Attach_3_Contractor_Submittal_Form.pdf

FA2517-17-Q-5056

Attachment 3 Contractor Submittal Form

RFQ# FA2517-17-Q-5056

Please complete the following:

1 Contractor Name

2 DUNS Number

3 CAGE Code

4 NAICS Code (Must match para. 1 of the RFQ and offeror must be registered in SAM under this NAICS in order to be considered responsive)

337215

5 Point of Contact

6 Address

7 Phone Number

8 Email address

9 Payment Terms (Net 30 unless any discount terms are offered)

10 GSA Contract #

CLIN Information

CLIN Supplies Extended Item Description

Qty Unit Unit Price ($) Total Amount ($)

0001 Remove and replace of existing lockers/benches

Provide all tools, materials, equipment and personnel necessary to remove and dispose of existing lockers/benches and provide new lockers/benches with installation for Fitness Center located in Bldg. 560 at PAFB, CO

1 Job

Total Price

_______ The Contractor takes NO EXCEPTION to the requirements in the SOW.

FA2517-17-Q-5056

** Delivery shall be made by 180 days after contract award Peterson Air Force Base, Colorado. All information described in Statement of Work, dated 27 July 2017. All deliverables are FOB destination.