SF18-95a Request for Quote.pdf

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NUMBER

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1 Contractor shall provide and install secured control door assemblies with monitoring cameras for the ER Department at the Claremore Indian

Hospital in accordance with the statement of work.

Additional Provisions and Conditions

(9 pages; 2-10 are attached hereto)

Statement of Work (12 pages), Attachment A.

Photos & drawings (25 pages) (attached).

Davis Bacon General Wage Decision OK20220052

Dated 09/02/2022 is hereby incorporated, 7 pages

(attached)

FAR Clause 52.213-4 attached

FAR Clause 52.204-7 applies

Official Site Visit information pages 10 & 11

1 JB

12. DISCOUNT FOR PROMPT PAYMENT

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

NUMBER PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

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

SIGN QUOTATION

15. DATE OF QUOTATION

a. NAME OF QUOTER

b. STREET ADDRESS 16. SIGNER

a. NAME (Type or print) b. TELEPHONE

c. COUNTY AREA CODE

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

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6/1995)

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

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

1. REQUEST NUMBER

246-22-Q-0160 5a. ISSUED BY

THIS RFQ IS A Small Bus Or Indian owned SET-ASIDE

PAGE OF PAGES

RATING

6. DELIVER BY (Date)

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

5b. FOR INFORMATION CALL (NO COLLECT CALLS) 7. DELIVERY

OTHER

NAME FOB DESTINATION (See Schedule)

Jeffrey Earnest

8. TO:

a. NAME

To Prospective Offerors

c. STREET ADDRESS

d. CITY

9. DESTINATION

a. NAME OF CONSIGNEE

Claremore Indian Hospital

b. STREET ADDRESS

101 South Moore Ave

c. CITY

Claremore

e. ZIP CODE

74017

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5a ON OR

BEFORE CLOSE OF BUSINESS (Date)

10/26/2022

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 5a. 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 service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for

Quotation must be completed by the quoter.

d. STATE

OK

f. ZIP CODE e. STATE

b. COMPANY

NUMBER

951-3740

AREA CODE

TELEPHONE NUMBER

4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

3. REQUISITION/PURCHASE REQUEST NUMBER

IHS1459401

2. DATE ISSUED

09/28/2022