SF1449 Cover Page.pdf
PDF 248 KB Posted
- Solicitation number
- 19PM0724Q0011
- Issued by
-
Department of State
About this file
This solicitation seeks ambulance services for the U.S. Embassy in Panama. The Medical Unit requires transportation for sick patients from the Embassy, private residences, or accident sites to local hospitals or airports, as well as from medical facilities back to residences. The contract will have a term of five years. Offerors must submit pricing and be registered in SAM prior to the January 25, 2024 response deadline. The Department of State intends to award a contract to the responsible vendor submitting the lowest priced, acceptable offer without discussions, but may hold discussions with competitive range offers if needed. The awardee must be able to safely transport patients in Panama City and surrounding areas to fulfill requirements.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 24Q0011_SF30 Amendment.pdf | ||
| 24Q0011_QA.pdf | ||
| Ambulance_Solicitation.pdf | ||
| RFQ_Ambulance_Cover Letter.pdf |
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Text version
AUTORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. 02/2012)
PREVIOUS EDITION IS NOT USABLE Computer Generated Prescribed by GSA - FAR (48 CFR) 53.212
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
1. REQUISITION NUMBER
PR11829468
PAGE 1 OF 41 PAGES
2. CONTRACT NO. 3. AWARD/ EFFECTIVE
DATE
4. ORDER NUMBER 5. SOLICITATION NUMBER
19PM0724Q0011
6. SOLICITATION ISSUE
DATE
01/11/2024
7. FOR SOLICITATION
INFORMATION CALL:
a. NAME Aranza I Gutierrez
b. TELEPHONE NUMBER(No collect calls)
(507) 317-5309 / 6400-8934
8. OFFER DUE DATE/
LOCAL TIME
01/25/2024 / 15:00
9. ISSUED BY CODE PM070 10. THIS ACQUISITION IS x UNRESTRICTED OR SET ASIDE: % FOR:
SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS
HUBZONE SMALL
BUSINESS
(WOSB) ELLIGIBLE UNDER THE WOMEN-OWNED
SMALL BUSINESS PROGRAM NAICS:
EDWOSB EMERGING SMALL BUSINESS
AMERICAN EMBASSY PANAMA CITY
APARTADO 0816-02561, ATTN: GSO
PANAMA
PANAMA
SERVICE-DISABLED
VETERAN-OWNED
SMALL BUSINESS 8 (A) SIZE STANDARD:
13b. RATING11. DELIVERY FOR FOB DESTINAT-
TION UNLESS BLOCK IS
MARKED
SEE SCHEDULE
12. DISCOUNT TERMS 13a. THIS CONTRACT IS A
RATED ORDER UNDER
DPAS (15 CFR 700)
14. METHOD OF SOLICITATION
x RFQ IFB RFP
15. DELIVER TO CODE 16. ADMINISTERED BY CODE
AMERICAN EMBASSY PANAMA CITY
NEC - CLAYTON BUILDING 783, ATTN:
WAREHOUSE
PANAMA CITY
PANAMA
AMERICAN EMBASSY PANAMA CITY
APARTADO 0816-02561, ATTN: GSO
PANAMA
PANAMA
CODE FACILITY
CODE
17a. CONTRACTOR/
OFFERER
TELEPHONE NO.
18a. PAYMENT WILL BE MADE BY
AMERICAN EMBASSY PANAMA CITY
DEMETRIO LAKAS STREET, BUILDING 783, ATTN:
FINANCIAL MANAGEMENT OFFICE
CLAYTON
PANAMA
CODE
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 SEE ADDENDUM
19.
ITEM NO.
20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
(Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only) x 27a.SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED
27b.CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED
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.
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) 31c. DATE SIGNED
Ambulance Service for U.S. Embassy Mission Panama for U.S.
Embassy Employees, EFM, locally Employed Staff and Visitors - See attached
5 years $ $
X
ITEM NO. 20.
SCHEDULE OF SUPPLIES/SERVICES
21.
QUANTITY
22.
UNIT
23.
UNIT PRICE
24.
AMOUNT
32a. QUANTITY IN COLUMN 21 HAS BEEN
RECEIVED INSPECTED 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
32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED
CORRECT FOR
36. PAYMENT 37. CHECK NUMBER
PARTIAL FINAL COMPLETE PARTIAL 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. 2/2012) BACK
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