Attachment 2_Fillable Pricing Table.docx

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Attached to
Amendment 0001 - Dental Chairs and Equipment - Mescalero Service Unit
Solicitation number
75H70726Q00077
Issued by

About this file

This is a fillable pricing template for submission in response to a solicitation for dental chairs and equipment for the Mescalero Service Unit. The template serves as Attachment 2 to the solicitation and is designated for Volume III (Price) of quotation submissions. Quoters are required to complete and submit this pricing schedule as part of their proposal package, along with technical capability documentation, past performance survey, signed SF 1449 form, and Indian Economic Enterprise representation if applicable. The specific pricing structure and line items within the template would detail costs for the dental operatory equipment being procured.

This solicitation (75H70726Q00077) is issued by the Department of Health and Human Services Indian Health Service under the Buy Indian Act and is set aside for Indian Small Business Economic Enterprises (ISBEEs), with cascading evaluation tiers including Service-Disabled Veteran-Owned Small Business, HUBZone Small Business, Small Disadvantaged Business, and All Other Small Business concerns if no acceptable ISBEE quotations are received. The procurement follows FAR Subpart 12 procedures for commercial items, with NAICS Code 339114 and PSC Code 6520, and applies a small business size standard of 750 employees.

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RFQ No. 75H70726Q000XXFillable Table**Dental Operatory Equipment – MSU
Item No.
Description
Qty
Unit Price
Extended Price
Total Amount

CLIN 1

A-dec 511 dental chairs
2

Including sewn upholstery, programmable foot switch, and floor box systems

CLIN 2
A-dec 343pro cart delivery systems
2

Including integrated control modules, tubing, trays, power supply, and intraoral light source

CLIN 3
A-dec 521 doctor’s stools
2
CLIN 4
A-dec 522 assistant stools
2
CLIN 5
Shipping
GRAND TOTAL:
$__________________

* - All-Inclusive Rate: The service rate must include all associated fees—such as travel, per diem, lodging, all applicable taxes, and any miscellaneous costs required to perform the services.

* - Once award is issued, “Service repairs and replacement parts” will be added at a set amount of $2,000.00/year. Added above, for reference, but should not be factored into yearly total for your quote.

***You may use this fillable table or a format of your own***

File details come from the government source that posted it. Updated .