SF1449.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS r. REQUISITIONNUMBER rAG~

OF

OFFEROR TO COMPLETE BLOCKS 12, 17,23,24, & 30 837297 I 128

2. CONTRACTNO. 13.AWARDI 14.ORDERNUMBER 15.SOLICITATIONNUMBER r'SOLICITATION

EFFECTIVEDATE AG-04P5-S-17-0005 ISSUEDATE

02/09/2017

7. FOR SOLICITATION

1"' NAME

lb. TELEPHONENUMBER (No collect calis) 18.OFFERDUEDATE/LOCALTIME

INFORMATION CALL: LINDA WATSON 541-885-3408 03/09/2017 1700 ET

9. ISSUEDBY CODE 104U3 10.THISACQUISITIONIS - UNRESTRICTEDOR .)(! SETASIDE: % FOR:

X SMALLBUSINESS

WOMEN-OV'oNEDSMALLBUSINESS

USDA FOREST SERVICE -1 (WOSB)ELIGIBLEUNDERTHEWOMEN-OWNED

FREMONT-WINEMA NF KLAMATH FALLS c_' HUBZONESMALL RMAII RII~II\IFRRPRn~RAM NAICS:562 9 91

2819 DAHLIA STREET

BUSINESS -= EDWOSB

KLAMATH FALLS OR 97601 -- SERVICE-DISABLED C:' 8(A) SIZESTANDARD: $7.50

VETERAN-OWNED

SMALLBUSINESS

n. DELIVERYFORFOBDESTINA- 12.DISCOUNTTERMS 13b.RATING

TIONUNLESSBLOCKIS

THISCONTRACTISA_ 13a.

MARKED RATEDORDERUNDER 14.METHODOFSOLICITATION

SEESCHEDULE DPAS(15CFR700) )(,RFQ _::IFB _ RFP

15.DELIVERTO CODE 104P5 16.ADMINISTEREDBY CODE 104U3

USDA FOREST SERVICE USDA FOREST SERVICE

FREMONT-WINEMA NF HQ FREMONT-WINEMA NF KLN1ATH FALLS

1301 SOUTH G STREET 2819 DAHLIA STREET

LAKEVIEW OR 97630 KLAMATH FALLS OR 97601

170 CONTRACTORI CODE 1 FACILITY1 lBe. PAYMENTWILL BEMADEBY CODE 1

OFFEROR CODE

TELEPHONENO.

,17b.CHECKIF REMITIANCEISDIFFERENTANDPUTSUCHADDRESSINOFFER 18b.SUBMITINVOICESTOADDRESSSHOWNINBLOCK18aUNLESSBLOCKBELOW

ISCHECKED USEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEMNO. SCHEDULEOFSUPPLIES/SERVICES QUANTITY UNIT UNITPRICE AMOUNT

Fremont-Winema National Forest Vault Toilets and

Septic System Pumping services, 2017 BASE Year, plus 2 option years.

Insert your prices on the Schedule of Items.

When submitting your quote, return to the address in Block 16 and on your sealed envelope, please write RFQ AG-04P5-S-17-0005. DUE 3/9/2017 by

2:00 pm.

Delivery: 12/31/2017

Period of Performance: 03/15/2017 to 12/31/2017

Continued ...

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

25. ACCOUNTING AND APPROPRIATION DATA 126, TOTAL AWARD AMOUNT (For Govt. Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 ISATTACHED. ADDENDA ex ARE

ARE

ARE NOT ATTACHED.

ARE NOT ATTACHED

29. AWARD OF CONTRACT: OFFER

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

HEREIN, IS ACCEPTED AS TO ITEMS:

X 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.

30b. NAME AND TITLE OF SIGNER (Type or print) 130C.DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type orprint) 131C.DATE SIGNED

LINDA C. WATSON

30a. SIGNATUREOFOFFEROR/CONTRACTOR 31a, UNITEDSTATESOFAMERICA(SIGNATURE OF CONTRACTING OFFICER)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV_2/20n) Prescribed by GSA - FAR (48 CFRI5~.212

22. 23. 24.21.

19. 20.

UNIT UNIT PRICE AMOUNT

SCHEDULE Of SUPPLIES/SERVICES QUANTITY _-----ITEM NO.

001 Fremont-Winema National Forest Vault Toilets and

Septic System Pumping services 2017

The Contractor must be registered and valid in the SYSTEM FOR AWARD MANAGEMENT (SAM):

www.sam.gov.

Quotations submitted are considered to be confidential. The name of the Contractor and the amount of the contract will be disclosed only after an award is made.

Quotes may be submitted to the address in block

16 or emailed to lcwatson@fs.fed.us

32a. QUANTITY IN COLUMN 21 HAS BEEN

. -: RECEIVED INSPECTED iJ ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE I32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

329. E·MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED 36. PAYMENT 37. CHECK NUMBER

CORRECT FOR

PARTIAL i ...' FINAL [J COMPLETE o PARTIAL ,- FINAL-

3fl. 8/'< ACCOUNT NUMBER 39. SIR VOUCHER NUMBER 40. PAlD BY

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

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

42b. RECEIVED AT (Location)

42c. DATE REC'D rVYIMMIDD) J42d. TOTAL CONTAINERS

STANDARD FORM 1449IREV. 2120121BACK