SOLICITATION__(2)_rfq.doc
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- Solicitation number
- HSCG41-16-Q-QWF723
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SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24 & 30
1. REQUISITION NUMBER.
21-16-416QWF723
2. CONTRACT NO.
3. AWARD/EFFECTIVE DATE
4. ORDER NUMBER
5. SOLICITATION NUMBER
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
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
FORMCHECKBOX
UNRESTRICTED OR FORMCHECKBOX
SET ASIDE: 100 % FOR:
FORMCHECKBOX
SMALL BUSINESS FORMCHECKBOX
EMERGING SMALL
BUSINESS
FORMCHECKBOX
HUBZONE SMALL BUSINESS
NAICS: 333241
SIZE STANDARD: 500emp 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
ONE COMPARTMENT SINK
STAINLESS STEEL; 24" X 24" X 14" BOWL SIZE; ROLLED EDGE;
(1) SWING FAUCET MIN 8"; (4) LEGS; NSF
RANGE 10 BURNER NATURAL GAS
OVERALL WIDTH 60"; (10) 30,000 BTU OPEN BURNERS; CAST IRON
GRATES; (2) STANDARD OVENS MIN OF (1) RACK PER;
(4) LEGS; NSF
REFRIGERATED BASE W/ DRAWERS
OVERALL WIDTH MIN 72"; (4) REFRIGERATED DRAWERS; EXTERIOR &
INTERIOR STAINLESS STEEL; NSF
PROOFING CABINET, HEATED
APPROX 25"W X 30"D X 71"H; LOAD SLIDES OR RACKS INCLUDED;
MUST REACH MIN 180 F HOLDING; (1) WINDOW DOOR;
(4) LOCK CASTERS; NSF
REACH-IN REFRIGERATOR
MIN VOLUME 72 CUBIC FT; (3) HINGED DOORS; EXTERIOR & INTEROR
STAINLESS STEEL; MIN OF (9) STANDARD SHELVES; NSF
CHARBROILER, 10 BURNER, NATURAL GAS
OVERALL WIDTH 60"W; (10) 30,000 BTU BURNERS; CAST IRON TOP
GRATES; BACKSPLASH & (2) SIDESPLASH; EXTERIOR STAINLESS STEEL;
MIN 24"D COOKING SURFACE; (6) 4" HEAVY DUTY LOCK CASTERS;
NSF
GRIDDLE 72” FLATTOP, NATURAL GAS
OVERALL WIDTH 72"; THERMOSTAT CONTROL; (6) 30,000 BTU BURNERS;
EXTERIOR STAINLESS STEEL; (4) LEGS; BACKSPLASH & (2) SIDESPLASH
; MIN 24"D COOKING SURFACE; (6) 4" HEAVY DUTY LOCK CASTERS; NSF
RENTAL GRILL PORTATBLE LP GAS
APPROX WIDTH 80"; MIN (10) BURNERS; MIN 24"D COOKING SURFACE;
MIN (2) LOCK CASTERS (4 WHEELS TOTAL); BACKSPLASHES &
SIDESPLASHES; NSF
Commercial planetary mixer
8 QUART; 3-SPEED; TIMER; SAFETY GUARD; STAINLESS STEEL BOWL;
WIRE WHIP/BEATER/DOUGH HOOK ATTACHMENTS; NSF
CARVING STATION
STAINLESS STEEL; INFRARED LAMP; DUAL LAMPS; BREATH/SNEEZE
GUARD; MIN 30"W X 25"D CARVING SURFACE; NSF
LOW-TEMP HOLDING CABINET, HEATED
APPROX 30"H X 25W" 30"D; REACH-IN; STAINLESS STEEL;
ADJUSTABLE THERMOSTAT; WITHIN RANGE OF 70 F - 200 F HOLDING;
(4) LOCK CASTERS; NSF
HAND WASHING SINK
STAINLESS STEEL; HANDS-FREE; MIN 6" BOWL DEPTH; GOOSENECK
FAUCET; BACKSPLASH; NSF
INDUCTION STOCK POT W/ COVER, 17-1/2 QT
