75P00121R00087_0001 - Revised SF1449 Only.pdf
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- Attached to
- Employee Assistance Program (EAP)/WorkLife Services IDIQ Federal contract opportunity
- Solicitation number
- PSCFOH_EAPWL_06242022
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Text version
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
CODE 16. ADMINISTERED BYCODE
X
X
624190
SIZE STANDARD:
% FOR:SET ASIDE:UNRESTRICTED ORDAM
RFPIFB
10. THIS ACQUISITION ISCODE
RFQ
14. METHOD OF SOLICITATION
13b. RATING
NAICS:
SMALL BUSINESS
08/01/2022 1000 ET
06/24/2022
301-492-5297Saundra Kpadeh
(No collect calls)
INFORMATION CALL:
FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME
4. ORDER NUMBER3. AWARD/ 6. SOLICITATION
75P00121R00087
5. SOLICITATION NUMBER
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF
1 3 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
TELEPHONE NO.
17a. CONTRACTOR/
15. DELIVER TO
Bethesda MD 20814 8th Floor 7700 Wisconsin Avenue
9. ISSUED BY
7.
2. CONTRACT NO.
EFFECTIVE DATE
$12.00
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
8(A)
DHHS/PSC/AMS/DAM
WOMEN-OWNED SMALL BUSINESS
(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM
EDWOSB
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
Title: EAP/Worklife Services
Contract Type IDIQ: Firm-Fixed Price (FFP), Time and Materials (T&M), and Labor Hour (LH) Orders
Anticipated Contract Term: November 30,2022 to November 29, 2023 with four 12-month options
All questions/inquiries concerning the solicitation document must be submitted by e-mail (no faxes or telephone calls please) to the Contract Specialist at Saundra.Kpadeh@psc.hhs.gov according to section L.
(Use Reverse and/or Attach Additional Sheets as Necessary)
HEREIN, IS ACCEPTED AS TO ITEMS:
X
XX
DATED . 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.
27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA
26. TOTAL AWARD AMOUNT (For Govt. Use Only)
OFFER
STANDARD FORM 1449 (REV. 2/2012)
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 BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER
37. CHECK NUMBER
FINALPARTIAL
36. PAYMENT
FINALPARTIAL
35. AMOUNT VERIFIED
CORRECT FOR
34. VOUCHER NUMBER33. SHIP NUMBER
COMPLETE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)
42b. RECEIVED AT (Location)
42a. RECEIVED BY (Print)
41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT
STANDARD FORM 1449 (REV. 2/2012) BACK
24.
AMOUNT
23.
UNIT PRICE
22.
UNIT
21.
QUANTITY
20.
SCHEDULE OF SUPPLIES/SERVICES
19.
ITEM NO.
Change Item 1 to read as follows(amount shown is the obligated amount):
1 Base Period: EAP/Worklife Services
Period of Performance: 11/30/2022 to 11/29/2023
Change Item 2 to read as follows(amount shown is the obligated amount):
2 Option Period 1: EAP/Worklife Services
(Option Line Item)
Period of Performance: 11/30/2023 to 11/29/2024
Change Item 3 to read as follows(amount shown is the obligated amount):
3 Option Period 2: EAP/Worklife Services
(Option Line Item)
Period of Performance: 11/30/2024 to 11/29/2025
Change Item 4 to read as follows(amount shown is the obligated amount):
4 Option Period 3: EAP/Worklife Services
(Option Line Item)
Period of Performance: 11/30/2025 to 11/29/2026
Change Item 5 to read as follows(amount shown is the obligated amount):
5 Option Period 4: EAP/Worklife Services
(Option Line Item)
Period of Performance: 11/30/2026 to 11/29/2027
Continued ...
32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE
3 2 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)
75P00121R00087/0001
Change Item 6 to read as follows(amount shown is the obligated amount):
6 Minimum Guarantee: EAP/Worklife Services
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110
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