L NELSON 505 248-4109

(X) SEC. DESCRIPTION PAGE{S) (X) SEC. DESCRIPTION PAGE{S)

PART I - THE SCHEDULE PART 11-CONTRACT CLAUSES

~ A SOLICITATIONICONTRACT FORM 1-2 [lCI I CONTRACT CLAUSES 12-21 ~ B SUPPLIES OR SERVICES AND PRICESICOSTS 3-4 PART 111-LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

~ C DESCRIPTIONISPECSJWORK STATEMENT 4 [lCI J LIST OF ATTACHMENTS 22

0 0 PACKAGING AND MARKING PART IV - REPRESENTATIONS AND INSTRUCTIONS

~ E INSPECTION AND ACCEPTANCE 4 ~ K REPRESENTATIONS, CERTIFICATIONS AND 23-25~ F DELIVERIES OR PERFORMANCE 4 OTHER STATEMENTS OF OFFERORS

~ G CONTRACT ADMINISTRATION DATA 5-6 ~ L INSTRS.,.CONDS., AND NOTICES TO DFFERORS 26-31 [lCI H SPECIAL CONTRACT REQUIREMENTS 7-11 IZI M EVALUATION FACTORS FOR AWARD 31

11 TABLE OF CONTENTS

OFFER (Must be fully completed by offeror)

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance wrth the above, the undersigned agrees, if this offer is accepted within calendar days (60 calendar days unless a different period is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point{s) within the time specified in the schedule

13. DISCOUNT FOR PROMPT PAYMENT

10 CALENDAR DAYS (%) 120 CALENDAR DAYS (%) 130 CALENDAR DAYS (%) 1 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

14. ACKNOWLEDGEMENT OF AMENDMENTS AMENDMENT NO. DATE AMENDMENT NO. DATE

(The offeror acknowledges receipt of amendments to the SOLICITATION forofferors and related documents numbered and dated):

15A. NAME

CODE I I FACILITY I 6. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER

AND (Type or print)

ADDRESS

OF

OFFEROR

- 15B. TELEPHONE NUMBER I 15C. CHECK IF REMmANCE ADDRESS 17. SIGNATURE 18. OFFER DATE

AREA CODE INUMBER IEXT. 10 IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS IN SCHEDULE.

AWARD (To be completed by government)

19. ACCEPTED AS TO ITEMS NUMBERED 120. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION: 23. SUBMIT INVOICES TO ADDRESS SHOWN IN

~IITEM

010 U.S.C. 2304 (c) ( ) 041 U.S.C. 253 (c) ( ) (4 copies unless othelWise specified)

24. ADMINISTERED BY (If other than Hem 7) CODE I 25. PAYMENT W1U BE MADE BY CODE I

26. NAME OF CONTRACTING OFFICER (Type or print) 27. UNITED STATES OF AMERICA 28. AWARD DATE

SONIA L. NELSON

(Signature of COntracting Officer) IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authonzed offiCIal wnHen notice.

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97) Prescribed by GSA - FAR'(48 CFR} 53.214(c)

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED

10-236-S0L-00031 31

NAME OF OFFEROR OR CONTRACTOR

ITEM NO.

(A)

SUPPLIES/SERVICES

(B)

QUANTITY IJNIT

(C) (D)

UNIT PRICE

(E)

AMOUNT

(F)

PROVIDE COLORECTAL CANCER SCREENING NEEDS

ASSESSMENT AND ENDOSCOPIC SURVEY TOOL SERVICE TO

THE IHS DIVISION OF EPIDEMIOLOGY DISEASE

Delivery: 09/12/2012 Delivery Location Code: IHSNATIONALPROGRAM

NATIONAL PROGRAM AREA OFFICE

5300 HOMESTEAD ROAD, NE

ALBUQUERQUE NM 87110 US

FOB: Destination Period of Performance: 09/13/2010 to 09/12/2012

SERVICE WITH THE IHS DIVISION OF EPIDEMIOLOGY

DISEASE PREVENTION FOR COLORECTAL CANCER

SCREENING NEEDS ASSESSMENT AND ENDOSCOPIC SURVEY

TOOL

Period of Performance: 09/01/2010 to 08/31/2012

TRAVEL - IHS DIVISION OF EPIDEMIOLOGY DISEASE

PREVENTION FOR COLORECTAL CANCER SCREENING NEEDS

ASSESSMENT AND ENDOSCOPIC SURVEY TOOL

OTHER DIRECT COSTS - IHS DIVISION OF EPIDEMIOLOGY

DISEASE PREVENTION FOR COLORECTAL CANCER

SCREENING NEEDS ASSESSMENT AND ENDOSCOPIC SURVEY

TOOL

Period of Performance: 09/01/2010 to 08/31/2012

MATERIAL HANDLING COST - IHS DIVISION OF

EPIDEMIOLOGY DISEASE PREVENTION FOR COLORECTAL

CANCER SCREENING NEEDS ASSESSMENT AND ENDOSCOPIC

SURVEY TOOL

Period of Performance: 09/13/2010 to 08/12/2012

1 J3

1 J3

1 LO

1 LO

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110