17-1/2 QUART; (1) FLAT STOCK POT COVER; ALUMINUM CLAD BOTTOM; STAINLESS STEEL; NSF
INDUCTION STOCK POT W/ COVER, 25-12 QT
25-1/2 QUART; (1) FLAT STOCK POT COVER; ALUMINUM CLAD BOTTOM; STAINLESS STEEL; NSF
INDUCTION STOCK POT W/ COVER, 38 QT
38 QUART; (1) FLAT STOCK POT COVER; ALUMINUM CLAD BOTTOM; STAINLESS STEEL; NSF
INDUCTION STOCK POT W/ COVER, 53 QT
53 QUART; (1) FLAT STOCK POT COVER; ALUMINUM CLAD BOTTOM; STAINLESS STEEL; NSF
INDUCTION STOCK POT W/ COVER, 74 QT
74 QUART; (1) FLAT STOCK POT COVER; ALUMINUM CLAD BOTTOM; STAINLESS STEEL; NSF
ROASTING PAN
42 QUART; 21-5/8" X 18-1/8" X 9"; HEAVY DUTY ALUMINUM, LOOP RIVETED HANDLES; NSF
STEAM TABLE PAN W/ COVER, 1/6 SIZE, 4"
1/6 SIZE; 4" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, 1/6 SIZE, 6"
1/6 SIZE; 6" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, 1/3 SIZE, 4"
1/3 SIZE; 4" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, 1/3 SIZE, 6"
1/3 SIZE; 6" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, HALF SIZE LONG, 4"
HALF SIZE; 4" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, HALF SIZE LONG, 6"
HALF SIZE; 6" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, 1/2 SIZE, 4"
1/2 SIZE; 4" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, FULL SIZE, 4"
FULL SIZE; 4" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
STEAM TABLE PAN W/ COVER, FULL SIZE, 6"
FULL SIZE; 6" DEEP; STAINLESS STEEL; (1) FLAT PAN COVER; ANTI-JAMMING; NSF
CUTTING BOARD, MULTI-COLOR
12"W X 18"D X 1/2";(1) SET OF SIX (WHITE, BLUE, RED, YELLOW, TAN, GREEN); POLYETHYLENE, STAIN RESISTANT; NSF
MAGNETIC KNIFE HOLDER
18" LONG; NSF
SQUARE FOOD CONTAINER, 2 QT
2 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 4 QT
4 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 6 QT
6 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 8 QT
8 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 12 QT
12 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 18 QT
18 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SQUARE FOOD CONTAINER, 22 QT
22 QUART; (1) LID THAT FITS; SCRATCH RESISTANT; POLYETHYLENE; NSF
SHEET PAN, FULL
18"W X 26"D X 1"H; ALUMINUM; NSF
SOLID SERVING SPOON
15"; STAINLESS; NSF
SLOTTED SERVING SPOON
15"; STAINLESS; NSF
CAN RACK
DESIGNED FOR #10 AND #5 CANS; MOBILE; (4) CASTERS W/ BRAKES; ALUMINUM
MIXING BOWL, 3 QT
3 QUART; STAINLESS; 9-3/8" DIAMETER; 4" DEPTH; NSF
MIXING BOWL, 8 QT
8 QUART; STAINLESS; 13-1/4" DIAMETER; 5-3/8" DEPTH; NSF
MIXING BOWL, 13 QT
13 QUART; STAINLESS; 16" DIAMETER; 6" DEPTH; NSF
MIXING BOWL, 30 QT
30 QUART; STAINLESS; 21-5/8" DIAMETER; 21-5/8" DEPTH; NSF
