Attachment 3 - Information Sheet.pdf

89 KB Posted

Attached to
Inter-Facility Patient Transfer Service
Solicitation number
FA486122R0010
Issued by

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Other files

File Type Posted
Solicitation - FA486122R0010.pdf PDF
Attachment 2 - Price List.pdf PDF
Attachment 1 - FA4861-22-R-0010 Statement of Work.pdf PDF

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Attachment 1

INFORMATION SHEET

Non-Emergency Patient Transfer Services

TO: 99th Contracting Squadron/PKB 5865 Swaab Blvd Bldg 588 Nellis AFB, NV 89191

FROM: _________________________________________

a. Firm (does) (does not) agree to the establishment of a BPA.

b. Firm (is) (is not) a small business concern.

c. Person(s) to contact for price lists and follow-up information, include telephone number and facsimile number:

SIGNATURE/TITLE DATE

CAGE #: _______________________________

DUNS#: ________________________________

TAX ID#: ________________________________

FROM 1:
FROM 2:
FROM 3:
FROM 4:
facsimile number:
1:
2:
CAGE:
DUNS:
TAX ID:
DATE:
Check Box1: Off
Check Box2: Off
Check Box3: Off

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