18-242-SOL-00016,_SFSU_Colostomy_Supply_Agreement.pdf

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

SFSU CODE 16. ADMINISTERED BYCODE

X

X

X

339113

SIZE STANDARD:

100.00 % FOR:SET ASIDE:UNRESTRICTED OR203

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

02/21/2018 1200 MD

02/14/2018

505-256-6752ERIC WRIGHT

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

18-242-SOL-00016

5. SOLICITATION NUMBER

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

1 10 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Santa Fe New Mexico 87505 1700 Cerrillos Road General Services Departemnt Santa Fe Service Unit

15. DELIVER TO

Albuquerque NM 87110 4101 Indian School Rd NE, Suite 225

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

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 a colostomy supply agreement to the following Albuquerque Area Indian Health Service Facility:

Santa Fe Service Unit General Services Department 1700 Cerrillos Road Santa Fe, New Mexico 87505

Acquisition will be for one base year with (4) one year option years for renewal.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

DATED

ERIC K. WRIGHT

. 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. ADDENDA

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.

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: 03/01/2018 to 02/28/2023

1 DESCRIPTION OF SERVICES/SUPPLIES

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.

The contract shall provide a colostomy supply agreement with the following specifications:

- The Contractor shall provide a Customer Service

Representative assigned to the account to assist in providing information on product description, product ordering and coordinating delivery arrangements.

- The Contractor shall ensure expiration dates of at least 1 year beyond the time of shipping on all colostomy supplies.

- The Contractor shall not make any substitutions without first receiving approval from ordering official.

- The Contractor shall provide a controlled environment for storage and transport of colostomy supplies that comply with the U.S. Food and Drug Administration regulations.

- The Contractor shall be responsible to provide a confirmation number and expected delivery date

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

10 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

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18-242-SOL-00016

at the time of order.

- The Contractor shall provide the ability to return incorrect items within 2 weeks of being notified of the error and credited for those items or a replacement within 30 days of items being returned.

- The Contractor shall properly address the packages noting attention to the specific ordering department labeled on the package and/or packaging list.

- The Contractor shall properly pack Colostomy supplies to ensure safe handling and transport.

- The Contractor must clearly mark or bear appropriate warning labels of each package to adequately alert the receiving organization of susceptible packages ie refrigerate immediately.

- The Contractor shall provide Santa Fe Service

Unit a comprehensive electronic report of product usage to include the date of purchase, cost, delivery location, date/time of delivery and an itemized description of the supplies purchased including the quantity and price of all items that are easily understandable and formatted.

- The Contractor shall provide a past performance contact information sheet.

- Emergency Preparedness o The Contractor shall provide the ability to drop-ship during disaster operations with the flexibility to use commercial carriers and/or private couriers to serve the needs of the Santa

Fe Service Unit in a time of a disaster preparedness or response.

o The Contractor shall ship colostomy supplies to the Santa Fe Indian Hospital within 24-hours during disaster operations.

SCHEDULE OF DELIVERABLES/REPORTING REQUIREMENTS

- The Contractor shall provide real time tracking information on vehicles carrying ordered

Colostomy supplies.

- Deliveries are received within the General

Services Department Monday through Friday, between the hours of 9:00am and 4:30pm.

(Excluding Federal holidays)

- Deliveries will be inspected at the time of delivery and Contractor notified immediately of damage.

Continued ...

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

Sponsored by GSA

FAR (48 CFR) 53.110

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18-242-SOL-00016

- Evaluation of Contract will be completed annually by the designated Contract Officer

Representative

DELIVERY LOCATION

The contractor shall provide a colostomy supply agreement to the following Albuquerque Area

Indian Health Service Facility:

Santa Fe Service Unit

General Services Department

1700 Cerrillos Road

Santa Fe, New Mexico 87505

CONTRACT OFFICER REPRESENTATIVE (COR)

Geraldine Nieto, 505-946-9508, is hereby designated as Contract Officer's Representative for this service. The Contract Officer

Representative responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The Contract Officer's

Representative does not have the authority to change or alter the order amount, terms and conditions.

