SF 1449 for FSIS-S-12-0053.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

FSIS-ASD-ACQUISITION

BELTSVILLE MD 20705-5230

5601 SUNNYSIDE AVENUE

MAILDROP 5230

USDA, FSIS, ASD, ACQUISITIONS

FSIS-BELTSVILL-CNTR CODE 16. ADMINISTERED BYCODE

X

X

313312

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED ORFSIS-ASD-ACQUISITION

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

07/03/2012 1300 ET

06/15/2012

301-504-4228MADONNA MONTGOMERY

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

AG-3A94-S-12-0053

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 31 580809OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

BELTSVILLE MD 20705

ATTN: LOADING DOCK

6351 AMMENDALE ROAD

BELTSVILLE SERVICE CENTER

15. DELIVER TO

BELTSVILLE MD 20705-5230

5601 SUNNYSIDE AVENUE

MAILDROP 5230

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)X

USDA, FSIS, ASD, ACQUISITIONS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOSB

PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Delivery: 30 Days After Award

001 Base Year-- 1 EA

CLIN 001--FSIS Item # FSIS-46 Apron (at a minimum Apron shall be 35 inches x 55 inches, thickness shall be 6 mil or greater, 3 laces (laces must be included with each apron), apron material must be able to repel water, blood, and animal fat.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

X

XX

DATED

MADONNA J. MONTGOMERY 06/15/2012

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

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

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

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

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

CLIN 002 FSIS-46-STRINGS for Apron strings

(see Section B.3 for pricing)

Product/Service Code: 8415

Product/Service Description: CLOTHING, SPECIAL

PURPOSE

002 Option Year 1-- 1 EA

CLIN 101--FSIS Item # FSIS-46 Apron (at a minimum

Apron shall be 35 inches x 55 inches, thickness shall be 6 mil or greater, 3 laces (laces must be included with each apron), apron material must be able to repel water, blood, and animal fat.

CLIN 102 FSIS-46-STRINGS for Apron strings

(see Section B.3 for pricing)

Product/Service Code: 8415

Product/Service Description: CLOTHING, SPECIAL

PURPOSE

003 Option Year 2-- 1 EA

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

31 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 31

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

AG-3A94-S-12-0053

CLIN 201--FSIS Item # FSIS-46 Apron (at a minimum Apron shall be 35 inches x 55 inches, thickness shall be 6 mil or greater, 3 laces (laces must be included with each apron), apron material must be able to repel water, blood, and animal fat.

CLIN 202 FSIS-46-STRINGS for Apron strings

(see Section B.3 for pricing) Product/Service Code: 8415 Product/Service Description: CLOTHING, SPECIAL

PURPOSE

004 Option Year 3-- 1 EA

CLIN 301--FSIS Item # FSIS-46 Apron (at a minimum Apron shall be 35 inches x 55 inches, thickness shall be 6 mil or greater, 3 laces (laces must be included with each apron), apron material must be able to repel water, blood, and animal fat.

CLIN 302 FSIS-46-STRINGS for Apron strings

(see Section B.3 for pricing) Product/Service Code: 8415 Product/Service Description: CLOTHING, SPECIAL

PURPOSE

005 Option Year 4-- 1 EA

CLIN 401--FSIS Item # FSIS-46 Apron (at a minimum Apron shall be 35 inches x 55 inches, thickness shall be 6 mil or greater, 3 laces (laces must be included with each apron), apron material must be able to repel water, blood, and animal fat.

CLIN 402 FSIS-46-STRINGS for Apron strings

(see Section B.3 for pricing) Product/Service Code: 8415 Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

4 31

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

AG-3A94-S-12-0053

Product/Service Description: CLOTHING, SPECIAL

PURPOSE

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110