SF-1449,_17-242-SOL-00036.pdf

Items required on SF-1449

Please complete the following section(s):

Section 15.

Provide your organization’s:

1. Complete Mailing Address

2. DUNS#

3. TIN#

Section 30a.

Signature

Section 30b.

Print Name

Section 30c.

Date Signed

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

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225 Albuquerque Indian Health Service

CODE 16. ADMINISTERED BYCODE

X

X

562920

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

03/24/2017 1200 MT

03/17/2017

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBERa. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

17-242-SOL-00036

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 4 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$20.50

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Albuquerque Indian Health Service

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

The contractor shall provide an office recycling and document destruction services agreement for the following Albuquerque Area Indian Health Service Facility:

ALBUQUERQUE INDIAN HEALTH CENTER

801 VASSAR DRIVE NE

ALBUQUERQUE NM 87106

Acquisition will be for a 1 year base period with four 1 year options for renewal.

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED . 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 FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDEND

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

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:

REF.

ALBUQUERQUE INDIAN HEALTH CENTER

801 VASSAR DRIVE NE

ALBUQUERQUE NM 87106

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. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Period of Performance: 04/01/2017 to 03/31/2022

1 The contractor shall be in accordance with all

Federal, State, Local, Tribal and IHS regulations and shall be made with minimal divergence from the schedule established and with minimum disturbance and maximum protection of government personnel, property and general public.

RECYCLING SERVICES AGREEMENT

The contractor shall provide an office recycling services agreement with the following specifications:

Pick Up and Recycle of the following items:

- Card Board(s)

- Mixed Bottle(s)

- Aluminum Can(s)

Pick Up Frequency:

- Once per month

The contractor shall be financially responsible for the following to comply with federal, state, OSHA,and EPA regulations:

- Required permits

- Licenses

- Bonds

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)

17-242-SOL-00036

Contractor shall provide the following recycling collection containers at the following locations:

Qty Requested Container Size Container Location

4 32 Gallon Recycling Bin Albuquerque Indian Health Center

1 5ft x5ft Cardboard Cage Albuquerque Indian Health Center

DOCUMENT DESTRUCTION SERVICES AGREEMENT

The contractor shall provide a document destruction services agreement with the following specifications:

Pick Up Frequency:

- Once per month

Certificate of Destruction:

- Contractor shall provide a certificate of destruction for confidential paper shredding.

a) Contractor shall provide the following secure document destruction collection containers at the following locations:

Qty Requested Container Size Container Location

2 32 Gallon Shredding Bin Albuquerque Indian Health Center

1 33 Gallon Shredding Bin Santa Ana Indian Health Center*

1 34 Gallon Shredding Bin Zia Indian Health Center**

8 68 Gallon Shredding Bin Albuquerque Indian Health Center

*Containers will be placed at the Santa Ana

Indian Health Center but delivery and pick up of the containers and the destruction of the items within the container will be at the Albuquerque

Indian Health Center.

** Containers will be placed at the Zia Indian

Health Center but delivery and pick up of the containers and the destruction of the items

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)

17-242-SOL-00036

within the container will be at the Albuquerque

Indian Health Center.

Upon shredding pick up, the contractor shall provide a (1) gaylord for shredding.

b) Contractor shall collect all documents to be destroyed from the provided secure document destruction containers based on the schedule specified in the Delivery Section of this statement of work.

c) Containers will be locked prior to collection and locked when the console bag (if applicable) is removed and replaced.

d) Contractor shall ensure sufficient reasonable safeguards are in place to protect all documents until final destruction has been completed.

e) Contractor shall destroy all sensitive and non-sensitive paper materials collected in the provided document destruction containers.

f) Contractor shall provide document destruction services by means of a cross cut shredder.

g) Contractor shall recycle all destroyed materials by means of pulping, bleaching or recycling into alternative paper products.

h) Contractor shall provide the COR with a certificate of destruction after document destruction services have been rendered.

i) Contractor shall have full responsibility for destruction services and will inspect all destruction of sensitive material to ensure material is rendered unreadable.

j) The contractor shall maintain record confidentiality in accordance with the Privacy

Act of 1974, Alcohol and Drug Abuse Patient

Records, Freedom of Information Act, Health

Insurance Portability and Accountability Act of

1996 and other pertinent federal laws and regulations.

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

Sponsored by GSA

FAR (48 CFR) 53.110

SF-1449, 17-242-SOL-00036