4._Response_Page.pdf

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Adult Sports Officials
Solicitation number
FA8101-17-R-0045
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Response Page

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RESPONSE SHEET

RETURN THIS SHEET (THREE PAGES) WITH THE COMPLETED INFORMATION AND AUTHORIZED

SIGNATURE

1. OFFEROR INFORMATION

BUSINESS NAME:

STREET ADDRESS: CITY, STATE, ZIP:

CAGE CODE and DUNS: SAM REGISTRATION DATE:

BUSINESS WEB ADDRESS: SOCIOECONOMIC STATUS:

POINT OF CONTACT (POC): POC TITLE:

TELEPHONE: FAX:

E-MAIL:

2. Supplies/Services and Prices/Costs

Base Year 01 Sep 17 – 31 Aug

CLIN

Unit of Issue Each (Game)

Price Per Game

Total

Intramural Basketball

0001 250

Soccer 0002 50

Flag Football 0003 90

Intramural Softball 0004 350

Intramural Volleyball

0005 50

Men’s Varsity Basketball

0006 12

Option I 01 Sep 17 – 31 Aug

CLIN

Unit of Issue Each (Game)

Price Per Game Total

Intramural Basketball

0001 250

Soccer 0002 50

Flag Football 0003 90

Intramural Softball 0004 350

Intramural Volleyball

0005 50

Men’s Varsity Basketball

0006 12

Option II 01 Sep 19 – 31 Aug

CLIN Unit of Issue Each (Game)

Price Per Game Total

Intramural Basketball

2001 250

Soccer 2002 50

Flag Football 2003 90

Intramural Softball

2004 350

Intramural Volleyball

2005 50

Men’s Varsity Basketball

2006 12

Total

Option III 01 Sep 20 – 31 Aug

CLIN Unit of Issue Each (Game)

Price Per Game Total

Intramural Basketball

3001 250

Soccer 3002 50

Flag Football 3003 90

Intramural Softball

3004 350

Intramural Volleyball

3005 50

Men’s Varsity Basketball

3006 12

Total

Option IV 01 Sep 21 – 31 Aug

SUBCLIN Unti of Issue Each (Game)

Price Per Game Total

Intramural Basketball

4001 250

Soccer 4002 50

Flag Football 4003 90

Intramural Softball

4004 350

Intramural Volleyball

4005 50

Men’s Varsity Basketball

4006 12

Total price for all SUBCLINs for base plus four option years:___________________________

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.

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