191D3226Q0004 A0001 CO sign.pdf

05/26/2026 06:20 GMT

Reilly, Jan (ReillyJM@state.gov)

SECTION I, Paragraph III. Price

In accordance with the Bank of Indonesia regulation No. 17/3/PBI/2015, the Contractor SHALL provide a firm fixed price in Indonesian Rupiah (one currency only).

The Contractor shall furnish to the Government, when and if ordered, the services as specified in this contract. The prices listed below shall include all labor, materials, overhead, and profit.

Company Legal name: ___________________________________________________________ Address, email, and phone number: _________________________________________________ Beneficiary information (name and address appears on invoice/bank account and/or SAM registration) if different than above: _________________________________________________ Project manager’s name, email, and direct phone number: ______________________________

CLIN & DESCRIPTION RFQ191D3226Q0004 Quantity Unit Price/Unit Total CLIN 1 – Meeting Services (July 7–9, 2026) To include meeting room, food and beverage services, and related support services for a full-day conference session in accordance with the Statement of Work.

198 Package

CLIN 2 – Meeting Services (July 10, 2026) To include meeting room, food and beverage services, and related support services for a half-day conference session in accordance with the Statement of Work.

66 Package

CLIN 3 – Equipment, Supplies, and Additional Services To include equipment, supplies, technical support, and related services in accordance with the Statement of Work. (1 lot daily for July 7-10, 2026)

Contractor must provide an itemized breakdown of all equipment, supplies, and additional services under CLIN 3 and clearly indicate which items are included in the meeting package at no additional cost (Rp.0) and which items are separately charged, in accordance with CLIN 3 requirements in the Statement of Work.

4 Lot

CLIN 4 – Lodging Services To include lodging accommodations and related services in accordance with the Statement of Work.

4a. Twin-bed, double occupancy 76 Room night

4b. Single occupancy 8 Room nights

CLIN 5 – Airport Transportation Services To include airport pickup and drop-off transportation services in accordance with the Statement of Work.

8 Trips

4. Estimated additional items (will be determined by U.S. Government) 1 Package

GRAND TOTAL IDR ____________________

SECTION I CONTINUATION, Part II Statement of Work

CLIN 1 through CLIN 3 remain unchanged.

CLIN 4 and 5 revisions:

CLIN 4 Lodging Lodging room, Air-conditioned, and basic Wi-Fi connection:

• Nineteen (19) rooms (Standard Room, twin bed, double occupancies), check-in July 6 and check out July 10 (4 nights). To include breakfast for 2 people.

• Three (3) rooms (single-bed, single occupancy), check-in July 7 and check-out July 9 (2 nights). To include breakfast for one person.

• One (1) room (single-bed, single occupancy), check-in July 8 and check-out July 10 (2 night). To include breakfast for 1 person.

• Additionally, approximately seven (7) rooms may be requested by U.S. Government personnel under personal accounts for four (4) nights. These rooms are not part of this purchase order and, if utilized, will be paid directly by the individual guests to the hotel.

CLIN 5 – Airport Transportation

• Four (4) pickup and four (4) drop-off transportation services using a 7-seater vehicle (Toyota Innova or equivalent) between the airport and hotel on various dates, as will be advised by the requestor.