SF-33.doc

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Attached to
Health Insurance Services Federal contract opportunity
Solicitation number
19AM10-19-R-0001
Issued by
Department of State US Consulates and Embassies

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SF-33

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SS-Insurance.doc DOC document

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Text version

SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING
PAGE OF PAGES

1 | 60

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

19AM10-19-R-0001

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

March 13, 2019

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE

8. ADDRESS OFFER TO (If other than item 7)

GSO

American Embassy Yerevan 1 American Ave.

Yerevan, Armenia 0082 Phone: (37410) 46-47-00 Fax: (37410) 46-47-42

NOTE: In sealed bid solicitation "offer" and "offeror” mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original and 2 copies for furnishing the supplies or services in the Schedule will be received at the place specificed, in the depository located in (see Block 7), until 17:00 local time April 15, 2019.

(hour)

(date)

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1. All offers are subject to all tems and conditions contained in this solicitation.

10. FOR INFORMATION

CALL:

A. NAME

Dana O. Al-Ebrahim

B. TELEPHONE (NO COLLECT CALLS)

(37410) 49-46-54

C. E-MAIL ADDRESS

Al-EbrahimDO@state.gov

11. TABLE OF CONTENTS

(x)
SEC.
DESCRIPTION
PAGE(S)
(x)
SEC.
DESCRIPTION
PAGE(S)
PART I - THE SCHEDULE
PART II - CONTRACT CLAUSES
X
A
SOLICITATION/CONTRACT FORM
X
I
CONTRACT CLAUSES
X
B
SUPPLIES OR SERVICE AND PRICES/COSTS

PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X
C
DESCRIPTION/SPECS/WORK STATEMENT
X
J
LIST OF ATTACHMENTS
X
D
PACKAGING AND MARKETING

PART IV - REPRESENTATIONS AND INSTRUCTIONS

X
E
INSPECTION AND ACCEPTANCE
X
K
REPRESENTATIONS, CERTIFICATIONS, AND
X
F
DELIVERIES OR PERFORMANCE

OTHER STATEMENTS OF OFFERORS

X
G
CONTRACT ADMINISTRATION
X
L
INSTRS., COND., AND NOTICES TO OFFERORS
X
H
SPECIAL CONTRACT REQUIREMENTS
X
M
EVALUATION FACTORS FOR AWARD

OFFER (Must be fully completed by offeror)

NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (120 calendar days unless a different period is inseted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

SEE 14

(See section I, Clause No 52.232-8)

10 CALENDAR DAYS

20 CALENDAR DAYS

30 CALENDAR DAYS

CALENDAR DAYS

14. ACKNOWLEDGMENT OF AMENDMENTS
AMENDMENT NO.
DATE
AMENDMENT NO.
DATE

(The offeror acknowledges receipt of amendments to the solicitation and related documents ) numbered and dated:

15A.

NAME

CODE

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE ADDRESS [ ]

IS DIFFERENT FROM ABOVE - ENTER

SUCH ADDRESS

17. SIGNATURE
18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

20. AMOUNT
21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7) CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD DATE

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

NSN 7540-01-152-8064

STANDARD FORM 33 (REV 9-97)

PREVIOUS EDITION NOT USABLE

Prescribed by GSA

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