SPATULA
13-7/8"; TAPERED EDGE; HEAT RESISTANT TO 600 F; NSF
UTILITY CART
33"L X 16"W X 37"H; POLYPROPYLENE; 300 LB CAPACITY; (4) CASTERS; NSF
WIRE GRATE
FITS INSIDE FULL SIZE SHEET PAN; NSF
COMBINATION FOOD PROCESSOR
COMMERICAL GRADE; 7 QUART; (1) STAINLESS STEEL BOWL; ATTACHMENTS (S-BLADE, GRATING DISC, SLICING DISC); NSF
IMMERSION BLENDER
COMMERICAL GRADE; 14"; NSF
SERVING LADLE, 72 OZ
72 OUNCES; 17" LONG; HOOKED HANDLE; 8-1/8" DIAMETER BOWL; NSF
MIXING PADDLE
36" LONG; STAINLESS STEEL; NSF
MIXING BOWL W/ DOLLY
(1) 80 QUART MIXING BOWL W/ STAND & DOLLY; STAINLESS STEEL; NSF
BANQUET CART
APPROX 28"L X 62"H; (4) SHELF; STAINLESS STEEL; (4) CASTERS; NSF
BANQUET CART
APPROX 28"L X 70"H; (5) SHELF; STAINLESS STEEL; (4) CASTERS; NSF
INGREDIENT BIN, 27 GL
27 GALLON; CLEAR SLIDING LID; (4) CASTERS; POLYTHYLENE; WHITE; NSF
INGREDIENT BIN, 36 GL
36 GALLON; CLEAR SLIDING LID; (4) CASTERS; POLYTHYLENE; WHITE; NSF
INGREDIENT BIN, 44 GL
44 GALLON; CLEAR SLIDING LID; (4) CASTERS; POLYTHYLENE; WHITE; NSF
PLASTIC SHELVING UNIT
APPROX 24" X 60" X 67"H; POLYPROPYLENE; (4) CASTERS; NSF
PLASTIC SHELVING UNIT
APPROX 24" X 60" X 75"H; POLYPROPYLENE; (4) CASTERS; NSF
PLASTIC FOOD PAN, 4" HALF SIZE
4" DEEP; 1/2 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 6" HALF SIZE
6" DEEP; 1/2 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 4" FULL SIZE
4" DEEP; FULL PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 6" FULL SIZE
6" DEEP; FULL PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 4" THIRD SIZE
4" DEEP; 1/3 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 6" THIRD SIZE
6" DEEP; 1/3 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 4" SIXTH SIZE
4" DEEP; 1/6 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 6" SIXTH SIZE
6" DEEP; 1/6 PAN; POLYCARBONATE; BLACK; ANTI-JAMMING; FRAMED; NSF
PLASTIC FOOD PAN, 4" LONG 1/2 SIZE
4" DEEP; 1/2 LONG PAN; POLYCARBONATE; LACK; ANTI-JAMMING; FRAMED; NSF
PIE PAN
11-1/4" X 1-1/4"; ALUMINUM
ROLLING PIN
15" - 18" POLYETHYLENE; NSF
ROLLER DOCKER
FOR DOCKING DOUGH; NSF
CAKE PAN, REMOVABLE BOTTOM
8" X 3"; ALUMINUM; NSF
CAKE PAN, REMOVABLE BOTTOM
9" X 3"; ALUMINUM; NSF
CAKE PAN, REMOVABLE BOTTOM
10" X 3"; ALUMINUM; NSF
CAKE PAN, SQUARE
12-3/4" X 9" X 2"; ALUMINUM; NSF
TRAY DRYING RACK
24"W X 60"L X 75"H; (3) SHELF; (4) CASTERS; ANIT-MICROBIAL COATING; NSF
DUNNAGE RACK
21"D X 30"W X 12"H; SLOTTED TOP; POLYPROPYLENE; NSF
KNIFE SET
CARVING TOOL SET; 9-PIECE; HEAVY DUTY STORAGE ROLL INCLUDED; NSF
KNIFE SET
