SF1447.pdf

SOLICITATION/CONTRACT 1. THIS CONTRACT IS A RATED

5. SOLICITATION TYPE2. CONTRACT NO. 4. SOLICITATION NUMBER

PAGE OF PAGES

7. ISSUED BY CODE 8. THIS ACQUISITION IS

BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27

RATING

ORDER UNDER DPAS (15 CFR 700)

3. AWARD/

EFFECTIVE DATE ISSUE DATE

6. SOLICITATION

UNRESTRICTED OR SET ASIDE:

SMALL BUSINESS

SIZE STANDARD:

9. (AGENCY USE)

NO COLLECT CALLS

10. ITEMS TO BE PURCHASED (BRIEF DESCRIPTION)

SUPPLIES SERVICES

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT WITHIN

CALENDAR DAYS (60 CALENDAR DAYS UNLESS OFFEROR INSERTS A DIFFERENT

PERIOD) FROM THE DATE SET FORTH IN BLOCK 9 ABOVE, THE CONTRACTOR

AGREES TO HOLD ITS OFFERED PRICES FIRM FOR THE ITEMS SOLICITED

HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO THE TERMS

AND CONDITIONS STATED HEREIN.

CODE 12. ADMINISTERED BY

13. CONTRACTOR FACILITY 14. PAYMENT WILL BE MADE BY CODE CODE

OFFEROR CODE

TELEPHONE NO.

UNIQUE ENTITY IDENTIFER

CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK:

15. PROMPT PAYMENT DISCOUNT 16. AUTHORITY FOR USING OTHER

THAN FULL AND OPEN COMPETITION

10 U.S.C. 2304 41 U.S.C. 253

NEGOTIATED

(RFP)

SEALED BIDS

(IFB)

1 76

08/14/2020

Indian Health Service 2225 Boring Court NW Bemidji MN 56601

Indian Health Service 425 7th Street NW Cass Lake MN 56633

100.00

518210

% FOR:

X

X x x

$35.00

75H70520R00007

NAICS:

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

8(A)

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

EDWOSB

17.

ITEM NO.

18.

SCHEDULE OF SUPPLIES/SERVICES

19.

QUANTITY

20.

UNIT

21.

UNIT PRICE

22.

AMOUNT

Continued ...

27. SIGNATURE OF OFFEROR/CONTACTOR 28. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

NAME AND TITLE OF SIGNER (TYPE OR PRINT) DATE SIGNED NAME OF CONTRACTING OFFICER DATE SIGNED

25. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET

FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY CONTINUATION SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

26. AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION

NUMBER SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS

OR CHANGES WHICH ARE SET FORTH HEREIN, IS

ACCEPTED AS TO ITEMS:

23. ACCOUNTING AND APPROPRIATION DATA 24. TOTAL AWARD AMOUNT

(FOR GOVERNMENT USE ONLY)

WILLIAM F. FISHER

x

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

STANDARD FORM 1447 (REV. 8/2016)

Prescribed by GSA - FAR (48 CFR) 53.214(d)

COPIES TO

IEE

Indian Health Service 2225 Boring Ct NW Bemidji, MN 56601

TYPE OR PRINT NAME AND TITLE OF SIGNER

SIGNATURENAME AND ADDRESS OF FIRM (Include ZIP Code)

WE DO NOT, DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF ITEMS INVOLVEDWE DO

DO NOT REGULARLY MANUFACTURE OR SELL THE TYPE OF ITEMS INVOLVED

CANNOT MEET DELIVERY REQUIREMENT

OTHER (Specify)

UNABLE TO IDENTIFY THE ITEM(S)

CANNOT COMPLY WITH SPECIFICATIONS

PAGE

NO RESPONSE FOR REASONS CHECKED

76 2 OF

DATE AND LOCAL TIME

AFFIX

STAMP

HERE

TO:

FROM:

SOLICITATION NO.

Indian Health Service 2225 Boring Court NW Bemidji MN 56601

75H70520R00007

STANDARD FORM 1447 (REV. 8/2016) BACK

(A)

ITEM NO.

(B)

SUPPLIES/SERVICES

(C)

QUANTITY

(D)

UNIT

(E)

UNIT PRICE

(F)

AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 76

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

75H70520R00007

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in subpart 12.6, as supplemented with additional information included in this notice.

This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. This solicitation is issued as a request for proposal

(RFP). This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular FAC

2020-08/08-13-2020.

Set-aside: 100% Indian Economic Enterprise Small

Business.

Attachments:

1-Administrative Data (5 pages)

2-Scope of Work (3 pages)

3-Service Contract Act (3 pages)

4-Clauses (9 pages)

5-Business Associates Agreement (7 pages)

6-Data Exchange Agreement (21 pages)

7-Provisions (20 pages)

8-Indian Economic Enterprise Certification (1 page)

9-Evaluation Criteria (4 pages)

NSN 7540-01-218-4386 STANDARD FORM 1447 (REV. 8/2016)

Prescribed by GSA - FAR (48 CFR) 53.214(d)