693C7318Q000019.pdf

693C7318Q000019

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

02/13/2018 HFLECO180090PR

1 6

Eastern Federal Lands Highway Div.

Acquisitions Office 21400 Ridgetop Circle

Federal Highway Administration

Daniel L. Smith Sterling VA 20166-6511

02/06/2018

Federal Highway Administration

Eastern Federal Lands Highway Div.

1827 Jack Delozier Dr.

Sevierville

TN 37876

703 948-1413DANIEL SMITH

03/01/2018 1400 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

***THIS SOLICITATION IS PREPARED IN ACCORDANCE

WITH FEDERAL ACQUISITION REGULATION PART 13,

SIMPLIFIED ACQUISITION PROCEDURES. ***

THIS WILL BE A FIRM, FIXED PRICE CONTRACT.

AWARD WILL BE ON ALL-OR-NONE BASIS.

PROVIDE GOVERNMENT PRICING FOR THE FOLLOWING IN

ACCORDANCE WITH THE ATTACHED FEDERAL HIGHWAY

ADMINISTRATION STATEMENT OF WORK:

IT Related Pur: IT PURCHASE-NO

00001 Hamburg Wheel Tracking Device used for AASHTO T324

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 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

693C7318Q000019

00002 Load and Height Verification System

00003 LVDT Calibration Kit

00004 Installation and Training

***TRAVEL (AIRFARE, LODGING, MEALS, AND

MISCELLANEOUS EXPENSES) AS REQUIRED TO PERFORM

SERVICES AS DETAILED IN THE ATTACHED STATEMENT OF

WORK. AIRFARE SHALL BE ON A REIMBURSABLE BASIS

WITH MEALS AND LODGING NOT TO EXCEED THE MAXIMUM

ALLOWABLE PER DIEM RATE ESTABLISHED BY THE GSA

FEDERAL TRAVEL REGULATIONS (41 CFR 301-304) AT

TIME OF TRAVEL, FOR MCCALLA, ALABAMA. OTHER

MISCELLANEOUS EXPENSES SUCH AS CAB FARE OR RENTAL

CAR, AND AIRLINE TRAVEL MUST BE SUPPORTED WITH

RECEIPTS.***

00005 Shipping

PLEASE PROVIDE THE FOLLOWING INFORMATION WITH

YOUR QUOTATION:

DUN & BRADSTREET (DUNS) NUMBER:

FEDERAL TAX ID NUMBER:

ESTIMATED DELIVERY TIME:

IMPORTANT PAYMENT REQUIREMENT: IN ACCORDANCE

WITH FEDERAL ACQUISITION REGULATION (FAR) SUBPART

4.1102, PROSPECTIVE CONTRACTORS SHALL BE

REGISTERED IN THE SYSTEM FOR AWARD MANAGEMENT

(SAM) DATABASE PRIOR TO AWARD OF A CONTRACT. FAR

CLAUSE 52.232-33 REQUIRES SAM REGISTRATION FOR

PAYMENT. IN ADDITION, WHEN SETTING UP VENDOR

INFORMATION IN THE SAM DATABASE, THE D&B LEGAL

NAME SHOULD BE THE SAME AS THE IRS CONSENT NAME.

SAM REGISTRATION IS AVAILABLE ONLINE AT

WWW.SAM.GOV.

RESPONSES TO REQUEST FOR QUOTATION WILL BE

ACCEPTED VIA FAX NUMBER 571-434-1551, EMAIL:

Daniel.Smith@dot.gov, OR MAIL TO THE ADDRESS IN

BLOCK NO. 9, AND MUST BE RECEIVED BY 2:00 PM,

EST, Thursday, March 1, 2018.

***PLEASE NOTE: QUESTION SUBMISSION: INTERESTED

OFFERORS MUST SUBMIT ANY QUESTIONS CONCERNING THE

SOLICITATION AT THE EARLIEST TIME POSSIBLE TO

Continued ...

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 6

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

693C7318Q000019

ENABLE THE BUYER TO RESPOND. QUESTIONS NOT

RECEIVED WITHIN A REASONABLE TIME PRIOR TO CLOSE

OF THE SOLICITATION MAY NOT BE CONSIDERED. ***

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