PRICE_LIST_RESPONSE_PAGE.pdf

PRICE LIST PAGE

RETURN THIS PAGE WITH THE COMPLETED INFORMATION AND AUTHORIZED SIGNATURE

1. OFFEROR INFORMATION

BUSINESS NAME:

STREET ADDRESS: CITY, STATE, ZIP:

CAGE CODE and DUNS:

BUSINESS WEB ADDRESS:

CONTACT PERSON:

TELEPHONE: FAX:

E-MAIL:

2. Supplies/Services and Prices/Costs

CLIN 0001/0002 Proposed Price: Unit/Monthly Price: $_______ Total Price for CLIN: $____________

CLIN 1002 Proposed Price: Unit/Monthly Price: $_______ Total Price for CLIN: $____________

CLIN 2002 Proposed Price: Unit/Monthly Price: $_______ Total Price for CLIN: $____________

CLIN 3002 Proposed Price: Unit/Monthly Price: $_______ Total Price for CLIN: $____________

CLIN 4002 Proposed Price: Unit/Monthly Price: $_______ Total Price for CLIN: $____________

Total Price for All CLINS: $___________________

Note: 6-Month extension will be used for evaluation purposes only. This 6-Month extension is not guaranteed.

The offerors Total price for all CLINS shall include this extension price.

DISCOUNT TERMS:

NET 30 or _______% IN _______ DAYS

DAYS REQUIRED FOR DELIVERY:

3. Certification of Response

Offeror’s Authorized Representative's Signature Date

Type or Print Name Position or Title

Contractor is Required to sign this document and return 1 copy 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.

6 Month extension IAW FAR 52.217-8: Unit/Monthly Price:$_____________Total Price for Ext:$____________ Note: 6 Month extension should be the same monthly price as CLIN 4002