RFQ_FORM_16RQ60286.pdf

REQUEST FOR QUOTATION

DATE OF ISSUE: 06/30/2016

Business Size: (check one) ___Small ___Large Payment Terms: _____%_____Days

PRICES DERIVED FROM (check one):

___COMMERCIAL PRICE LIST(give date)___________________ ___INTERNAL PRICE LIST ?(Please explain):________________ ___OTHER (Please explain):______________________________

WAWF Registered (check one)? Yes ____ No____ Government credit card accepted? Yes ____ No____ Place of Manufacture:_____________________________________

Delivery date/time: ____________ARO (Best Date Possible, Please!)

Ship To:

Portsmouth Naval Shipyard Receiving Officer, Bldg. 170 Kittery, ME 03904 xxx If checked, to be awarded on an "All or None" basis, NAVSUP Provision L7011.

xxx PPIRS evaluation procedures apply.

Prospective vendor must be registered in the System for Award Management (SAM) database prior to award. Information, instructions, forms, etc. are available on www.SAM.gov . Click on "Register/Update Entity" located in teh center of the Homepage screen.

DUNS No.: Cage Code: Taxpayer ID.:

Offeror Signature: Date:

REFERENCE

NUMBER

N3904016Q60286

THIS IS NOT AN ORDER

QUOTE DUE BY: 01:00 p.m., Mon., 07/11/2016

Business Name: ___________________________________ POC(s): __________________________________________ Address: _________________________________________ City, ST, Zip:______________________________________

PHONE: _________________________________________

FAX: ____________________________________________

EMAIL ADDRESS(es): ______________________________

PLEASE COMPLETE FORM IN ITS ENTIRETY

Portsmouth Naval Shipyard,Code 410.2 Deana Manfredi Contract Specialist Portsmouth NH 03801-2590

PHONE: 207-438-1630

FAX: 207-438-4193

EMAIL ADDRESS: deana.manfredi@navy.mil

ITEM

DESCRIPTION

Vendor Services, Remove/Repair/Reinstall Diesel Engine Upper Crankshaft

Estimated Period of Performance: 08/15/2016 - 07/14/2017 Place of Performance: Portsmouth Naval Shipyard, PNS, Kittery, ME

* Reference Attachment:

1) Statement of Work, 767 San Tank Cleaning (1 page)

QUANTITY

UNIT

of

ISSUE

JOB

QUOTE

$_________1

Sum Total Quote: $_________

0002 Vendor Services, Remove/Repair/Reinstall Diesel Engine Upper Vertical Drive Assembly

1 JOB $_________

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