RFQ_NO._DTFH7116Q00044.pdf

DTFH7116Q00044

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

08/09/2016 EFL16PP132

1 2

Eastern Federal Lands Highway Div.

Acquisitions Office/JAN BEAVER 21400 Ridgetop Circle

Federal Highway Administration

703-404-6216 Sterling VA 20166-6511

08/29/2016

Federal Highway Administration

Eastern Federal Lands Highway Div.

Planning and Programming Office 21400 Ridgetop Circle

Sterling

VA 20166-6205

703 404-6216Jan Beaver

08/19/2016 1400 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

Project: ROCR 10(5) Schedule B DC DOEE E&SC and Stormwater Issuance Fees

00001 DC Department of Energy & Environment Stormwater Management Plan Review Final Issuance Fee.

00002 DC Department of Energy & Environment Soil Erosion and Sediment Control Plan Review Final Issuance Fee.

00003 DCRA Building Permit Fee.

IMPORTANT PAYMENT REQUIREMENT: IN ACCORDANCE

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

DTFH7116Q00044

WITH FEDERAL ACQUISITION REGULATION (FAR) SUBPART

4.1102, PROSPECTIVE CONTRACTORS SHALL BE

REGISTERED IN THE SYSTEM FOR AWARD MANAGEMENT

(SAM) DATABASE PRIOR TO AWARD OF A CONTRACT. FAR

CLAUSE 52.232-33 REQUIRES SAM REGISTRATION FOR

PAYMENT. IN ADDITION, WHEN SETTING UP VENDOR

INFORMATION IN THE SAM DATABASE, THE D&B LEGAL

NAME SHOULD BE THE SAME AS THE IRS CONSENT NAME.

SAM REGISTRATION IS AVAILABLE ONLINE AT

WWW.SAM.GOV.

RESPONSES TO REQUEST FOR QUOTATION WILL BE

ACCEPTED VIA FAX NUMBER 571-434-1551, EMAIL:

JAN.BEAVER@DOT.GOV, OR MAIL TO THE ADDRESS IN

BLOCK NO. 9, AND MUST BE RECEIVED BY 2:00 PM,

EST, FRIDAY, AUGUST 19, 2016.

THIS SOLICITATION INCORPORATES BY REFERENCE, WITH

THE SAME FORCE AND EFFECT AS IF THEY WERE GIVEN

IN FULL TEXT, THE FOLLOWING FEDERAL ACQUISITION

REGULATION (FAR) CLAUSES:

52.213-4 TERMS AND CONDITIONS—SIMPLIFIED

ACQUISITIONS (OTHER THAN COMMERCIAL ITEMS) (OCT

2015).

52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN

TEXT MESSAGING WHILE DRIVING (AUG 2011).

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)