Signed PO_75H71123P00635.pdf

PDF 127 KB Posted Sep 14, 2023

Attached to: Backup Generator, Kickapoo Tribe Water Treatment Plant Federal contract opportunity
Solicitation number: 75h71123P00365
Issued by: Department of Health and Human Services Indian Health Service

About this file

Written by GovTribe AI · Dec 21, 2023

This document is a signed purchase order awarding a contract to Native Energy Source LLC to furnish and install a standby generator at the Kickapoo Tribal Complex Water Treatment Plant in McLoud, Oklahoma. The contractor shall deliver the generator by December 25, 2023 after the period of performance beginning September 13, 2023. The total award amount is $51,323 to be paid by the Oklahoma City Area Office of the Indian Health Service. The contract is funded by two line items, with $45,000 allocated from one project and $6,323 from another. The notice provides contact information for the oversight monitor, contract specialist, and finance office for invoicing.

Relevant details include the solicitation and award numbers, contractor and contracting agency names, period of performance dates, delivery date, total award amount, funding sources and amounts, and points of contact for performance oversight and invoicing.

View the file

On GovTribe

Work with this file on GovTribe

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

IHSOKLAHOMACITY

OKLAHOMA CITY OK 73114

701 MARKET DRIVE

IHSOKLAHOMACITY

405-4811982

1640062

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

Oklahoma City OK 73114 701 Market Drive Oklahoma City Area IHS

IHSOKLAHOMACITY CODE 16. ADMINISTERED BYCODE

238290

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR303

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

405-951-3740Jeffery Earnest

75H71123P00635

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION 5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 11 IHS1476424OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

TECUMSEH OK 74873

101 W MAIN ST

NATIVE ENERGY SOURCE, LLC 101

Attn: DAVID L THOMASSON

NATIVE ENERGY SOURCE LLC 1640062

17a. CONTRACTOR/

OKLAHOMA CITY OK 73114

701 MARKET DRIVE

OKLAHOMA CITY AREA OFFICE

15. DELIVER TO

Oklahoma City OK 73114 701 Market Drive

9. ISSUED BY

2. CONTRACT NO.

EFFECTIVE DATE

$22

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

HHS NET 30P

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)

Oklahoma City Area IHS

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.

UEI: E2BBRMJ3TB36

Contractor shall furnish and install a standby generator to provide emergency electrical power for the Water Treatment Plant at the Kickapoo Tribal Complex McLoud, Oklahoma.

Delivery: 12/25/2023 Period of Performance: 09/13/2023 to 12/25/2023

Continued ...

(Use Reverse and/or Attach Additional Sheets as Necessary)

$51,323.00

HEREIN, IS ACCEPTED AS TO ITEMS:

DATED

SEAN L. LONG 09/14/2023

. 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

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.

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

See schedule

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.

1 Contractor shall furnish and install a standby 45000 J3 1.00 45,000.00 generator to provide emergency electrical power for the Water Treatment Plant at the Kickapoo

Tribal Complex Mcloud, Oklahoma. (This is spread over two-line items because of available funding)

Project Data:

134662.6.EMJK0000000-OKLAHOMA AREA IHS.25235-ALL

OTR SVCS.06/14/2023

Accounting Info:

2023.J5003IJ.25235 Appr. Yr.: 2023 CAN: J5003IJ

Object Class: 25235

Funded: $45,000.00

2 Contractor shall furnish and install a standby 6323 J3 1.00 6,323.00 generator to provide emergency electrical power for the Water Treatment Plant at the Kickapoo

Tribal Complex Mcloud, Oklahoma.

Project Data:

133633.4.HGFK0000000-OKLAHOMA AREA IHS.25235-ALL

OTR SVCS.06/14/2023

Accounting Info:

2023.J5002ED.25235 Appr. Yr.: 2023 CAN: J5002ED

Object Class: 25235

Funded: $6,323.00

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

11 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 11

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

NATIVE ENERGY SOURCE LLC 1640062

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

75H71123P00635

Clauses 8 pages attached.

General Decision number OK20230046, dated

6/9/2023, is hereby incorporated (7pages attached).

statement of work (9 pages attached)

Drawing (5 pages attached.

building a Better America signage (11 Pages attached).

Oversite Monitor: Kody James, Environmental

Engineer

Office: 405-214-4210

Cell 405-642-9703

E-mail: kody.james@ihs.gov

Contract Specialist (C): Jeffrey Earnest, (IHS/OKC) 405-951-3740

Send original invoice to:

Oklahoma City Area Indian Health Service

Attention: Finance

701 Market Drive

Oklahoma City, OK 73114

Or Fax to: 405-951-3873

Invoice inquiries may be made to Denise Karr at

405-951-3919 denise.karr@ihs.gov

The total amount of award: $51,323.00. The obligation for this award is shown in box 26.

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