SF33.pdf

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LES Health Insurance
Solicitation number
191N6522R0016
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SOLICITATION, OFFER AND AWARD

1. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE OF PAGES

1 | 74

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

191N6522R0016

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[x] NEGOTIATED (RFP)

5. DATE ISSUED

March 16, 2022

6. REQUISITION/PURCHASE NO.

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than item 7)

U.S. Embassy, Shanti Path, Chanakyapuri

New Delhi 110021, India

Phone: 24198000

The Contracting Officer

U.S. Embassy, Gate-C, Chandragupta Marg, Chanakyapuri, New Delhi 110021, India

NOTE: In sealed bid solicitation "offer" and "offeror” mean "bid" and "bidder".

SOLICITATION

9. Sealed offers in original for furnishing the supplies or services in the Schedule will be received at newdelhibids@state.gov , until 5:00 P.M. local time on

April 14, 2022.

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

10. FOR

INFORMATION

CALL:

A. NAME

Omar A. Ali

Contracting Officer

B. TELEPHONE (NO COLLECT

CALLS)

AREA CODE NUMBER EXT

91-11-24198328

C. E-MAIL ADDRESS

alioa@state.gov

11. TABLE OF CONTENTS

(x) SEC. DESCRIPTION PAGE(S) (x) SEC. DESCRIPTION PAGE(

S)

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

X A SOLICITATION/CONTRACT FORM 1 X I CONTRACT CLAUSES 15

X B SUPPLIES OR SERVICE AND PRICES/COSTS 5 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK STATEMENT 9 X J LIST OF ATTACHMENTS 2

X D PACKAGING AND MARKETING 1 PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 2 X K REPRESENTATIONS, CERTIFICATIONS, AND 23

X F DELIVERIES OR PERFORMANCE 1 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 2 X L INSTRS., COND., AND NOTICES TO OFFERORS 7

X H SPECIAL CONTRACT REQUIREMENTS 4 X M EVALUATION FACTORS FOR AWARD 3

OFFER (Must be fully completed by offeror) NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within 120 calendar days (120 calendar days unless a different period is inserted by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT SEE 14

(See section I, Clause No 52.232-8)

10 CALENDAR

DAYS %

20 CALENDAR DAYS

30 CALENDAR

DAYS %

CALENDAR DAYS

14. ACKNOWLEDGMENT OF

AMENDMENTS

AMENDMENT NO. DATE AMENDMENT NO. DATE

(The offeror acknowledges receipt of amendments to the solicitation and related documents ) numbered and dated:

15A. NAME

AND

CODE FACILITY 16. NAME AND TITLE OF PERSON AUTHORIZED

ADDRESS

OF

OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE

ADDRESS [ ] IS DIFFERENT FROM

ABOVE - ENTER SUCH ADDRESS

17. SIGNATURE 18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED 20. AMOUNT 21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS SHOWN

IN

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7)

CODE

25. PAYMENT WILL BE MADE BY CODE

26. NAME OF CONTRACTING OFFICER (Type or print)

27. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

28. AWARD

DATE

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

JAMES ZADROGA 9/11 VICTIMS HEALTH AND COMPENSATION ACT OF 2010 NOTICE: UNLESS A WAIVER OR

EXCEPTION APPLIES, PAYMENTS SUBSEQUENT TO THIS PROCUREMENT ARE SUBJECT TO AN EXCISE TAX OF 2%

PERSUANT TO 26 U.S.C. 5000C.

mailto:newdelhibids@state.gov

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