2.3C Central OSP.pdf

OFFER SUBMISSION PACKAGE (OSP)

INTO-PLANE / PURCHASE PROGRAM

2.3 C CENTRAL (DOMESTIC)

SOLICITATION SPE607-24-R-0200

PERIOD OF PERFORMANCE: 1 OCT 2024 THROUGH 30 SEP 2028

CLOSING DATE AND TIME: July 15, 2024 @ 1:00 PM FORT BELVOIR, VA- EASTERN STANDARD TIME (EST). Late Offers: Any offers received after July 15, 2024 @ 3:00 PM will be considered “LATE” and may be excluded from the competition. Submit your offers well ahead of the closing date and time.

OSP CHECKLIST

1) STANDARD FORM 1449: Signature and date in ink or digitally in Blocks 30a, b and c. include your company name, address, telephone, and fax, “DUNS” and “CAGE code” number in Block 17a.

2) OFFEROR PRICE BREAKDOWN SHEET: For each item number/ICAO code. Sign and date in ink or digital signature.

3) CERTIFICATE OF ANALYSIS OR CERTIFICATE OF QUALITY: Offerors shall submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) from each supplier verifying that the fuel delivered meets Government’s specifications for each fuel type in Solicitation (C16.08-3 for Jet A).

4) COMMITMENT LETTER (Reference template letter attached to solicitation)

5) SAM ACCOUNT: Completed or updated by Solicitation closing date: http://beta.sam.gov/

By submitting your OSP, you agree to the terms and conditions of the entire Solicitation, and any Amendments, unless clearly stated herein.

http://beta.sam.gov/

INSTRUCTIONS: CLOSING DATE AND TIME: July 15, 2024 @ 1:00 PM FORT BELVOIR, VA- EASTERN STANDARD TIME (EST). Late Offers: Any offers received after July 15, 2024 @ 3:00 PM will be considered “LATE” and may be excluded from the competition. Submit your offers well ahead of the closing date and time.

1. Only one CAGE code may be listed on an OSP. Offerors with more than one CAGE code MUST complete a separate OSP and Offer Price Breakdown Sheet for each company’s CAGE Code for every location that is offered on. DLA Energy will not accept an OSP with multiple CAGE Codes.

2. Pursuant to FAR 52.212-1(g), the Government has reserved the right to make award without discussions. However, the Government reserves the right to conduct discussions if later determined by the Contracting Officer to be necessary. The Government may reject any or all offers if such action is in the public interest; accept other than the lowest offer; and waive informalities and minor irregularities in offers received. All Offer Submission Packages must be factual, accurate, and complete. Failure to provide all information and documents required under the solicitation may render a proposal technically unacceptable and preclude further.

NOTE:

X Standard Form 1449 (SF1449) - Sign and date in ink or digitally in Blocks 30a, b and c. Include your company name, address, telephone, and fax, DUNS and CAGE numbers in Block 17a.

X Offer Price Breakdown Sheet must be expressed in U.S. Dollars per gallon and to the 6th decimal (Example: $0.000000) place for the Product being solicited. (Jet A without FSII and Jet A with FSII.)

3. Offerors MUST update and complete registration in the System for Award Management (SAM) database by the solicitation closing date. The Website to obtain details and instructions is: https://sam.gov/SAM/

4. Evaluation Criteria: Proposals will be evaluated based on a lowest price technically acceptable (LPTA) source selection process. DLA Energy will make award(s) to the technically acceptable proposal with the lowest evaluated price for the requirements as solicited for the particular airport.

5. Offerors must provide a Supplier Invoice with the Price Paid for fuel or government posting per location effective on the BASE REFERENCE DATE of 19 March 2024. (Invoice Date: 19 March 2024 – 26 March 2024)

6. Offerors SHALL submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) from each Supplier verifying that the fuel delivered meets C16.08-3 TURBINE FUEL, AVIATION (JET A) (INTOPLANE) (DLA ENERGY AUG 2018) standards. Offeror(s) must annotate each item number/ICAO code on the COAs and COQs.

