Sol_RFQ-RT-15-00061.pdf

RFQ-RT-15-00061

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

06/24/2015 PR-ORD-14-02801

1 2

US Environmental Protection Agency 109 T.W. Alexander Drive Mail Code: AA005

RTPPOD

Research Triangle Park NC 27709

5 Days After Award

NHEERL RTP 1

US Environmental Protection Agency National Health and Environmental Effects Research Lab 4930 Page Road

Durham

NC 27703

919 541-4826Nicole Hairston

07/06/2015 0800 ET

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

0001 Histology, small animals (232 testes & 116 epididymides to H&E stained slides) Task Code: XTRTBLGRAYSHC This item contains full funding for all items on the PR and the actual amount of line item 1.

Line 1: Quantity = 348 and unit price is $15.80.

0002 Pathology (232 testes & 116 epididymides with 348 EA draft/final report) Task Code: XTRTBLGRAYSHC unit price is $24.35

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 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

RFQ-RT-15-00061

0003 Histology (218 testes & 109 epididymides to H&E 327 EA slides) Task Code: XTRTBLGRAYSHC unit price is $15.80

0004 Pathology (218 testes & 109 epididymides to H&E 327 EA slides) Task Code: XTRTBLGRAYSHC unit price is $24.35

0005 Histology (270 testes & 135 epididymides to H&E 405 EA slides) Task Code: XTRTBLGRAYSHC unit price is $14.10

0006 Pathology (270 testes & 135 epididymides to H&E 405 EA slides) Task Code: XTRTBLGRAYSHC unit price is $21.40

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