SF18-95a Request for Quotation.pdf

REQUEST FOR QUOTATION THIS RFQ (8] IS □ IS NOT A BUY-INDIAN SET-ASIDE PAGE OF PAGES

(THIS IS NOT AN ORDER) 1 I 12

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NUMBER 4. CERT. FOR NAT. DEF.

RATING 1. REQUEST NUMBER

246-22-Q-0104 06/06/2022 IHS1452920

UNDER BOSA REG. 2

AND/OR OMS REG. 1

Sa. ISSUED BY 6. DELIVER BY (Date)

Indian Health Svc-Oklahoma City Area, 701 Market Drive, Oklahoma City, OK 73114

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

OTHER

NAME TELEPHONE NUMBER □ FOB DESTINATION D (See Schedule)

AREA CODE

I

NUMBER 9. DESTINATION

Jeffrey Earnest 405 951-3740 a. NAME OF CONSIGNEE

8. TO: Clinton IHS

a. NAME l b COMPANY b. STREET ADDRESS

To Prospective Offerors 10321 N 2274 Rd.

c. STREET ADDRESS c. CITY

Clinton

d. CITY e.STATE

I

f. ZIP CODE d. STATE

e. ZIP CODE

OK 73601

10. PLEASE FURNISH QUOTATIONS TO THE IMPORTANT: This is a request for information and quotations furnished are not offers. If you are unable to quote, please ISSUING OFFICE IN BLOCK Sa ON OR so indicate on this form and return it to the address in Block Sa. This request does not commit the Government to pay any BEFORE CLOSE OF BUSINESS (Date) costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for 07/07/2022 Quotation must be completed by the quoter.

11. SCHEDULE (Include app/Jcable Federal, State and local taxes)

ITEM NUMBER SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(a) (b) (c) (d) (e) (f)

1 Contractor shall repair, asphaltic pavements on 1 JB the oval perimeter road and related parking lots in accordance with the Statement of Work and Drawing at the Clinton Indian Health Center

Additional Provisions and Conditions (ten pages; 2-11 are attached hereto)

Scope of Work including Drawings (attached) Statement of Work (23 pages), Drawing (3 pages)

Davis Bacon General Wage Decision OK20220018 Dated 02/25/2022 is hereby incorporated, 7 pages (attached)

FAR Clause 52.213-4 attached FAR Clause 52.204-7 applies

Official site visit information Page 11

a. 10 CALENDAR DAYS(%) b. 20 CALENDAR DAYS(%) c. 30 CALENDAR DAYS(%) d. CALENDAR DAYS

12. DISCOUNT FOR PROMPT PAYMENT NUMBER

I

PERCENTAGE

NOTE: Additional provisions and representations IXI are I I are not attached.

13. NAME AND ADDRESS OF QUOTER 14. SIGNATURE OF PERSON AUTHORIZED TO 15. DATE OF QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

SIGN QUOTATION

a. NAME (Type or print)

e. STATE f. ZIP CODE c. TITLE (Type or print)

16. SIGNER

b. TELEPHONE

I AREA CODE

NUMBER

STANDARD FORM 18 (REV. 6/1995)

Prescribed by GSA-FAR (48 CFR) 53.215-1 (a)