KC_337_Rate_Schedule.pdf

See reverse side for Privacy Act, Public Burden and Nondiscrimination Statements.

KC-337 U.S. DEPARTMENT OF AGRICULTURE

(12-31-2015) Farm Service Agency Rate Schedule

Country/Region: Base Year / Option Year 1 / 2 / 3 / 4 (Circle, as appropriate)

DISCHARGE SURVEYS

Metric Tons (MT)

(Rates are per net MT except for Min. Fee)

Type of Cargo

Up to 999 MT Min. Fee*

1,000 - 5,000 MT

5,001 - 10,000 MT

10,001 MT and above

Bulk-No bagging Bulk-Including Bagging Breakbulk

DRAFT SURVEYS

(Cost is separate from your base rates) Rate for each draft survey:

CUSTOMS LOCATIONS

(Cost shall be expressed per workday) Rate per workday:

THROUGH BILL OF LADING SURVEYS

(Rates must include cost to perform surveys at both the discharge and delivery locations.)

Metric Tons (MT)

(Rates are per net MT except for Min. Fee)

Type of Cargo

Up to 999 MT Min. Fee*

1,000 - 5,000 MT

5,001 - 10,000 MT

10,001 MT and above

Bulk-No bagging Bulk-Including Bagging Breakbulk

CONTAINERIZED SHIPMENT SURVEYS

(Rates for shipments delivered inland must cover surveys conducted at both the discharge and delivery locations.)

Number of Containers (Rates are per container except for Min. Fee)

Min. Fee*

Min. 10 Max. 25

Min. 26 Max. 50

51 and above

No Devanning (1) Devan at Port (2) Devan at Inland Delivery Location (3) Devan at Port + Breakbulk Inland Delivery Location (4)

* Minimum fee applies only to shipments of less than 1,000 MT or shipments of less than 10 containers.

Rate schedule must be stated in U.S. currency ($0.00) I certify that this firm has the expertise necessary to perform the survey services required by Commodity Credit Corporation in this country/region. I further certify that this rate schedule is my bid to perform survey services in this country/region for a period of one year from the date the contract is awarded to this firm and that such rate schedule is all-inclusive and will not change during the period under which the contract is effective.

Signature: ____________________________________ Date:_________ Title: ____________________________________________

Firm Name: ________________________________________________ E-Mail: ____________________________________________

(1) Containers are not devanned OR surveyor not a witness to devanning. Container and seal check only. Attendance at port.

(2) Containers are devanned at port (within 25 km radius). Attendance at port.

(3) Containers are transported inland where devanning occurs. Attendance at port and inland delivery location.

(4) Containers are devanned at port, cargo loaded onto conveyance to inland destination for breakbulk survey. Attendance at port and inland delivery location.

KC-337 (REVERSE)

PRIVACY ACT AND PUBLIC BURDEN STATEMENTS

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a) and the Paperwork Reduction Act of 1995, as amended. The authority for requesting the following information is 7 CFR 1400, Subchapter C. The information will be used to evaluate bids to purchase commodities and provide services. Furnishing the requested information is voluntary; however, failure to furnish the requested information will result in nonconsideration. This information may be provided to other agencies, IRS, Department of Justice, or other State and Federal law enforcement agencies, and in response to a court magistrate or administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 641, 651, 1001; 15 USC 714m; and 31 USC 3729, may be applicable to the information provided.

NONDISCRIMINATION STATEMENT

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA=s TARGET Center at (202) 720-2600 (voice and TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.