Amendment 3 - DOL110RP20935.doc

1. THIS CONTRACT IS A RATED ORDER

RATING

PAGE OF

PAGES

UNDER DPAS (15 CFR 700)

2. CONTRACT NUMBER

3. SOLICITATION NUMBER

4. TYPE OF SOLICITATION

5. DATE ISSUED

6. REQUISITION/PURCHASE NUMBER

SEALED BID (IFB)

NEGOTIATED (RFP)

7. ISSUED BY

CODE

8. ADDRESS OFFER TO

(If other than Item 7)

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

9. Sealed offers in original and ________SEE SECTION L_______ copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if handcarried, in the depository located in until local time _______________________

(Hour)

(Date)

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All Offers are subject to all terms and conditions contained in this solicitation.

A. NAME

B. TELEPHONE (NO COLLECT CALLS)

C. E-MAIL ADDRESS

AREA CODE

NUMBER

EXT.

(X)

SEC.

DESCRIPTION

PAGE(S)

(X)

SEC.

DESCRIPTION

PAGE(S)

PART I - THE SCHEDULE

PART II - CONTRACT CLAUSES

X A

SOLICITATION/CONTRACT FORM 1 X 11

I

CONTRACT CLAUSES

X B

SUPPLIES OR SERVICES AND PRICES/COSTS 3

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

X C

DESCRIPTION/SPECS./WORK STATEMENT 6 X 28

J

LIST OF ATTACHMENTS

X D

PACKAGING AND MARKING 1

PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E

INSPECTION AND ACCEPTANCE 1 X

X F

DELIVERIES OR PERFORMANCE 2

X G

CONTRACT ADMINISTRATION DATA 4 X

L

INSTR., CONDS., AND NOTICES TO OFFERORS 6

X H

SPECIAL CONTRACT REQUIREMENTS 11 X 5

M

EVALUATION FACTORS FOR AWARD

K

REPRESENTATIONS, CERTIFICATIONS AND OTHER 5

STATEMENTS OF OFFERORS

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ________ calendar days (60 calendar days unless a different period is inserted by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT

10 CALENDAR DAYS (%)

20 CALENDAR DAYS (%)

30 CALENDAR DAYS (%)

CALENDAR DAYS (%)

(See Section I, Clause No. 52-232-8)

14. ACKNOWLEDGEMENT OF AMENDMENTS

AMENDMENT NO.

DATE

AMENDMENT NO.

DATE

(The offeror acknowledges receipt of amendments to the

SOLICITATION for offerors and related documents numbered and dated:

FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER

15A. NAME AND

ADDRESS

OF OFFEROR

(Type or print)

15B. TELEPHONE NUMBER

17. SIGNATURE

18. OFFER DATE

AREA CODE

NUMBER

EXT.

15C. CHECK IF REMITTANCE ADDRESS IS DIFFERENT FROM

ABOVE - ENTER SUCH ADDRESS IN SCHEDULE

19. ACCEPTED AS TO ITEMS NUMBERED

20. AMOUNT

21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

ITEM

(4 copies unless otherwise specified)

10 U.S.C. 2304(a) ( )

41 U.S.C. 253(c) ( )

24. ADMINISTERED BY (If other than Item 7)

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

28. AWARD DATE

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

(Signature of Contracting Officer)

(REV. 9-97)

10. FOR INFORMATION CALL:

11. TABLE OF CONTENTS

AUTHORIZED FOR LOCAL REPRODUCTION

STANDARD FORM 33

Previous edition is unusable

Prescribed by GSA-FAR (48 CFR) 53.214(c)

SOLICITATION, OFFER AND AWARD

SOLICITATION

OFFER (Must be fully completed by offeror)

AWARD (To be completed by Government)

N/A 1 84

DOL110RP20935

X

99-1093-1128

OASAM Office of Procurement Services

U. S. Department of Labor

RM S4307

200 Constitution Ave., NW

Washington DC 20210

11:00AM EST

06/21/2010

SHEILA J. THOMPSON

202-693-4572 Thompson.Sheila@dol.gov

See Attached Table of Contents

OASAM Office of Procurement Services

U. S. Department of Labor

RM S4307

200 Constitution Ave., NW

Washington DC 20210

OASAM BRANCH OF INVOICE PAYMENTS

RM: S-5526

US DEPARTMENT OF LABOR

200 CONSTITUTION AVENUE, NW

WASHINGTON DC 20210