18R0066_-_pages_1-2.pdf
PDF 105 KB Posted
- Attached to
- Health Insurance for Locally Engaged Staff, Baku
- Solicitation number
- 19GE5018R0066
About this file
missing pages 1 and 2 of solicitation
View the file
Other files
| File | Type | Posted |
|---|---|---|
| updated_Employee_Statistic_with_gender.xlsx | XLSX spreadsheet | |
| 19GE5018R0066_A0002p1.pdf | ||
| 19GE5018R0066_A0001.pdf | ||
| Exhibit_A_-_Employee_Statisitic_18R0066.xlsx | XLSX spreadsheet | |
| 19GE5018R0066.pdf | ||
| 19GE5018R0066_-_Exhibits_and_Attachments.zip | ZIP file |
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Text version
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER
5. SOLICITATION NUMBER
19GE5018R0066
2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER 6. SOLICITATION ISSUE
DATE
07/23/2018
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME Wencke Jacobsen
b. TELEPHONE NUMBER (No collect calls)
c. EMAIL jacobsenw@state.gov
8. OFFER DUE DATE / LOCAL
TIME
CODE FRANK
AMERICAN CONSULATE GENERAL FRANKFURT
GIESSENER STRASSE 30
ATTN: RPSO
FRANKFURT, 60435
GERMANY
9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR
SMALL BUSINESS
HUBZONE SMALL
BUSINESS
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM
EDWOSB
8(A)
NAICS:
SIZE STANDARD:
10. THE ACQUISITION IS
SEE
SCHEDULE
11. DELIVERY FOR FOB DESTINATION
UNLESS BLOCK IS MARKED
12. DISCOUNT TERMS
13a. THIS CONTRACT IS
RATED ORDER UNDER DPAS
13b. RATING
RFQ IFB X RFP
14. METHOD OF SOLICITATION
BAKU_CODE15. DELIVER TO
AMERICAN EMBASSY BAKU
111 AZADLIG AVENUE
ATTN: HR
BAKU, 1007
AZERBAIJAN
CODE FRANK16. ADMINISTERED BY
AMERICAN CONSULATE GENERAL FRANKFURT
GIESSENER STRASSE 30
ATTN: RPSO
FRANKFURT, 60435
GERMANY
FACILITY
CODE
CODE
Contact Duns Telephone No.
17a. CONTRACTOR/OFFEROR BAKU_CODE18a. PAYMENT WILL BE MADE BY
AMERICAN EMBASSY BAKU
BAKUDBO@STATE.GOV
ATTN: BAKUDBO@STATE.GOV
BAKU, 1007
AZERBAIJAN
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN
OFFER SEE ADDENDUM
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS
CHECKED
19. ITEM NO. 20. SCHEDULE OF SUPPLIES/SERVICES
(Use Reverse and/or Attach Additional Sheets as Necessary)
21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT
See Line Items Section
25. ACCOUNTING AND APPROPRIATION DATA
See Line Item Detail
26. TOTAL AWARD AMOUNT (For Govt. Use Only)
X 27a. SOLICITATION INCORPORATES BY REFERENCES FAR 52.212-1, 52.212-4, FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA X ARE ARE NOT ATTACHED
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4, 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO
ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH
OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE
TERMS AND CONDITIONS SPECIFIED.
29. AWARD OF CONTRACT: REF. OFFER DATED . YOUR OFFER ON
SOLICITATION (BLOCK 5) INCLUDING ANY ADDITIONS OR CHANGES WHICH
ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:
30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)
30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT)
Fabiola A. Bellevue 31c. DATE SIGNED 07/23/2018
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 02/2012)
Prescribed by GSA - FAR (48 CFR) 53.212
19GE5018R0066
001 BASE YEAR - HEALTH INSURANCE FOR LOCALLY
EMPLOYED STAFF
This CLIN is inclusive of the following Sub CLINs:
1.00 LT
0001A Single Employees (Self Only) 0001B Family Plan 0001C Retirees Doc Ref No:
Delivery Date FOB:
101 OPTION YEAR ONE - HEALTH INSURANCE FOR
LOCALLY EMPLOYED STAFF
This CLIN is inclusive of the following Sub CLINs:
1.00 LT
1001A Single Employees (Self Only) 1001B Family Plan 1001C Retirees Doc Ref No:
Delivery Date FOB:
201 OPTION YEAR TWO - HEALTH INSURANCE FOR
LOCALLY EMPLOYED STAFF
This CLIN is inclusive of the following Sub CLINs:
1.00 LT
2001A Single Employees (Self Only) 2001B Family Plan 2001C Retirees Doc Ref No:
Delivery Date FOB:
301 OPTION YEAR THREE - HEALTH INSURANCE FOR
LOCALLY EMPLOYED STAFF
This CLIN is inclusive of the following Sub CLINs:
1.00 LT
3001A Single Employees (Self Only) 3001B Family Plan 3001C Retirees Doc Ref No:
Delivery Date FOB:
401 OPTION YEAR FOUR - HEALTH INSURANCE FOR
LOCALLY EMPLOYED STAFF
This CLIN is inclusive of the following Sub CLINs:
1.00 LT
4001A Single Employees (Self Only) 4001B Family Plan 4001C Retirees Doc Ref No:
Delivery Date FOB:
19GE5018R0066
Line Item Summary
Solicitation Number:
19GE5018R0066
Contract Number: Title: AJ-BAKU HEALTH
INSURANCE
Date of Solicitation:
07/23/2018
Line Item No. Description Quantity Unit Unit Price Total Cost
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