10-PIECE; PARING KNIFE; UTILITY KNIFE; BONING KNIFE; CHEF'S KNIFE; BREAD KNIFE; BREAD KNIFE; SANTOKU-GRANTON; CARVER KNIFE & FORK; SHARPENING STEEL; COMMERICAL GRADE; HEAVY DUTY STORAGE ROLL; NSF
DOUGH CUTTER
STAINLESS STEEL BLADE; POLYPROPYLENE HANDLE; NSF
CAN OPENER
MANUAL; COMMERICAL GRADE; UP TO 11"; STAINLESS STEEL; NSF
PORTION SCALE
DIGITAL, FOOD-SERVICE SCALE; 20 LB; STAINLESS STEEL; SELF-CALIBRATING; NSF
PORTION SCALE
DIGITAL, FOOD-SERVICE SCALE; 10 LB; LCD DISPLAY; STAINLESS STEEL; FIELD RECALIBRATABLE; NSF
WORK TABLE
96"W X 48"D; STAINLESS STEEL; ROLLED EDGE FRONT & BACK; STAINLESS STEEL UNDERSHELF; (8) STAINLESS STEEL LEGS; NSF
HEAVY DRAWER ASSEMBLY
FOR WORKTABLE; 20" X 20" X 5"; STAINLESS STEEL; REMOVABLE DRAWERS; NSF
TABLE CASTERS
FOR WORKTABLE; SET OF EIGHT - (4) SWIVEL (4) BRAKE; 5" DIAMETER; 250 LB CAPACITY PER
WORK TABLE
96"W X 36"D; STAINLESS STEEL; ROLLED EDGE FRONT & BACK; STAINLESS STEEL UNDERSHELF; (8) STAINLESS STEEL LEGS; NSF
POT RACK
FOR WORKTABLE; 88"W X 20"D; TABLE MOUNT; STAINLESS STEEL; TRIPLE BAR DESIGN; (24) DOUBLE PRONGED HOOKS; NSF
SOLID TURNER
SPATULA; 8" X 3"; NSF
PERFORATED TURNER
PERFORATED SPATULA; 8" X 3"; NSF
SOLID TURNER
SPATULA; 4" X 9"; NSF
POT FORK
8" LONG; STANLESS STEEL; NSF
GRATER
STAINLESS STEEL; NSF
PIZZA CUTTER
WHEEL BLADE; NSF
SANDWICH SPATULA
10" BLADE; STAINLESS STEEL; NSF
SANDWICH SPATULA
8" BLADE; STAINLESS STEEL; NSF
SANDWICH SPATULA
6" BLADE; STAINLESS STEEL; NSF
BAKER SPATULA
10" BLADE; STAINLESS STEEL; NSF
BAKER SPATULA
4-/14"L X 3/4"W BLADE; STAINLESS STEEL; NSF
BAKER SPATULA
8" BLADE; STAINLESS STEEL; NSF
GRATER
9" BOX STYLE GRATER; MULTI SLICING PATTERNS; NSF
TONGS
12"; STAINLESS STEEL; NSF
BLENDER
COMMERICAL GRADE BLENDER; 64 OUNCE CONTAINER; BLADE ATTACHMENTS; VITAMIX PREFERRED; NSF
BLENDER CONTAINER
ADDITIONAL 64 OUNCE CONTAINER; NSF
SQUEEZE BOTTLE
PLASTIC, 24OZ. NSF
SQUEEZE BOTTLE
TWIN TIP; 24OZ. NSF
BOULLION STRAINER
8" DIAMETER; STAINLESS STEEL MESH; NSF
SAUCE DISPENSER
1 OZ; GUN TYPE; NSF
PLASTIC SHELVING UNIT
24"W X 60"L X 72"H; 5-TIER; POLYPROPYLENE EXTERIOR; NSF
PLASTIC SHELVING UNIT
24"W X 54"L X 72"H; 5-TIER; POLYPROPYLENE EXTERIOR; NSF
PLASTIC SHELVING UNIT
24"W X 72"L X 72"H; 4-TIER; POLYPROPYLENE EXTERIOR; NSF
00001 00001 00003
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00002 ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea ea
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# 21-16-416QWF723
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
TOTAL PRICE
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
_1534045711.unknown
_1534047521.unknown
_1534045670.unknown
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