22-R-1006 Price Submission Form - Attachment 004.pdf

M67854-22-R-1006 USMC Suspension System Components

Attachment 004 – Price Submission Form

004-1

Company Information

Company Name

Cage Code Tax Payer ID DUNS Code

Street Address

City

State Zip Code

Phone Number

Fax Number Website

Business Type ( e.g. Large, Small, 8(a), etc.) In Accordance With FAR 19.001, https://www.acquisition.gov/ )

Point of Contact Information

Point of Contact Name

Telephone Number Email Address https://www.acquisition.gov/

M67854-22-R-1006 USMC Suspension System Components

Attachment 004 – Price Submission Form

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Price:

CLIN Description Quantity Unit of Issue

Unit Price Total CLIN Price

0001 Hip Belt, Small, Coyote-498 (FAT) 4 Each $ $

0002 Shoulder Harness Assembly, Short, Coyote-498 (FAT) 4 Each $ $

0003 Hip Belt, Small, Coyote-498 48,049 max Each $ $

0004 Shoulder Harness Assembly, Short, Coyote-498 17,062 max Each $ $

TOTAL PRICE: $

The best value offer that conforms to the RFP may be selected for award. In order to be compliant and eligible for award, the Offeror must meet all solicitation requirements. No deviations will be accepted.

Discount Terms (NET 30 if unspecified):

FOB Destination Compliance (circle one):

YES NO (see FAR 52.247-34)

Carefully review all documents before signing Offeror’s Authorized Representative's Typed or Printed Name Position or Title

Offeror’s Authorized Representative's Signature Date