RFQ.doc

REQUEST FOR QUOTE

F2Z3TT0133A001

(This is the PR Number)

PLEASE RETURN THIS REQUEST FOR PRICING COB 08 June 2010 Christopher Pasco 22nd Contracting Squadron/LGCA Telephone No: 316-759-4537

53147 Kansas St., Suite 102

Fax: 316-759-1411 McConnell AFB, KS 67221-3606 Email address: christopher.pasco@mcconnell.af.mil

Qty/Unit Unit

Extended

Item Description of Issue

Price

Amount

Hot Water Storage Tank

2/EA

AO Smith Storage Tank, 250 Gallon, (TJV-250A), Jacketed-Vertical, ASME Code Construction 125 PSI, Glass Lined, Meet ASHRAE 90.1 Standards, Cathodic Protection or equal. (See attachment for exact size fittings) 0002-0026 See attached sheet for list of items

ARE THE ITEM(S) ON A GSA CONTRACT? YES ___________ NO ________________

GSA CONTRACT NUMBER: ______________________

FOB DESTINATION: YES/NO

PROMPT PAYMENT DISCOUNT TERMS: _______________

DELIVERY TIME AFTER RECEIPT OF ORDER: ________________________

CENTRAL CONTRACTOR REGISTRATION (CCR) REGISTERED: YES / NO

DUNS NUMBER: _____________________

FEDERAL TAX ID NUMBER: ___________________

CAGE CODE: _________________

BUSINESS SIZE: ( ) SMALL ( ) WOMAN-OWNED ( ) DISADVANTAGED ( ) LARGE

( ) SERVICE DISABLED VETERAN

Quote is valid through: ______________________

Company Name: _______________________________________________

Phone No.: ____________________ Fax No.: ____________________, E-Mail Address: _____________________________

Quoted By: Name: ___________________________ Title: _____________________________________

ORCA (On-Line Representation and Certifications Application): In accordance with FAR 52.212-3, annual representations and certifications must be completed on-line at http://orca.bpn.gov. Has your company done this? Yes ____/No ____

PLEASE COMPLETE THE DFARS 252.225-7000 BUY AMERICAN ACT – BALANCE OF PAYMENTS PROGRAM CERTIFICATE (BELOW) AND RETURN IT WITH YOUR PRICING.

252.225-7000 Buy American Act – Balance of Payments Program Certificate

As prescribed in 225.1101(1), use the following provision:

BUY AMERICAN ACT – BALANCE OF PAYMENTS PROGRAM CERTIFICATE (APR 2003)

Definitions. “Domestic end product,” “foreign end product,” “qualifying country,” and “qualifying country end product” have the meanings given in the Buy American Act and Balance of Payments Program clause of this solicitation.

Evaluation. The Government –

(1) Will evaluate offers in accordance with the policies and procedures of Part 225 of the Defense Federal Acquisition Regulation Supplement; and

(2) Will evaluate offers of qualifying country end products without regard to the restrictions of the Buy American Act or the Balance of Payments Program.

(c) Certifications and identification of country or origin.

(1) For all line items subject to the Buy American Act and Balance of Payments Program clause of this solicitation, the offeror certifies that -

(i) Each end product, except those listed in paragraphs (c)(2) or (3) of this provision, is a domestic end product; and

(ii) Components of unknown origin are considered to have been mined, produced, or manufactured outside the United

States or a qualifying country.

(2) The offeror certifies that the following end products are qualifying country end products:

Line Item Number Country of Origin

The following end products are other foreign end products:

Line Item Number Country of Origin

(End of provision)