PO_75H70621P00844.pdf

ORDER FOR SUPPLIES OR SERVICES

3. ORDER NO. 4. REQUISITION/REFERENCE NO.

PAGE OF PAGES

5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS

IMPORTANT: Mark all packages and papers with contract and/or order numbers. 1

1. DATE OF ORDER 2. CONTRACT NO. (If any) 6. SHIP TO:

a. NAME OF CONSIGNEE

c. CITY d. STATE e. ZIP CODE

7. TO:

a. NAME OF CONTRACTOR

f. SHIP VIA

8. TYPE OF ORDER

b. COMPANY NAME

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

9. ACCOUNTING AND APPROPRIATION DATA

a. PURCHASE b. DELIVERY

REFERENCE YOUR:

Please furnish the following on the terms and conditions specified on both sides of this order and on the attached sheet, if any, including delivery as indicated.

Except for billing instructions on the reverse, this delivery order is subject to instructions contained on this side only of this form and is issued subject to the terms and conditions of the above-numbered contract.

10. REQUISITIONING OFFICE

11. BUSINESS CLASSIFICATION (Check appropriate box(es))

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED d. WOMEN-OWNED

13. PLACE OF

a. INSPECTION b. ACCEPTANCE

14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT

ON OR BEFORE (Date)

16. DISCOUNT TERMS

17. SCHEDULE (See reverse for Rejections)

06/30/2021

75H70621P00844 IHS1432216

Aberdeen Area Indian Health Servic

Federal Building

115 Fourth Ave, SE

Aberdeen SD 57401

KENNETH

SODS MECHANICAL CONTRACTING, INC. 379534

SOD'S MECHANICAL CONTRACTING, INC

302 1ST AVE

MARTIN SD 575515836

See Schedule

12. F.O.B. POINT

07/30/2021

Great Plains Area IHS

Great Plains Area IHS

115 4TH AVENUE SE

ABERDEEN SD 57401-4301

PETERSEN KURT L (IHS)

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT

PRICE

(e)

AMOUNT

(f)

QUANTITY

ACCEPTED

(g)

X

X

Destination Destination

ABERDEEN SD 57401-4301

IHS NET 15P

f. SERVICE-DISABLED

VETERAN-OWNED

e. HUBZone

g. WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

h. EDWOSB

Firm Fixed-Price, Commercial Item, Purchase Order to install new copper piping, hangers, shutoff valves, and insulation to get the fan coil units functional at the Rosebud IHS Hospital, Rosebud, South Dakota. Period of Performance: June 16, Continued ...

19. GROSS SHIPPING WEIGHT18. SHIPPING POINT 20. INVOICE NO.

21. MAIL INVOICE TO:

a. NAME

b. STREET ADDRESS

(or P.O. Box)

c. CITY d. STATE e. ZIP CODE

SEE BILLING

INSTRUCTIONS

ON REVERSE

17(h)

TOTAL

(Cont.

pages)

17(i)

GRAND

TOTAL

$46,090.00

22. UNITED STATES OF

AMERICA BY (Signature)

23. NAME (Typed)

TITLE: CONTRACTING/ORDERING OFFICER

CRAIG J. WELLS

$46,090.00

OPTIONAL FORM 347 (Rev. 2/2012)

Prescribed by GSA/FAR 48 CFR 53.213(f)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

06/30/2021

IHSGREATPLAINS AREA

Great Plains Area IHS

115 4TH AVENUE SE

ABERDEEN SD 57401-4301

ABERDEEN SD 57401-4301

DATE OF ORDER

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

06/30/2021 75H70621P00844

PAGE NO

(a) (b) (c) (d) (e) (f) (g)

2021 through July 30, 2021.

Verbal approval by Mr. Craig Wells on

6/16/2021.

Admin Office:

Aberdeen Area Indian Health Servic

Federal Building

115 Fourth Ave, SE

Aberdeen SD 57401

Period of Performance: 06/16/2021 to

07/30/2021

1 Rosebud FCU Piping 46,090.00

Project Data:

131242.41237-01000-E.HGFA0000000-ABERD

EEN AREA IHS.25235-ALL OTR

SVCS.06/23/2021

Accounting Info:

2021.J45MI09.25235 Appr. Yr.: 2021

CAN: J45MI09 Object Class: 25235

Funded: $46,090.00

The "Unit Price" is an all-inclusive cost.

All "inclusive cost" is defined to include travel, lodging, per diem, fringe benefits, i.e., life insurance, social security, federal, state, and local taxes, plus all other costs pertinent to the performance of this purchase order.

Attachments:

- Quote

- Statement of Work

- Clauses Incorporated by Reference and in Full Text

- HHS Residual Standards of Conduct

- Violence in the Workplace

- Courtesy and Respect in the Workplace

- Standards of Ethical Conduct

- Mandatory Seasonal Influenza Immunizations

- Wage Determinations No.: 2015-5377 Revision No.: 15

Continued ...

Prescribed by GSA FAR (48 CFR) 53.213(f)

OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION

PREVIOUS EDITION NOT USABLE

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $46,090.00

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

06/30/2021 75H70621P00844

PAGE NO

(a) (b) (c) (d) (e) (f) (g)

Date of Last Revision: 06/04/2021

INVOICE SUBMISSION AND PAYMENT:

The contractor shall submit a signed and approved invoice to request payment.

A. The contractor shall submit an original invoice to:

The Great Plains Area Indian Health Service

Attn: Accounts Payable

115 4th Avenue SE, Room 309

Federal Building

Aberdeen, South Dakota 57401

The contractor shall submit a copy of the invoice to:

GPA OEHE Department

Attn: Kurt Petersen, Mechanical Engineer, COR II

115 4th Ave SE Room 309

Aberdeen, South Dakota 57401

Phone: 605-906-0697

Kurt.petersen@ihs.gov

B. The contractor shall include the following information on each invoice in accordance with the prompt payment act (5

CFR Part 1315.9(b)):

1. Contractor's name

2. Invoice number and date

3. Entire award number or other authorization number for delivery of goods or services

4. Description (including dates of service), price and quantity of goods and services rendered

5. Shipping and payment terms

6. Duns number and taxpayer identifying number (TIN)

7. Contact name (where practicable), title and telephone number

Continued ...

Prescribed by GSA FAR (48 CFR) 53.213(f)

OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $0.00

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

06/30/2021 75H70621P00844

PAGE NO

(a) (b) (c) (d) (e) (f) (g)

Payment shall be made by the Great Plains

Area Financial Management Branch, 115 4th

Avenue SE, Room 309, Federal Building, Aberdeen, South Dakota 57401.

The Government reserves the right to accept or reject services, if the level of performance is unacceptable.

The total amount of award: $46,090.00. The obligation for this award is shown in box

17(i).

Prescribed by GSA FAR (48 CFR) 53.213(f)

OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $0.00