SF_18_HSSS01-17-Q-0190.pdf

HSSS01-17-Q-0190

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

08/10/2017 488730

1 7

COMMUNICATIONS CENTER (PRO)

245 MURRAY LANE SW

BLDG T-5

PRO-PROCUREMENT DIV

WASHINGTON DC 20223

950 H ST NW SUITE 7100

950 H ST NW

SUITE 7100

WASHINGTON

DC 20223

CATHRYN BRADLEY

08/18/2017 1500 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

Refer to the Request for Quotes (RFQ# HSSS01-17-Q-0190 and the Statement of Work).

Period of Performance: 09/01/2017 to 08/31/2018

0001 Peer Support Trainers Program per the Statement 1 US of Work.

Anticipated Award Type: Firm-fixed-price

USSS BETC: DISB

Product/Service Description: EDUCATION/TRAINING-

TRAINING/CURRICULUM DEVELOPMENT

1001 Option Period 1. Peer Support Trainers Program 1 US Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 7

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

HSSS01-17-Q-0190

per the Statement of Work.

Anticipated Award Type: Firm-fixed-price

USSS BETC: DISB

(Option Line Item)

09/01/2018 Product/Service Description: EDUCATION/TRAINING-

TRAINING/CURRICULUM DEVELOPMENT

Period of Performance: 09/01/2018 to 08/31/2019

2001 Option Period 2. Peer Support Trainers Program 1 US per the Statement of Work.

Anticipated Award Type: Firm-fixed-price

USSS BETC: DISB

(Option Line Item)

09/01/2019 Product/Service Description: EDUCATION/TRAINING-

TRAINING/CURRICULUM DEVELOPMENT

Period of Performance: 09/01/2019 to 08/31/2020

3001 Option Period 3. Peer Support Trainers Program 1 US per the Statement of Work.

Anticipated Award Type: Firm-fixed-price

USSS BETC: DISB

(Option Line Item)

09/01/2020 Product/Service Description: EDUCATION/TRAINING-

TRAINING/CURRICULUM DEVELOPMENT

Period of Performance: 09/01/2020 to 08/31/2021

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)