SF_1449 RFQ.pdf

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Attached to
Temporary Lodging for US Coast Guard (North Everett, WA Area) Federal contract opportunity
Solicitation number
HSCG3312QDRBH00
Issued by
Department of Homeland Security US Coast Guard

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SF1449 (RFQ)

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SOW FAR Clauses and Wage Rates —

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SOLlClTATlON/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 Ib. TELEPHONE NUMBER (No collect Calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY CODE 10. THIS ACQUISITON IS

UNRESTRICTED

SET ASIDE: %FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR

FOB DESTINATION

UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A RATED

ORDER UNDER DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/

OFFEROR

TELEPHONE NO.

CODE FACILITY

CODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18a. PAYMENT WILL BE MADE BY CODE

18b. SUBMIT INVOICESTO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

IS CHECKED

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)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

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

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES 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.

29. AWARD OF CONTRACT: REF. OFFER

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 31a. UNITED STATES OF AMERICA (SIGNATURE O F CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 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

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:

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. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER

PARTIAL FINAL

34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

36. PAYMENT

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

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

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41 b. 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. 4/2002) BACK

Untitled
Untitled
total_pages:
requisition_no:
award_effective_date:
order_no:
solicitation_no: HSCG33-12-Q-DRBH000
solicitation_issue_date: 09/22/11
contract_no:
name: GREG M. HERMSEN
phone_no: 206.217.6370
offer_due_date: 10/10/11
9_issued_by: CONTRACTING AND PROCUREMENT

US COAST GUARD BASE SEATTLE

1519 ALASKAN WAY SOUTH

SEATTLE, WA 98134

(206)217-6370

9_code: 52150
10_acquisition_is_set_aside: X
10_acquisition_is_set_aside_percent:
10_acquisition_is_small_business: X
10_acquisition_is_hubzone:
10_acquisition_is_8a:
10_acquisition_is_naics: 721110
10_acquisition_is_size_standard: $7.0
11_see_schedule:
12_discount_terms:
13_a_contract_is_rated:
13_b_rating:
10_acquisition_is_unrestricted:
15_deliver_to: SK1 TIMOTHY DUMPH

USCG PORT SECURITY UNIT (PSU) 313

2000 WEST MARINE VIEW DR, BLDG 2108

EVERETT, WA 98027

(425)304-5881

15_code:
16_administered_by: CONTRACTING AND PROCUREMENT

US COAST GUARD BASE SEATTLE

1519 ALASKAN WAY SOUTH

SEATTLE, WA 98134

(206)217-6370

16_code: 52150
17_a_contractor_offeror: TBD
17_a_phone_no:
17_a_code:
17_a_facility_code:
17_b_remittance_is_different:
18_a_payment_made_by: ELECTRONIC FUNDS TRANSFER (EFT)

VIA USCG FINANCE CENTER

18_a_code:
18_b_submit_invoices:
14_method_of_solicitation_ifb:
14_method_of_solicitation_rfp:
14_method_of_solicitation_rfq: X
19_item_no:
0: 0001
1:
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0:
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20_schedule_of_supplies:
0: THIS IS A REQUEST FOR QUOTE (RFQ) FOR
1: TEMPORARY LODGING FOR USCG PSU 313.
2:
3: PERIOD OF PERFORMANCE:
4: 10/11/11 THROUGH 09/30/12.
5:
6: LODGING WILL BE NEEDED ON AN AS NEEDED
7: BASIS. THE NUMBER OF ROOMS NEEDED WILL
8: VARY FROM MONTH TO MONTH BASED ON THE
9: NEEDS OF THE SERVICE.
10:
0: QUOTES SUBMITTED SHALL BE IN THE FORM
1: OF NIGHTLY RATES.
2:
3: FOR ADDITIONAL INFORMATION, PLEASE
4: REVIEW THE SCOPE OF WORK INCLUDED IN
5: THIS REQUEST FOR QUOTE.
6:
7: FEDERAL ACQUISITION REGULATION CLAUSES
8: AND THE DEPARTMENT OF LABOR WAGE RATES
9: FOR SERVICES ARE INCLUDED IN THIS RFQ
10: AND ARE APPLICABLE.
11:
12: QUOTE:
13:
14: ROOM TYPE NIGHTLY RATE
15: ---------- ------------
16: SINGLE OCCUPANCY $___________
17: DOUBLE OCCUPANCY $___________
18:
19:
20:
21: ALL QUOTES & SUPPORTING DOCUMENTATION
22: SHALL BE SUBMITTED TO GREG HERMSEN
23: VIA EMAIL GREGORY.M.HERMSEN@USCG.MIL
24: OR VIA FAX (206) 217-6732.
25:
26: ALL QUOTES SHALL BE SUBMITTED NO LATER
27: THAN 3:30 PM (PST) ON 10/10/11.
28:
29:
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21_quantity:
0:
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22_unit:
0:
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23_unit_price:
0:
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0:
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24_amount:
0: 0
1: 0
2: 0
3: 0
4: 0
5: 0
6: 0
7: 0
8: 0
9: 0
10:
0: 0.00
1: 0
2: 0
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5: 0
6: 0
7: 0
8: 0.00
9: 0
10: 0
11: 0
12: 0
13: 0
14: 0
15: 0
16: 0
17: 0
18: 0
19: 0
20: 0
21: 0
22: 0
23: 0
24: 0
25: 0
26: 0
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28: 0
29: 0
30: 0
31: 0
32: 0
33: 0
34: 0
35: 0
36: 0
37: 0
38: 0
39: 0
25_acct_and_appropriation_data:
26_total_award_amt:
27_a_solicitation_incorporates: x
27_b_contract_pruchase_order:
28_contractor_is_required:
28_no_copies:
29_award_contract:
29_ref_no:
29_offer_dated:
30_b_name_title_of_signer:
31_b_name_of_officer:
30_c_date_signed:
31_c_date_signed:
32_a_qty_received:
32_a_qty_inspected:
32_a_qty_accepted:
32_a_qty_except_as_noted:
32_c_date:
32_d_printed_name_title_auth_gov_rep:
32_e_mailing_address_auth_gov_rep:
32_f_phone_auth_gov_rep:
32_g_email_auth_gov_rep:
33_ship_number:
33_ship_no_partial:
33_ship_no_final:
34_voucher_no:
35_amt_verified_correct:
36_payment_complete:
36_payment_partial:
36_payment_final:
37_check_number:
38_s_r_acct_no:
39_s_r_voucher_no:
40_paid_by:
41_c_date:
42_a_received_by:
42_b_received_at:
42_c_date_received:
42_d_total_containers:
27_a_addenda_are_attached: x
27_a_addenda_are_not_attached:
27_b_addenda_are_attached:
27_b_addenda_are_not_attached:
Reset:
41_b_signature_title_cert_officer:

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