Amendment 1.pdf

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Great Plains Area lndian Health Service 1 15 4th Avenue SE Federal Building, Room 309 Aberdeen, SD 57401 ll{lay 14,2021

OUR REFERENCE: CRHC/Procurement Amendment No. One (1)

CRHC21-28

To whom it may concern:

Enclosed is the SF-l8 document in reference to solicitation number CRHC21-25. Please retain for your ow1r records.

Should you have any questions or need information, please contact Paige Kerstiens, Purchasing Agent at

(60s) e64-1s6s.

Sincerely, &,1*/t. /lrut,7q",< Danielle Chasing Hawli/ Supervisory Contract SPecialist Cheyenne River Health Center

Attachments cc: file

THIS RFQ IS A SMALL BUSINESS SET-ASIDE

PAGE OFPAGES

1of 2REoUEST FOR QUOTATIONS

(THIS IS NOT AN ORDER)

RATING

I. REQUEST NO.

ceF4C.,1-28

2. DATE ISSUED

511712021

3. REQUISITION/PURCHASIT Kts(2utD I I

CRHC21-28 Amend. #1 LTNDER BDSA REG.2

AND/OR DMS REG. I

6. DELIVER BY (Date)

5A, ISSUED BY"ii6i"Ertte lndian Health Service, Chevennelly:t99*ice Unit oA-r-?A.tAAth qr po Rox 1012 Eaole Butte, sD 57625 l-l nos DESTINATIoN X rr* schectu!15b. FOR INIUKMA

9. DESTINATION

NAME

Paige Kerstiens AREA CODE

NUMBER

964-1 565

a. NAME OF CONSIGNEE

Chevenne River Service Unit

-b.

STREET ADDRESS

242761661h St, PO Box 1012

c. CITY

Eagle Buttea, NAME b. LUM

c. STREET ADDRESS

d. STATE

SD

e. ZIP CODE

57625d CITY e. STATE I. LIY

io. PLEASE FURNISH QUoTATIoNS To

THE ISSUING OFFICE IN BLOCK

5a ON OR BY l:00 PM MST ON (Date)

May 28,2021

IMPOR-I-AN I:

so indicate on th costs incurred ir domestic origin r)rrntatinn( mlrsl

I hts ls a requesl Ior lnrotmatturt, alru quulalrvlrr is form and ietum it to the address in Block 5a. This request does not commit the Government to pay any

,r,"pi.p"Ji""ofthesubmissionofthisquotationortocontractforsuppliesorservices Suppliesareof unless otherwise indicated by quot"r Any representations and/or certifications attached to this Request for he comnleted bv the quoter.

cnr.rnnt tr F llnrludo nnnlirohle Federal. State and local toxes)

ITEMNO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

I.'NIT

(d)

TINIT PRICE

(e)

AMOUNT

(fl

Amendment No. One (l), to CRHC2I-28, hereby authorizes the following changes:

1) Change last day to submit questions from May 23,2021at l:00 PM MST, to May 24,2021 at 1:00 PM

MST.

2) All else remains the same.

There are no other changes by reason of this Amendment.

12. DISCOUNT FOR PROMPT

PAYMENT

a.

10 CALENDAR DAYS b.20

CALENDAR

DAYS%

c. 30 CALENDAR DAYS Yo

d. CALENDAR DAYS

NUMBER I PERCENTAGE

NOTE: Additional provisions and reprpqg4laqlp4g are are not attached.

I3. NAME AND ADDRESS OF QUOTER E srcNeruRr oF PERSoN AUTHoRIZED To

SIGN QUOTATION

15. DATE OF

QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

I6. SIGNER

a. NAME (Type of Print) b. TELEPHONE

AREACODE

d. crTY I e. STATE f.ZIP CODE c. TITLE (type or Pnnt) NUMBER lous AurHoRzg,o FoR LocAL REPRoDUCTIoN STANDARD FORM l8 (REV 6-95) Prev edition not usable

FormFloilDelrina Inc.

Prescribed by GSA-FAR (48 CFR) 53-215-l(a) suppltr,slsERVlcES

DLrNS & Bradstreet Number:

iln" ouns a gradstreet number is required' i'rovided you do not have it, you may call 866-705-

5711 andtbtain one.) You will need a DUNS &

Bradstreet NUMBER to be awgrded the oqchase ffiiiitt"r"d with the Svst"m ro' Aword

Management: vou can reeister al wwwsam"gov

The quoter is hereby notified that they must be registered in the System for Award Management

(SAVI) before the Government will issue an award. You may do this by going to www'sam'gov to register and you are required to update this registration

.rity yeur prior to the expiration date'

No contract award shall be made to a vendor listed on the OIG Exclusion List (http ://exlusions.oi g.hhs. gov) throughout the duration of the contract.

Federal Tax ID Number: