PO_75H71124P00324 signed PO.pdf
PDF 210 KB Posted
- Attached to
- Sewer service with lift station, Okmulgee, OK
- Solicitation number
- 75H71124P00324
About this file
This document is an Order for Supplies or Services for Contract 75H71124P00324 awarded to Tywell Builders LLC on 2024-07-05 in the amount of $15,620.00.
The order is for Tywell Builders LLC to furnish and install a Sewer Service Line and Lift Station in Okmulgee, OK. The period of performance is 2024-07-05 to 2024-09-06. The work is to be performed in accordance with the attached Statement of Work and drawing. The order incorporates the Davis Bacon General Wage Decision OK20240030 dated 2024-04-05 and FAR Clause 52.213-4. The contracting office is the Oklahoma City Area IHS, and the Oversight Monitor is Kala Yarnall.
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Text version
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)
07/05/2024
75H71124P00324 IHS1495580
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
MATT COOPERRIDER
TYWELL BUILDERS LLC 1647856
TYWELL BUILDERS LLC 3005 W 117
3005 W 117TH ST S
JENKS OK 74037
See Schedule
12. F.O.B. POINT
09/06/2024
OKLAHOMA CITY AREA OFFICE
701 MARKET DRIVE
OKLAHOMA CITY OK 73114
OKLAHOMA CITY OK 73114
ORACLE
ITEM NO.
(a)
SUPPLIES OR SERVICES
(b)
QUANTITY
ORDERED
(c)
UNIT
(d)
UNIT
PRICE
(e)
AMOUNT
(f)
QUANTITY
ACCEPTED
(g)
XX
X
Destination Destination HHS NET 30P
f. SERVICE-DISABLED
VETERAN-OWNED
e. HUBZone
g. WOMEN-OWNED SMALL BUSINESS (WOSB)
ELIGIBLE UNDER THE WOSB PROGRAM
h. EDWOSB
UEI: FWKFTNV8NP19
Contractor to furnish and install a Sewer Service Line and Lift Station.
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
$15,620.00
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
EDSON W. YELLOWFISH
$15,620.00
OPTIONAL FORM 347 (Rev. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
07/08/2024
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
Oklahoma City OK 73114
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
07/05/2024 75H71124P00324
PAGE NO
(a) (b) (c) (d) (e) (f) (g)
Admin Office:
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
Period of Performance: 07/05/2024 to
09/06/2024
1 Contractor shall furnish and install a 15620 J3 1.00 15,620.00
Sewer Service Line and Lift Station for A
Chastain in accordance with the Statement of Work and Drawing.
Project Data:
131328.4.HGFK0000000-OKLAHOMA AREA
IHS.25235-ALL OTR SVCS.05/10/2024
Accounting Info:
2024.J5002CB.25235 Appr. Yr.: 2024
CAN: J5002CB Object Class: 25235
Funded: $15,620.00
Additional Provisions and Conditions (10 pages; 3-12 are attached hereto)
Scope of Work includes: Statement of Work 5 p, drawing 1 p, Okmulgee ordinances 2 p,.
Davis Bacon General Wage Decision
OK20240030 Dated 04/05/2024 is hereby incorporated, (attached)
FAR Clause 52.213-4 attached FAR Clause
52.204-7 applies
Oversite Monitor: Kala Yarnall, Environmental Engineer
Office Phone: 918-586-8402
Phone (cell): 405-308-8781
E-mail: kala.yarnall@ihs.gov
Contract Specialist (C): Jeffrey Earnest, (IHS/OKC) 405-951-3740
The total amount of award: $15,620.00. 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
PREVIOUS EDITION NOT USABLE
TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $15,620.00
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