SF1449_HSCG41-16-Q-QW6617_REVISED_16SEP2016.pdf

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

MODIFIED 9/16/2016

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

9/21/2016 2:00pm EST

9. ISSUED BY CODE Z63100

COMMANDING OFFICER

USCG TRAINING CENTER YORKTOWN

1 US COAST GUARD TRAINING CENTER

YORKTOWN, VA 23690-5000

juan.a.soto@uscg.mil

10. THIS ACQUISITION IS

UNRESTRICTED OR SET ASIDE: 100 % FOR:

SMALL BUSINESS EMERGING SMALL

BUSINESS

HUBZONE SMALL BUSINESS

NAICS: 334310

SIZE STANDARD: 750emp SERVICE-DISABLED VETERAN- 8 (A)

OWNED SMALL BUSINESS

11. DELIVERY FOR FOB DESTINA-TION

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 Z63100

COMMANDING OFFICER

USCG TRAINING CENTER YORKTOWN

1 US COAST GUARD TRAINING CENTER

YORKTOWN, VA 23690-5000

16. ADMINISTERED BY CODE Z63100

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

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

SEE ADDENDUM

ITEM NO. 20.

SCHEDULE OF SUPPLIES/SERVICES 21.

QUANTITY 22.

UNIT 23.

UNIT PRICE 24.

TOTAL PRICE

Labor, material and Installation of Audio/Visual Equipment Upgrade for Classrooms 106, 108, 126, 136, 133, 206 and 234 at Hamilton Hall, Bldg 221, per Scope of Work.

Labor, material and installation of Audio/Visual Equipment Upgrade for Classrooms 222, 225 and 232 at Hamilton Hall, Bldg 221, per Scope of Work.

Labor, material and installation of Audio/Visual Equipment Upgrade for Classroom Computer Lab Room 104 at Hamilton Hall, Bldg 221, per Scope of Work.

Labor, material and installation of Audio/Visual Equipment Upgrade for Classroom Conference Room 112 at Hamilton Hall, Bldg 221, per Scope of Work.

00001

JOB

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Government Use Only)

27a. SOLICITATION INCORPORATED 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.

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 mailto:juan.a.soto@uscg.mil https://www.fincen.uscg.mil/secure/web_invoices.htm

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

Preventive and Service Maintenance Agreement for Base Year

Preventive and Service Maintenance Agreement for Year One

Preventive and Service Maintenance Agreement for Year Two

Preventive and Service Maintenance Agreement for Year Three

Preventive and Service Maintenance Agreement for Year Four

PROVIDE PRICING TO INCLUDE THE FOLLOWING INFORMATION:

SHIPPING CHARGES (IF APPLICABLE), DUNS#, TAX ID#, LEAD TIME AND POC.

PERIOD OF PERFORMANCE: COMPLETION OF THE PURCHASE ORDER IS 120

DAYS AFTER RECEIPT OF ORDER (ARO).

ITEMS REQUESTED ARE NEW, NO USED OR REFURBISHED ITEMS.

INSTALLATION DATES WILL BE COORDINATED WITH THE TECHNICAL POINT

OF CONTACT CWO3 DAVID PORCO.

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EA

EA

EA

EA

EA

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED 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 PARTIAL FINAL

37. CHECK NUMBER

PARTIAL 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