PO_75H71125P00038 signed po.pdf
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- Attached to
- Water Service Line Sand Springs, OK
- Solicitation number
- 75H71125P00038
About this file
This is a signed Purchase Order (Form 347) issued by the Oklahoma City Area Indian Health Service to 3rd Gen Excavation and Construction for furnishing and installing a water service line in Osage County, OK. The order number is 75H71125P00038 and was issued on January 10, 2025.
The contract is valued at $23,325.00 and requires the contractor to install a water service line for C Sellers in accordance with the provided statement of work and drawing. The period of performance is January 10, 2025 to March 14, 2025. The contractor is classified as a small business. The work includes Davis Bacon wage requirements (Decision OK20240030) and oversight will be provided by Christopher Houston. Payment terms are NET 30 and invoices can be submitted electronically to okcapinvoices@ihs.gov or mailed to the Oklahoma City Area Indian Health Service office at 701 Market Drive, Oklahoma City, OK 73114.
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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)
01/10/2025
75H71125P00038 IHS1504574
Oklahoma City Area IHS
701 Market Drive
Oklahoma City OK 73114
TYREL FIELDEN
TYREL FIELDEN 1665647
3RD GEN EXCAVATION AND CONSTRUCTION
12227 HILLSIDE DR
SPERRY OK 74073
See Schedule
12. F.O.B. POINT
03/14/2025
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)
X
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: E7UHX2JFT3M1
CONTRACTOR TO FURNISH AND INSTALL A WATER
SERVICE LINE FOR C SELLERS IN ACCORDANCE
WITH THE STATEMENT OF WORK AND DRAWING.
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
$23,325.00
22. UNITED STATES OF
AMERICA BY (Signature)
23. NAME (Typed)
TITLE: CONTRACTING/ORDERING OFFICER
EDSON W. YELLOWFISH
$23,325.00
OPTIONAL FORM 347 (Rev. 2/2012)
Prescribed by GSA/FAR 48 CFR 53.213(f)
AUTHORIZED FOR LOCAL REPRODUCTION
PREVIOUS EDITION NOT USABLE
01/15/2025
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
01/10/2025 75H71125P00038
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: 01/10/2025 to
03/14/2025
1 The Contractor shall furnish and install a 23325 J3 1.00 23,325.00 water service line in accordance with the statement of work and drawing for C Sellers in Osage County.
Project Data:
134466.3.HGFK0000000-OKLAHOMA AREA
IHS.25235-ALL OTR SVCS.11/06/2024
Accounting Info:
2025.J5002IH.25235 Appr. Yr.: 2025
CAN: J5002IH Object Class: 25235
Funded: $23,325.00
Additional Provisions and Conditions (10 pages; 4-13 are attached hereto)
Scope of Work includes Statement of Work (2 pages), drawing (1 page) (attached).
Davis Bacon General Wage Decision
OK20240030 Dated 11/15/2024 is hereby incorporated, (attached)
FAR Clause 52.213-4 attached FAR Clause
52.204-7 applies
Oversite Monitor: Christopher Houston
Work: 918-762-6590
Cell: 918-290-0985
E-mail: christopher.houston@ihs.gov
Contract Specialist (C): Jeffrey Earnest, (IHS/OKC) 405-951-3740
E-mail jeffrey.earnest@ihs.gov
Complete invoices and supporting documentation shall be sent either electronically via e-mail or by regular postal mail to the paying office (Bill To) below:
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)) $23,325.00
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
01/10/2025 75H71125P00038
PAGE NO
(a) (b) (c) (d) (e) (f) (g)
Bill To:
E-mail Invoice to: okcapinvoices@ihs.gov
Or mail invoices to:
Oklahoma City Area Indian Health Service
Attention Finance Department
701 Market Drive
Oklahoma City, OK 73114
Accounts Payable POC is Alicia Kinney
Phone 405-951-3924
E-mail alicia.kenney@ihs.gov
Please Note: Email a copy of the invoice to the Contract Specialist and Oversite
Monitor so that they can verify work is complete and make sure it is received in the system.
The total amount of award: $23,325.00. 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)) $0.00
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