SF-18.pdf

PDF 1000 KB Posted May 11, 2017

Attached to: Computational Psychiatry Consulting on Pediatric Mental Illnesses
Solicitation number: HHS-NIH-NIDA-SSSA-RFQ-2017-369
Issued by: Department of Health and Human Services National Institutes of Health

View the file

Other files

File	Type	Posted
Statement_of_Work.pdf	PDF	May 11, 2017

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

15. DATE OF QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

b. TELEPHONE

AREA CODE

NUMBER

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

8. TO:

b. COMPANYa. NAME

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

c. CITY

d. STATE e. ZIP CODE

7. DELIVERY

FOB DESTINATION

OTHER

(See Schedule)

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS (Date)

IMPORTANT: This is a request for information and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/ SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

PAGE OF PAGES

1. REQUEST NO. 2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

RATING

5a. ISSUED BY 6. DELIVER BY (Date)

5b. FOR INFORMATION CALL (NO COLLECT CALLS)

NAME TELEPHONE NUMBER

AREA CODE NUMBER

1.2 Acrobat Distiller 2.1 for Windows D:19960415163144 D:20000330134507 \\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg \\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

THIS RFQ

IS NOT A SMALL BUSINESS SET-ASIDE

15. DATE OF QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

b. TELEPHONE

AREA CODE

NUMBER

STANDARD FORM 18 (REV. 6-95) Prescribed by GSA-FAR (48 CFR) 53.215-1(a) AUTHORIZED FOR LOCAL REPRODUCTION Previous edition not usable

8. TO:

b. COMPANY

a. NAME

c. STREET ADDRESS

d. CITY

e. STATE

f. ZIP CODE

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

c. CITY

d. STATE

e. ZIP CODE

7. DELIVERY

FOB DESTINATION

OTHER

(See Schedule)

10. PLEASE FURNISH QUOTATIONS TO THE ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS (Date) IMPORTANT: This is a request for information and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/ SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%)

b. 20 CALENDAR DAYS (%)

c. 30 CALENDAR DAYS (%)

d. CALENDAR DAYS

NUMBER

PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY

e. STATE

f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN QUOTATION

PAGE

PAGES

1. REQUEST NO.

2. DATE ISSUED

3. REQUISITION/PURCHASE REQUEST NO.

4. CERT. FOR NAT. DEF. UNDER BDSA REG. 2 AND/OR DMS REG. 1

RATING

5a. ISSUED BY

6. DELIVER BY (Date) 5b. FOR INFORMATION CALL (NO COLLECT CALLS)

NAME

TELEPHONE NUMBER

AREA CODE

NUMBER

THIS RFQ IS A SMALL BUSINESS SET-ASIDE.: 0

7. DELIVERY. FOB DESTINATION: 0

NOTE: Additional provisions and representations are attached.: 0

NOTE: Additional provisions and representations are not attached.: 0

7. DELIVERY. OTHER (See Schedule): 0

THIS RFQ IS NOT A SMALL BUSINESS SET-ASIDE.: 0

PAGE OF: 1

4. CERT. FOR NAT. DEF. UNDER BDSA REG. 2 AND/OR DMS REG. 1. RATING:

3. REQUISITION/PURCHASE REQUEST NUMBER: 4464450

1. REQUEST NUMBER:

5a. ISSUED BY: National Institutes of Health

5b. FOR INFORMATION CALL (NO COLLECT CALLS). NAME: Zenab Chowdhry, Contract Specialist

8. TO. a. NAME:

13. NAME AND ADDRESS OF QUOTER. f. ZIP CODE:

16. SIGNER. a. NAME (Type or print):

16. SIGNER. b. TELEPHONE. AREA CODE:

16. SIGNER. b. TELEPHONE. NUMBER:

16. SIGNER. c. TITLE (Type or print):

13. NAME AND ADDRESS OF QUOTER. e. STATE:

13. NAME AND ADDRESS OF QUOTER. d. CITY:

13. NAME AND ADDRESS OF QUOTER. b. STREET ADDRESS:

13. NAME AND ADDRESS OF QUOTER. c. COUNTRY:

13. NAME AND ADDRESS OF QUOTER. a. NAME OF QUOTER:

8. TO. c. STREET ADDRESS: National Institute on Drug Abuse, 6011 Executive Blvd.

8. TO. d. CITY: Rockville

11. SCHEDULE (Include applicable Federal, State and local taxes). ITEM NUMBER. COLUMN A. Line 18 of 18:

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: This is a request for quote to provide the Emotion

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: and Development Branch (EDB) of the National

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: Institute of Mental Health (NIMH) with an expert

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: in the applications of computational approaches

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: to behavioral and brain imaging experiments

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: Attachment One: Statement of Work

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: Attachment Two: FAR Clauses 52.212-1; 52.212-2;

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: 52.212-3; 52.212-4; and 52.212-5

11. SCHEDULE (Include applicable Federal, State and local taxes). SUPPLIES/SERVICES. COLUMN B.: Attachment Three: Invoice Instructions

11. SCHEDULE (Include applicable Federal, State and local taxes). QUANTITY. COLUMN C.:

11. SCHEDULE (Include applicable Federal, State and local taxes). UNIT. COLUMN D.:

8. TO. e. STATE: MD

8. TO. f. ZIP CODE: 20852

5b. FOR INFORMATION CALL (NO COLLECT CALLS). TELEPHONE NUMBER. AREA CODE: 301

8. TO. b. COMPANY:

5b. FOR INFORMATION CALL (NO COLLECT CALLS). TELEPHONE NUMBER. NUMBER: 827-6909

9. DESTINATION. a. NAME OF CONSIGNEE:

9. DESTINATION. b. STREET ADDRESS:

9. DESTINATION. c. CITY:

9. DESTINATION. e. ZIP CODE:

9. DESTINATION. d. STATE:

PAGES: 1

2. DATE ISSUED. Enter 2 digit month, 2 digit day and 4 digit year.:

10. PLEASE FURNISH QUOTATIONS TO THE ISSUING OFFICE IN BLOCK 5a ON OR BEFORE CLOSE OF BUSINESS (Date). Enter 2 digit month, 2 digit day and 4 digit year.: 2017-04-06

15. DATE OF QUOTATION. Enter 2 digit month, 2 digit day and 4 digit year.:

6. DELIVER BY (Date). Enter 2 digit month, 2 digit day and 4 digit year.:

11. SCHEDULE (Include applicable Federal, State and local taxes). UNIT PRICE. COLUMN E.:

11. SCHEDULE (Include applicable Federal, State and local taxes). AMOUNT. COLUMN F.:

11. SCHEDULE (Include applicable Federal, State and local taxes). UNIT PRICE. COLUMN E.:

12. DISCOUNT FOR PROMPT PAYMENT. a. 10 CALENDAR DAYS (%):

12. DISCOUNT FOR PROMPT PAYMENT. b. 20 CALENDAR DAYS (%):

12. DISCOUNT FOR PROMPT PAYMENT. c. 30 CALENDAR DAYS (%):

12. DISCOUNT FOR PROMPT PAYMENT. d. CALENDAR DAYS. NUMBER:

12. DISCOUNT FOR PROMPT PAYMENT. d. CALENDAR DAYS. PERCENTAGE:

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN QUOTATION. Digital Signature:

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN QUOTATION. This is a protected field:

File details come from the government source that posted it. Updated Nov 14, 2017.