Standard Form 18.pdf

12-247-SOL-00073

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

07/17/2012

1 2

4212 North 16th Street Phoenix AZ 85016

Phoenix Indian Medical CTR Multiple

602 200-5371BRADLEY PLATERO

07/27/2012 1200 MT

FOB DESTINATION

OTHER

(See Schedule)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

The purpose of this Request for Quote (RFQ) is to enter into an agreement with a company that has a proven record for providing asbestos removal/abatement, and disposal, in accordance with current laws and regulations governing such removal and disposal. Asbestos removal/abatement services shall be performed at the Phoenix Indian Medical Center (PIMC).

The Contractor shall provide all plans, labor, materials, equipment, transportation and supplies for the designated Asbestos removal/abatement.

The work shall be conducted by competent persons, certified and qualified in the techniques of asbestos abatement, handling, and disposal of Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

12-247-SOL-00073

asbestos containing and asbestos-contaminated materials and subsequent cleaning of contaminated areas.

All abatement techniques employed shall be considered industry standard, including removal and disposal.

This is a Small Business Set-Aside under 52.219-6

Notice of Total Small Business Set-Aside. RFQ's will be sought from businesses which are 100%

Total Small Business owned, operated and controlled sources only.

Submittal Requirements:

Standard Form (SF) 18, Request for Quote, requires completion of section nos. 12 through

16.

Offerors are required to enter price proposal quotes on Section 11, Box (c) through (f) in the

Standard Form 18.

Offerors are required to submit past performance requirements from Pages 14 through 15.

The Offerors are required to submit RFQ by email to: bradley.platero@ihs.gov.

All sections must be completed otherwise the IHS will not consider your RFQ. Late Quotes will not be accepted.

Complete proposal are due by 12:00 P.M., Arizona

Time (MT) on June 27, 2012.

For questions regarding the Asbestos

Removal/Abatement Services at PIMC please contact the Project Officer at email address:

Jason.lindner@ihs.gov or phone number (602)

263-1200. Please ask to speak with Jason Lindner in the Engineering Department when calling this number.

If you have any questions regarding this solicitation please contact Contract Specialist, Bradley Platero at 602-200-5371.

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