Attachment_3_Contact Information and Pricing Table.pdf
PDF 128 KB Posted
- Solicitation number
- W912LP-23-Q-4516
About this file
This attachment provides templates for a contact information table and pricing table to be completed and submitted in response to solicitation number W912LP-23-Q-4516 from the Iowa Army National Guard. The solicitation seeks occupational health medical surveillance examination services to be provided in Waterloo, Iowa. The contact information table requires the offeror's company name, point of contact information, CAGE code, UEI number, tax ID, payment terms, and socio-economic group. The pricing table outlines six line items for physical exams, vision screenings, three types of blood tests, and totals. Offerors should complete these templates to submit pricing and contact details for the medical surveillance services at the specified location by the response date.
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Text version
Attachment 3
Iowa Army National Guard
RFQ# W912LP-23-Q-4516
CONTACT INFORMATION TABLE
Company Name
Point of Contact (POC) Name
POC Phone
POC Email
CAGE Code
UEI Number
Tax ID Number Prompt Payment Discount Terms (Net 30 unless otherwise noted)
Business Size/Socio-economic Group(s) (Must correspond with FAR 52.212- 3 and/or 52.219-1 representations and certifications completed within
SAM)
Period of Performance
PRICING TABLE
Item # Description Qty Unit Unit Price Extended Amt
0001 Physical/Dermatological Exams 29 JOB $ $
0002 Vision Screenings 29 JOB $ $
0003 Complete Lab Draw 29 JOB $ $
0004 Lead Blood Level 29 JOB $ $
0005 Chromium Blood Level 29 JOB $ $
0006 Cadmium Blood Level 20 JOB $ $
TOTAL $
File details come from the government source that posted it. Updated .