Attachment 3 - SF1449 Quote Submission Forms (0002).pdf
PDF 413 KB Posted
- Attached to
- Lab Gases - RFQ
- Solicitation number
- 1232SA26Q1051
About this file
This is a Request for Proposal (RFP) and Solicitation/Contract/Order for Commercial Items issued by the USDA Agricultural Research Service (ARS) for the supply of compressed and liquefied gases. The solicitation number is 1232SA26Q1051, with an offer due date of September 16, 2026, at 2359 PT. The requisition number is 1175351. The contracting officer is Kristine M. Stout, and the solicitation information contact is Aaron Dimeo at (608) 416-0027.
The contract requires delivery of various compressed and liquefied gases to the PWA Physiology and Pathology of Trees facility located at 1104 N Western Avenue, Wenatchee, WA 98801, with invoices submitted to USDA ARS Acquisition and Property Division at 5601 Sunnyside Avenue, RM 3-2102, Beltsville, MD 20705. The period of performance runs from September 25, 2026, through September 24, 2027, with a delivery date of September 24, 2027. The contract is unrestricted with a small business size standard of 1,200 employees under NAICS code 325120. The line items include K Air (50L) – 12 cylinders; 50# CO2 (50L) – 10 cylinders; Liquid CO2 (55 gallons) – 1 cylinder; K N2 (50L) – 16 cylinders; UHP N2 (50L) – 6 cylinders; Liquid N2 (55 gallons) – 80 cylinders; K H2 (50L) – 3 cylinders; He (50L) – 3 cylinders; UHP He (50L) – 5 cylinders; SPAN (50L) – 2 cylinders; and Cylinder Rental for 12 months. All products fall under Product/Service Code 6830. The solicitation incorporates Federal Acquisition Regulation (FAR) clauses 52.212-1, 52.212-4, and includes FAR 52.212-3 and 52.212-5. Offerors must complete Blocks 12, 17, 23, 24, and 30 on the Standard Form 1449 and provide company information, quote details, and country of manufacture information as specified in the accompanying quote information form.
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Text version
SEE ADDENDUMIS CHECKED
CODE 18a. PAYMENT WILL BE MADE BY
CODE
FACILITYCODE
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER
OFFEROR
ARS-1232SA
BELTSVILLE MD 20705
RM 3-2102
5601 SUNNYSIDE AVENUE
USDA ARS ACQUISITION AND PROPERTY D
ARS-120536 CODE 16. ADMINISTERED BYCODE
X
X
325120
SIZE STANDARD:
% FOR:SET ASIDE:UNRESTRICTED ORARS-1232SA
REQUEST FOR
PROPOSAL
(RFP)
INVITATION
FOR BID (IFB)
10. THIS ACQUISITION ISCODE
REQUEST FOR
QUOTE (RFQ)
14. METHOD OF SOLICITATION
13b. RATING
NORTH AMERICAN INDUSTRY
CLASSIFICATION STANDARD
(NAICS):
SMALL BUSINESS
09/03/2026
(608)-416-0027AARON DIMEO
(No collect calls)
INFORMATION CALL:
FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIME
09/16/2026 2359 PT
b. TELEPHONE NUMBERa. NAME
4. ORDER NUMBER3. AWARD/ 6. SOLICITATION
1232SA26Q1051
5. SOLICITATION NUMBER
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF
1 4 1175351OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
TELEPHONE NO.
17a. CONTRACTOR/
WENATCHEE WA 98801
1104 N WESTERN AVENUE
PWA PHYSIOLOGY AND PATHOLOGY OF TRE
15. DELIVER TO
BELTSVILLE MD 20705
RM 3-2102
5601 SUNNYSIDE AVENUE
9. ISSUED BY
7.
2. CONTRACT NO.
EFFECTIVE DATE
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW
ISSUE DATE
DELIVERY FOR FREE ON BOARD
(FOB) DESTINATION UNLESS
BLOCK IS MARKED
11.
SEE SCHEDULEX
12. DISCOUNT TERMS THIS CONTRACT IS A RATED
ORDER UNDER THE DEFENSE
PRIORITIES AND ALLOCATIONS
SYSTEM - DPAS (15 CFR 700)
13a.
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
(SDVOSB)
HUBZONE SMALL
BUSINESS
8(A)
USDA ARS ACQUISITION AND PROPERTY D
WOMEN-OWNED SMALL
BUSINESS (WOSB)
ECONOMICALLY DISADVANTAGED
WOMEN-OWNED SMALL
BUSINESS (EDWOSB)
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
0001 12 CL
Period of Performance: 09/25/2026 to 09/24/2027
K Air (50L) Product/Service Code: 6830 Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027 Period of Performance: 09/25/2026 to 09/24/2027
Continued ...
(Use Reverse and/or Attach Additional Sheets as Necessary)
HEREIN, IS ACCEPTED AS TO ITEMS:
X
XX
DATED
KRISTINE M. STOUT
. YOUR OFFER ON SOLICITATION (BLOCK 5),
INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH
COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER
ARE
ARE
31c. DATE SIGNED
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA
31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)
30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)
ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL
SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.
27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3
AND 52.212-5 ARE ATTACHED. ADDENDA
26. TOTAL AWARD AMOUNT (For Government Use Only)
OFFER
STANDARD FORM 1449 (REV. 11/2021)
Prescribed by GSA - FAR (48 CFR) 53.212
ARE NOT ATTACHED.
