Sol_75H71023Q00083 SF1449.pdf
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- Solicitation number
- 75H71023Q00083
About this file
This solicitation requests proposals for non-personnel pharmacist services for the Crownpoint Healthcare Facility Pharmacy Department. The Department of Health and Human Services Indian Health Service seeks to award multiple contracts for two pharmacists to provide services from September 11, 2023 through September 10, 2024 with two one-year option periods. The solicitation is set aside exclusively for Native American-owned small businesses under NAICS code 561320 with a size standard of $34 million. Offerors must submit proposals through the Federal Procurement Data System by August 10, 2023. The contracts will have a single award amount and require services be provided at the Crownpoint Healthcare Facility location.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_75H71023Q00083 - Price Schedule.pdf | ||
| PWS_0001.pdf | ||
| IHS IEE Representation Form_Jan 2022_508 Compliant.pdf | ||
| Sol_75H71023Q00083.pdf |
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Text version
SEE ADDENDUMIS CHECKED
CODE 18a. PAYMENT WILL BE MADE BY
CODE
FACILITYCODE
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER
OFFEROR
Crownpoint NM 87313 P.O. Box 358 Crownpoint Health Care Facility
CODE 16. ADMINISTERED BYCODE
X
X
X
561320
SIZE STANDARD:
100.00 % FOR:SET ASIDE:UNRESTRICTED OR50
REQUEST FOR
PROPOSAL
(RFP)
INVITATION
FOR BID (IFB)
10. THIS ACQUISITION ISCODE
REQUEST FOR
QUOTE (RFQ)
14. METHOD OF SOLICITATION
13b. RATING
NORTH AMERICAN INDUSTRY
CLASSIFICATION STANDARD
(NAICS):
SMALL BUSINESS
08/24/2023 1700 MT
08/10/2023
505-786-2530MARSHALL ARVISO
(No collect calls)
INFORMATION CALL:
FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME
4. ORDER NUMBER3. AWARD/ 6. SOLICITATION
75H71023Q00083
5. SOLICITATION NUMBER
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF
1 37 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
TELEPHONE NO.
17a. CONTRACTOR/
Multiple Destinations
15. DELIVER TO
Crownpoint NM 87313 P.O. Box 358
9. ISSUED BY
7.
2. CONTRACT NO.
EFFECTIVE DATE
$34
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW
ISSUE DATE
DELIVERY FOR FREE ON BOARD
(FOB) DESTINATION UNLESS
BLOCK IS MARKED
11.
SEE SCHEDULEX
12. DISCOUNT TERMS THIS CONTRACT IS A RATED
ORDER UNDER THE DEFENSE
PRIORITIES AND ALLOCATIONS
SYSTEM - DPAS (15 CFR 700)
13a.
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS
(SDVOSB)
HUBZONE SMALL
BUSINESS
8(A)
Crownpoint Health Care Facility
WOMEN-OWNED SMALL
BUSINESS (WOSB)
ECONOMICALLY DISADVANTAGED
WOMEN-OWNED SMALL
BUSINESS (EDWOSB)
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
This Acquisition is a 100% Buy Indian Set-aside under the North AMerican Industry Classification System (NAICS) Code 561320 with an associated small business size standard of $34.00 millions of dollars.
This contract is subject to the electronic payment process by the Department of Treasury.
52.212-4(g) must be submitted thorough qqq.ipp.gov. For additional information, refer to the incorporated clause at 352.232-71 Electronic
(Use Reverse and/or Attach Additional Sheets as Necessary)
HEREIN, IS ACCEPTED AS TO ITEMS:
DATED
LEONA I. CANTU
. YOUR OFFER ON SOLICITATION (BLOCK 5),
INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH
COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER
ARE
ARE
31c. DATE SIGNED
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA
31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)
30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)
ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL
SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.
27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3
AND 52.212-5 ARE ATTACHED. ADDENDA
26. TOTAL AWARD AMOUNT (For Government Use Only)
OFFER
STANDARD FORM 1449 (REV. 11/2021)
Prescribed by GSA - FAR (48 CFR) 53.212
ARE NOT ATTACHED.
ARE NOT ATTACHED.
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
30b. NAME AND TITLE OF SIGNER (Type or print)
30a. SIGNATURE OF OFFEROR/CONTRACTOR
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
25. ACCOUNTING AND APPROPRIATION DATA
29. AWARD OF CONTRACT: REFERENCE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED
40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER
37. CHECK NUMBER
FINALPARTIAL
36. PAYMENT
FINALPARTIAL
35. AMOUNT VERIFIED
CORRECT FOR
34. VOUCHER NUMBER33. SHIP NUMBER
COMPLETE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)
42b. RECEIVED AT (Location)
42a. RECEIVED BY (Print)
41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT
STANDARD FORM 1449 (REV. 11/2021) BACK
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
Submission of Payment Requests (Feb 2022).
Multiple awards may be made.
Period of Performance: 09/11/2023 to 09/10/2024
1 Base Year:
Contractor shall provide two (2) Pharmacists services for the Crownpoint Healthcare Facility, Pharmacy Department.
Delivery Location Code: IHSCROWNPOINT
CROWNPOINT COMPREHENSIVE HEALTH CAR
PO Box 358
Crownpoint NM 87313 US
Period of Performance: 09/11/2023 to 03/11/2024
2 1st Option Period:
Contractor shall provide two (2) Pharmacist
Services for the Crownpoint Healthcare Facility, Pharmacy Department.
Delivery Location Code: IHSCROWNPOINT
IHSCROWNPOINT
Continued ...
32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
37 2 of
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
3 37
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
75H71023Q00083
PO Box 358
Crownpoint NM 87313 US
Period of Performance: 03/12/2024 to 09/11/2024
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
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