3._Contractor_Submittal_Form.docx
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- Repair Relays PSS
- Solicitation number
- FA2517-18-R-5016
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FA2517-17-Q-5044
FA2517-17-Q-5044
FA2517-18-R-5016
Attachment 3 Contractor Submittal Form
RFQ# FA2517-18-R-5016
Please complete the following:
| 1 |
| Contractor Name |
| 2 |
| DUNS Number |
| 3 |
| CAGE Code |
| 4 |
| NAICS Code (Must match para. (iv) of the RFQ and offeror must be registered in SAM in order to be considered responsive) |
| 238210 |
| 5 |
| Point of Contact |
| 6 |
| Address |
| 7 |
| Phone Number |
| 8 |
| Email address |
| 9 |
| Payment Terms (Net 30 unless any discount terms are offered) |
| 10 |
| [Contractor Name]: |
CLIN Information
| CLIN |
| Supplies |
| Qty |
| Unit |
| Unit Price ($) |
| Total Amount ($) |
| 0001 |
| Repair Relays PSS, IAW the SOW – Attachment 1, dated 26 July 2018 |
| 1 |
| Lot |
Total Price
** Delivery & Installation shall be completed at Peterson Air Force Base (AFB) Colorado, within 150 days after the date of contract award. Include all shipping costs (if applicable) in the total amount quoted. By completing and signing this form you are certifying that you are able to meet all requirements as outlined in the Statement of Work, dated 26 July 2018, attachment 1 to the solicitation FA2517-18-R-5016.
Company Name
Name
Title
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