RFQ_HSCG41-16-Q-QW6617_.doc
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- AUDIO VISUAL EQUIPMENT UPGRADE
- Solicitation number
- HSCG41-16-Q-QW6617
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SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER.
21-16-416QW6617
2. CONTRACT NO.
3. AWARD/EFFECTIVE DATE
4. ORDER NUMBER
5. SOLICITATION NUMBER
HSCG41-16-Q-QW6617
6. SOLICITATION ISSUE DATE
8/1/2016
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME
JUAN A. SOTO
b. TELEPHONE NUMBER (No Collect calls) (757)856-2564
8. OFFER DUE DATE/ LOCAL TIME
8/8/2016 9:00AM EST
9. ISSUED BY CODE Z63100
COMMANDING OFFICER
USCG TRAINING CENTER YORKTOWN
1 US COAST GUARD TRAINING CENTER
YORKTOWN, VA 23690-5000
Juan.A.Soto1@navy.mil
10. THIS ACQUISITION IS
FORMCHECKBOX
UNRESTRICTED OR FORMCHECKBOX
SET ASIDE: 100 % FOR:
FORMCHECKBOX
SMALL BUSINESS FORMCHECKBOX
EMERGING SMALL
BUSINESS
FORMCHECKBOX
HUBZONE SMALL BUSINESS
NAICS: 334310
SIZE STANDARD: 750emp FORMCHECKBOX
SERVICE-DISABLED VETERAN- FORMCHECKBOX
8 (A)
OWNED SMALL BUSINESS
11. DELIVERY FOR FOB DESTINA-TION UNLESS BLOCK IS MARKED
FORMCHECKBOX
SEE SCHEDULE
12. DISCOUNT TERMS
FORMCHECKBOX
13a. THIS CONTRACT IS A
RATED ORDER UNDER
DPAS (15 CFR 700)
13b. RATING
14. METHOD OF SOLICITATION
FORMCHECKBOX
RFQ FORMCHECKBOX
IFB FORMCHECKBOX
RFP
15. DELIVER TO CODE Z63100
COMMANDING OFFICER
USCG TRAINING CENTER YORKTOWN
1 US COAST GUARD TRAINING CENTER
YORKTOWN, VA 23690-5000
16. ADMINISTERED BY CODE W63100
SAME AS BLOCK 9
17a. CONTRACTOR/OFFEROR CODE C FACILITY CODE
TELEPHONE NO. ATTN:
18a. PAYMENT WILL BE MADE BY CODE
COMMERCIAL INVOICES
USCG FINANCE CENTER
PO BOX 4115
CHESAPEAKE, VA 23327-4115 (800)564-5504
https://www.fincen.uscg.mil/secure/web_invoices.htm
FORMCHECKBOX
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
FORMCHECKBOX
SEE ADDENDUM
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
TOTAL PRICE
AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 222, Room 225 and Room 232 at Hamilton Hall, Bldg 221
AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 106 and Room 108 at Hamilton Hall, Bldg 221
AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 206 and Room 234 at Hamilton Hall, Bldg 221
AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 126 and Room 136 at Hamilton Hall, Bldg 221
AS STATED ON STATEMENT OF WORK: Video Teleconference Equipment Upgrade for Room 112 at Hamilton Hall, Bldg 221
00003 00002 00002 00002 00001
JOB
JOB
JOB
JOB
25. ACCOUNTING AND APPROPRIATION DATA
26. TOTAL AWARD AMOUNT (For Government Use Only)
FORMCHECKBOX
27a. SOLICITATION INCORPORATED BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA FORMCHECKBOX
ARE FORMCHECKBOX
ARE NOT ATTACHED
FORMCHECKBOX
27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA FORMCHECKBOX
ARE FORMCHECKBOX
ARE NOT ATTACHED
FORMCHECKBOX
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.
FORMCHECKBOX
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 OF CONTRACTING OFFICER)
30b. NAME AND TITLE OF SIGNER (Type or print)
30c. DATE SIGNED
31b. NAME OF CONTRACTING OFFICER (Type or print)
MARIA L. NESTICO
31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. 3/2005)
PREVIOUS EDITION IS NOT USABLE Prescribed by GSA – FAR (48 CFR) 53.212
STANDARD FORM 1449 (REV 3/2005)
Prescribed by GSA - FAR (48 CFR) 53.212
ORDER NUMBER
RFQ# 21-16-416QW6617
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
TOTAL PRICE
AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 104 at Hamilton Hall, Bldg 221 AS STATED ON STATEMENT OF WORK: Audio Visual Equipment Upgrade for Room 133 at Hamilton Hall, Bldg 221
PREVENTIVE AND SERVICE MAINTENANCE AGREEMENT/CONTRACT.
YEAR 1 WITH 5 YEAR OPTIONS
PROVIDE PRICING TO INCLUDE THE FOLLOWING INFORMATION:
SHIPPING CHARGES (IF APPLICABLE), DUNS#, TAX ID#, LEAD TIME AND POC.
DELIVERY DATE IS 30 DAYS AFTER RECEIPT OF ORDER (ARO).
ITEMS REQUESTED ARE NEW, NO USED OR REFURBISHED ITEMS.
REQUESTED INSTALLATION DATES ARE INCLUDED IN STATEMENT OF WORK (SOW) OR TO BE DETERMINED(TBD).
00001 00001 00001
JOB
YEAR
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED FORMCHECKBOX
INSPECTED FORMCHECKBOX
ACCEPTED, AND CONFORM 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. TELEPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE |
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
33. SHIP NUMBER
34. VOUCHER NUMBER
35. AMOUNT VERIFIED CORRECT FOR
36. PAYMENT
COMPLETE FORMCHECKBOX
PARTIAL FORMCHECKBOX
FINAL
37. CHECK NUMBER
FORMCHECKBOX
PARTIAL FORMCHECKBOX
FINAL
38. S/R ACCOUNT NO.
39. S/R VOUCHER NUMBER
40. PAID BY
| 41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT |
| 42a. RECEIVED BY (Print) |
41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
41c. DATE
42b. RECEIVED AT (Location)
42c. DATE REC'D (YY/MM/DD)
42d. TOTAL CONTAINERS
STANDARD FORM 1449 (REV. 3/2005) BACK
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