SF 18 Request for Quotations 9-30-2022.pdf

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

1. REQUEST NUMBER 12. DATE ISSUED

246-23-Q-0002 09/30/2022 5a. ISSUED BY

THIS RFQ [8j IS □ A Small Bus Or Indian owned SET-ASIDE PAGE OF 1 I

3. REQUISITION/PURCHASE REQUEST NUMBER 4. CERT. FOR NAT. DEF.

RATING

IHS1459401

UNDER BDSA REG. 2

AND/OR DMS REG. 1

6. DELIVER BY (Date)

Indian Health Svc-Oklahoma City Area, 701 Market Drive, Oklahoma City, OK 73114

5b. FOR INFORMATION CALL (NO COLLECT CALLS) 7. DELIVERY

PAGES

NAME

OTHER

TELEPHONE NUMBER □ FOB DESTINATION □ (See Schedule)

AREA CODE

I

NUMBER 9. DESTINATION

Jeffrey Earnest 405 951-37 40 a. NAME OF CONSIGNEE ____________________ ____..,___ ____ _.__ ________ ---t s. TO: Claremore Indian Hospital

a. NAME To Prospective Offerers

c. STREET ADDRESS

d. CITY l

b. COMPANY b. STREET ADDRESS

101 South Moore Ave

e. STATE I

f. ZIP CODE

C. l,II T

Claremore

d. STATE l e . .:.w ... uuic

OK 74017

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS (Date)

10/26/2022

IMPORTANT: This is a request for information and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NUMBER

(a)

SUPPLIES/SERVICES

(b)

Contractor shall repair or replace OR flooring in accordance with the statement of work at the

Claremore Indian Hospital.

Additional Provisions and Conditions

(9 pages; 2-10 are attached hereto)

Statement of Work (6 pages), Photos & drawings (14 pages) (attached).

Davis Bacon General Wage Decision OK20220052

Dated 09/02/2022 is hereby incorporated, 7 pages

(attached)

FAR Clause 52.213-4 attached

FAR Clause 52.204-7 applies

Official Site Visit information pages 10 & 11

QUANTITY

(C)

UNIT

(d)

1 JB

UNIT PRICE

(e)

AMOUNT

(f)

12. DISCOUNT FOR PROMPT PAYMENT ►

a 10 CAlENDAR DAYS (%) "20 CALENDAR DAYS(%) o 30 CALENDAR DAYS (%)

NU

�;:-EN

r

AGE

NOTE: Additional provisions and representations IXI are I I are not attached.

13. NAME AND ADDRESS OF QUOTER 14. SIGNATURE OF PERSON AUTHORIZED TO 15. DATE OF QUOTATION a

- . -NA_M_E_O _F_Q _U-OT_E_R- - - - - - ---------------l SIGN QUOTATION

b. STREET ADDRESS

---------- ---------------� a.NAME (Type or print)

c. COUNTY

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

I -·-· -· ·- • •• I '-'· , 11 Lo:: f I yµi, u, µ1mtJ

16. SIGNER

b. TELEPHONE

AREA CODE

i�uiv1tsi=.f<

STANDARD FORM 18 (REV. 6/1995)

Prescribed by GSA-FAR (48 CFR)53.215-1(a)