Attachment 5 - RFQ QUOTATION FORM.docx
DOCX document 25 KB Posted
- Attached to
- Z2DA--557-23-103 | Replace Building 2 and Building 4 Generators | Construction (VA-27-00003948)
- Solicitation number
- 36C24726Q0772
About this file
This is a Request for Quotations (RFQ) vendor quotation form for a construction project to replace generators at the Carl Vinson VA Medical Center in Dublin, Georgia. The solicitation number is 36C24726Q0772, and the project number is 557-23-103. This is a Total Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside under 38 U.S.C. 8127, restricted to firms meeting the SBA VetCert verification requirements. The NAICS code is 236220 (Commercial and Institutional Building Construction) with a $45 million size standard for small business classification.
The scope of work includes temporary and permanent generator installation with replacement fuel tanks, automatic transfer switches, switchboards, electrical panels, day tanks, load banks, civil site work, physical enclosures, fire alarm and sprinkler modifications, and electronic security modifications based on provided design drawings and specifications. The contract is Firm-Fixed-Price (FFP) with a 455 calendar-day performance period from Notice to Proceed, and award will be made on a Lowest Price Technically Acceptable (LPTA) basis. Vendors must submit complete quotations including an Itemized Cost Breakdown Worksheet, a bid guarantee equal to 20 percent of the total quoted price (not to exceed $3,000,000) in the form of a bid bond, irrevocable letter of credit, or certified check, Davis-Bacon prevailing wage rates for Laurens County, Georgia, performance and payment bonds (100% each), proof of active SAM.gov registration, and SDVOSB VetCert verification. All representations and certifications must be initialed by the authorized representative. Quote response deadline is 14 September 2026 at 1300 EST, submitted via email to Contracting Officer Zaire Naylor at Zaire.Naylor@VA.GOV, with quotes remaining valid for 120 calendar days from the due date.
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ATTACHMENT 5
REQUEST FOR QUOTATIONS -- VENDOR QUOTATION FORM
Project 557-23-103 | Replace Building 2 & 4 Generators | Carl Vinson VA Medical Center, Dublin, GA Solicitation No.: 36C24726Q0772 | INSTRUCTIONS: Complete all sections. Sign and date Section 6. Submit with Volume II of your quote package. Incomplete forms will be deemed non-responsive.
SECTION 1 -- VENDOR INFORMATION
Legal Company Name
DBA / Trade Name (if different)
Unique Entity Identifier (UEI)
CAGE Code
Business Address (Street)
City, State, ZIP
Point of Contact Name
Title
Phone Number
Email Address
State of Incorporation
| Business Type |
| [ ] Corporation [ ] LLC [ ] Partnership [ ] Sole Proprietor [ ] Joint Venture |
SECTION 2 -- ELIGIBILITY AND CERTIFICATIONS
| Item |
| Response |
| SAM.gov Registration Status: |
| [ ] Active Registration Expiration Date: _______________ |
| SDVOSB Verification (SBA VetCert): |
| [ ] Verified SDVOSB VetCert ID No.: _______________ Expiration: _______________ |
| NAICS 236220 -- Size Standard $45.0M: |
| [ ] Small Business [ ] Other Than Small Avg. Annual Receipts (last 3 yrs): $_______________ |
| Limitations on Subcontracting (FAR 52.219-14): |
| [ ] Acknowledged -- Prime will perform a minimum of 15% of the contract cost for personnel with its own employees |
| Davis-Bacon Wage Determination Reviewed: |
| [ ] Yes -- Prevailing wage rates for Laurens County, GA are incorporated in quoted price [ ] No |
| Pre-Bid Site Visit: |
| [ ] Attended [ ] Did Not Attend -- site conditions independently assessed and priced |
| VETS-4212 Report (Title 38 U.S.C. 4212(d)): |
| [ ] Filed for current fiscal year -- Confirmation No.: _______________ [ ] Will file in accordance with 38 U.S.C. 4212(d) upon contract award |
| FAPIIS / Debarment / Suspension: |
| [ ] Not debarred, suspended, proposed for debarment, or ineligible for award |
SECTION 3 -- PRICE QUOTATION
| CLIN |
| Description |
| QTY |
| Unit |
| Total Quoted Price (Firm-Fixed-Price) |
| 0001 |
| Project Number 557-23-103: Work will include but is not limited to temporary generator, replacement fuel tanks, installation of new generators and all associated automatic transfer switches, switchboards, electrical panels, day tanks, load banks, civil site work, physical enclosures, fire alarm and sprinkler modifications, and electronic security based on provided A/E design drawings and specifications. All work will be done in compliance with Federal, State, and local regulations within 455 Calendar Days from NTP. |
| 1 |
| Lump Sum |
| $ |
TOTAL QUOTED PRICE
NOTE: The total quoted price must include all labor (at Davis-Bacon prevailing wage rates), materials, equipment, overhead, profit, bid bond, performance bond, payment bond, insurance, and all other direct and indirect costs required to complete the full scope of work. Prices must be Firm-Fixed-Price. Any qualifications, exceptions, exclusions, or conditions to the quoted price may result in rejection of the quote. Complete and submit Itemized Cost Breakdown Worksheet attachment as part of Volume II. Division totals must sum to the CLIN 0001 total quoted price above.
