SF_18.pdf

AG-82BH-S-14-0056

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

07/31/2014 703589

1 2

2840 KACHINA DRIVE

PUEBLO CO 81008

PIKE SAN ISABEL NATIONAL FOREST

90 Days After Award

PIKE SAN ISABEL NATIONAL FOREST

2840 KACHINA DRIVE

PUEBLO

CO 81008

719 553-1433ANGELINA SANCHEZ

08/29/2014 1000 MT

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

DO NOT ENTER YOUR QUOTATIONS ON THIS PAGE. ENTER

YOUR QUOTE ON THE ATTACHED SCHEDULE OF ITEMS.

USDA is an equal opportunity employer.

The U.S. Department of Agriculture (USDA) prohibits discrimination on the basis of race, color, national origin, sex, religion, age, disability, political beliefs, and marital or family status. (Not all basis apply to all programs). Persons with disabilities who require alternative means for communication of program information (braille, large print, audio tape, etc) should contact the USDA Office of Communication at 202-720-2791

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

AG-82BH-S-14-0056

To file a complaint, write the Secretary of Agriculture, U.S. Department of Agriculture, Washington, D.C., or call 1-800-245-6340 (Voice), or call 202-720-1127 (TDD).

001 Delivery, installation, and setting of one DO pre-cast concrete double vault toilet building without chase, in accordance to attached technical specifications which herein are a part of any resultant contract.

Delivery: 90 Days After Award FOB: Destination

All invoices are to be submitted via the electronic Invoice Processing Platform. This is a mandatory requirement initiated by the U.S.

Department of Treasury and you can find more information at this website https://www.ipp.gov/index.htm.

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