BOP1449 0013-8 PG1 2.pdf

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

PAGE OF PAGES1. REQUISITION NUMBERSOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12,17,23,24, & 30

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS

6. SOLICITATION

ISSUE DATE

3. AWARD/EFF. DATE 5. SOLICITATION NUMBER2. CONTRACT NO. 4. ORDER NUMBER

a. NAME b. TELEPHONE NUMBER (No collect calls)7. FOR SOLICITATION

INFORMATION CALL:

Expiration Date:

OMB No:

NAICS:

SIZE STANDARD:

15. DELIVER TO CODE DELIVERY DATE 16. ADMINISTERED BY CODE

13a. THIS CONTRACT IS A RATED

ORDER UNDER DPAS (15 CFR 700)

12. DISCOUNT TERMS11. DELIVERY FOR FOB

DESTINATION UNLESS

BLOCK IS MARKED

SEE SCHEDULE

13b. RATING

14. METHOD OF SOLICITATION

IFB RFPRFQ

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/ CODE

OFFEROR

FACILITY

CODE

TIN NO.

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS

BLOCK BELOW IS CHECKED. SEE ADDENDUM

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS

IN OFFER.

PHONE: FAX:

ARE

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

24.

AMOUNT

22.

UNIT

23.

UNIT PRICE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

31c. DATE SIGNED

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt Use Only)

30A. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE

SIGNED

STANDARD FORM 1449 (REV. 3/2005)

Prescribed by GSA - FAR (48 CFR) 53.212

31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND

RETURN COPIES TO ISSUING OFFICE. CONTRACTOR

AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR

OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

29. AWARD OF CONTRACT: REF.

. YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING

ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO

ITEMS:

OFFER DATED

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED.

ADDENDA

ADDENDA

ARE ARE NOT ATTACHED.

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED

UNRESTRICTED OR

SET ASIDE : % FOR:

SMALL BUSINESS

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS

HUBZONE SMALL BUSINESS 8(A)

EMERGING SMALL BUSINESS

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

ADDITIONAL INFORMATION:

CONTRACT NO.: REQUISITION NUMBER AWARD/EFF. DATE

PAGE OF PAGES

32a. QUANTITY IN COLUMN 21 HAS BEEN

ACCEPTED AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVT. REPRESENTATIVE 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

FINALPARTIAL

36. PAYMENT 37. CHECK NUMBER

COMPLETE PARTIAL FINAL

39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41c. DATE 42b. RECEIVED AT (Location)

STANDARD FORM 1449 (REV. 3/2005) BACK

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)