75H70624Q00076-Marco chair.pdf

75H70624Q00076

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

09/06/2024

1 22

Federal Building 115 Fourth Ave, SE Aberdeen SD 57401

Aberdeen Area Indian Health Servic 90 Days After Award

IHSWAGNER

110 WASHINGTON ST

WAGNER SD 57380

WAGNER

SD 57380

ERIN DOERING

09/13/2024 1700 CT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

***100% Small Business Set-Aside***

Solicitation for firm fixed price quote for a MARCO exam chair for the IHS clinic in Wagner, South Dakota. Period of performance will be date of award with delivery no later than 90 days after award.

BASIS FOR AWARD: Quoters are advised that award shall be made to the Lowest Price Technically Acceptable (LPTA) offer. Quotes will also include the following to be considered acceptable:

1. Complete and signed SF-18, Request for Quotations

2. Complete Indian Health Service Buy-Indian Form 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 22

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00076

(if applicable)

3. Provide Items per Specifications

4. Meet 90 day or less delivery schedule

Any questions regarding this solicitation shall be requested before September 11, 2024 before noon CDT; in writing by email to Ms. Erin Doering at Erin.Doering@ihs.gov.

Our Work Order: CALLTSK0108421-7

Period of Performance: 09/20/2024 to 09/20/2024

1 CS0MA1262WG Marco EZ Tilt Chair Warm Grey 1264 1 EA

Upholstery Color Required (Wagner Location)

Period of Performance: 09/20/2024 to 12/20/2024

2 CS0MA1207WGFG Marco Deluxe Stand Warm Grey 1 EA

Includes Deluxe Refractor Arm (Wagner Location)

Period of Performance: 09/20/2024 to 12/20/2024

3 CS1ZZMOI Marco Chair Mover for Chair w 1 EA

Rectangular Base up to 22 1 2 inches wide (Wagner

Location)

Period of Performance: 09/20/2024 to 12/20/2024

4 Freight and Handling (Wagner Location)

Period of Performance: 09/20/2024 to 12/20/2024

Quotation must set forth, full, accurate and complete information as required by the Request for Quotation (RFQ), and be returned no later than the date referenced in Block #10 of the

Request for Quotation form SF-18. All required information must be submitted in order to be considered responsive and eligible for award.

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm

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 22

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

75H70624Q00076 for a period of at least 30 days from the date of receipt by the Government. All required information must be submitted in order to be considered responsive and eligible for award.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract.

Contractor must be registered with the System for

Award Management (SAM) before award can be made.

The website to register at is: www.sam.gov.

Invoicing under this order shall be processed through the Invoice Payment Platform (IPP), located at www.ipp.gov.

The Government reserves the right to accept or reject services if the level of work is unsatisfactory.

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