SF-18.doc

REQUEST FOR QUOTATIONS

(THIS IS NOT AN ORDER)

THIS RFQ FORMCHECKBOX

IS FORMCHECKBOX

IS NOT A BUY-INDIAN, SMALL BUSINESS SET-ASIDE SOLICITATION.

PAGE OF PAGES

1 3

1. REQUEST NO.

RFQ-18-021

2. DATE ISSUED

12/27/2017

3. REQUISITION/PURCHASE REQUEST NO.

45201-PO-18-WIN-9306

4. CERT.FOR NAT. DEF.

UNDER BDSA REG.2

AND/OR DMS REG. 1

RATING

5A. ISSUED BY

Great Plains Area Indian Health Service, Federal Building, Room 309, 115 4th Avenue SE, Aberdeen, South Dakota 57401-4360

6. DELIVER BY (Date)

FORMCHECKBOX

FOB DESTINATION FORMCHECKBOX

(See Schedule)

NAME

Connie Valandra, Contract Specialist

AREA CODE

NUMBER

226-7567

a. NAME OF CONSIGNEE

Omaha/Winnebago IHS Hospital

TO:

b. STREET ADDRESS Omaha/Winnebago Service Unit 202 Bluff Street

a. NAME

b. COMPANY

c. CITY

Winnebago

c. STREET ADDRESS

d. CITY

e. STATE

f. ZIP CODE

d. STATE

NE

e. ZIP CODE

68071

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK

5a ON OR BEFORE CLOSE OF

BUSINESS (Date) January 3, 2018 @11:00am CST/CDT IMPORTANT: This is a request for information, and quotations furnished are not offiers. 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)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

Firm Fixed-Price, BPA (Blanket Purchase Agreement) for Coffee and Tea Subsistence Supplies for the Omaha/Winnebago IHS Hospital, Winnebago, NE.

The IHS anticipates issuing up to four awards from the solicitation.

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 the purchase order.

12. DISCOUNT FOR PROMPT

PAYMENT

a. 10 CALENDAR DAYS

b. 20 CALENDAR DAYS

c. 30 CALENDAR DAYS

d. CALENDAR DAYS

NOTE: Additional provisions and representations FORMCHECKBOX are FORMCHECKBOX are not attached.

SIGN QUOTATION

15. DATE OF

QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

16. SIGNER

a. NAME (Type of print)

b. TELEPHONE

AREA CODE

AUTHORIZED FOR LOCAL REPRODUCTION

FormFlow/Delrina Inc.

STANDARD FORM 18 (REV 6-95)

Previous edition not usable

Prescribed by GSA-FAR (48 CFR) 53-215-1(a)

CONTINUATION FOR RFQ-18-021

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

The period of performance will be Date of Award - December 31, 2018 with 4 one-year options with performance dates of January 1, 2019 - December 31, 2019; January 1, 2020 - December 31, 2020; January 1, 2021 - December 31, 2021; and January 1, 2022 - December 31, 2022, respectively.

ATTACHMENTS:

· Specifications – Supply Lists

· Provisions/Clauses incorporated in full text

· Provisions/Clauses incorporated by reference

Basis for Award:

· Past Performance

· Ability to meet specification requirements

· Ability to meet delivery schedule

· Price Reasonableness (3%-5% variance in comparison with other quotes)

Delivery Order Process

1. Omaha/Winnebago Service Unit will issue a BPA Call on a rotational basis with all vendors awarded a BPA from this solicitation.

2. Performance and evaluation will be based upon the vendor’s ability to delivery supplies and meet delivery schedule as requested by the Service Unit.

DUN & Bradstreet Number:

(The Dun & Bradstreet number is required. Provided you do not have one, you may call 866-705-5711 and obtain a number.)

If applicable, DUNS + 4:

CONTINUATION FOR RFQ-18-021

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

The quoter is hereby notified that they must be registered in the System for Award Management (SAM) before the Government will issue an award. (You may do this by going to www.sam.gov to register. You are required to update this registration every year prior to the expiration date.)

FEDERAL TAX ID NUMBER:

E-MAIL ADDRESS:

NET TERMS: