sf18 RFQ.pdf

PDF 131 KB Posted

Attached to
Breathing Air System Supply Parts Federal contract opportunity
Solicitation number
1371548
Issued by
Department of Health and Human Services National Institutes of Health

About this file

SF 18 Request for Quote

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Other files attached to Breathing Air System Supply Parts, newest first.
File Type Posted
Terms and Conditions.doc DOC document
Spare Parts for the IRF.xls XLS spreadsheet

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Text version

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

PAGE OF PAGES

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

UNDER BDSA REG. 2

AND/OR DMS REG. 1

RATING

5a. ISSUED BY 6. DELIVER BY (Date)

5b. FOR INFORMATION CALL (NO COLLECT CALLS)

NAME TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANYa. NAME

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

c. CITY

d. STATE e. ZIP CODE

7. DELIVERY

FOB DESTINATION

OTHER

(See Schedule)

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFICE IN BLOCK 5a ON OR

BEFORE CLOSE OF BUSINESS (Date)

IMPORTANT: This is a request for information, and quotations furnished are not officers. 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 service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

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

ITEM NO.

(a)

SUPPLIES/ SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

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 are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

15. DATE OF QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

b. TELEPHONE

AREA CODE

NUMBER

STANDARD FORM 18 (REV. 6-95)

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

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

FormFlow/Delrina Inc.

Page: 1
Pages: 8
RFQNoSm: Off
RFQSmall: Yes
IssDate: 4 Jan 2010
ReqNo:
Rating: N/A
IssuedBy: National Institutes of Health, Hamilton MT 59840
DelvBy:
POCName: Jim Parr, Contracting Officer
POCArea: 406
POCPhone: 363-9207
FOBDest: Yes
DelvOthr: Off
ToName:
ToComp:
ToStrt:
ToCity:
ToSt:
ToZIP:
Consigne: NIH - ORF
ConsgStr: 903 S. 4th Street, Bldg 29
ConsgCty: Hamilton
ConsgSt: MT
ConsgZIP: 59840
ClosBus: 01/29/2010
ItemA: 1
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ServA: Laboratory Breathing Air System
ServB: Parts. See Attached Spreadsheet
ServC:
ServD:
ServE: If proposing on an or equal product
ServF: please provide detailed
ServG: specifications so the Government can
ServH: determine if the product will be
ServI: acceptable for use with the breathing
ServJ: air system in our Laboratory.
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PurchNo: 1371548

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