Standard_Form_1449_attachment.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

515919

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

AG-03R6-S-16-0023

6. SOLICITATION ISSUE DATE

March 3, 2016

7. FOR SOLICITATION

INFORMATION CALL

a. NAME

MARTI BOWLAND

b. TELEPHONE NUMBER (No collect calls)

406-363-7128

8. OFFER DUE DATE/LOCAL TIME

March 23, 2016 12:00 noon

9. ISSUED BY CODE

10. THIS ACQUISITION IS 11. DELIVERY FOR FOB 12. DISCOUNT TERMS

USDA, Forest Service

Flathead National Forest

C/o Marti Bowland- Region One Acquisition

1801 N 1st Street, Hamilton, MT 59840

Email quote to: mbowland@fs.fed.us

UNRESTRICTED

SET ASIDE: 100% FOR

SMALL BUSINESS

DESTINATION UNLESS

BLOCK IS MARKED

SEE SCHEDULE

HUBZONE SMALL

BUSINESS

13a. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

8(A) 13b. RATING

NAICS: 561720

SIZE STANDARD: $16.5 million

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE

16. ADMINISTERED BY CODE

See Delivery Schedule

USDA, Forest Service

Region 1 AQM

24 Fort Missoula Road, Missoula, MT 59804

17a. CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO.

Submit invoice to IPP.GOV for the work performed. Invoice will be reviewed and approved or rejected by the COR within 7 days of receipt of the invoice. Rejected invoices must be corrected and resubmitted.

USDA, OCFO, COD, APB

PO Box 60075

New Orleans, LA 70160

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS

BLOCK BELOW IS CHECKED SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Certified Noxious Weed Seed-Free small bale hay, delivered to two locations on the Flathead National Forest, rural

Hungry Horse area, Montana 59919

Please place your Quote on Attachment- SCHEDULE

OF ITEMS and return quote package to the email address in BLOCK 9 By the due date listed in BLOCK

8.

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

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _____ COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED HEREIN.

29. AWARD OF CONTRACT: REF. ___________________ OFFER DATED

_________________. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

30c. DATE SIGNED

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (4/2002)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

AG-03R6-S-16-0023

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ___________________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT

VERIFIED CORRECT

FOR

36. PAYMENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL FINAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERIFYING OFFICER 41c. DATE

42.b. RECEIVED AT (Location)

42.c DATE REC’D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 4/2002) BACK