Attch 3 - Contractor Submittal Form.docx

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Roman Catholic Priest Services, PAFB CO
Solicitation number
FA2517-21-Q-9002
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Attachment 3 Contractor Submittal Form

FA2517-21-Q-9002

Please complete the following:

1
Contractor Name
2
DUNS Number
3
CAGE Code
4
NAICS Code (Must match para. iv of the RFQ and offeror must be registered in SAM under this NAICS in order to be considered responsive)
5
Point of Contact
6
Address
7
Phone Number
8
Email address
9
Payment Terms (Net 30 unless any discount terms are offered)

CLIN Information Please complete the following:

CLIN
Supplies/Services
Qty
Unit
Unit Price ($)
Total Amount ($)
0001
Catholic Priest Services
7
Months
1001
Catholic Priest Services
12
Months
2001
Catholic Priest Services
12
Months
3001
Catholic Priest Services
12
Months
4001
Catholic Priest Services
12
Months
5001
Catholic Pries Services (6-month extension)
6
Months

** The anticipated start date is 1 June 2021. Place of performance is Peterson AFB, CO.

Company Name Name Title

___________________________________________________
SignatureDate

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