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Vendor Confirmation
| VENDOR CONFIRMATION FORM | | |
| INSTRUCTIONS: Please put in the model name and put a check in the "YES" or "NO" box if the model in your quotation meets the standards below. Provide supporting documents as necessary to verify your answers. | Vendor Name: | |
| Solicitation FA461323R0003: Closed Circuit Television (CCTV) Repair, Replacement and Maintenance (Multiple Dormitories) | | Cage Code: |
| **Verify if CLINS are on GSA Schedule, as applicable. | | | | | | |
| Yes | No | Comments | Unit Price | Multiplier | Total Price: |
| CLIN 0001 | | | | | | |
| Semiannual Maintenance of CCTV System (Bldgs 220, 222, 223, 224, 226, 228. 230, 236, 244, 248) - Input price of maintenance for one year (1 Sep 2023 through 31 Aug 2024) in Column F9. | | | | | 1 | $0.00 |
| CLIN 0002 | | |
| NTE Parts Replacement Per Year (Refer to Offeror's FFP Replacement Parts Price List. Input total costs of all parts in F12). | 1 | $0.00 |
| CLIN 0003 | | |
| Emergency Visits - Input Wage Rate/Hour in Column F15 (e.g. video retrieval) | 20 | $0.00 |
| CLIN 1001 | | |
| Semiannual Maintenance for CCTV System - Input price of maintenance for one year (1 Sep 2024 through 31 Aug 2025) in Column F18. | 1 | $0.00 |
| CLIN 1002 | | |
| NTE Parts Replacement Per Year (Refer to Offeror's FFP Replacement Parts Price List. Input total costs of all parts in F21). | 1 | $0.00 |
| CLIN 1003 | | |
| Emergency Visits - Input Wage Rate/Hour in Column F24 (e.g. video retrieval) | 20 | $0.00 |
| CLIN 2001 | | |
| Semiannual Maintenance for CCTV System - Input price of maintenance for one year (1 Sep 2025 through 31 Aug 2026) in Column F27. | 1 | $0.00 |
| CLIN 2002 | | |
| NTE Parts Replacement Per Year (Refer to Offeror's FFP Replacement Parts Price List. Input total costs of all parts in F30). | 1 | $0.00 |
| CLIN 2003 | | |
| Emergency Visits - Input Wage Rate/Hour in Column F33 (e.g. video retrieval) | 20 | $0.00 |
| CLIN 3001 | | |
| Semiannual Maintenance for CCTV System - Input price of maintenance for one year (1 Sep 2026 through 31 Aug 2027) in Column F36. | 1 | $0.00 |
| CLIN 3002 | | |
| NTE Parts Replacement Per Year (Refer to Offeror's FFP Replacement Parts Price List. Input total costs of all parts in F39). | 1 | $0.00 |
| CLIN 3003 | | $0.00 |
| Emergency Visits - Input Wage Rate/Hour in Column F42 (e.g. video retrieval) | 20 | $0.00 |
| CLIN 4001 | | |
| Semiannual Maintenance for CCTV System - Input price of maintenance for one year (1 Sep 2027 through 31 Aug 2028) in Column F45. | 1 | $0.00 |
| CLIN 4002 | | |
| NTE Parts Replacement Per Year (Refer to Offeror's FFP Replacement Parts Price List. Input total costs of all parts in F48). | 1 | $0.00 |
| CLIN 4003 | | $0.00 |
| Emergency Visits - Input Wage Rate/Hour in Column F51 (e.g. video retrieval) | 20 | $0.00 |
6 Month Extension: Half of Option Year 4 Total Costs $0.00
| Overall Extended Price (Base + Option Years Only): | $0.00 |
| Company | | |
For Eval Purposes Only: 6-Month Extension Added by dividing OY4 total costs by two, then adding this number to the overall extended price.
| TOTAL EVALUATED PRICE | $0.00 |
| Name / Title | | |
Signature