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FA2517-17-Q-5044
FA2517-17-Q-5044
FA2517-19-Q-XXXX
Attachment 2 Contractor Submittal Form
RFQ# FA2517-19-Q-XXXX
Please complete the following:
| 4 |
| NAICS Code (Must match para. (iv) of the RFQ and offeror must be registered in SAM in order to be considered responsive) |
| 811310 |
| 9 |
| Payment Terms (Net 30 unless any discount terms are offered) |
CLIN Information
| CLIN |
| Portable /Wheeled Type Fire Extinguishers |
| Max # of Fire Ext |
| Price Per Unit |
| Ordering Period Total |
(Unit Price times Max # of fire ext)
Annual Insp/Maint
| 0002 |
| BC, Dry Chemical (wheeled), 125 lbs |
| 50 |
| $ |
| $ |
| 0003 |
| Halon Ext (wheeled), 150 lbs |
| 300 |
| $ |
| $ |
| 0004 |
| 23 Cubic Feet Nitrogen |
| 50 |
| $ |
| $ |
5 & 6 Yr
| 0008 |
| Class D, 30 lbs |
| 7 |
| $ |
| $ |
| 0009 |
| Class K, 6 Ltr |
| 26 |
| $ |
| $ |
| 0011 |
| BC, Dry Chemical (wheeled), 125 lbs |
| 12 |
| $ |
| $ |
| 0012 |
| Halon Ext (wheeled), 150 lbs |
| 62 |
| $ |
| $ |
| 0013 |
| 23 Cubic Feet Nitrogen |
| 14 |
| $ |
| $ |
12-Yr Hydro Testing/Recharging
| 0017 |
| Class D, 30 lbs |
| 13 |
| $ |
| $ |
| 0018 |
| BC, Dry Chemical (wheeled), 125 lbs |
| 13 |
| $ |
| $ |
| 0019 |
| Halon Ext (wheeled), 150 lbs |
| 6 |
| $ |
| $ |
IAW PWS Para 1.3 Ktr will be responsible for parts and materials for repairs up to a cap of $1,500.00 annually. This will not be separately priced but captured in the individual price of each item
** Inspection and repairs shall be completed at different locations on Peterson Air Force Base (AFB) Colorado. Work will commence within 15 days after the date of contract award. Include all labor 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 22 July 2019, attachment 1 to the solicitation FA2517-19-Q-XXXX.
Company Name
Name
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