Offerors who are not the Refueler or Fixed- Based Operator are also required to submit a Commitment Letter from the FBO with its initial proposal. COA and COQ must be in English. Reference sample Commitment Letter in the attachments. FAILURE to submit a COA or COQ and a Commitment Letter from a FBO with the initial proposal may result in the proposal being excluded from the competition.

7. All proposals must be received before 1:00 p.m. Eastern Standard Time (EST), July 15, 2024. Any proposals received after 3:00 p.m. EST, July 15, 2024, will be considered “late.” Offerors assume all risk for any delay in the transmission of their proposals. Refer to FAR 52.212-2(f). Faxed proposals are not authorized. Please e-mail your proposal to:DLA-Energy-PH.Requirements@dla.mil. Please ensure that your proposal (SF1449) is signed per FAR 52.212-1. Late proposals will be processed in accordance with FAR 15.208 – Submission, Modification, Revision, and Withdrawal of Proposals. When submitting a proposal via e-mail, please ensure it is sent within enough time in order for it to be processed through the server. The maximum file size per email is 10 MB (IAW L2.11-4).

8. Exceptions to the specifications, terms, and conditions of this solicitation may be considered pursuant to the Provision M72 EVALUATION OF OFFERS (EXCEPTIONS/DEVIATIONS) (DLA ENERGY APR 1997). Indicate any exceptions and the extent to which your offer differs from the solicitation requirements on company letter signed by an authorized representative of the company attached with your offer.

mailto:DLA-Energy-PH.Requirements@dla.mil

9. Offerors must agree to honor prices their proposal for 180 calendar days from the closing date of this solicitation. The successful Offeror’s proposal in response to the solicitation may be incorporated into the resultant contract in whole or in part at the time of award.

10. The Platts publication is the only price escalator publication for this solicitation. DLA Energy will not grant exemptions to use any other published price escalator. All Offerors shall use the Platts publication escalators listed in the line item descriptions under section B of the Schedule of Supplies attachment.

11. Offerors must fully disclose and identify all contractor team arrangement relationships including proposed partnerships or joint ventures as defined by FAR 9.601 with its proposal before the solicitation close date. For example, Offerors should fully disclose and identify that a teaming arrangement with a third party Refueler at a fixed-based operator exists, and whether it is a Partnership, Joint Venture and/or Prime/Sub relationship. Offerors with such a contractor team arrangement shall specify the arrangement in the commitment letter. The Government will determine the responsibility of any potential partner/subcontractor identified by the Offeror in its contractor teaming arrangement in accordance with FAR subpart 9.1.

12. Primary Solicitation Point of Contact: For clarification, explanation, and additional information, please contact Alberto Williams at 571-346-0151; email alberto.williams@dla.mil or Jamika Forde at 571-767-6959; email:

jamika.forde@dla.mil mailto:alberto.williams@dla.mil mailto:jamika.forde@dla.mil

Offerors, who submit an offer under Solicitation SPE607-24-R-0200 with any Amendments, for all locations, must complete all Certifications and Representations below. Full text for all Certifications and Representations are found in Solicitation clauses for SPE607-24-R-0200. Those Certifications and Representations available in SAM should be completed in SAM; those not available in SAM should be completed below.

FAR CLAUSES, DFAR CLAUSES AND DLA ENERGY CONTRACT TEXTS:

1. B15.01, SUPPLIES AND ESTIMATED QUANTITIES TO BE FURNISHED (INTO-PLANE) (DLA ENERGY (DEC 2018)

2. FAR 52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

3. FAR 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE

CERTAIN FEDERAL TRANSACTIONS (SEP 2007)

4. FAR 52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE CERTAININTERNAL

CONFIDENTIALITY AGREEMENTS OR STATEMENTS—REPRESENTATION (JAN 2017)

5. FAR 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (JUL 2016)

6. FAR 52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JULY 2016)

7. FAR 52.204-20 PREDECESSOR OF OFFEROR (JULY 2016)

8. FAR 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS-

REPRESENTATION (NOV 2015)

9. FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (OCT 2015)

10. FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

11. FAR 52.209-11 REPRESENTATION BY CPRPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A

FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

12. FAR 52.212-3 OFFEROR REPRESENTATIONS AND CORPORATIONS COMMERCIAL ITEMS (OCT 2018)

13. FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

14. FAR 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE PLAN (MAR 2015)

15. DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN GOVERNMENT (JUN 2010)

16. DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

17. DFARS 252.247-7022 REPRESENTATION OF EXTENT OF TRANSPORTATION BY SEA (AUG 1992)

18. DFARS 252.225-7966 PROHIBITION REGARDING RUSSIAN FOSSIL FUEL BUSINESS OPERATIONS—REPRESENTATION (Deviation 2024-O0006) (FEB 2024)

19. DFARS 252.225-7967 PROHIBITION REGARDING RUSSIAN FOSSIL FUEL OPERATIONS (DEVIATION 2024-O0006)

(FEB 2024)

20. K-0001 K15 RELEASE OF UNIT PRICES (DLA ENERGY MAR 2009)

21. K-0002 K33.01 AUTHORIZE NEGOTIATORS (DLA ENERGY APR 2007)

22. K-0004 K150 WIDE AREA WORKFLOW (DLA ENERGY MAY 2014)

The Offeror has completed the Certifications and Representations 1 through 22 above for the Solicitation SPE607-24-R-0200.

Print Name of Authorized Official:

Signature of Authorized Official: _ Date:

I. NOTES/EXCEPTIONS.

SECTION B: SUPPLIES OR SERVICES AND PRICE/COST

1. EMERGENCIES. In the event of an emergency during nonduty hours (nights, weekends, and holidays), please contact the Command Control Center at (571) 767-8420.

(a) All market prices must be stated in U.S. dollars per U.S. gallon in accordance with the CONVERSION FACTORS.

(b) TABLE.

Sub

Item No.

Reference Price &

Name of Publication Location Published and

Name of Product Method of Delivery Applicable Reference Price is Applicable

Market Price as of 19 March 2024 to Market

Price (Excluded All Taxes)

NOTE: Prices posted to the DLA Energy webpage, also known as Prices to Web, pursuant to paragraph (c) of clause B19.35 represent the Government’s calculation of the price adjustment under that clause. The Government does not warrant the accuracy of this calculation. The contractor has a duty to independently verify the calculation of the price adjustment prior to submitting an invoice. The contractor shall notify the contracting officer of any discrepancy in the calculation of the price adjustment for resolution prior to submitting an invoice. The contractor shall be liable to the Government for any administrative fee charged by the AIR Card® contractor to reprocess a transaction to correct any overpayment or underpayment resulting from the contractor’s failure to verify the calculation of the price adjustment prior to invoicing.

FAR 52.209-2 – PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS-REPRESENTATION (NOV 2015)

(a) Representation. The Offeror represents that—

(1) It [ ] is, [ ] is not an inverted domestic corporation; and

(2) It [ ] is, [ ] is not a subsidiary of an inverted domestic corporation.

(End of provision)

FAR 52.209-5 – CERTIFICATION REGARDING RESPONSIBILITY MATTERS (OCT 2015)

(a)

(1) The Offeror certifies, to the best of its knowledge and belief, that --

(i) The Offeror and/or any of its Principals --

(A) Are [_] are not [_] presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any Federal agency;

(B) Have [_] have not [_], within a three-year period preceding this offer, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) contract or subcontract; violation of Federal or State antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violating Federal criminal tax laws, or receiving stolen property (if Offeror checks “have”, the Offeror shall also see 52.209-7, if included in this solicitation); and

(C) Are [_] are not [_] presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph (a)(1)(i)(B) of this provision; and

(D) Have [_], have not [_], within a three-year period preceding this offer, been notified of any delinquent Federal taxes in an amount that exceeds $3,500 for which the liability remains unsatisfied.

(1) Federal taxes are considered delinquent if both of the following criteria apply:

(ii) The Offeror has [_] has not [_], within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal agency.

(End of Provision)

FAR 52.209-7 – INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

(b) The Offeror [_] has [_] does not have current active Federal contracts and grants with total value greater than $10,000,000.

(End of provision)

DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

(c) Certification and identification of country of origin.

