Signed PO 75H71123P00649 WSL L. Ortiz.pdf
PDF 129 KB Posted
- Attached to
- Water Service Line Barnsdall, OK
- Solicitation number
- 75H71123P00649
About this file
This order for supplies or services is for a water service line installation project awarded by the Department of Health and Human Services Indian Health Service. The contractor will furnish and install a 216-foot water service line for $21,625 by November 20, 2023 at the Oklahoma City Area IHS location. The awarded contractor is Lyday Construction LLC. The project number is 134466.3.HGFK0000000-OKLAHOMA AREA IHS.25235-ALL OTR SVCS and the accounting information includes the fiscal year 2023, account number J5003IH, and object class 25235.
View the file
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ORDER FOR SUPPLIES OR SERVICES
3. ORDER NO. 4. REQUISITION/REFERENCE NO.
PAGE OF PAGES
5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS
IMPORTANT: Mark all packages and papers with contract and/or order numbers. 1
1. DATE OF ORDER 2. CONTRACT NO. (If any) 6. SHIP TO:
a. NAME OF CONSIGNEE
c. CITY d. STATE e. ZIP CODE
7. TO:
a. NAME OF CONTRACTOR
f. SHIP VIA
8. TYPE OF ORDER
b. COMPANY NAME
c. STREET ADDRESS
d. CITY e. STATE f. ZIP CODE
9. ACCOUNTING AND APPROPRIATION DATA
a. PURCHASE b. DELIVERY
REFERENCE YOUR:
Please furnish the following on the terms and conditions specified on both sides of this order and on the attached sheet, if any, including delivery as indicated.
Except for billing instructions on the reverse, this delivery order is subject to instructions contained on this side only of this form and is issued subject to the terms and conditions of the above-numbered contract.
10. REQUISITIONING OFFICE
11. BUSINESS CLASSIFICATION (Check appropriate box(es))
a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED d. WOMEN-OWNED
13. PLACE OF
a. INSPECTION b. ACCEPTANCE
14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT
ON OR BEFORE (Date)
16. DISCOUNT TERMS
17. SCHEDULE (See reverse for Rejections)
09/19/2023
75H71123P00649 IHS1477470
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
SHAWN D LYDAY
SHAWN LYDAY 1627606
LYDAY CONSTRUCTION LLC 3209 BE
3209 BENNETT ROAD
HOWE TX 75459
See Schedule
12. F.O.B. POINT
11/20/2023
OKLAHOMA CITY AREA OFFICE
701 MARKET DRIVE
OKLAHOMA CITY OK 73114
OKLAHOMA CITY OK 73114
ORACLE
ITEM NO.
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT
PRICE
(e)
AMOUNT
(f)
QUANTITY
ACCEPTED
(g)
X
X
Destination Destination HHS NET 30P
f. SERVICE-DISABLED
VETERAN-OWNED
e. HUBZone
g. WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOSB PROGRAM
h. EDWOSB
UEI: HFMWKRHX16D3
Contractor shall furnish and install a water service line in accordance with the statement of work and drawing.
Continued ...
19. GROSS SHIPPING WEIGHT18. SHIPPING POINT 20. INVOICE NO.
21. MAIL INVOICE TO:
a. NAME
b. STREET ADDRESS
(or P.O. Box)
c. CITY d. STATE e. ZIP CODE
SEE BILLING
INSTRUCTIONS
ON REVERSE
17(h)
TOTAL
(Cont.
pages)
17(i)
GRAND
TOTAL
$21,625.00
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
SEAN L. LONG
$21,625.00
OPTIONAL FORM 347 (Rev. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
09/20/2023
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
Oklahoma City OK 73114
DATE OF ORDER
ORDER FOR SUPPLIES OR SERVICES
SCHEDULE - CONTINUATION
CONTRACT NO.
AMOUNTUNIT
PRICE
UNITQUANTITY
ORDERED
SUPPLIES/SERVICESITEM NO.
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
ORDER NO.
QUANTITY
ACCEPTED
09/19/2023 75H71123P00649
PAGE NO
(a) (b) (c) (d) (e) (f) (g)
Admin Office:
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
Period of Performance: 09/19/2023 to
11/20/2023
1 Contractor shall furnish and install a 21625 J3 1.00 21,625.00 water service line for L Ortiz in accordance with the statement of work and drawing.
Project Data:
134466.3.HGFK0000000-OKLAHOMA AREA
IHS.25235-ALL OTR SVCS.06/30/2023
Accounting Info:
2023.J5003IH.25235 Appr. Yr.: 2023
CAN: J5003IH Object Class: 25235
Funded: $21,625.00
Additional Provisions and Conditions (10 pages; 4-13 are attached hereto)
Scope of Work includes: Statement of Work
(2 pages), drawing (1 page) (attached).
Davis Bacon General Wage Decision
OK20230030 Dated 06/09/2023 is hereby incorporated, (attached)
FAR Clause 52.213-4 attached FAR Clause
52.204-7 applies
Oversite Monitor: Christopher Houston
Work: 918-762-6590
Cell: 918-290-0985
E-mail: christopher.houston@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
Continued ...
Prescribed by GSA FAR (48 CFR) 53.213(f)
OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION
PREVIOUS EDITION NOT USABLE
TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $21,625.00
DATE OF ORDER
ORDER FOR SUPPLIES OR SERVICES
SCHEDULE - CONTINUATION
CONTRACT NO.
AMOUNTUNIT
PRICE
UNITQUANTITY
ORDERED
SUPPLIES/SERVICESITEM NO.
IMPORTANT: Mark all packages and papers with contract and/or order numbers.
ORDER NO.
QUANTITY
ACCEPTED
09/19/2023 75H71123P00649
PAGE NO
(a) (b) (c) (d) (e) (f) (g)
Invoice inquiries may be made to Denise
Karr at 405-951-3919 denise.karr@ihs.gov
The total amount of award: $21,625.00. The obligation for this award is shown in box
17(i).
Prescribed by GSA FAR (48 CFR) 53.213(f)
OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION
PREVIOUS EDITION NOT USABLE
TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $0.00
File details come from the government source that posted it. Updated .