The Contract Officer's Representative responsibilities include ensuring contractor accountability, monitoring the contractor's technical progress- including the surveillance and assessment of performance and recommending to the Contracting Officer changes in requirements, interpreting the statement of work, performing technical evaluations as required, performing technical inspection and acceptance required, assisting the contractor in the resolution of technical problems encountered during performance and receiving and processing invoices for payment.

ISBEE CASCADING SET-ASIDE:

Offers will be solicited from Indian Small

Business Economic Enterprise (ISBEE) concerns.

If we do not receive enough competition and/or reasonably priced offers from the ISBEE set-aside, we will then evaluate quotes and consider for award to other small business concerns. Any acquisition resulting from this

Continued ...

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cascading set-aside will be from such a concern as follows: First Tier: ISBEE Second Tier: all other Small Business Concerns. Offers received from enterprises that are not one of these small business concerns will not be considered.

SUBCONTRACTS:

None of the services furnished under this agreement shall be subcontracted or transferred to another contractor, or organization, without the specific prior written approval of the

Contracting Officer.

IHS CONTRACTING OFFICER:

The authority to negotiate a change in terms, conditions, or amounts cited is reserved for the

IHS contracting Officer. The COR designated holds no such authority.

GENERAL CONTRACT INFORMATION:

Contractor Requirements Mandated by the Federal

Acquisition Regulation (FAR) to comply with the mandate, the contractor must obtain a Data

Universal Numbering System (DUNS) Number. The

DUNS No. is a 9-digit number assigned by Dun and

Bradstreet Inc., to identify unique business entities. If the offeror (Contractor) does not have a DUNS Number, it should contact Dun and

Bradstreet directly to obtain one by calling

1-866-705-5711 or via the internet at http://www.dnb.com. Refer to FAR Clause No.

52.204-6, Data Universal Numbering System (DUNS)

Number (Dec 2012).

Effective on July 31, 2012, the System for Award

Management (SAM) replaced the Central Contractor

Registration (CCR). During the term of the contract, the Contractor's DUNS number shall be in active status in accordance to FAR 52.204-6, Data Universal Numbering Systems (DUNS) and updated annually in the System Award Management

(SAM) pursuant to 52.204-7, Central Contractor

Registration (Dec 2012). You June access SAM at www.sam.gov.

Contractors/Vendors wanting to do business with the government are required to register in CCR

Continued ...

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18-242-SOL-00016

and revalidate annually. This provides payment information, validates Small Business

Administration certifications as small, disadvantaged, 8(a), or HUB-Zone businesses, calculates business size, and validates taxpayer

IDs with IRS.

CONTRACT ADMINISTRATION DATA

Accounting and Appropriation Data

The accounting data must be in cited on invoice for reimbursement.

CONTRACTING OFFICER RESPONSIBILITY:

The authorities to negotiate changes in the terms and conditions or the amounts cited in the contract are reserved to the Contracting Officer.

INVOICE SUBMISSION:

The Contractor shall submit invoices directly to the following address:

1. Division of Accounting Services Albuquerque Indian Health Service

4101 Indian School Road NE, Suite 225 2nd Floor

Albuquerque, NM 87110

(505) 256-6760

The following information must be cited on each invoice submitted for payment.

- Contract No.

- Contractors Name and Address

- Date of Invoice period

- Hours of services provide during the invoiced period.

- Invoice No.

- Invoice signed and dated, and to include the following certification:

"I hereby certify that all services provided and invoiced are for appropriate purposes and in accordance with the terms and conditions of the cited contract."

Per mandate by the U. S. Department of Treasury and effective July 1996, all contractor payments will be by Electronic Funds Transfer System (EFT).

Payment Office

The payment office is:

1. Albuquerque Indian Health Service Division of Accounting Services

Continued ...

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18-242-SOL-00016

4101 Indian School Road NE, Suite 225 2nd Floor

Albuquerque, NM 87110

Electronic Funds Transfer (EFT) Disbursed by:

1. U S Department of Treasury Office of Disbursements

Austin, TX 73301

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