Attachment_1_-_Required_Form_to_Return.pdf

1282D718Q0011

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

05/16/2018 909874

1 49

900 GRAND AVENUE

GLENWOOD SPRINGS CO 81602-0948

WHITE RIVER NATIONAL FOREST

Multiple

WHITE RIVER NATIONAL FOREST

900 GRAND AVENUE

GLENWOOD SPRINGS

CO 81602-0948

970 945-3217ROBERT HALL

05/27/2018 2359 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

White River NF - Annual Fire Extinguisher Inspections

This is a request for quote for annual fire extinguisher inspections in accordance with the line items and attached statement of work. The anticipated contract type will be an unfunded Blanket Purchase Agreement upon which the Government will issues funded BPA calls each year based upon the anticipated number of inspections required for that year. These inspections will be conducted at our Supervisor's Office and Ranger District Offices (8 different locations).

Contract Requirements:

1. Active registration - www.sam.gov 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 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

1282D718Q0011

2. Invoicing and Payment - www.ipp.gov

3. FAR Part 12 - Commercial Items

4. FAR Part 13 - Simplified Acquisition Procedures

5. Service Contract Act Wages for Garfield, Pitkin, Eagle, Blanco and Summit Counties, CO

6. Award based upon lowest price and price related factors technically acceptable along with a check of your past performance.

Period of Performance: 07/01/2018 to 06/30/2023

001 Fire Extinguisher Inspections - Base Year

Product/Service Code: H142

Product/Service Description: QUALITY CONTROL-

FIRE FIGHTING/RESCUE/SAFETY EQUIPMENT; ENVIRON

PROTECT EQUIPMENT/MATLS

Delivery: 06/30/2019

Period of Performance: 07/01/2018 to 06/30/2019

002 Fire Extinguisher Inspections - Year 2

(Option Line Item)

Product/Service Code: H142

Product/Service Description: QUALITY CONTROL-

FIRE FIGHTING/RESCUE/SAFETY EQUIPMENT; ENVIRON

PROTECT EQUIPMENT/MATLS

Delivery: 06/30/2020

Period of Performance: 07/01/2019 to 06/30/2020

003 Fire Extinguisher Inspections - Year 3

(Option Line Item)

Product/Service Code: H142

Product/Service Description: QUALITY CONTROL-

FIRE FIGHTING/RESCUE/SAFETY EQUIPMENT; ENVIRON

PROTECT EQUIPMENT/MATLS

Delivery: 06/30/2021

Period of Performance: 07/01/2020 to 06/30/2021

004 Fire Extinguisher Inspections - Year 4

(Option Line Item)

Product/Service Code: H142

Product/Service Description: QUALITY CONTROL-

Continued ...

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

1282D718Q0011

FIRE FIGHTING/RESCUE/SAFETY EQUIPMENT; ENVIRON

PROTECT EQUIPMENT/MATLS

Delivery: 06/30/2022

Period of Performance: 07/01/2021 to 06/30/2022

005 Fire Extinguisher Inspections - Year 5

(Option Line Item)

Product/Service Code: H142

Product/Service Description: QUALITY CONTROL-

FIRE FIGHTING/RESCUE/SAFETY EQUIPMENT; ENVIRON

PROTECT EQUIPMENT/MATLS

Delivery: 06/30/2023

Period of Performance: 07/01/2022 to 06/01/2023

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

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 4 of 49

C – Description / Statement of Work E - Inspection and Acceptance F - Deliveries or Performance H - Special Contract Requirements I - Contract Clauses J - List of Documents, Exhibits, and Other Attachments K - Representations, Certifications, and Other Statements of Offerors L - Instructions, Conditions, and Notices to Offerors or Respondents Instructions on Submitting an Offer M - Evaluation Factors for Award