SECTION 4 -- BID GUARANTEE
A bid guarantee is required pursuant to FAR 52.228-1. Failure to submit a bid guarantee in the proper form and amount is cause for rejection of the quote as non-responsive.
Bid Guarantee Information
| Form of Bid Guarantee: |
| [ ] Bid Bond (SF 24) [ ] Irrevocable Letter of Credit (ILOC) [ ] Certified Check [ ] Cashier's Check |
| Amount of Bid Guarantee: |
| $___________________________ (must equal 20% of total quoted price; not to exceed $3,000,000) |
Surety Company Name (if bid bond):
| Surety NAIC Code / Treasury Circular 570: |
| [ ] Surety is listed on Treasury Circular 570 (https://fiscal.treasury.gov/surety-bonds/list-certified-companies.html) |
| Bid Guarantee Enclosed: |
| [ ] YES -- Attached to this quote package [ ] NO -- (Quote will be rejected as non-responsive) |
SECTION 5 -- REPRESENTATIONS AND ACKNOWLEDGMENTS
IMPORTANT: Initial each item below. Failure to initial all representations will result in rejection of your quote as incomplete. By initializing each item below, the authorized representative confirms the representations and acknowledgments:
| Initials |
| Representation / Acknowledgment |
| _____ |
| The quoter has read, understands, and agrees to comply with all terms, conditions, and requirements of Solicitation No. 36C24726Q0772 and all attachments, including the Statement of Work, construction drawings, and specifications. |
| _____ |
| The quoted price reflects the quoter's complete understanding of the scope of work and includes all costs to complete the project, including all Davis-Bacon prevailing wage rates for Laurens County, GA. |
| _____ |
| The quoter is a verified Service-Disabled Veteran-Owned Small Business (SDVOSB) under the SBA VetCert program and will maintain verified status through contract performance. |
| _____ |
| The quoter's SAM.gov registration is active and all representations and certifications in SAM are current, accurate, and complete as of the date of this quote. |
| _____ |
| The Itemized Cost Breakdown Attachment is accurate and complete. All division totals sum to the CLIN 0001 Total Quoted Price in Section 3. |
| _____ |
| Performance Bond (100%) and Payment Bond (100%) will be furnished within 10 calendar days of Notice of Award from a surety listed on Treasury Circular 570. |
| _____ |
| The quoter has not attached any qualifications, exceptions, exclusions, or conditions to this quote that would preclude the Government from evaluating it. |
| _____ |
| The quoter acknowledges receipt of all solicitation amendments issued (if any). Amendment Nos. received: _______________. If none, enter N/A. Note: Before submitting your quote, confirm you have received all amendments posted to SAM.gov for Solicitation 36C24726Q0772. List amendment numbers above. Quoters who fail to acknowledge amendments risk rejection. |
SECTION 6 -- AUTHORIZED SIGNATURE
By signing below, the quoter makes a quote to the Government of the United States to perform all work described in Solicitation No. 36C24726Q0772 for the total quoted price stated in Section 3, subject to all terms and conditions of this solicitation. This quote shall remain valid for 120 calendar days from the quote due date.
The undersigned certifies under penalty of law that all representations, certifications, and information contained in this Quotation Form are accurate, current, and complete.
Authorized Signature:
Printed Name:
Date:
Title:
Company:
Email:
Phone:
FOR GOVERNMENT USE ONLY
Quote Received Date/Time:
| Received via Email: |
| [ ] YES [ ] NO |
| Price Rank: |
| _____ of _____ quotes received |
| Bid Guarantee Verified: |
| [ ] YES [ ] NO |
| VetCert Verified by CO: |
| [ ] YES [ ] NO Date: ___________ |
| SAM.gov Active: |
| [ ] YES [ ] NO |
| Technical Rating (F1/F2/F3/F4): |
| F1: ___________ F2: ___________ F3: ___________ F4: ___________ |
| Overall Technical Rating: |
| [ ] ACCEPTABLE [ ] UNACCEPTABLE |
| Reviewed by CO: |
| _______________ Date: ___________ |
TOTAL SDVOSB SET-ASIDE | NAICS 236220 | Page 1 | FAR Parts 12 and 36 | LPTA
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