SF 1449.pdf

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

ADM-ORF

MD 20892-7511

Bethesda

OD - Office of Research Facilities

National Institutes of Health

BLDG 102, RTP

CODE 16. ADMINISTERED BYCODE

X

X

X

561210

SIZE STANDARD:

100.00

% FOR:SET ASIDE:UNRESTRICTED OR

IO-ORF

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

06/03/2009 1330 ET

05/18/2009

+1 919 541 5763KYLE TURNER

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION

8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

NIHOF2009144

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

1. REQUISITION NUMBER PAGE OF

1 31069109OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Research Triangle Park NC 27709

PO Box 12233

111 TW Alexander Dr.

BLDG 102

Bldg 102, Research Triangle Park

15. DELIVER TO

MD 20892-7511

Bethesda

OD - Office of Research Facilities

National Institutes of Health

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$32.5

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

HUBZONE SMALL

BUSINESS

EMERGING SMALL

BUSINESS

8(A)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Period of Performance: 07/01/2009 to 06/30/2009

1 Base Year - Point-of-Use Filtration 12 EA

Systems, Non-Bottled Water Filtration Systems

Install, lease, maintain water filtration units

(18) including cups per the attached Statement of

Work

Delivery To: 102/S153

Product/Service Code: AD25

Continued ...

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

X

X

X

DATED

KYLE A. TURNER

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

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

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED

ARE NOT ATTACHED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS

NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY

39. S/R VOUCHER NUMBER

38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

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

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

STANDARD FORM 1449 (REV. 3/2005) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

Period of Performance: 07/01/2009 to 06/30/2010

2 Option Year - Point-of-Use Filtration 12 EA

Systems, Non-Bottled Water Filtration Systems

Install, lease, maintain water filtration units

(18) including cups per the attached Statement of

Work

Delivery To: 102/S153

(Option Line Item)

Product/Service Code: AD25

Period of Performance: 07/01/2010 to 06/30/2011

3 Option Year - Point-of-Use Filtration 12 EA

Systems, Non-Bottled Water Filtration Systems

Install, lease, maintain water filtration units

(18) including cups per the attached Statement of

Work

Delivery To: 102/S153

(Option Line Item)

Product/Service Code: AD25

Period of Performance: 07/01/2011 to 06/30/2012

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED

PAGE OF

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

NIHOF2009144

4 Option Year - Point-of-Use Filtration 12 EA

Systems, Non-Bottled Water Filtration Systems

Install, lease, maintain water filtration units

(18) including cups per the attached Statement of

Work

Delivery To: 102/S153

(Option Line Item)

Product/Service Code: AD25

Period of Performance: 07/01/2012 to 06/30/2013

5 Option Year - Point-of-Use Filtration 12 EA

Systems, Non-Bottled Water Filtration Systems

Install, lease, maintain water filtration units

(18) including cups per the attached Statement of

Work

Delivery To: 102/S153

(Option Line Item)

Product/Service Code: AD25

Period of Performance: 07/01/2014 to 06/30/2015

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

Sponsored by GSA

FAR (48 CFR) 53.110