FA7014-06-D-0026-0020.pdf

773 ESS/PK

3515 S. GENERAL MCMULLEN, STE 200

SAN ANTONIO TX 78226-1865

UNDER DPAS (15 CFR 700)

11. DELIVERY FOR FOB

RFQ

SEE SCHEDULE

14. METHOD OF SOLICITATION

IFB RFP

CODE

SEE ADDENDUM

BLOCK IS MARKED

DESTINATION UNLESS

12. DISCOUNT TERMS

Net 30 Days

F67100

(No Collect Calls)

13b. RATING

13a. THIS CONTRACT IS A RATED ORDER

CODE

SEE ITEM 9

b. TELEPHONE NUMBER 8. OFFER DUE DATE/LOCAL TIME

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV 3/2005)

Prescribed by GSA

FAR (48 CFR) 53.212

(TYPE OR PRINT)

26-Sep-2011

(SIGNATURE OF CONTRACTING OFFICER) 31c. DATE SIGNED

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

22. UNIT 23. UNIT PRICE 24. AMOUNT21. QUANTITY

HOSPITAL KLEAN OF TEXAS, INC.

CHRISTOPHER FLORES

15303 TRADESMAN

SAN ANTONIO TX 78249-1311

CODE 10. THIS ACQUISITION IS

UNRESTRICTED

FAX: NAICS:

TEL:

CODE 18a. PAYMENT WILL BE MADE BYOFFEROR

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

1H8K0

TEL. 210-764-2908

FA8052

SIZE STD:

9. ISSUED BY

FACILITY

CODE

17a.CONTRACTOR/

DFAS-LIMESTONE

27 ARKANSAS ROAD

LIMESTONE ME 04751-1500

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

15. DELIVER TO CODE 16. ADMINISTERED BY

GOODFELLOW AFB

17TH MEDICAL GROUP/SGSLF

271 FORT RICHARDSON AVE BLDG 1001

GOODFELLOW AFB TX 76908-4902

FA7014-06-D-0026 01-Oct-2011 0020

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES

SEE SCHEDULE

561720

TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS

SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

SB

HUBZONE SB

SET ASIDE: % FOR

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

F2MTAJ1171A018

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

Alice P. Sanders / Contracting Officer

TEL: EMAIL: alice.sanders.2@us.af.mil

See Schedule $197,139.36

1 COPIES

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

.OFFER DATED YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN 29. AWARD OF CONTRACT: REFERENCE

X

8(A)

SVC-DISABLED VET-OWNED SB

EMERGING SB

X

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

SEE SCHEDULE

19. ITEM NO. 20. SCHEDULE OF SUPPLIES/ SERVICES 21. QUANTITY 22. UNIT 24. AMOUNT

PAGE 2 OF

23. UNIT PRICE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV 3/2005) BACK

Prescribed by GSA

FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

FA7014-06-D-0026

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 577,296 Square

Foot $0.1779 $102,700.96

Basic HAMS RS 7

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

PURCHASE REQUEST NUMBER: F2MTAJ1171A018

SIGNAL CODE: A

NET AMT $102,700.96

ACRN AA

CIN: 000000000000000000000000000000

$0.00

0002 12 Months $2,921.77 $35,061.24 Clinic Site Manager

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Estimated unit per month is 40 hours per week FOB: Destination

NET AMT $35,061.24

0003 4 Job $186.53 $746.12 Light Fixture Cleaning

FFP

The Contractor shall provide services in accordance with the attached PWS and IMFE. To be performed in October 2011, January, April and July 2012 FOB: Destination

NET AMT $746.12

0004 2 Job $225.21 $450.42 Exterior Window Cleaning

FFP

The Contractor shall provide services in accordance with the attached PWS and IMFE. To be performed in October 2011 and May 2012.

FOB: Destination

NET AMT $450.42

0005 1 Job $204.02 $204.02 Interior Duct Cleaning

FFP

The Contractor shall provide services in accordance with the attached PWS and IMFE. To be performed in Aug 2012.

FOB: Destination

NET AMT $204.02

0006 12 Months $2,705.49 $32,465.88 Daytime Dedicated FTE

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE

FOB: Destination

NET AMT $32,465.88

0007 577,296 Square

Foot $0.0109 $6,292.53

FY 2008 CBA Adjustment

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

NET AMT $6,292.53

0008 577,296 Square

Foot $0.0136 $7,851.23

FY 2009 CBA Adjustment

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

NET AMT $7,851.23

0009 577,296 Square

Foot $0.0069 $3,983.34

FY 2010 CBA Adjustment

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

NET AMT $3,983.34

0010 577,296 Square

Foot $0.00549 $3,169.36

FY 2011 CBA Adjustment

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

NET AMT $3,169.36

0011 577,296 Square

Foot $0.0073 $4,214.26

FY 2012 CBA Adjustment

FFP

The Contractor shall provide services in accordance with the attached PWS and

IMFE.

