SF 18 RFQ-23-102.pdf

AUTHORIZED FOR LOCAL REPRODUCTION

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FonnFlow/Delnna Inc. STANDARD FORM 18 (REV 6-95) Prescribed by GSA-FAR (48 CFR) 53-215-l{a)

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

THIS RFQ X IS □ IS NOT A SMALL BUSINESS SET-ASIDE PAGE OF PAGES

I. REQUEST NUMBER , 2. DATE ISSUED

RFQ-23-102 05/16/2023

3. REQUISITION/PURCHASE REQUEST NUMBER

IHS1473710

4. CERT.FOR NAT. DEF.

UNDER BDSA REG.2

AND/OR DMS REG. I

RATING

Sa. ISSUED BY

Great Plains Area - Indian Health Service, Division of Acquisition Mgmt.

115 4th Avenue Southeast, Aberdeen, South Dakota 57401

6. DELIVER BY (Date)

60 CALENDAR DAYS FROM DATE OF AWARD

Sb. FOR INFORMATION CALL (NO COLLECT CALLS) 7. DELIVERY OTHER

FOB DESTINATION (See Schedule)

NAME

Ms. Erin Doering

Erin.Doering@ihs.gov

TELEPHONE NUMBER 9. DESTINATION

AREA CODE

NUMBER

226-7662

a. NAME OF CONSIGNEE

Great Plains Area IHS Office of Environmental Health

8. TO: b. STREET ADDRESS

115 4th Avenue SE Room 309 a.NAME b.COMPANY c.CITY

Aberdeen c. STREET ADDRESS d.CITY e. STATE f.ZIPCODE d. STATE e.ZJPCODE

SD 57401

IO. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK Sa ON OR

BEFORE CLOSE OF BUSINESS (Date)

May 31, 2023 (ii) 3:00pm CDT

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 Sa. 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 aoolicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1.

2.

Firm Fixed-Price, Non-Personal services

Purchase order to provide Environmental Site

Assessments and Hazardous Materials and

Asbestos Surveys at sites at Manderson and

Allen IHS Clinics.

Phase 1 ESA and HMAS –Manderson, SD

Phase 1 ESA and HMAS –Allen, SD

The Period of Performance will begin "Date of

Award" and end 60 days after award date.

JB

JB

Total Cost

12. DISCOUNT FOR PROMPT PAYMENT -

a. IO CALENDAR DAYS

b. 20 CALENDAR DAYS

c. 30 CALENDAR DAYS

d. CALENDAR DAYS

NUMBER I PERCENTAGE

NOTE: Additional provisions and representations D are 181 are not attached.

13. NAME AND ADDRESS OF QUOTER 15. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

15. DATE OF QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY 16. SIGNER

a. NAME {Type or print) b. TELEPHONE

AREA CODE

d.CITY e. STATE f.ZIPCODE c. TITLE (type or print) NUMBER mailto:Erin.Doering@ihs.gov

CONTINUATION FOR RFQ-23-102

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

The quoted "unit price" must be an all-inclusive cost.

SAM UEI & Duns & Bradstreet Number:

Total Cost

(The Duns and Bradstreet number is required, provided you do not have it;

you may Call 866-705-5711 and obtain one.)

Federal Tax ID Number:

Email Address:

Net Terms:

The quoter is hereby notified that they must be registered in the System for Award Management (SAM), before the Government will issue an award.

www.sam.aov/ http://www.sam.aov/