SF1449.pdf

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Engine Test Cell Upgrade & Sustainment, Building 100, USCG Aviation Logistics Center, Elizabeth City, NC
Solicitation number
HSCG38-10-R-410009
Issued by

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SF1449

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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: See 31c
order_no:
solicitation_no: HSCG38-10-R-410009
solicitation_issue_date: 10/28/09
contract_no:
name: Ginger Woodington
phone_no: 252-334-5051
offer_due_date: 11/30/09 3 pm
9_issued_by: Contracting Officer

Department of Homeland Security USCG Aviation Logistics Center Aviation Logistics Division, Building 63 Elizabeth City, NC 27909-5000

ATTN: Ginger Woodington

9_code: Z50100
10_acquisition_is_set_aside: x
10_acquisition_is_set_aside_percent:
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10_acquisition_is_hubzone:
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10_acquisition_is_naics: 488190
10_acquisition_is_size_standard:
11_see_schedule:
12_discount_terms:
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13_b_rating:
10_acquisition_is_unrestricted:
15_deliver_to: Department of Homeland Security

USCG Aviation Logistics Center Engine Test Cell Facility, Building 100 Elizabeth City, NC 27909-5000

15_code: Z50100
16_administered_by: See Block 9
16_code: Z50100
17_a_contractor_offeror:
17_a_phone_no:
17_a_code: 1EE69
17_a_facility_code:
17_b_remittance_is_different:
18_a_payment_made_by: Department of Homeland Security

USCG Aviation Logistics Center Building 63, Fiscal Branch Elizabeth City, NC 27909-5000

18_a_code: Z50100
18_b_submit_invoices:
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3: Aviation Logistics Center, Elizabeth
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25_acct_and_appropriation_data:
26_total_award_amt:
27_a_solicitation_incorporates: x
27_b_contract_pruchase_order:
28_contractor_is_required: x
28_no_copies: 1
29_award_contract:
29_ref_no:
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Reset:
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