Attachment 4 - Quote Submission Form.docx
DOCX document 88 KB Posted
- Attached to
- Bottled Laboratory Gases Cylinder delivery
- Solicitation number
- 1232SA26Q0048
About this file
This document is a Quote Submission Form for a Request for Quotation (RFQ) for bottled laboratory gas cylinders issued by the United States Department of Agriculture (USDA) Agricultural Research Service. The solicitation (Number 1232SA26Q0048) is a total small business set-aside for commercial items under NAICS code 325120, with a small business size standard of 1,200 employees. The RFQ covers a base year and four option years for ERRC Bottle Gas Cylinder delivery, with vendors required to provide comprehensive pricing across all line items. Eligible businesses can qualify under various socio-economic categories, including small business, veteran-owned, woman-owned, and service-disabled veteran-owned enterprises. The solicitation emphasizes the USDA's commitment to fair contracting and offers an internal Alternative Dispute Resolution (ADR) process for potential protest resolution.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 2 - Bottled Gas SOW.pdf | ||
| Attachment 3 - Schedule B Cylinder Gases.xlsx | XLSX spreadsheet | |
| Attachment 1 - Solicitation Terms and Conditions 1232SA26Q0048.pdf |
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Text version
Research, Education, and Economics Agricultural Research Service
QUOTE SUBMISSION FORM
Solicitation Title: ERRC Bottled Laboratory Gases - RFQ
Solicitation Number: 1232SA26Q0048
Company Information:
Currently Registered and Active in the System for Award Management (SAM): ( ) Yes ( ) No
SAM Unique Entity Identifier (UEI) Number:
Company Legal Name: Doing Business As (if applicable): Company Address as registered in the System for Award Management (SAM):
CAGE Code(s):
Socio-economic status for the NAICS code: 325120 (with a small business threshold of under 1200 Employees) – please check ALL that apply:
United States Department of Agriculture
Contracting Operations Branch ● Acquisition and Property Division 5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
( ) Small Business Concern SBA-certified 8(a) Program Participant Veteran Owned[ ]
Woman-Owned[ ]
( ) Other Than Small Business Concern
Disadvantaged SBA-certified HUB Zone Business Service-Disabled Veteran Owned[ ]
Economically Disadvantaged Woman Owned[ ]
( ) I confirm that my company is registered in the System for Award Management (SAM) with the socio-economic status identified above and the NAICS code specified or that my firm qualifies for the selected the socio-economic status under the applicable NAICS code.
Quote Information:
Research, Education, and Economics Agricultural Research Service United States Department of Agriculture
Contracting Operations Branch ● Acquisition and Property Division 5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
Quote Number:
Quote Date:
Quote Expiration Date:
Quoted Prices:
Vendors shall insert pricing/data in the cells below. All line items must be priced.
The Line-Item Total Amount is the Quantity multiplied by the Unit Price.
The Total Quoted Price is the sum of all Line-Item Total Amounts.
| Line Item |
| Item Description |
| Quantity |
| Unit |
| Unit Price |
| Total Amount |
| 0001 |
| ERRC Bottle Gas Cylinder (Base Year) |
| 1001 |
| ERRC Bottle Gas Cylinder (Option Year I) |
| 2001 |
| ERRC Bottle Gas Cylinder (Option Year II) |
| 3001 |
| ERRC Bottle Gas Cylinder (Option Year III) |
| 4001 |
| ERRC Bottle Gas Cylinder (Option Year IV) |
Total Quoted Price:
Time to Delivery: ( ) days( ) weeks months
Certification:( )
I understand that incomplete sections, failure to provide all required documentation, and/or failure to sign this certification may remove my company’s quote from being put into consideration by the Government for award.
Signature:
Name:
Title:
Contact Information:
Date:
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