Solicitation_-_SF33.rtf.pdf
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- Solicitation Notice for Workers' Compensation Medical Bill Processing (WCMBP) Federal contract opportunity
- Solicitation number
- DOL141RP21903
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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 1605 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 _____________________________ 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
A SOLICITATION/CONTRACT FORM 14 I CONTRACT CLAUSES 8
B SUPPLIES OR SERVICES AND PRICES/COSTS 13 PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.
C DESCRIPTION/SPECS./WORK STATEMENT 347 J LIST OF ATTACHMENTS
D PACKAGING AND MARKING 1 PART IV - REPRESENTATIONS AND INSTRUCTIONS
E INSPECTION AND ACCEPTANCE 5
F DELIVERIES OR PERFORMANCE 44
G CONTRACT ADMINISTRATION DATA 12 L INSTR., CONDS., AND NOTICES TO OFFERORS 35
H SPECIAL CONTRACT REQUIREMENTS 20 M EVALUATION FACTORS FOR AWARD 12
K
REPRESENTATIONS, CERTIFICATIONS AND OTHER 7
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:
CODE 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 CODE CODE
PHONE: FAX:
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
DOL141RP21903
X
13 January 2014
OASAM Office of Procurement Services
U. S. Department of Labor See Item 7
RM S4307
200 Constitution Ave., NW
Washington DC 20210
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
DOL141RP21903 A
Table of Contents
PART I - THE SCHEDULE .......................................................................................................................... A-1
SECTION A - SOLICITATION/CONTRACT FORM ................................................................................ A-1
SF 33 SOLICITATION, OFFER AND AWARD ............................................................................... A-1
PART I - THE SCHEDULE............................................................................................................................ B-1
SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS ................. B-Error! Bookmark not defined.
SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK ..................................... C-1
SECTION D - PACKAGING AND MARKING ........................................................................................... D-2
SECTION E - INSPECTION AND ACCEPTANCE.................................................................................... E-1
SECTION F - DELIVERIES OR PERFORMANCE ................................................................................... F-2
SECTION G - CONTRACT ADMINISTRATION DATA .......................................................................... G-1
SECTION H - SPECIAL CONTRACT REQUIREMENTS ......................... H-Error! Bookmark not defined.
PART II - CONTRACT CLAUSES .............................................................................................................. I-1
SECTION I - CONTRACT CLAUSES ...................................................................................................... I-1
PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS ................................ J-1
SECTION J - LIST OF ATTACHMENTS .................................................................................................... J-1
PART IV - REPRESENTATIONS AND INSTRUCTIONS ................................................................... K-1
SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF
OFFERORS ............................................................................................................................................ K-1
K.1 NOTICE LISTING SOLICITATION PROVISIONS INCORPORATED BY REFERENCE ....... K-1
K.2 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (NOV 2011)K-Error! Bookmark not defined.
K.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JAN 2011)K-Error! Bookmark not defined.
K.4 52.227-15 STATEMENT OF LIMITED RIGHTS DATA AND RESTRICTED COMPUTER
SOFTWARE (DEC 22007) ........................................................... K-Error! Bookmark not defined.
K.5 SIGNATURE BLOCK .................................................................. K-Error! Bookmark not defined.
SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS .............................. L-1
SECTION M - EVALUATION FACTORS FOR AWARD ........................................................................ M-1
DOL141RP21903
PART I - THE SCHEDULE
SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS
See Section J - Attachment 1 – Supplies or Services and Price/Costs
B.1 PRICE/COST SCHEDULE
See Attachment - “Section B – Schedule of Supplies or Services and Prices-Costs”
SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK
See Attachment - “Section C – Performance Work Statement”
SECTION D - PACKAGING AND MARKING
No information or documentation for this section.
SECTION E - INSPECTION AND ACCEPTANCE
See Attachment – “Section E – Inspection and Acceptance”
SECTION F - DELIVERIES OR PERFORMANCE
See Attachment - “Section F – Deliveries or Performance”
SECTION G - CONTRACT ADMINISTRATION DATA
See Attachment – “Section G – Contract Administration Data”
SECTION H - SPECIAL CONTRACT REQUIREMENTS
See Attachment – “Section H – Special Contract Requirements”
PART II CONTRACT CLAUSES
SECTION I - CONTRACT CLAUSES
See Attachment – “Section I – Contract Clauses”
PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS
SECTION J - LIST OF ATTACHMENTS
See Attachments
PART IV - REPRESENTATIONS AND INSTRUCTIONS
SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF
OFFERORS
See Attachment – “Section K – Contract Clauses”
SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS
See Attachment – “WCMBP Section L ‘Instructions, Conditions, and Notices to Offerors”
SECTION M - EVALUATION FACTORS FOR AWARD
See Attachment – “WCMBP Section M – Evaluation Factors for Award
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