RFQ.pdf
PDF 165 KB Posted
- Attached to
- POOL WATER TREATMENT SERVICE Federal contract opportunity
- Solicitation number
- HSCG27-15-Q-PPF359
About this file
REVISED REQUEST FOR QUOTE FORM. REQUEST QUOTE FOR BASE PLUS 4 OPTION YEARS.
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| File | Type | Posted |
|---|---|---|
| RFQ_Package.pdf |
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Text version
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
1. REQUISITION NUMBER PAGE 1 OF
2. CONTRACT NO. 3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE
DATE
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME b. TELEPHONE NUMBER (No collect calls)
8. OFFER DUE DATE/
LOCAL TIME
9. ISSUED BY 11. DELIVERY FOR
FOB DESTINATION
UNLESS BLOCK IS
MARKED
12. DISCOUNT TERMS
13a. THIS CONTRACT IS A RATED
ORDER UNDER DPAS (15 CFR 700)
13b. RATING
14. METHOD OF SOLICITATION
SEE SCHEDULE
CODE
15. DELIVER TO 16. ADMINISTERED BY CODE
18a. PAYMENT WILL BE MADE BY CODE 17a. CONTRACTOR/
OFFEROR
CODE
FACILITY
CODE
CODE
TELEPHONE NO.
17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN
OFFER
18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW
IS CHECKED
RFQ IFB RFP
SEE ADDENDUM
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
(Use Reverse and/or Attach Additional Sheets as Necessary)
CONTRACTOR AGREES TO FURNISH AND
25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY
ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.
29. AWARD OF CONTRACT: REF.
DATED . YOUR OFFER ON SOLICITATION
(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE
SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:
30a. SIGNATURE OF OFFEROR/CONTRACTOR
30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED
31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)
31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION IS NOT USABLE
STANDARD FORM 1449 (REV. 4/2002)
Prescribed by GSA - FAR (48 CFR) 53.212
10. THIS ACQUISITON IS
UNRESTRICTED
SET ASIDE: % FOR
SMALL BUSINESS
HUBZONE SMALL
BUSINESS
8(A)
NAICS:
SIZE STANDARD:
27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA
ARE ARE NOT ATTACHED
ARE ARE NOT ATTACHED
COPIES TO ISSUING OFFICE.
OFFER
STANDARD FORM 1449 (REV. 4/2002) BACK
32b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT
32c. DATE
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
40. PAID BY
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED
CORRECT FOR
PARTIAL FINAL
37. CHECK NUMBER
38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER
36. PAYMENT
COMPLETE PARTIAL FINAL
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| Pages: 2 |
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| SolNo: HSCG27-15-Q-PPF359 |
| SolDate: 07/1/2015 |
| Contact: ANGEL L. POL |
| PhoneNo: 757-483-8541 |
| DueDate: 7/29/15 |
| LocalTim: 4:00 PM |
| UssuedBy: Angel Pol |
USCG Base Portsmouth 4000 Coast Guard Blvd Portsmouth, VA 23703-2199
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| AsidePct: 100 |
| NAICS: 561790 |
| SizeStd: $7.5 M |
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| Deliver: USCG Base Portsmouth |
4000 Coast Guard Blvd, VA 23703-2199
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| Administ: Same as block 9 |
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| Payment: Angel Pol |
USCG Base Portsmouth Portsmouth, VA 23703-2199 Email: angel.pol@uscg.mil
(757) 483-8541
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| SupplyA: This is a request for quote to provide |
| SupplyB: weekly pool water treatment as per |
| SupplyC: attached S.O.W., FAR Clauses & DOL |
| SupplyD: Wage Determination. |
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| SupplyF: Estimated price of contract per year |
| SupplyG: is less than $25K. |
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| ServiceM: This is an option year contract for a |
| ServiceN: base year and up to four option years. |
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| ServiceP: Payment is to be made after invoicing |
| ServiceQ: by government credit credit card |
| ServiceR: card. |
| ServiceS: |
| ServiceT: Base Year: 8/17/15 through 8/12/16 |
| ServiceU: |
| ServiceV: Option Year 1: 8/15/16 through 8/11/17 |
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| ServiceX: Option Year 2: 8/14/17 through 8/10/18 |
| ServiceY: |
| ServiceZ: Option Year 3: 8/13/18 through 8/09/19 |
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| ServicAB: Option Year 4: 8/12/19 through 8/07/20 |
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| ServicAD: Unit POC for site visit/technical |
| ServicAE: questions: Robert Ward 757-483-8582 |
| ServicAF: |
| ServicAG: |
| ServicAH: |
| ServicAI: Submit this form along with your quote |
| ServicAJ: & one copy of your business and/or |
| ServicAK: contractor's license & liability |
| ServicAL: insurance certificate. You must be |
| ServicAM: registered in www.sam.gov in order to |
| ServicAN: obtain this contract award. |
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| Pay: Off |
| Acq: Set Aside |
| SmBus: Small Business |
| Method: Request for Quotation |
| ThrAtt: Off |
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File details come from the government source that posted it. Updated .