47PJ0019Q0081_Generated_PDF_with_TOC.pdf

Table Of Contents

Section Description Page Number Section A Solicitation Form 1 Section B Schedule 2

FOR

GOVERNMENT

USE

ONLY

5. ACCOUNTING AND APPROPRIATION DATA

FUND FUNCTION CODE B/A CODE CC-A

CC-B PROJ./PROS NO. O/C CODE ORG. CODE

7. TYPE OF ORDER

C/E CODE FY REGION

W/ITEM PRT./CRFT

Please furnish the following on the terms and conditions specified on the order and the attached sheets, if any, including delivery as indicated.

B.

This delivery order is issued subject to the terms and conditions of the above numbered contract.

C.

This task order is issued subject to the terms and conditions of the above numbered contract.

26A. UNITED STATES OF AMERICA (NAME OF CONTRACTING/ORDERING OFFICER)

25B. SIGNATURE

25A. NAME AND TITLE OF OFFEROR/CONTRACTOR

26B. SIGNATURE

21. MAIL INVOICE TO: (Electronic Invoice Preferred)

GENERAL SERVICES ADMINISTRATION

GENERAL SERVICES ADMINISTRATION GSA 300 (REV. 5/2010)

ORDER FOR SUPPLIES AND SERVICES

REQUISITION/REFERENCE NUMBER PAGE OF

A.

PAGES

1. DATE OF ORDER 2. ORDER NUMBER 3. CONTRACT NUMBER 4. PDN NUMBER

ITEM NUMBER

(A)

SUPPLIES OR SERVICES

(B)

QUANTITY

ORDERED

(C)

UNIT

(D)

UNIT PRICE

(E)

AMOUNT

(F)

6. TO: CONTRACTOR (Name, address and zip code)

D. MODIFICATION NUMBER AUTHORITY FOR ISSUING

8A. Data Universal Numbering System (DUNS) Number 8B. Taxpayer Identification Number (TIN)

Except as provided herein, all terms and conditions of the original order, as heretofore mentioned, remain unchanged.

9A. BUSINESS CLASSIFICATION

9B. START DATE:

9C. COMPLETION DATE:

13. PLACE OF INSPECTION AND ACCEPTANCE 14. REQUISITION OFFICE (Name, Symbol and Telephone Number)

15. F.O.B. POINT 16. GOVERNMENT B/L NUMBER 17. DELIVERY F.O.B. POINT 18. PAYMENT/DISCOUNT TERMS

19. SCHEDULE

20. RECEIVING OFFICE (Name, Symbol and Telephone Number)

23. SHIPPING POINT

22. GROSS SHIP WEIGHT

TOTAL

FROM

300-A(s)

GRAND

TOTAL

24A. FOR INQUIRIES REGARDING PAYMENT CONTACT: 24B. TELEPHONE NUMBER

25C. DATE SIGNED 26C. DATE SIGNED

11. REMITTANCE ADDRESS (MANDATORY) 12. SHIP TO (Consignee Address, Zip Code and Telephone Number)10. ISSUING OFFICE (Address, Zip Code, and Telephone Number)

PURCHASE

DELIVERY (For Supplies)

TASK ORDER (For Services)

b. OTHER THAN SMALLa. SMALL c. SMALL DISADVANTAGED

d. WOMAN-OWNED e. HUBZone f. EMERGING SMALL

h. SERVICE DISABLED VETERANg. VETERAN felipe.jolles@gsa.gov

Felipe Jolles

GSA PBS Acquisition Division 8PQ 1 Denver Federal Center PO Box 25546, Building 41 Denver, CO 80225-0546 USA

(312) 886-6932

GSA PBS CLIENT SOLUTIONS DIVISION 8PA 1 DENVER FEDERAL CENTER PO BOX 25546, BUILDING 41 DENVER, CO 80225-0546 USA

See below for additional information

1EQ8PA-19-0014

703 Main Street Rapid City , SD 57701

Section A Page 1

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

GSA 300-A (REV. 5/2010)

ORDER FOR SUPPLIES AND

SERVICES (Continuation)

THIS NUMBER MUST APPEAR ON ALL PACKAGES AND PAPERS

RELATING TO THIS ORDER

PAGE

OF

PAGESDATE ORDER NUMBERPDN NUMBER

GENERAL SERVICES ADMINISTRATION

PoP: 04/30/2019 - 10/01/2019

FPD, Rapid City Move

Relocation services for FPD from excess furniture removal as described in the attached scope origin to destination. This includes the supply of move of work. RWA: N1886757

LS

materials, physical move of employees, and any designated

Section B Page 2