Sol_28321318Q00000411.pdf

LEVEL 1 = LOW RISK/ NON-SENSITIVE

28321318Q00000411

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

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 services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

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

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

06/05/2018 0456-18-1005

1 19

Office of Acquisition and Grants 1540 Robert M. Ball Building 6401 Security Blvd

Social Security Administration

Baltimore MD 21235

120 Days After Notice to Proceed

Social Security Administration

Wilkes Barre Child Care Playground 1150 E Mountain Dr

Wilkes-Barre

PA 18702-7997

410 965-5750JEREMIAH QUIJOTE

06/22/2018 1300 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

See attached combined synopsis/solicitation for the removal and replacement of the resilient surfacing at the Wilkes-Barre Child Care Playground.

0001 Wilkes-Barre Child Care Playground Resilient Surfacing

* Please see Statement of Work

* Sample of selected granule color combination required

* Remove/replace poured-in-place resilient surfacing on play areas

* Skimming of resilient topcoat on exposed exterior shed pad surfaces Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 19

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

28321318Q00000411

* Final walkthrough required prior to final sign off

* Minimum 5-year warranty required

Period of Performance: 120 days after a Notice to

Proceed

Delivery: 120 Days After Notice to Proceed

Please refer to Request for Quote (RFQ) no.

28321318Q00000411 in the submission of your quotation. Contractors shall submit their quote via e-mail to Jeremiah.Quijote@ssa.gov by June

22, 2018 at 1:00 PM EST.

Attachments:

1. Statement of Work

2. Diagram of Wilkes-Barre Child Care Playground

3. Wage Determination (Pennsylvania Counties of

Lackawanna, Luzerne, Wyoming)

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)