75H70521Q00001.pdf

75H70521Q00001

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

10/23/2020 See Schedule

1 49

2225 Cooperative Ct NW Bemidji MN 56601

Indian Health Service 12/01/2020

218 444-0482LEAH AZURE

11/09/2020 1400 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

Set-Aside: 100% Indian Economic Enterprise Small Business This is a combined synopsis/solicitation prepared in accordance FAR Part 13.5, Simplified Acquisition Procedures, and Part 12, Commercial Items, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation;

quotations are being requested and a written solicitation will not be issued. The solicitation is issued as a request for quotation (RFQ). The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2021-01/10-01-2020.

NAICS: 561320 - Temporary Help Services 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 49

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70521Q00001

Size: $25.5 in millions of dollars

Period of Performance: 12/01/2020 to 11/30/2021

1 PHARMACIST - TEMPORARY HELP SERVICES. 2080 HR

Requisition No: IHS1414690

Delivery: 12/01/2020

Delivery Location Code: IHSREDLAKE

RED LAKE

Indian Health Service

24760 Hospital Drive

P.O. Box 497

Red Lake MN 56671-0497 US

2 PHARMACIST - TEMPORARY HELP SERVICES. 2080 HR

Requisition No: IHS1414899

Delivery: 12/01/2020

Delivery Location Code: IHSWHITEEARTH

WHITE EARTH HEALTH CENTER

Indian Health Service

40520 CO HWY 34

OGEMA MN 56569 US

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