SF_1449_Sol_Rev2010.doc
DOC document 68 KB Posted
- Attached to
- Fuel Supply for the American Embassy Phnom Penh
- Solicitation number
- S-CB600-11-Q-0536
About this file
SF 1449 Solicitation / Contract / Order for Commerical Items
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Solicitation11_rev.doc | DOC document | |
| Cover page_re.doc | DOC document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
1. REQUISITION NUMBER
2. CONTRACT NO.
3. AWARD/EFFECTIVE
DATE
4. ORDER NUMBER
5. SOLICITATION NUMBER
S-CB600-11-Q-0536
6. SOLICITATION ISSUE DATE
March 2, 2011
7. FOR SOLICITATION
INFORMATION CALL
a. NAME
PAUL E. BRAND
b. TELEPHONE NUMBER(No collect calls)
855 23 728 000
8. OFFER DUE DATE/ LOCAL TIME
April 1, 2011, 4:00 pm
9. ISSUED BY
CODE
10. THIS ACQUISITION IS
General Services Officer
American Embassy Phnom Penh
#1, Street 96, Phnom Penh 303
FORMCHECKBOX
UNRESTRICTED
FORMCHECKBOX
SET ASIDE: % FOR
FORMCHECKBOX
SMALL BUSINESS FORMCHECKBOX
EMERGING SMALL BUSINESS
Cambodia
FORMCHECKBOX
HUBZONE SMALL BUSINESS SMALL BUSINESS
Tel: (855) 23-728 000 Fax: (855) 23-728 504
FORMCHECKBOX
SERVICE-DISABLED VETERAN OWNED FORMCHECKBOX
8(A)
NAICS:
454319 – Other Fuel Dealers
SIZE STD:
| 11. DELIVERY FOR FOB |
| 12. DISCOUNT TERMS |
| FORMCHECKBOX |
13a. THIS CONTRACT IS A RATED ORDER
UNDER DPAS (15 CFR 700)
DESTINATION UNLESS BLOCK IS MARKED
FORMCHECKBOX
SEE SCHEDULE
13b. RATING
14. METHOD OF SOLICITATION
FORMCHECKBOX
RFQ FORMCHECKBOX
IFB FORMCHECKBOX
RFP
15. DELIVER TO:
Code
16. Administered by:
See Page 4 of this solicitation
FACILITY MANAGEMENT SECTION
AMERICAN EMBASSY PHNOM PENH
#1, Street 96 Phnom Penh, 303
17.a. CONTRACTOR/OFFEROR CODE FACILITY CODE
TELEPHONE NO:
18a. PAYMENT WILL BE MADE BY
Financial Management Office
American Embassy Phnom Penh
#1, Street 96
Phnom Penh, 303
FORMCHECKBOX
17b CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED
FORMCHECKBOX
SEE ADDENDUM
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
DIESEL delivery to the american embassy phnom penh compound and residences and to CD25 plate vehicles at the contracor gas stations
SUPER gasoline SUPPLY at the contractor gas stations to CD25 plate vehicles
REGULAR gasoline SUPPLY at the contractor gas stations to CD25 plate vehicles Estimated
2,300,000
200,000
50,000 Liters
Liters
Liters
(Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA
26. TOTAL AWARD AMOUNT (For Govt. Use Only)
FORMCHECKBOX
27a.SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA FORMCHECKBOX
ARE FORMCHECKBOX
ARE NOT ATTACHED.
FORMCHECKBOX
27b.CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA FORMCHECKBOX
ARE FORMCHECKBOX
ARE NOT ATTACHED.
FORMCHECKBOX
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.
FORMCHECKBOX
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:
| 30a. SIGNATURE OF OFFEROR/CONTRACTOR |
| 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) |
30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)
30c. DATE SIGNED
31b. NAME OF CONTRACTING OFFICER (Type or Print)
PAUL E. BRAND
31c. DATE SIGNED
AUTHORIZED FOR LOCAL REPRODUCTION
STANDARD FORM 1449 (REV10/2010)
PREVIOUS EDITION IS NOT USABLE
Computer Generated
Prescribed by GSA - FAR (48 CFR) 53.212
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
32a. QUANTITY IN COLUMN 21 HAS BEEN
FORMCHECKBOX
RECEIVED
FORMCHECKBOX
INSPECTED
FORMCHECKBOX
ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ____________________________
32b. SIGNATURE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
| 32c. DATE |
| 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT |
REPRESENTATIVE
Vuthy Prum, Electrical Engineering Technician
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE
FACILITY MANAGEMENT SECTION
AMERICAN EMBASSY PHNOM PENH
#1, Street 96 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
855-23-728-443 32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
PrumV@state.gov
| 33. SHIP NUMBER |
| 34. VOUCHER NUMBER |
| 35. AMOUNT VERIFIED |
CORRECT FOR
| 36. PAYMENT |
| 37. CHECK NUMBER |
PARTIAL
FINAL
FORMCHECKBOX
COMPLETE
FORMCHECKBOX
PARTIAL
FORMCHECKBOX
FINAL
38. S/R ACCOUNT NO.
| 39. S/R VOUCHER NO. |
| 40. PAID BY |
| 41.a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT |
| 42a. RECEIVED BY (PRINT) |
41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
41C. DATE
42b. RECEIVED AT (Location)
| 42c. DATE REC’D (YY/MM/DD) |
| 42d. TOTAL CONTAINERS |
STANDARD FORM 1449 (REV. 10/2010) BACK
File details come from the government source that posted it. Updated .