SF 18 RFQ-23-143 SB.pdf

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

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-23-143 10/03/2023

3. REQUISITION/PURCHASE REQUEST NUMBER

IHS1477202

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)

45 days ARO

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

X FOB DESTINATION (See Schedule)

NAME

Erin.Doering@ihs.gov

TELEPHONE NUMBER 9. DESTINATION

AREA CODE

NUMBER

226-7662

a. NAME OF CONSIGNEE

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)

October 11, 2023 @ 3:00pm CT

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 othetwise 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)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1.

2.

3.

4.

5.

6.

7.

Firm Fixed-Price, commercial item, Purchase

Order for three Canon Copiers for the Indian

Health Service, Office of Environmental Health and Engineering, Aberdeen, South Dakota.

4063C001AA: Canon Single Pass DADF-

C1

5634C001AA: Canon Cabinet Type –W

5745C003AA- Canon GPR-67 Black Toner

5972C002AA-Canon imageRUNNER

ADVANCE DX 4925i

4000C002BA-Canon Inner Finisher-L1

Freight

Professional Assembly and Installation

*See attached specifications for delivery locations.

The Period of Performance will end 45 days after date of award

EA

LS

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 x are 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

CONTINUATION FOR RFQ-23-143

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: _________________

Total Cost

Federal Tax ID Number:

Email Address:

Net Terms:

Invoicing under this order shall be processed through the Invoice Payment

Platform (IPP), located at www.ipp.gov .

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.gov/ http://www.ipp.gov/ http://www.sam.gov/