(1) For all line items subject to the Trade Agreements—Basic clause of this solicitation, the Offeror certifies that each end product to be delivered under this contract, except those listed in paragraph (c)(2) of this provision, is a U.S.-made, qualifying country, or designated country end product.

(2) The following supplies are other non-designated country end products:

FAR 52.209-11 – REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A FELONY

CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(b) The Offeror represents that—

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN GOVERNMENT (JUN 2010)

Offeror’s Point of Contact for Questions about Disclosure (Name and Phone Number with Country Code, City Code and Area Code, as applicable) Name and Address of Offeror

Name and Address of Entity Controlled by a Foreign Government

Description of Interest, Ownership Percentage, and Identification of Foreign Government

(End of provision)

252.225-7966 PROHIBITION REGARDING RUSSIAN FOSSIL FUEL BUSINESS OPERATIONS—REPRESENTATION (Deviation

2024-O0006) (FEB 2024)

(a) Definitions. The terms business operations and fossil fuel company have the meanings given in the 252.225-7067 clause of this solicitation.

(b) Representation. By submission of an offer, the Offeror represents it is not, or that it does not knowingly have fossil fuel business operations with an entity or individual that is, 50 percent or more owned, individually or collectively, by—

(1) An authority of the government of the Russian Federation; or

(2) A fossil fuel company that operates in the Russian Federation, except if the fossil fuel company transports oil or gas—

(i) Through the Russian Federation for sale outside of the Russian Federation; and

(ii) That was extracted from a country other than the Russian Federation with respect to the energy sector of which the President has not imposed sanctions as of the date on which the contract is awarded.

(End of provision)

252.225-7967 PROHIBITION REGARDING RUSSIAN FOSSIL FUEL OPERATIONS (DEVIATION 2024-O0006) (FEB 2024)

(a) Definitions. As used in this clause— “Business operations” means knowingly engaging in commerce in any form, including acquiring, developing, maintaining, owning, selling, possessing, leasing, or operating equipment, facilities, personnel, products, services, personal property, real property, or any other known apparatus of business or commerce. The term does not include—

(1) Any shipment subject to price caps as specified in the—

(i) “Statement of the G7 and Australia on a Price Cap for Seaborne Russian-Origin Crude Oil”, issued on December 2, 2022, between member countries of that coalition; or

(ii) “Statement of the G7 and Australia on Price Caps for Seaborne Russian-Origin Petroleum Products Berlin, Brussels, Canberra, London, Ottawa, Paris, Rome, Tokyo, Washington”, issued on February 4, 2023, between such members, if such shipment complies with the applicable price caps; or

(A) Actions taken for the benefit of the country of Ukraine, as determined by the Secretary; or

(B) Actions taken to support the suspension or termination of business operations for commercial activities during the period beginning on the effective date and ending on December 31, 2029, including—

(1) Any action to secure or divest from facilities, property, or equipment;

(2) The provision of products or services provided to reduce or eliminate operations in territory internationally recognized as the Russian Federation or to comply with sanctions relating to the Russian Federation; and;

(3) Activities that are incident to liquidating, dissolving, or winding down a subsidiary or legal entity in Russia.

Fossil fuel company means an entity or individual that—

(1) Carries out oil, gas, or coal exploration, development, or production activities;

(2) Processes or refines oil, gas, or coal; or

(3) Transports, or constructs facilities for the transportation of, Russian oil, gas, or coal.

(b) Prohibition. In accordance with section 804 of the National Defense Authorization Act for Fiscal Year 2024 (Pub. L. 118-31), the Contractor is prohibited from entering into a subcontract or other contractual instrument for the procurement of products or services with any entity or individual that is known to be, or that is known to have fossil fuel business operations with an entity or individual that is, not less than 50 percent owned, individually or collectively, by—

(1) An authority of the government of the Russian Federation; or

(2) A fossil fuel company that operates in the Russian Federation, except if the fossil fuel company transports oil or gas—

(i) Through the Russian Federation for sale outside of the Russian Federation; and energy sector of which the President has not imposed sanctions as of the date on which the contract is awarded.

(c) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (c), in all subcontracts and other contractual instruments, including those for the acquisition of commercial products or commercial services.

