BETA.SAM - SOLICITATION QUOTATION WORKSHEET.pdf

SOLICITATION QUOTATION WORKSHEET for W912NR-22-R-0009

VENDOR NAME: _______________________________________________________________

PHONE #______________________ FAX #___________________________

Point of Contact: ______________________________________________________________

UEI _______________ CAGE CODE_____________ Federal Tax ID ___________________

SIZE OF BUSINESS (SMALL/LARGE) _______________

NAME OF PERSON PROVIDING PROPOSAL_________________________________________

DATE Proposal Received________________

8 August 022 – Combined Synopsis/Solicitation posted

11 August 2022 / 02:00 p.m. – Deadline for questions/clarifications

18 August 2022 / 02:00 p.m. – Solicitation closes

Requirement Description:

Shop Rag cleaning service see Performance Work Statement attached.

ITEM DESCRIPTION QTY UNIT PRICE TOTAL PRICE

________ __________ 0001 rag cleaning est. # by PWS EA

Total: __________________________

Vendors are advised that the solicitation closes on 18 August 2022 / 02:00 p.m. Central Time. All proposals/ quotes shall be emailed to Ms. Crystal L. Stiles / crystal.l.stiles2.mil@army.mil.

Contracting Office Address: USPFO for Louisiana, 420 F Street, Camp Beauregard, Pineville, LA 71360

POINT OF CONTACT(S):

Point of Contact(s):318-290-5933, Crystal L. Stiles, Supervisory Contract Specialist.

COMMENTS: Prices are all inclusive meaning that all services, supplies and delivery need to be included.

mailto:reva.l.johnson3.mil@army.mil mailto:crystal.l.stiles2.mil@army.mil reva.cummings Highlight reva.cummings Highlight reva.cummings Highlight reva.cummings Highlight reva.cummings Highlight

Representation. As prescribed in 4.2105(a), complete the following representation in FAR Clause 52.204-24(d) Representation. The Offeror represents that —

(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional disclosure information required at paragraph (c)(1) of this section if the Offeror responds “will” in paragraph (d)(1) of this section; and

(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—It □ does,

□ does not use covered telecommunications equipment or services, or use any equipment, system, or service that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information required at paragraph (c)(2) of this section if the Offeror responds “does” in paragraph (d) (2) of this section.

Vendor Name: _______________________________________________________________________________

Authorized Representative Name/Title: ____________________________________________________________ (Print Name/Title)

Authorized Representative Signature: ______________________________________________________________

NOTE: For your offer to be considered ensure the following:

Worksheet has been accurately and completely filled out.

Registration in SAM is current and accurate.

Pricing for all items listed and total of all items complete.

Representation selection has been made (#1 & #2).

Submission made via email by the specified time and date.

ITEM DESCRIPTION QTY UNIT PRICE TOTAL PRICE