RFQ NO. 693C7321Q000003.pdf

693C7321Q000003

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.

11. SCHEDULE (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDEX

10/30/2020 HFLECO210010PR

1 3

EASTERN FEDERAL LANDS HIGHWAY DIVISION

QUANTUM PARK, 22001 LOUDOUN COUNTY PKWY

SUITE E2-3-300

FEDERAL HIGHWAY ADMINISTRATION

JAN BEAVER/703-404-6216

ASHBURN VA 20147

11/16/2020

Federal Highway Administration

Eastern Federal Lands Highway Div.

1827 Jack Delozier Dr.

Sevierville

TN 37876

703 404-6216Jan Beaver

11/16/2020 1400 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

***THIS SOLICITATION IS PREPARED IN ACCORDANCE

WITH FEDERAL ACQUISITION REGULATION PART 13,

SIMPLIFIED ACQUISITION PROCEDURES.***

PROVIDE GOVERNMENT PRICING FOR THE FOLLOWING:

00001 Cannon Instruments Bending Beam Rheometer, 115V 50/60 Hz, Part No. 9728-V30

Quantity: 1 EA

00002 Shipping Cost for Delivery to:

FEDERAL HIGHWAY ADMINISTRATION

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA - FAR (48 CFR) 53.215-1(a)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

693C7321Q000003

1827 JACK DELOZIER DRIVE

SEVIERVILLE, TN 37876

RESPONSES TO QUOTATION WILL BE ACCEPTED VIA FAX

NUMBER 571-434-1551, EMAIL: JAN.BEAVER@DOT.GOV,

OR MAIL TO THE ADDRESS IN BLOCK NO. 9, AND MUST

BE RECEIVED BY 2:00 PM, EST, MONDAY,

NOVEMBER 16, 2020.

PROVIDE THE FOLLOWING INFORMATION WITH YOUR

QUOTATION:

DUN & BRADSTREET (DUNS) NUMBER:

FEDERAL TAX ID NUMBER:

ESTIMATED DELIVERY TIME:

IMPORTANT PAYMENT REQUIREMENT: IN ACCORDANCE

WITH FEDERAL ACQUISITION REGULATION (FAR) SUBPART

4.1102, PROSPECTIVE CONTRACTORS SHALL BE

REGISTERED IN THE SYSTEM FOR AWARD MANAGEMENT

(SAM) DATABASE PRIOR TO AWARD OF A CONTRACT. FAR

CLAUSE 52.232-33 REQUIRES SAM REGISTRATION FOR

PAYMENT. IN ADDITION, WHEN SETTING UP VENDOR

INFORMATION IN THE SAM DATABASE, THE D&B LEGAL

NAME SHOULD BE THE SAME AS THE IRS CONSENT NAME.

SAM REGISTRATION IS AVAILABLE ONLINE AT

WWW.SAM.GOV.

THIS SOLICITATION INCORPORATES BY REFERENCE THE

FOLLOWING FAR PROVISIONS:

52.204-7 SYSTEM FOR AWARD MANAGEMENT

52.204-8 ANNUAL REPRESENTATIONS AND

CERTIFICATIONS

52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE

REPORTING

THIS SOLICITATION INCORPORATES THE FOLLOWING

ATTACHED PROVISIONS IN FULL TEXT:

52.204-24 REPRESENTATION REGARDING CERTAIN

TELECOMMUNICATIONS AND VIDEO SURVEILLANCE

SERVICES OR EQUIPMENT.

52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR

SERVICES-REPRESENTATION.

***PROVISION 52.204-26 REQUIRES THAT OFFERORS

REVIEW SAM PRIOR TO COMPLETING THEIR REQUIRED

Continued ...

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

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)

693C7321Q000003

REPRESENTATIONS. OFFERORS SHALL CONSULT SAM TO

VALIDATE WHETHER THE PRODUCTS THEY ARE OFFERING

ARE FROM AN ENTITY COVERED UNDER THE DEFINITION

OF "COVERED TELECOMMUNICATIONS EQUIPMENT OR

SERVICES", INCLUDING ANY KNOWN SUBSIDIARIES OR

AFFILIATES.

THE ATTACHED VENDOR REPRESENTATION FORM MUST BE

COMPLETED PRIOR TO AWARD.***

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