Maximum estimated facility unit Sq Ft/Month = 48,108 FOB: Destination

NET AMT $4,214.26

0012 Lot $51,389.15 OPTION Continuity of Services

COST

Contractor shall be reimbursed for all reasonable phase-in, phase-out costs (i.e., costs incurred within the agreed period (45 days) after contract expiration that result from phase-in, phase-out operations) and a fee (profit) not to exceed a pro rata portion of the fee (profit) under this contract.

FOB: Destination

ESTIMATED COST $51,389.15

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government 0005 Destination Government Destination Government 0006 Destination Government Destination Government 0007 Destination Government Destination Government 0008 Destination Government Destination Government 0009 Destination Government Destination Government 0010 Destination Government Destination Government 0011 Destination Government Destination Government 0012 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC

0001 POP 01-OCT-2011 TO

30-SEP-2012

N/A GOODFELLOW AFB

17TH MEDICAL GROUP/SGSLF

271 FORT RICHARDSON AVE BLDG 1001

GOODFELLOW AFB TX 76908-4902

FOB: Destination

0002 POP 01-OCT-2011 TO

30-SEP-2012

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 01-OCT-2011 TO

0004 POP 01-OCT-2011 TO

0005 POP 01-OCT-2011 TO

0006 POP 01-OCT-2011 TO

0007 POP 01-OCT-2011 TO

0008 POP 01-OCT-2011 TO

0009 POP 01-OCT-2011 TO

0010 POP 01-OCT-2011 TO

0011 POP 01-OCT-2011 TO

0012 POP 01-OCT-2012 TO

14-NOV-2012

ACCOUNTING AND APPROPRIATION DATA

AA: SUBJECT TO AVAILABILITY OF FUNDS

AMOUNT: $0.00

CIN 000000000000000000000000000000: $0.00

CLAUSES INCORPORATED BY REFERENCE

52.237-3 Continuity Of Services JAN 1991 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

MAR 2008

CLAUSES INCORPORATED BY FULL TEXT

52.232-18 AVAILABILITY OF FUNDS (APR 1984)

Funds are not presently available for this contract. The Government's obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.

(End of clause)

WIDE AREA WORKFLOW – RECEIPT AND ACCEPTANCE (WAWF‐RA)

ELECTRONIC RECEIVING REPORT AND INVOICING INSTRUCTIONS

IN ACCORDANCE WITH DFARS 252.232-7003, USE OF ELECTRONIC PAYMENT REQUESTS,

IS MANDATORY. USE OF WAWF WILL SPEED UP YOUR PAYMENT PROCESSING TIME AND

ALLOW YOU TO MONITOR YOUR PAYMENT STATUS ONLINE. THERE ARE NO CHARGES

OR FEES TO USE WAWF.

Requests for payments must be submitted electronically via the Internet through the Wide Area WorkFlow – Receipt and Acceptance (WAWF-RA) system at https://wawf.eb.mil. The WAWF Vendor Instructions for Installation and Registration Guide is available online at: http://www.wawftraining.com

Please direct your payment questions/concerns to wawfafdw@afncr.af.mil. Please have your order number and invoice number ready when contacting DFAS about payment status. You can also access payment information using WAWF.

THE FOLLOWING CODES WILL BE REQUIRED TO ROUTE YOUR RECEIVING REPORTS, INVOICES

AND ADDITIONAL E-MAILS CORRECTLY THROUGH WAWF.

CONTRACT NO. ISSUED BY/ADMIN DODAAC: CAGE CODE: TYPE OF DOCUMENT:

FA7014-06-D-0026 FA8052 1H8K0 COMBO 2 IN 1

DELIVERY ORDER NO. PAY OFFICE DODAAC: INSPECTED BY DODAAC: SERVICE ACCEPTOR/SHIP TO:

0020 F67100 F2MTAJ F2MTAJ

SEND MORE E-MAIL NOTIFICATIONS TO:

CONTRACT ADMINISTRATOR: E-MAIL:

WILLIAM DUNLAP William.dunlap.12.ctr@us.af.mil

CONTRACTING OFFICER: E-MAIL:

ALICE SANDERS Alice.sanders.2@us.af.mil

CONTRACTING OFFICER’S TECHNICAL REPRESENTATIVE E-MAIL:

JIMMIE CONNELL Jimmie.connell@us.af.mil

CONTRACTING OFFICER’S TECHNICAL REPRESENTATIVE E-MAIL:

Daniel Gutierrez daniel.gutierrez@goodfellow.af.mil

ADDITIONAL NOTIFICATION E-MAIL:

Robert Brown Robert.Brown@goodfellow.af.mil

Revised 03 AUG 2006

* NOTE TO CONTRACTOR: The codes in these blocks identify the customer responsible for inspection and acceptance of goods or services provided under this contract. In the event problems are encountered when using these codes to process invoices for payment, use the code cited in block 9 of the SF 1449 or block 6 of the SF30 instead.

Section J

Exhibit/Attachment Table of Contents

DOCUMENT TYPE DESCRIPTION PAGES DATE

Attachment 1 Performance Work

Statement

35 28-FEB-2006

Attachment 2 IMFE 9 01-SEP-2011