12-249-SOL-00026_-sf1449.docx
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- Mobile Mammography Services
- Solicitation number
- 13-249-SOL-00027
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SF 1449
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|---|---|---|
| 13-249-SOL-00027_Attachments.pdf | ||
| 13-249-SOL-00027_Mobile_Mammography.docx | DOCX document |
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SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
| 1. REQUISITION NUMBER |
| PAGE 1 OF |
| Offeror to complete blocks 12, 17, 23, 24, & 30 |
| MR-13-074 |
| 62 |
| 2. CONTRACT NO. |
| 3. AWARD/EFFECTIVE DATE |
| 4. ORDER NUMBER |
| 5. SOLICITATION NUMBER |
| 6. SOLICITATION ISSUE DATE |
| 13-249-SOL-00027 |
| May 10, 2013 |
7. FOR SOLICITATION
| a. NAME |
| b. TELEPHONE (No Collect Calls) |
| 8. OFFER DUE DATE/ |
LOCAL TIME 4:30 PM
| INFORMATION CALL |
| Delvena Carlyle, Contract Specialist |
| 520/295-2456 |
| 06/10/2013 4:30 MST |
| 9. ISSUED BY (MAIL OFFERS TO) |
| CODE |
10. THIS ACQUISITION IS
|_| UNRESTRICTED
| 11. DELIVERY FOR FOB DESTINATION UNLESS BLOCK IS MARKED. |
| 12. DISCOUNT TERMS |
| INDIAN HEALTH SERVICE |
| |X| SET-ASIDE. 100% FOR |
| |_| SEE SCHEDULE |
| TUCSON AREA OFFICE |
| |X| SMALL BUSINESS, |
|_| HUBZONE SMALL BUSINESS
|_| 13a. THIS CONTRACT IS A RATED ORDER
| 7900 S. J. STOCK ROAD |
| |_| 8(A) |
| TUCSON, AZ 85746-7012 |
| |_| SOLE SOURCE |
| 13b. RATING |
| NAICS: 621512 |
| 14. METHOD OF SOLICITATION |
| delvena.carlyle@ihs.gov | ||
| SIZE STANDARD: $13.5 | ||
| |X| RFQ | |_| IFB | |_| RFP |
| 15. DELIVER TO: |
| CODE |
| 16. ADMINISTERED BY |
| CODE |
TUCSON AREA INDIAN HEALTH SERVICE
San Xavier Health Center 7900 S “J” Stock Road Tucson, AZ 85746
Same as Block 9
| 17a. CONTRACTOR/OFFEROR |
| CAGE |
FACILITY CODE
| 18a. PAYMENT WILL BE MADE BY |
| CODE |
DUNS #____________________________
HHS ALBUQUERQUE
5300 HOMESTEAD ROAD
ALBUQUERQUE, NM 87110
| TELEPHONE: __________ |
| TIN: ____________________ |
| 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK |
| |_| 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER |
| IS CHECKED: |_| SEE ADDENDA |
19.
ITEM NO,
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
| 1 |
| The Contractor shall provide Mobile Mammography Screening services (clinics) to the Tucson Area Indian Health Service patients. |
| SEE ENCLOSED FEE SCHEDULE |
See additional pages for additional information, terms and conditions.
Only one award will be made from this solicitation.
(Use Reverse and/or Attach Additional Sheets as Necessary)
| 25. ACCOUNTING AND APPROPRIATION DATA |
| 26. TOTAL AWARD AMOUNT (For Govt. Use Only) |
|X| 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 and ADDENDA |X| ARE |_| ARE NOT ATTACHED.
|X| 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 AND ADDENDA |X| ARE |_| ARE NOT ATTACHED.
28.
|X|
| CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ORIGINAL TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. |
| 29. |
AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION (BLOCK 5), DATED (BLOCK 30c) INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:
| 30a. SIGNATURE OF OFFEROR/CONTRACTOR |
| 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) |
| 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) |
| 30c. DATE SIGNED |
| 31b. NAME OF CONTRACTING OFFICER |
| 31c. DATE SIGNED |
AUTHORIZED FOR LOCAL REPRODUCTION
STANDARD FORM 1449 (Rev. 4/2002)
PREVIOUS EDITION IS NOT USABLE
Prescribed by GSA FAR (48 CFR) 53.212
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