Attachment 4 - Response Form .pdf
PDF 112 KB Posted
- Attached to
- X-Ray Inspection/Screening Systems
- Solicitation number
- FA461324Q1066
About this file
This document is an Offeror Response Form for a federal contract opportunity. The solicitation is for the purchase of two RAPISCAN ORION 920DX X-ray Inspection Systems for the Department of the Air Force Global Strike Command. The contract will be a Firm Fixed-Price contract awarded to the responsible offeror with the lowest priced technically acceptable quote. Quotes are due by September 23, 2024 at 11:00 am MT. The contract will be awarded as a Total Small Business Set-Aside under NAICS code 334511. The contractor must be registered in SAM.gov at the time of quote submission. The quoted price must include all costs to furnish, deliver, install, and train personnel on the X-ray systems in accordance with the attached Statement of Work. The contractor must also provide specification sheets, pictures, and a one-year warranty with on-site 72-hour response time. Award will be made to the lowest priced quote that meets the technical requirements.
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Text version
Attachment 4 - Response Form
FA461324Q1066
Offeror Response Form
Solicitation Number: FA461324Q1066 Description: WGF X-RAY Machines
Company Information
Company Name (as registered in SAM.gov):
Registered in SAM under NAICS 336411:
Cage Number: Unique Entity ID:
Mailing Address:
Socioeconomic Status (SB, SDB, WOSB, EDWOSB, VOSB, SDVOSB, 8(a), 8(a) JV, HUBZone):
Point of Contact:
Email: Phone number:
City/State/Zip Code of MANUFACTURER:
Period of Performance Start Time (in days) after award:
Delivery Date:
YES or NO - Registered with System for Award Management at the time of submission of quote:
YES or NO - Confirm quoted price is for TWO (2) each RAPISCAN ORION 920DX and meets ALL salient characteristics per specifications listed in the Statement of Work.
In the preceding fiscal year, did your company received 80 percent or more of its annual gross revenues from Federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of Federal financial assistance; and did $25,000,000 or more in annual gross revenues come from Federal contracts (and subcontracts), loans, grants (and subgrants), cooperative agreements, and other forms of Federal financial assistance:
YES If yes, compliance IAW 4.1402 applies.
NO If no, then the requirements of FAR 52.204-10 do not apply.
My signature below acknowledges and confirms the quoted total price in the amount of
$________________ includes ALL materials, labor, tools, equipment, shipping, delivery, installation, training, warranty, etc., ALL costs, direct and indirect, to complete the requirement in accordance with the Statement of Work and Solicitation Number FA461324Q1066.
COMPANY NAME: __________________________________________________________
PRINT NAME and TITLE SIGNATURE and DATE
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