ESU_Analyzer_RFQ.pdf

SEE ADDENDUM

(No Collect Calls)

N6809619R0004 25-Sep-2019

b. TELEPHONE NUMBER

671-344-9014

8. OFFER DUE DATE/LOCAL TIME

03:00 PM 26 Sep 2019

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

N680969. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JOHN J. CAMACHO

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

US NAVAL HOSPITAL GUAM

MATERIAL MANAGEMENT DEPT

PSC 455 BOX 208

FPO AP 96540

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE N68096 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

US NAVAL HOSPITAL GUAM

SUPPLY OFFICER

BLDG 50 FARENHOLT RD STE 1Y02

AGANA HEIGHTS GU 96910

TEL: (671) 344-9673 FAX: (671) 344-9256

(671)-344-9288FAX:

TEL: (671)-344-7352

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

1,000

NAICS:

339112

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF12

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

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 AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

N6809619R0004

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 2 Each

ESU-2400H

FFP

ESU Analyzer, Digital, Internal Loads, High Sampling

FOB: Destination

MFR PART NR: ESU-2400H

PSC CD: H265

NET AMT

0002 2 Each

BC20-20500

FFP

Power Cord, NA Hospital Grade (ESU/PFC)

FOB: Destination

MFR PART NR: BC20-20500

0003 2 Each

BC20-00131

FFP

Force Triad PM Kit (ESU-2400)

FOB: Destination

MFR PART NR: BC20-00131

0004 2 Each

BC20-00132

FFP

Cable Kit - ESU-2400 - ConMed Automation

FOB: Destination

MFR PART NR: BC20-00132

0005 2 Each

BC20-03005

FFP

ESU-2400 - Monopolar Hand piece Simulator

FOB: Destination

MFR PART NR: BC20-03005

0006 2 Each

TRL-2420

FFP

Tissue Response Load for ESU-2400

FOB: Destination

MFR PART NR: TRL-2420

0007 2 Each

BC20-03004

FFP

Simulator, Foot Switch, Covidien FX/Force Triad

FOB: Destination

MFR PART NR: BC20-03004

0008 2 Each

BC20-03003

FFP

Cable, Foot Switch, Force Triad (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03003

0009 2 Each

BC20-03001

FFP

Cable, Foot Switch, ForceFX (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03001

0010 2 Each

BC20-03002

FFP

Cable, Foot Switch, Conmed (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03002

0011 2 Each

BC20-03000

FFP

Cable, Foot Switch, Unterminated (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03000

0012 2 Each

BC20-03006

FFP

Foot Switch Cable - Olympus ESG-100 (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03006

0013 2 Each

BC20-03007

FFP

Foot Switch Cable - Olympus ESG-400 (ESU-2400)

FOB: Destination

MFR PART NR: BC20-03007

0014 2 Each

CQM-2000

FFP

Module, REM/ARM/CQM (ESU-2050/P)

FOB: Destination

MFR PART NR: CQM-2000

0015 1 Each

SHIPPING

FFP

Shipping Charge

FOB: Destination

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

0002 Destination Government Destination Government

0003 Destination Government Destination Government

0004 Destination Government Destination Government

0005 Destination Government Destination Government

0006 Destination Government Destination Government

0007 Destination Government Destination Government

0008 Destination Government Destination Government

0009 Destination Government Destination Government

0010 Destination Government Destination Government

0011 Destination Government Destination Government

0012 Destination Government Destination Government

0013 Destination Government Destination Government

0014 Destination Government Destination Government

0015 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 30 dys. ADC 2 US NAVAL HOSPITAL GUAM

SUPPLY OFFICER

BLDG 50 FARENHOLT RD STE 1Y02

AGANA HEIGHTS GU 96910

(671) 344-9673

N68096

0002 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0003 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0004 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0005 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0006 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0007 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0008 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0009 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0010 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0011 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0012 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0013 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0014 30 dys. ADC 2 (SAME AS PREVIOUS LOCATION)

0015 30 dys. ADC 1 (SAME AS PREVIOUS LOCATION)

CLAUSES INCORPORATED BY REFERENCE

52.209-11 Representation by Corporations Regarding Delinquent Tax

Liability or a Felony Conviction under any Federal Law

FEB 2016

52.212-2 Evaluation - Commercial Items OCT 2014

52.212-5 Contract Terms and Conditions Required to Implement

Statutes or Executive Orders--Commercial Items

AUG 2019

52.216-8 Fixed Fee JUN 2011

252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

OCT 2016

252.232-7006 Wide Area WorkFlow Payment Instructions DEC 2018

252.232-7010 Levies on Contract Payments DEC 2006