QuoteSubmissionCklist_Amend001.pdf

AG-0120-S-16-0014, Amendment 001, Relocation Services Page 1 of 1

COMBINED SYNOPSIS/SOLICITATION IAW FAR 12.603

SOLICITATION NUMBER: AG-0120-S-16-0014

Quote Submission Checklist

• Current registration in the System for Award Management (SAM) (www.sam.gov)

• Provide documentation requested in the “Quote Submission Information” section of this solicitaton

• Complete form below – or provide same information on contractor’s quote form.

• Submit completed quote to Primary Point of Contact named in this combined synopsis/solicitation Company Information

Company Name

DUNS Code

Street Address City State Zip Code

Phone Number

Fax Number Website

Point of Contact Information Point of Contact Name

Telephone Number

Email Address

Quote Information CLIN Requirement Est.

Quantity Unit of Issue

Price Per Unit (Firm Fixed

Price)

Total Price (Firm Fixed

Price) 001 Relocation of Government

Property

1 LS

002 Dismantling and Hauling of Residual Government Property Marked for Disposal

1 LS

*003 Disposal of Residual Government Property Marked for Disposal

10,000 Pounds $.06 $600.00

*004 Disposal of Residual Appliances Marked for Disposal

4 EA $25.00 $100.00

005 Disassemble/reassemble office furniture (Dispatch office)

1 LS

Total *These figures are used for evaluation purposes only. Payment will be made on actual quantity based on weight and/or disposal tickets submitted.

Carefully review all documents before signing Quoters Authorized Representative’s Typed or Printed Name

Position or Title

Quoters Authorized Representative’s Signature

Date http://www.sam.gov/