(End of clause)

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

7002786970

2. CONTRACT NO.

7. FOR SOLICITATION

INFORMATION CALL:

3. AWARD/EFFECTIVE

DATE

a. NAME

Alberto Williams WNB

4. ORDER NUMBER 5. SOLICITATION NUMBER

SPE607-24-R-0200

b. TELEPHONE NUMBER (No Collect calls)

Phone: DSN392-767-6959

6. SOLICITATION ISSUE

DATE

2024 JUNE 13

8. OFFER DUE DATE/

LOCAL TIME

2024 JUL 15

01:00PM

9. ISSUED BY CODE SPE607 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

DLA ENERGY

INTOPLANE

8725 JOHN J. KINGMAN ROAD

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

FORT BELVOIR VA 22060

USA SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

EDWOSB

8 (A)

NAICS: 324110

SIZE STANDARD:

11. DELIVERYFOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

15. DELIVER TO

12. DISCOUNT TERMS

CODE

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

16. ADMINISTERED BY

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

CODE

17a. CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE

18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

OFFER BELOW IS CHECKED SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE

ARE NOT ATTACHED

ARE NOT ATTACHED

AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE STANDARD FORM 1449 (REV. 2/2012)

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 CONTRACTING OFFICER (Type or Print) 31c. DATE SIGNED

Prescribed by GSA - FAR (48 CFR) 53.212

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

36. PAYMENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL FINAL

38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print) 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

OFFER PRICE BREAKDOWN SHEET (Domestic version) Jet A w/o FSII and Jet A w/FSII

AIRPORT NAME AND ICAO CODE:

(Identify the airport and its ICAO code found in the solicitation schedule)

VENDOR CAGE CODE: LARGE OR SMALL BUSINESS:

CLIN NUMBER: STATE/ COUNTRY:

EST QUANTITY GALLONS:

IF THE INCUMBENT, STATE YOUR CONTRACT NUMBER #:

REFERENCE DATE: 19 MARCH 2024

MARKET PRICE (PLATTS/OPIS) FOR THE ABOVE REFERENCE DATE:

STATE/LOCAL TAXES & FEES - Specify tax/fee types and the amount per Contract Provisions I28.02-2 and M57:

$ b.1

$ b.2

$ b.3

$ b.4

TOTAL STATE/LOCAL TAXES & FEES (Must equal b.1 through b.4):

INTO-PLANE FEE (Differential & additional fees, inclusive of fees for all modes of delivery: into-plane, truck, rapid refuel)

JET A TOTAL UNIT PRICE: (Sum of A thru C)

FSII PRICE: (If none, state “None.”)

JET A WITH FSII TOTAL UNIT PRICE: (Sum of D and E)

PUBLICATION/REFERENCE SELECTED FOR MARKET PRICE ADJUSTMENT

PLATTS: __________________________________________________________________________

OPIS: __________________________________________________________________________

OTHER: __________________________________________________________________________

Prices will change on [ ] Monday [ ] Tuesday [ ] Weekly [ ] Monthly [ ] Other_____________

($ USD Currency)

$ A.

$ B.

$ C.

$ D.

$ E.

$ F.

Refinery/

** NOTE Call Out Fees and hours are not evaluated items; however, in the event that 24-hour service is not available and the Government is unable to provide advance notification of after-hour delivery requirements, into-plane fuel may be procured from another source.

Per Hour or Per Occurrence (Included)

Hours of Operations [ ] 24 hours per day, 7 days per week (preferred) OR [ ] Other (Specify hours/call-out, and phone number for call-outs):

Circle One

Call-Out/Overtime Fee and Advance Notice: Holidays Included: YES or NO

Are you the REFUELER for this offer under this location? (Please check one)

**** (Commitment letter must match the name and Address of the Refueler/FBO information below. COA or COQ must be in English)

Refueler (FBO) Point of Contact Name:

Full Physical Address (Country & State)

Person at Facility Phone Number:

Source Name:

Physical Address:

Phone Number:

K-0002 - K33.01 Authorized Negotiators (Reference: DLA Energy APR 2007)

Name & Title: Email &Phone:

Name & Title: Email & Phone:

YES NO