75H71124P00085 signed po.pdf
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- Solicitation number
- 246-24-Q-0022
About this file
This document is an award notice for a contract to install a grinder pump lift station, sewer service line, electrical cabling and pump and abandon an existing septic tank. The contract was awarded to Horizon Underground on November 6, 2024 for $17,239.50 by the Department of Health and Human Services Indian Health Service. The contractor will furnish and install a grinder pump lift station, sewer service line, buried electrical cabling, connections, pump and abandon the existing septic tank and connect to the community sewage system in accordance with the attached statement of work and drawing. The period of performance is January 16, 2024 to March 22, 2024.
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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)
01/16/2024
75H71124P00085 IHS1484474
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
MATT
HORIZON UNDERGROUND LLC 856176
HORIZON UNDERGROUND LLC 4205 B
4205 BEELINO RD
BEGGS OK 74421
See Schedule
12. F.O.B. POINT
# 1012
03/22/2024
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)
XX
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: MN1NZAEAMNF8
Contractor to furnish and install a Lift Station and Sewer Service Line in accordance with the statement or 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
$17,239.50
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
EDSON W. YELLOWFISH
$17,239.50
OPTIONAL FORM 347 (Rev. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
01/17/2024
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
01/16/2024 75H71124P00085
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: 01/16/2024 to
03/22/2024
1 Contractor shall furnish and install a 17239.5 J3 1.00 17,239.50 grinder pump lift station, sewer service line, buried electrical cabling, connections, pump and abandon existing septic tank and connection to community sewage system in accordance with the statement of work and drawing.
Project Data:
133381.6.EMJK0000000-OKLAHOMA AREA
IHS.25235-ALL OTR SVCS.11/06/2023
Accounting Info:
2024.J5003IJ.25235 Appr. Yr.: 2024
CAN: J5003IJ Object Class: 25235
Funded: $17,239.50
Additional Provisions and Conditions (10 pages; 4-13 are attached hereto)
Scope of Work includes: Statement of Work
(4 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: Tobias Filener
Office Phone: 918-586-8409
Cell Phone: 918-399-9277
E-mail: tobias.filener@ihs.gov
Contract Specialist (C): Jeffrey Earnest, (IHS/OKC) 405-951-3740
Send original invoice to:
Oklahoma City Area Indian Health Service
Attention: Finance
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)) $17,239.50
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
01/16/2024 75H71124P00085
PAGE NO
(a) (b) (c) (d) (e) (f) (g)
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: $17,239.50. 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
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