Attachment B1 - SF 114.pdf

DATE OF ACCEPTANCE JOB TITLE OF CONTRACTING OFFICER (Type or print)

AUTHORIZED FOR LOCAL REPRODUCTION

previous edition is usable

STANDARD FORM 114 (REV. 5/2003)

Prescribed by GSAFPMR (41 CFR) 101-45.3

RETURN WITH BID

SALE OF GOVERNMENT PROPERTY- BID AND AWARD

(See SF 114C for Privacy Act Statement)

INVITATION FOR BIDS NO. PAGE NO.

ISSUED BY ADDRESS YOUR BID TO:

AGENCY'S NAME

FOR INFORMATION CONTACT:

BUREAU/SERVICE/OFFICE

ACCEPTANCE BY THE GOVERNMENT (This section for Government Use Only)

ACCEPTED AS TO ITEM(S) NUMBERED AMOUNT($) CONTRACT NUMBER(S)

BY - UNITED STATES OF AMERICA (Contracting Officer) NAME OF CONTRACTING OFFICER (Type or print)

NAME

STREET

CITY STATE ZIP CODE

TELEPHONE

AREA CODE PHONE EXTENSION

BIDDER ID NUMBER BIDDER'S TIN/SOCIAL SECURITY NO.

SIGNATURE OF PERSON AUTHORIZED TO SIGN THIS BID DATE OF BID

NAME OF SIGNER (Type or print) JOB TITLE OF SIGNER (Type or print)

ZIP CODE

NAME

TELEPHONE

AREA CODE NUMBER EXTENSION

E-MAIL ADDRESS

BIDS WILL BE

OPENED AT

PLACE

DATE TIME

SEALED BIDS

Sealed bids for purchasing any or all items listed on the accompanying schedule, will be received at the place designated above until the date and time specified above and at that time publicly opened. (Copies of the below mentioned forms, if not attached, are on file at the issuing office and are available upon request). Bidder is required to pay for any or all of the items listed on the Item Bid page(s) as part of this Bid, at the price sent opposite each.

NO. OF COPIES

SUBJECT TO

SF 114C, General Sale Terms and Conditions Other Special Terms and Conditions Attached Incorporated by reference:

IF 'YES", PERCENTAGE OF TOTAL

BID

DEPOSIT MADE PAYABLE TO PAYMENT DUE

(Calendar Days)

REMOVAL OF PROPERTY

(Calendar Days)

BID (Completed by Bidder)

In compliance with the above, the undersigned offers and agrees, if this Bid is accepted (60 calendar days if no period is specified by the Government or the Bidder, but not less than 10 calendar days in any case) after date of Bid opening, to pay for and remove the property.

BID ACCEPTANCE (Calendar Days) TOTAL AMOUNT

BID DEPOSIT REQUIRED

YES NO

DEPOSIT ATTACHED

YES NO

DEPOSIT FORM(S) AMOUNT OF DEPOSIT

BIDDER REPRESENTS THAT:

(Check appropriate boxes)

BIDDER REPRESENTS THAT: (Check appropriate boxes) (Complete if the total amount of the bid(s) exceeds $25,000.)

YES YESNOACTION NOACTION

Property was inspected Bidder is an individual Bidder is a small business. (See CFR, title 13, Chapter 1, Part 121, Sec. 121.3-9, for the definition of small business.)

Bidder employed or retained any company or person (other than a full-time, bona fide employee working solely for the Bidder) to solicit or secure this contract.

Bidder paid or agreed to pay any company or person (other than a full-time, bona fide employee working solely for the Bidder) any fee, commission, percentage or brokerage fee, contingent upon or resulting from the award of this contract.

Bidder agreed to furnish information relating to use of a company or person in securing or soliciting contract as requested by the Contracting Officer.

