18-239-SOL-00116.pdf

18-239-SOL-00116

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

09/06/2018

1 19

522 Minnesota Ave NW Bemidji MN 56601

Indian Health Service 30 Days After Award

IHSREDLAKE

Indian Health Service 24760 Hospital Drive P.O. Box 497 Red Lake MN 56671-0497

Red Lake

MN 56671-0497

218 444-0482LEAH AZURE

09/14/2018 1433 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

This is a Request for Quote(RFQ) in accordance with FAR Part 13, Simplified Acquisition Procedures, and offers are being accepted.

Equipment: Pharmacy

Submit with Offer:

(1) Delivery is 30 days ARO unless specified otherwise in the offer.

(2) Warranty details including T&C.

(3) Equipment specifications and dimension.

(4) Complete pricing

(5) Company Tax ID

(6) Company Dun & Bradstreet/Cage Code

(7) Backorder items are prohibited.

Verify that the product is available ARO.

(8) Provisions-Complete attachment if data is not 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)

IHS1351495

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 19

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

18-239-SOL-00116

available in www.sam.gov

Evaluation Criteria:

Price

Delivery

RFQ Compliance

1 [New] Unit Dose Packaging System. 1 EA

Footprint: 36"L x 15"W x 14"H

Delivery: 30 Days After Award

2 [New] Auto-Print Oral Solid Feeder PF-1. 1 EA

Delivery: 30 Days After Award

3 [New] Variable Package Length VL-1 1 EA

Delivery: 30 Days After Award

4 [New] Barcode Verifier BV-1 1 EA

Delivery: 30 Days After Award

5 [New] 2D USB Barcode Scanner 1 EA

Delivery: 30 Days After Award

6 One(1) Day Onsite Training. 1 EA

Delivery: 30 Days After Award

7 Installation 1 EA

Delivery: 30 Days After Award

8 Owner's Manual 1 EA

Delivery: 30 Days After Award

9 Trade-In Existing Unit. 1 EA

[Medical Packaging Inc.]

Model: Auto-Print

Yr: 2007

SN: 5278

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 19

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

18-239-SOL-00116

Delivery: 30 Days After Award

10 Warranty 1 EA

[Provide with offer the type of warranty, length of time, and a complete copy of the warranty terms and conditions]

Delivery: 30 Days After Award

Contract Type: Firm-Fixed-Price

Shipment Terms: FOB Destination

Payment Terms: Net 30 in arrears.

Electronic Funds Transfer.

NAICS:339112

Employees: 1000

FEDERAL ACQUISITION REGULATIONS:

52.252-2 Clauses Incorporated by Reference. (FEB

1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the

Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): https://www.acquisition.gov/

52.204-13 System for Award Management Maintenance

52.204-18 Commercial and Government Entity Code

Maintenance.

52.204-19 Incorporation by Reference of

Representations and Certifications.

52.213-4 Terms and Conditions-Simplified

Acquisitions (Other Than Commercial Items).

52.232-33 Payment by Electronic Funds Transfer- System for Award Management.

52.247-34 F.o.b. Destination.

52.232-39 Unenforceability of Unauthorized

Obligations.

52.232-40 Providing Accelerated Payments to Small

Business Subcontractors.

52.243-1 Changes-Fixed-Price.

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