ARE NOT ATTACHED.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
30b. NAME AND TITLE OF SIGNER (Type or print)
30a. SIGNATURE OF OFFEROR/CONTRACTOR
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
25. ACCOUNTING AND APPROPRIATION DATA
29. AWARD OF CONTRACT: REFERENCE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED
40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER
37. CHECK NUMBER
FINALPARTIAL
36. PAYMENT
FINALPARTIAL
35. AMOUNT VERIFIED
CORRECT FOR
34. VOUCHER NUMBER33. SHIP NUMBER
COMPLETE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)
42b. RECEIVED AT (Location)
42a. RECEIVED BY (Print)
41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT
STANDARD FORM 1449 (REV. 11/2021) BACK
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
0002 10 CL
0003 1 CL
0004 16 CL
0005 6 CL
50# CO2 (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
Liquid CO2 (55gal)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
K N2 (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
UHP N2 (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
Continued ...
32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
4 2 of
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
3 4
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
1232SA26Q1051
0006 80 CL
0007 3 CL
0008 3 CL
0009 5 CL
0010 2 CL
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
Liquid N2 (55gal)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
K H2 (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
He (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
UHP He (50L)
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
SPAN (50L)
Continued ...
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
4 4
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
1232SA26Q1051
0011 12 MO
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
Cylinder Rental
Product/Service Code: 6830
Product/Service Description: GASES: COMPRESSED
AND LIQUEFIED
Delivery: 09/24/2027
Period of Performance: 09/25/2026 to 09/24/2027
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
United States Department of Agriculture
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
Research, Education, and Economics Agricultural Research Service
Solicitation Title: _____________________________________________________________________
Solicitation Number: ______________________
Company Information:
Currently Registered and Active in the System for Award Management (SAM): ( ) Yes ( ) No
SAM Unique Entity Identifier (UEI) Number:
Company Legal Name: _____________________________________________
Doing Business As (if applicable): ____________________________________
Company Address as registered in the System for Award Management (SAM):
CAGE Code(s):
Socio-economic status for the NAICS code: __________ (with a small business threshold of under ______________) – please check ALL that apply:
( ) Small Business Concern [ ] Disadvantaged
[ ] SBA-certified 8(a) Program Participant [ ] SBA-certified HUB Zone Business
[ ] Veteran Owned [ ] Service-Disabled Veteran Owned
[ ] Woman-Owned [ ] Economically Disadvantaged Woman Owned
( ) Other Than Small Business Concern
( ) I confirm that my company is registered in the System for Award Management (SAM) with the socio-economic status identified above and the NAICS code specified or that my firm qualifies for the selected the socio-economic status under the applicable NAICS code.
Research, Education, and Economics Agricultural Research Service
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
Quote Information:
Quote Number: _________________
Quote Date:
Quote Expiration Date:
Quoted Price:
Offeror’s shall insert the Total Quoted Price in the cell below. The Total Quoted Price is to be the sum of all Line-Item Total Amounts from the SF1449 (including all options).
Total Quoted Price:
Period of Performance:
Time to Deliver: ( ) days ( ) weeks ( ) months
Country of Manufacture Information:
Product Name(s) and Part Number(s):
Manufacturer’s Legal Name:
Product is Manufactured in the United States of America (is a domestic product): ( )Yes ( )No
Manufacturing Address (for domestic products):
Country of Origin (for nondomestic products):
Research, Education, and Economics Agricultural Research Service
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
( ) I confirm that a written certification of the above information was obtained from the product’s manufacturer and is included in the support documents submitted with this quote.
Certification:
I understand that incomplete sections, failure to provide all required documentation, and/or failure to sign this certification may remove my company’s quote from being put into consideration by the Government for award.
Signature:
Name:
Title:
Contact Information:
Date:
| Quote Submission Forms |
| 1 |
Quote Submission Form Pg 2 - Products
| Solicitation Title: Lab Gases - RFQ |
| Solicitation Number: 1232SA26Q1051 |
| SAM Unique Entity Identifier UEI Number: |
| Company Legal Name: |
| Doing Business As if applicable: |
| Company Address as registered in the System for Award Management SAM 1: |
| Company Address as registered in the System for Award Management SAM 2: |
| Company Address as registered in the System for Award Management SAM 3: |
| Company Address as registered in the System for Award Management SAM 4: |
| CAGE Codes: |
| please check ALL that apply: 1,200 Employees |
| Group1: Off |
| Group2: Off |
| Check Box7: Off |
| Check Box9: Off |
| Check Box12: Off |
| Check Box15: Off |
| Check Box16: Off |
| Check Box17: Off |
| Check Box18: Off |
| Text19: 325120 |
| Group3: Off |
| Quote Number: |
| Quote Date: |
| Quote Expiration Date: |
| Total Quoted Price: |
| Time to Deliver: |
| Product Names and Part Numbers: |
| Manufacturers Legal Name: |
| Manufacturing Address for domestic products 1: |
| Manufacturing Address for domestic products 2: |
| Manufacturing Address for domestic products 3: |
| Manufacturing Address for domestic products 4: |
| Country of Origin for nondomestic products: |
| Group4: Off |
| Group5: Off |
| Name: |
| Title: |
| Contact Information: |
| Date: |
| Group6: Off |
File details come from the government source that posted it. Updated .