RRB11R004 SF 1449.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

2. CONTRACT NO.

7. FOR SOLICITATION

INFORMATION CALL: ~.

9. ISSUED BY

3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER

a. NAME

Milt Vasich milt.vasich@oig.rrb.gov

10. THIS ACQUISITION ISCODE

1. REQUISITION NUMBER

5. SOLICITATiON NUMBER

RRB11 R004

b. TELEPHONE NUMBER (No collect calls)

(312)751-4687

PAGE 1 OF

6. SOLICITATION ISSUE .

DATE

03/10/2011

8. OFFER DUE DATE/

LOCAL TIME

3/22/11 2:00P

[RJ UNRESTRICTED OR DSETASIDE: % FOR:Office of Inspector General o SMALL BUSINESS D EMERGING SMALL U.S. Railroad Retirement Board BUSINESSNAICS: 541990 D HUBZONE SMALL 844 N. Rush St.

BUSINESS

Chicago, IL 60611 SIZE STANDARD: o SERVICE-DISABLED VETERAN

D 13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

16. ADMINISTERED BY

U.S. Railroad Retirement Board

Office of Inspector General

18a. PAYMENT WILL BE MADE BY

D8(A)OWNED SMALL BUSINESS

13b. RATING

TION UNLESS BLOCK IS

MARKED

11. DELIVERY FOR FOB DESTINA 12. DISCOUNT TERMS

14. METHOD OF SOLICITATION

D SEE SCHEDULE

DRFQ DIFB [RJRFP

15. DELIVER TO CODE CODE I

Office of Inspector General

U.S. Railroad Retirement Board

17a. CONTRACTOR! CODE I I FACILITY CODE I

OFFEROR CODE

U.S. Railroad Retirement Board

Bureau of Fiscal Operations

844 N. Rush St.

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK o BELOW IS CHECKEDOFFER o SEE ADDENDUM

22. 23. 24.

ITEM NO..

19. 20. 21.

UNIT UNIT PRICE AMOUNTSCHEDULE OF SUPPLIES/SERVICES QUANTITY

Actuarial audit services as described in the attached document.

(Use Reverse and/or Attach Additiona/ Sheets as Necessary)

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

[RJ 270. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA DARE [g] ARE NOT ATTACHED o 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA DARE D ARE NOT ATTACHED

[g] 28. CONTRACTOR is REQUIRED TO SIGN THIS DOCUMENT AND RETURN 1

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

D 29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

31c. DATE SIGNED 30c. DATE SIGNED

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES F

30b. NAME AND TiTLE OF SIGNER (Type or print)

Martin J. Dickman, Inspector General

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. 3/2005)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 dkruel Text Box dkruel Typewritten Text

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

I

32a. QUANTITY IN COLUMN 21 HAS BEEN

DRECEIVED o INSPECTED 0 ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER

o PARTIAL DFINAL

38. SIR ACCOUNT NO. 39. SIR VOUCHER NUMBER 40. PAID BY

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

41 b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

42c. DATE REC'D (YYIMMlDD) 142d. TOTAL CONTAINERS

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

321. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

CORRECT FOR

AMOUNT VERIFIED 35. 36. PAYMENT

o COMPLETE o PARTIAL o FINAL

37. CHECK NUMBER

STANDARD FORM 1449 (REV. 3/2005) BACK