19AL6024P0283.pdf
PDF 160 KB Posted
- Solicitation number
- PR12335267
- Issued by
-
Department of State
About this file
This document is an Order for Supplies or Services related to the award of Contract 19AL6024P0283 to ALB-STAR for the installation of a new underground fuel line at the American Embassy compound in Tirana, Albania. The total contract value is $48,273.61 USD (ALL 4,476,412.21), which includes the base service price of ALL 4,141,742.17 (VAT included) and a $334,670 DBA (Defense Base Act) insurance fee. The contract requires delivery of the work by June 30, 2024. The ordering office is the American Embassy in Tirana, and the contractor is Elda Shaqiri of ALB-STAR. The order specifies the required labor, materials, and performance in accordance with the Statement of Work. Billing instructions are provided, requiring the invoice to be emailed to the Finance Management Office and delivered or mailed to the Embassy's Main Entrance.
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Text version
ORDER FOR SUPPLIES OR SERVICES
IMPORTANT: Mark all packages and papers with contract and/or order numbers. PAGE OF PAGES
1. DATE OF ORDER
13 May 2024
2. CONTRACT NO.(If any) 6. SHIP TO:
19AL6024P0283, TIRAN
3. ORDER NO.
19AL6024P0283
4. REQUISITION/REFERENCE NO.
PR12335267
a. NAME OF CONSIGNEE
ATTN: GSO/WAREHOUSE
5. ISSUING OFFICE (Address correspondence to)
AMERICAN EMBASSY TIRANA
RRUGA STAVRO VINJAU, NO. 14 ATTN: GSO/PROCUREMENT
TIRANA,
Contact Name: Elida Lako Phone:
Email: LAKOE@STATE.GOV
b. STREET ADDRESS
RRUGA STAVRO VINJAU, NO. 14
c. CITY
TIRANA
d. STATE
e. ZIP CODE
f. SHIP VIA
7. TO: 8. TYPE OF ORDER
a. NAME OF CONTRACTOR
ELDA SHAQIRI
DUNS NUMBER
123456787
CONTACT PHONE NUMBER
0672061528
E-MAIL:
elda.shaqiri@albstar.al
FAX:
a. PURCHASE ORDER
REFERENCE YOUR: _______
Please furnish the following on the terms and conditions specified on both sides of this order and on the attached sheet, if any, including delivery as indicated.
b. DELIVERY ORDER -- Except for billing instructions on the reverse, this delivery order is subject to instructions contained on this side only of this form and is issued subject to the terms and conditions of the above-numbered contract.
b. COMPANY NAME
ALB - STAR
c. STREET ADDRESS
SHESHI ITALIA, ARENA CENTER SEKSIONI D, KATI 5
d. CITY
TIRANA
e. STATE
f. ZIP CODE
10. REQUISITIONING OFFICE
AMERICAN EMBASSY TIRANA
ATTN: MAIN/FM
9.ACCOUNTING AND APPROPRIATION DATA
See line item detail. $48,273.61USD
Funds Certification Officer Signature:
11. BUSINESS CLASSIFICATION (Check appropriate box(es)) 12. F.O.B. POINT Destination
a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED
d. WOMEN-OWNED e. HUBZone f. SERVICE-DISABLED VETERAN-OWNED
g. WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER
THE WOMEN-OWNED SMALL BUSINESS PROGRAM
h. EDWOSB
13. PLACE OF 14. GOVERNMENT B/L NO.
15. DELIVER TO F.O.B. POINT ON OR BEFORE (Date) See line item detail.
16. DISCOUNT TERMS
a. INSPECTION
b. ACCEPTANCE
17. SCHEDULE (See reverse for Rejections)
ITEM NO.
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT PRICE
(e)
AMOUNT
(f)
QUANTITY ACCEPTED
(g)
SEE LINE ITEM DETAIL
SEE BILLING
INSTRUCTIONS ON
REVERSE
18. SHIPPING POINT 19. GROSS SHIPPING
WEIGHT
20. INVOICE NO. 17(h) TOT.
(Cont. pages)
21. MAIL INVOICE TO:
a. NAME
AMERICAN EMBASSY TIRANA
b. STREET ADDRESS (or P.O. Box)
RRUGA STAVRO VINJAU, NO. 14
ATTN: FMC
4,476,412.21ALL
17(i)
(GRAND TOTAL)
c. CITY
TIRANA
d. STATE e. ZIP CODE
22. UNITED STATES OF AMERICA BY (Signature)
13 May 2024
23. NAME Typed John M Langer
TITLE: CONTRACTING/ORDERING OFFICER
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
OPTIONAL FORM 347 (REV. 9/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
Page: 1 of 2
ORDER FOR SUPPLIES OR SERVICES
SCHEDULE - CONTINUATION
PAGE NO.
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
DATE OF ORDER
13 May 2024
TITLE
FAC- Underground Fuel Line at Embassy Compound.7901
RSTR.
CONTRACT NO.
ORDER NO.
ITEM NO.
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT PRICE
(e)
AMOUNT
(f)
QUANTITY
ACCEPTED
(g)
0001 Install a new Underground Fuel Line at Embassy Compound Works will include labor and materials as per BOQ in accordance with section B Performance Work Statement.
Total service price = ALL 4,141,742.17 (VAT included)
Tax: 690,290.36ALL
Delivery Date: 30 Jun 2024
Fiscal Data:
3451451.81ALL 1900-2024--19___X0535000C-2202-OBO-
-7901-19AL6024P0283-2510-XJZMRSTR---------
690290.36ALL 1900-2024--19___X0535000C-2202-OBO-
-7901-19AL6024P0283-4161-XJZMRSTR--------- (Tax)
1.00 each 3,451,451.81ALL 3,451,451.81ALL
0002 DBA = USD 3500.
Exchange rate 1 USD = 95.62 ALL DBA price in ALL 334,670.00
Tax: 55,778.34ALL
Delivery Date: 31 Aug 2024
Fiscal Data:
278891.70ALL 1900-2024--19___X0535000C-2202-OBO-
-7901-19AL6024P0283-2510-XJZMRSTR---------
55778.34ALL 1900-2024--19___X0535000C-2202-OBO-
-7901-19AL6024P0283-4161-XJZMRSTR--------- (Tax)
1.00 each 278,891.70ALL 278,891.70ALL
Order Comments:
Billing Instructions: The invoice should be delivered and addressed to the Finance Management Office. It must be emailed to TiranaVoucherExaminers@state.gov AND delivered at the Embassy's Main Entrance or mailed at the following address: US Embassy RR. Stavro Vinjau, NO.14, Tirana Please make sure to insert the Purchase Order number and the Bank Details. Lack of this information might result in payment delays. For any issues regarding billing and/or payment, please contact the individuals named below. Entela Jegeni Elxhi Shijaku TiranaVoucherExaminers@state.gov Tel embassy switchboard – (355)-4224-7285/6/7/8
TOTAL
TAX TOTAL
GRAND TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17h)
3,730,343.51ALL
746,068.70ALL
4,476,412.21ALL
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
OPTIONAL
FORM 348
(REV.
9/2012)
Prescribed by
GSA - FAR (48
CFR) 53.213(f)
Page: 2 of 2
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