Attachment 4 - Quote Submission Form.pdf
PDF 1 MB Posted
- Attached to
- Service Plan for a MACSQuant Tyto Cell Sorter - RFQ Federal contract opportunity
- Solicitation number
- 1232SA26Q0178
About this file
This is a Quote Submission Form for a Request for Quote (RFQ) issued by the United States Department of Agriculture, Agricultural Research Service, Office of the Director. The solicitation (Number 1232SA26Q0178) seeks an Annual Service Plan for a MACSQuant Tyto Cell Sorter. The form requires vendors to complete company information sections, including SAM registration status, UEI number, legal company name, CAGE code, and socio-economic status certifications under NAICS code 811210 (with a small business threshold of under $34 million). Vendors must indicate whether they qualify as small businesses, disadvantaged businesses, SBA-certified 8(a) participants, HUB Zone businesses, veteran-owned, service-disabled veteran-owned, woman-owned, or economically disadvantaged woman-owned businesses.
The pricing structure spans a base term of 12 months plus four optional years of 12 months each, with an additional option to extend up to six months. Each period requires separate pricing for four service categories: Technical Support Service, Preventive Maintenance Service, Repair Service, and Software Update Service, all quoted in monthly increments. All line items must be priced, with the total quoted price calculated as the sum of all line-item total amounts (quantity multiplied by unit price). The form requires vendor signature, printed name, title, contact information, and submission date. Incomplete submissions or failure to provide required documentation and certification will result in removal from government consideration for award.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 5 - SCLS Exemption Certification.pdf | ||
| Attachment 1 - Solicitation Terms and Conditions (0003).pdf | ||
| Attachment 4 - Quote Submission Form (0003).pdf | ||
| Attachment 3 - Wage Rate Determination 2015-5559 (0003).pdf | ||
| Attachment 1 - Solicitation Terms and Conditions (0002).pdf | ||
| Attachment 1 - Solicitation Terms and Conditions (0001).pdf | ||
| Attachment 1 - Solicitation Terms and Conditions.pdf | ||
| Attachment 2 - Statement of Requirements.pdf | ||
| Attachment 3 - Wage Rate Determination 2015-5559.pdf |
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Text version
United States Department of Agriculture
Research, Education, and Economics Agricultural Research Service
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
QUOTE SUBMISSION FORM
Solicitation Title: _____________________________________________________________________
Solicitation Number: ______________________
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: __________ (with a small business threshold of under ______________) – please check ALL that apply:
( ) Small Business Concern [ ] Disadvantaged
[ ] SBA-certified 8(a) Program Participant [ ] SBA-certified HUB Zone Business
[ ] Veteran Owned [ ] Service-Disabled Veteran Owned
[ ] Woman-Owned [ ] Economically Disadvantaged Woman Owned
( ) Other Than Small Business Concern
( ) 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.
Agricultural Research Service
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
Quote Information:
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 Base Term: Technical Support Service Months 0002 Base Term: Preventive Maintenance
Service Months
0003 Base Term: Repair Service Months 0004 Base Term: Software Update Service Months 1001 Option Year 1: Technical Support Service Months 1002 Option Year 1: Preventive Maintenance
Service Months
1003 Option Year 1: Repair Service Months 1004 Option Year 1: Software Update Service Months 2001 Option Year 2: Technical Support Service Months 2002 Option Year 2: Preventive Maintenance
Service Months
2003 Option Year 2: Repair Service Months 2004 Option Year 2: Software Update Service Months 3001 Option Year 3: Technical Support Service Months 3002 Option Year 3: Preventive Maintenance
Service Months
3003 Option Year 3: Repair Service Months 3004 Option Year 3: Software Update Service Months 4001 Option Year 4: Technical Support Service Months 4002 Option Year 4: Preventive Maintenance