B

ID

D E

R 'S

IN

FO

R

M A

TI

O

N

STREET ADDRESS

CITY STATE

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DATE OF ACCEPTANCE

JOB TITLE OF CONTRACTING OFFICER (Type or print)

AUTHORIZED FOR LOCAL REPRODUCTION

previous edition is usable STANDARD FORM 114 (REV. 5/2003) Prescribed by GSAFPMR (41 CFR) 101-45.3

RETURN WITH BID

SALE OF GOVERNMENT PROPERTY- BID AND AWARD

(See SF 114C for Privacy Act Statement)

INVITATION FOR BIDS NO.

PAGE NO.

ISSUED BY

ADDRESS YOUR BID TO:

AGENCY'S NAME

FOR INFORMATION CONTACT:

BUREAU/SERVICE/OFFICE

ACCEPTANCE BY THE GOVERNMENT (This section for Government Use Only)

ACCEPTED AS TO ITEM(S) NUMBERED

AMOUNT($)

CONTRACT NUMBER(S)

BY - UNITED STATES OF AMERICA (Contracting Officer) NAME OF CONTRACTING OFFICER (Type or print)

NAME

STREET

CITY

STATE

ZIP CODE

TELEPHONE

AREA CODE

PHONE

EXTENSION

BIDDER ID NUMBER

BIDDER'S TIN/SOCIAL SECURITY NO.

SIGNATURE OF PERSON AUTHORIZED TO SIGN THIS BID

DATE OF BID

NAME OF SIGNER (Type or print) JOB TITLE OF SIGNER (Type or print)

ZIP CODE

NAME

TELEPHONE

AREA CODE

NUMBER

EXTENSION

E-MAIL ADDRESS

BIDS WILL BE OPENED AT

PLACE

DATE

TIME

SEALED BIDS

Sealed bids for purchasing any or all items listed on the accompanying schedule, will be received at the place designated above until the date and time specified above and at that time publicly opened. (Copies of the below mentioned forms, if not attached, are on file at the issuing office and are available upon request). Bidder is required to pay for any or all of the items listed on the Item Bid page(s) as part of this Bid, at the price sent opposite each.

NO. OF COPIES

SUBJECT TO

SF 114C, General Sale Terms and Conditions Other Special Terms and Conditions Attached Incorporated by reference:

IF 'YES", PERCENTAGE OF TOTAL BID

DEPOSIT MADE PAYABLE TO

PAYMENT DUE (Calendar Days) REMOVAL OF PROPERTY (Calendar Days) BID (Completed by Bidder) In compliance with the above, the undersigned offers and agrees, if this Bid is accepted (60 calendar days if no period is specified by the Government or the Bidder, but not less than 10 calendar days in any case) after date of Bid opening, to pay for and remove the property.

BID ACCEPTANCE (Calendar Days)

TOTAL AMOUNT

BID DEPOSIT REQUIRED

YES

NO

DEPOSIT ATTACHED

YES

NO

DEPOSIT FORM(S)

AMOUNT OF DEPOSIT

BIDDER REPRESENTS THAT:

(Check appropriate boxes) BIDDER REPRESENTS THAT: (Check appropriate boxes) (Complete if the total amount of the bid(s) exceeds $25,000.)

YES

YES

NO

ACTION

NO

ACTION

Property was inspected Bidder is an individual Bidder is a small business. (See CFR, title 13, Chapter 1, Part 121, Sec. 121.3-9, for the definition of small business.)

Bidder employed or retained any company or person (other than a full-time, bona fide employee working solely for the Bidder) to solicit or secure this contract.

Bidder paid or agreed to pay any company or person (other than a full-time, bona fide employee working solely for the Bidder) any fee, commission, percentage or brokerage fee, contingent upon or resulting from the award of this contract.

Bidder agreed to furnish information relating to use of a company or person in securing or soliciting contract as requested by the Contracting Officer.

BIDDER'S INFORMATION

STREET ADDRESS

CITY

STATE

8.2.1.4029.1.523496.503679