B - Prices/Costs Schedule of Items

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 5 of 49

CLIN 001 – Base Year – July 2018 – Jun 2019

Item

Number

Activity Unit Unit Price

1 Annual Inspections and Retag Each $

2 New Fire Extinguisher – 2.5 lb Each $

3 New Fire Extinguisher – 5.0 lb Each $

4 New Fire Extinguisher – 10 lb Each $

5 Refurbished Fire Extinguisher – 2.5 lb Each $

6 Refurbished Fire Extinguisher – 5.0 lb Each $

7 Refurbished Fire Extinguisher – 10 lb Each $

8 Recharge (less than 6 years old) – 2.5 lb Each $

9 Recharge (less than 6 years old) – 5.0 lb Each $

10 Recharge (less than 6 years old) – 10 lb Each $

11 Recharge (6 years old) – 2.5 lb Each $

12 Recharge (6 years old) – 5.0 lb Each $

13 Recharge (6 years old) – 10 lb Each $

14 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

15 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

16 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

17 Travel (per Federal Travel Regulations) NA NA

TOTAL

ALL

ITEMS

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 6 of 49

CLIN 002 – Year 2 – July 2019 – Jun 2020

Number

Activity Unit Unit Price

1 Annual Inspections and Retag Each $

2 New Fire Extinguisher – 2.5 lb Each $

3 New Fire Extinguisher – 5.0 lb Each $

4 New Fire Extinguisher – 10 lb Each $

5 Refurbished Fire Extinguisher – 2.5 lb Each $

6 Refurbished Fire Extinguisher – 5.0 lb Each $

7 Refurbished Fire Extinguisher – 10 lb Each $

8 Recharge (less than 6 years old) – 2.5 lb Each $

9 Recharge (less than 6 years old) – 5.0 lb Each $

10 Recharge (less than 6 years old) – 10 lb Each $

11 Recharge (6 years old) – 2.5 lb Each $

12 Recharge (6 years old) – 5.0 lb Each $

13 Recharge (6 years old) – 10 lb Each $

14 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

15 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 7 of 49

CLIN 003 – Year 3 – July 2020 – Jun 2021

Number

Activity Unit Unit Price

1 Annual Inspections and Retag Each $

2 New Fire Extinguisher – 2.5 lb Each $

3 New Fire Extinguisher – 5.0 lb Each $

4 New Fire Extinguisher – 10 lb Each $

5 Refurbished Fire Extinguisher – 2.5 lb Each $

6 Refurbished Fire Extinguisher – 5.0 lb Each $

7 Refurbished Fire Extinguisher – 10 lb Each $

8 Recharge (less than 6 years old) – 2.5 lb Each $

9 Recharge (less than 6 years old) – 5.0 lb Each $

10 Recharge (less than 6 years old) – 10 lb Each $

11 Recharge (6 years old) – 2.5 lb Each $

12 Recharge (6 years old) – 5.0 lb Each $

13 Recharge (6 years old) – 10 lb Each $

14 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

15 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 8 of 49

CLIN 004 – Base Year – July 2021 – Jun 2022

Number

Activity Unit Unit Price

1 Annual Inspections and Retag Each $

2 New Fire Extinguisher – 2.5 lb Each $

3 New Fire Extinguisher – 5.0 lb Each $

4 New Fire Extinguisher – 10 lb Each $

5 Refurbished Fire Extinguisher – 2.5 lb Each $

6 Refurbished Fire Extinguisher – 5.0 lb Each $

7 Refurbished Fire Extinguisher – 10 lb Each $

8 Recharge (less than 6 years old) – 2.5 lb Each $

9 Recharge (less than 6 years old) – 5.0 lb Each $

10 Recharge (less than 6 years old) – 10 lb Each $

11 Recharge (6 years old) – 2.5 lb Each $

12 Recharge (6 years old) – 5.0 lb Each $

13 Recharge (6 years old) – 10 lb Each $

14 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

15 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

1282D718Q0011 White River NF – Fire Extinguisher Inspections BPA Page 9 of 49

C – Description / Statement of Work

C.1 Scope of Contract and Statement of Work

The White River NF with headquarters in Ft Collins, Colorado has a requirement for annual fire extinguisher inspections to be done on a per call basis in coordination with the program manager.

Statement of Work

The Contractor shall furnish all technical expertise, supervision, labor, equipment, operating supplies, transportation, and incidentals necessary to annual inspect, certify, tag and replace as necessary approximately 214 fire extinguishers located across the White River NF. Actual quantities may vary from year to year. Upon scheduling, the contractor will travel to the designated site where all fire extinguishers will be gathered for that day(s) activity.

This is a performance-based service contract and requires the Contractor to be responsible for an end product. If an end product is not provided in compliance with the contract specifications, an adjustment to the payment may be made by the Contracting Officer.

CLIN 005 – Year 5 – July 2022 – Jun 2023

Item

Number

Activity Unit Unit Price

1 Annual Inspections and Retag Each $

2 New Fire Extinguisher – 2.5 lb Each $

3 New Fire Extinguisher – 5.0 lb Each $

4 New Fire Extinguisher – 10 lb Each $

5 Refurbished Fire Extinguisher – 2.5 lb Each $

6 Refurbished Fire Extinguisher – 5.0 lb Each $

7 Refurbished Fire Extinguisher – 10 lb Each $

8 Recharge (less than 6 years old) – 2.5 lb Each $

9 Recharge (less than 6 years old) – 5.0 lb Each $

10 Recharge (less than 6 years old) – 10 lb Each $

11 Recharge (6 years old) – 2.5 lb Each $

12 Recharge (6 years old) – 5.0 lb Each $

13 Recharge (6 years old) – 10 lb Each $

14 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $

15 12 year Hydrostatic Test and Recharge ( 6 years old) – 2.5 lb Each $