Service Months
Agricultural Research Service
Office of the Director Contracting Operations Branch ● Acquisition and Property Division
5601 Sunnyside Avenue ● Beltsville, MD 20705 USDA is an Equal Opportunity Provider and Employer
4003 Option Year 4: Repair Service Months 4004 Option Year 4: Software Update Service Months 5001 Option to Extend Up to Six Months:
Technical Support Service Months
5002 Option to Extend Up to Six Months:
Preventive Maintenance Service
Months
5003 Option to Extend Up to Six Months:
Repair Service
Months
5004 Option to Extend Up to Six Months:
Software Update Service
Months
Total Quoted Price:
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:
| Quote Submission Form Pg 1 |
| Quote Submission Form Pg 2B |
| Solicitation Title: Annual Service Plan for a MACSQuant Tyto Cell Sorter - RFQ |
| Solicitation Number: 1232SA26Q0178 |
| 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 1: |
| Company Address as registered in the System for Award Management SAM 2: |
| Company Address as registered in the System for Award Management SAM 3: |
| Company Address as registered in the System for Award Management SAM 4: |
| CAGE Codes: |
| please check ALL that apply: $34 Million |
| Group1: Off |
| Group2: Off |
| Check Box7: Off |
| Group3: Off |
| Check Box9: Off |
| Check Box12: Off |
| Check Box15: Off |
| Check Box16: Off |
| Check Box17: Off |
| Check Box18: Off |
| Text19: 811210 |
| Quote Number: |
| Quote Date: |
| Quote Expiration Date: |
| QuantityBase Term Technical Support Service: 12 |
| Unit PriceMonths: |
| Total AmountMonths: 0 |
| QuantityBase Term Preventive Maintenance Service: 12 |
| Unit PriceMonths_2: |
| Total AmountMonths_2: 0 |
| QuantityBase Term Repair Service: 12 |
| Unit PriceMonths_3: |
| Total AmountMonths_3: 0 |
| QuantityBase Term Software Update Service: 12 |
| Unit PriceMonths_4: |
| Total AmountMonths_4: 0 |
| QuantityOption Year 1 Technical Support Service: 12 |
| Unit PriceMonths_5: |
| Total AmountMonths_5: 0 |
| QuantityOption Year 1 Preventive Maintenance Service: 12 |
| Unit PriceMonths_6: |
| Total AmountMonths_6: 0 |
| QuantityOption Year 1 Repair Service: 12 |
| Unit PriceMonths_7: |
| Total AmountMonths_7: 0 |
| QuantityOption Year 1 Software Update Service: 12 |
| Unit PriceMonths_8: |
| Total AmountMonths_8: 0 |
| QuantityOption Year 2 Technical Support Service: 12 |
| Unit PriceMonths_9: |
| Total AmountMonths_9: 0 |
| QuantityOption Year 2 Preventive Maintenance Service: 12 |
| Unit PriceMonths_10: |
| Total AmountMonths_10: 0 |
| QuantityOption Year 2 Repair Service: 12 |
| Unit PriceMonths_11: |
| Total AmountMonths_11: 0 |
| QuantityOption Year 2 Software Update Service: 12 |
| Unit PriceMonths_12: |
| Total AmountMonths_12: 0 |
| QuantityOption Year 3 Technical Support Service: 12 |
| Unit PriceMonths_13: |
| Total AmountMonths_13: 0 |
| QuantityOption Year 3 Preventive Maintenance Service: 12 |
| Unit PriceMonths_14: |
| Total AmountMonths_14: 0 |
| QuantityOption Year 3 Repair Service: 12 |
| Unit PriceMonths_15: |
| Total AmountMonths_15: 0 |
| QuantityOption Year 3 Software Update Service: 12 |
| Unit PriceMonths_16: |
| Total AmountMonths_16: 0 |
| QuantityOption Year 4 Technical Support Service: 12 |
| Unit PriceMonths_17: |
| Total AmountMonths_17: 0 |
| QuantityOption Year 4 Preventive Maintenance Service: 12 |
| Unit PriceMonths_18: |
| Total AmountMonths_18: 0 |
| Unit PriceMonths_19: |
| Unit PriceMonths_20: |
| Unit PriceMonths_21: |
| Unit PriceMonths_22: |
| Unit PriceMonths_23: |
| Unit PriceMonths_24: |
| Total Quoted Price: 0 |
| Name: |
| Title: |
| Contact Information: |
| Date: |
| Total AmountMonths_19: 0 |
| Total AmountMonths_20: 0 |
| Total AmountMonths_21: 0 |
| Total AmountMonths_22: 0 |
| Total AmountMonths_23: 0 |
| Total AmountMonths_24: 0 |
| QuantityOption Year 4 Repair Service: 12 |
| QuantityOption Year 4 Software Update Service: 12 |
| QuantityOption to Extend Up to Six Months Technical Support Service: 6 |
| QuantityOption to Extend Up to Six Months Preventive Maintenance Service: 6 |
| QuantityOption to Extend Up to Six Months Repair Service: 6 |
| QuantityOption to Extend Up to Six Months Software Update Service: 6 |
File details come from the government source that posted it. Updated .