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Attachment 2 Contractor Submittal Form ANRS and Consortium II Maintenance Support
FA2517-16-Q-6038
Please complete the following:
| 4 |
| NAICS Code (Must match para. iv of the RFQ and offeror must be registered in SAM under this NAICS in order to be considered responsive) |
| 9 |
| Payment Terms (Net 30 unless any discount terms are offered) |
CLIN Information Please complete the following:
| CLIN |
| Supplies/Services |
| Qty |
| Unit |
| Unit Price ($) |
| Total Amount ($) |
| 0001 |
| NXT Communicator Remote Hosted Service Subscription– In Accordance With (IAW) para 2.0, Task 1, of SOW, PoP 29 Sep 16 to 28 Sep 17 |
| 12 |
| MO |
| 0002 |
| Desktop Alert Annual Software Maintenance Support Bundle IAW para 2.0, Task 3, of SOW, PoP 29 Sep 16 to 28 Sep 17 |
| 12 |
| MO |
| 0003 |
| Alert Notification and Recall Systems (ANRS) Program Management and Systems Engineering Services IAW para 2.0, Task 4 of SOW, PoP 29 Sep 16 to 28 Sep 17 |
| 1 |
| Lot |
| 0004 |
| Consortium Conference Bridge Maintenance Services IAW para 2.0, Task 2 of SOW, PoP 29 Sep 16 to 28 Sep 17 |
| 1 |
| Lot |
| 0005 |
| Support Desk Services for Consortium IAW para 2.0, Task 2 of SOW, PoP 29 Sep 16 to 28 Sep 17 |
| 1 |
| Lot |
| 1001 |
| NXT Communicator Remote Hosted Service Subscription– In Accordance With (IAW) para 2.0, Task 1, of SOW, PoP 29 Sep 17 to 28 Sep 18 |
| 12 |
| MO |
| 1002 |
| Desktop Alert Annual Software Maintenance Support Bundle IAW para 2.0, Task 3, of SOW, PoP 29 Sep 17 to 28 Sep 18 |
| 12 |
| MO |
| 1003 |
| Alert Notification and Recall Systems (ANRS) Program Management and Systems Engineering Services IAW para 2.0, Task 4 of SOW, PoP 29 Sep 17 to 28 Sep 18 |
| 1 |
| Lot |
| 1004 |
| Consortium Conference Bridge Maintenance Services IAW para 2.0, Task 2 of SOW, PoP 29 Sep 17 to 28 Sep 18 |
| 1 |
| Lot |
| 1005 |
| Support Desk Services for Consortium IAW para 2.0, Task 2 of SOW, PoP 29 Sep 17 to 28 Sep 18 |
| 1 |
| Lot |
| 2001 |
| NXT Communicator Remote Hosted Service Subscription– In Accordance With (IAW) para 2.0, Task 1, of SOW, PoP 29 Sep 18 to 28 Sep 19 |
| 12 |
| MO |
| 2002 |
| Desktop Alert Annual Software Maintenance Support Bundle IAW para 2.0, Task 3, of SOW, PoP 29 Sep 18 to 28 Sep 19 |
| 12 |
| MO |
| 2003 |
| Alert Notification and Recall Systems (ANRS) Program Management and Systems Engineering Services IAW para 2.0, Task 4 of SOW, PoP 29 Sep 18 to 28 Sep 19 |
| 1 |
| Lot |
| 2004 |
| Consortium Conference Bridge Maintenance Services IAW para 2.0, Task 2 of SOW, PoP 29 Sep 18 to 28 Sep 19 |
| 1 |
| Lot |
| 2005 |
| Support Desk Services for Consortium IAW para 2.0, Task 2 of SOW, PoP 29 Sep 18 to 28 Sep 19 |
| 1 |
| Lot |
| 3001 |
| NXT Communicator Remote Hosted Service Subscription– In Accordance With (IAW) para 2.0, Task 1, of SOW, PoP 29 Sep 19 to 28 Sep 20 |
| 12 |
| MO |
| 3002 |
| Desktop Alert Annual Software Maintenance Support Bundle IAW para 2.0, Task 3, of SOW, PoP 29 Sep 19 to 28 Sep 20 |
| 12 |
| MO |
| 3003 |
| Alert Notification and Recall Systems (ANRS) Program Management and Systems Engineering Services IAW para 2.0, Task 4 of SOW, PoP 29 Sep 19 to 28 Sep 20 |
| 1 |
| Lot |
| 3004 |
| Consortium Conference Bridge Maintenance Services IAW para 2.0, Task 2 of SOW, PoP 29 Sep 19 to 28 Sep 20 |
| 1 |
| Lot |
| 3005 |
| Support Desk Services for Consortium IAW para 2.0, Task 2 of SOW, PoP 29 Sep 19 to 28 Sep 20 |
| 1 |
| Lot |
| 4001 |
| NXT Communicator Remote Hosted Service Subscription– In Accordance With (IAW) para 2.0, Task 1, of SOW, PoP 29 Sep 20 to 28 Sep 21 |
| 12 |
| MO |
| 4002 |
| Desktop Alert Annual Software Maintenance Support Bundle IAW para 2.0, Task 3, of SOW, PoP 29 Sep 20 to 28 Sep 21 |
| 12 |
| MO |
| 4003 |
| Alert Notification and Recall Systems (ANRS) Program Management and Systems Engineering Services IAW para 2.0, Task 4 of SOW, PoP 29 Sep 20 to 28 Sep 21 |
| 1 |
| Lot |
| 4004 |
| Consortium Conference Bridge Maintenance Services IAW para 2.0, Task 2 of SOW, PoP 29 Sep 20 to 28 Sep 21 |
| 1 |
| Lot |
| 4005 |
| Support Desk Services for Consortium IAW para 2.0, Task 2 of SOW, PoP 29 Sep 20 to 28 Sep 21 |
| 1 |
| Lot |
** The start date is 29 September 2016. Place of performance Peterson AFB, CO, and if needed, Cheyenne Mountain Air Force Station (CMAFS). All deliverables FOB point destination. Include all shipping costs (if applicable) in the total amount quoted.
Please complete the following:
DFARS 252.209-7992, Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law-Fiscal Year 2015 (Deviation 2015-OO0005)Appropriations (Dec 2014)
1. In accordance with sections 744 and 745 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 201 5 (Pub. L. 1 13-235), none of the funds made available by this or any other Act may be used to enter into a contract with any corporation that-
0. Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless the agency has considered suspension or debarment of the corporation and made a determination that this further action is not necessary to protect the interests of the Government; or
0. Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless the agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.
1. The Offeror represents that-
0. It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability,
0. It is [] is not [] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.
(End of provision)
Company Name
Name
Title
| ___________________________________ | ________________ | |
| Signature | | Date |
