BETA.SAM - SOLICITATION QUOTATION WORKSHEET.pdf

SOLICITATION QUOTATION WORKSHEET for W912NR-22-R-0056

VENDOR NAME: _______________________________________________________________

PHONE #______________________ FAX #___________________________

Point of Contact: ______________________________________________________________

UEI _______________ DUNS & BRADSTREET # _______________ CAGE CODE_____________

Federal Tax ID ___________________

SIZE OF BUSINESS (SMALL/LARGE) _______________

SMALL BUSINESS SUB-CATEGORY (IF APPLICABLE) ______________________

NAME OF PERSON QUOTING PRICE___________________________________________

DATE QUOTE RECEIVED________________

27 AUGUST 2022 – Combined Synopsis/Solicitation posted

1 SEPTEMBER 2022 / 10:00 am CST – Deadline for questions/clarifications (If applicable)

7 SEPTEMBER 2022 / 02:00 p.m. CST– Solicitation closes

Requirement Description:

Qty 1 battery powered walk behind variable reach heavy duty forklift with a 3,500 lb lift capacity

ITEM DESCRIPTION QTY UNIT PRICE TOTAL PRICE

________ __________ 0001 Forklift 1 EA

Total: __________________________

Vendors are advised that the solicitation closes on 07 September 2022 / 02:00 p.m. Central Time. All proposals/ quotes shall be emailed to 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):

crystal.l.stiles2.mil@army.mil, 318-290-5933, Crystal L. Stiles, 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

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