SF-1449_Gasoline.doc

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

2. CONTRACT NO.

3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

SFR630-17-Q-0019

6. SOLICITATION ISSUE DATE

June, 13 2017

7. FOR SOLICITATION

INFORMATION CALL

a. NAME

Jean-Charles ROYER

b. TELEPHONE NUMBER(No collect calls)

01 43 12 24 61

8. OFFER DUE DATE/ LOCAL TIME

July 12, 2017 / 16 H 00

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

CONTRACTS OFFICE, A M-8

AMERICAN EMBASSY

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UNRESTRICTED

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SET ASIDE: % FOR

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SMALL BUSINESS FORMCHECKBOX

EMERGING SMALL BUSINESS

2 AVENUE GABRIEL

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HUBZONE SMALL BUSINESS SMALL BUSINESS

75008 PARIS

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SERVICE-DISABLED VETERAN OWNED FORMCHECKBOX

8(A)

NAICS:

SIZE STD:

13a. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

DESTINATION UNLESS BLOCK IS MARKED

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SEE SCHEDULE

13b. RATING

14. METHOD OF SOLICITATION

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RFQ FORMCHECKBOX

IFB FORMCHECKBOX

RFP

15. DELIVER TO:

Code

16. Administered by:

CONTRACTS OFFICE, A M-8

2 AVENUE GABRIEL - 75008 PARIS

17.a. CONTRACTOR/OFFEROR CODE FACILITY CODE

TELEPHONE NO:

18a. PAYMENT WILL BE MADE BY

FMC/DBO

2 AVENUE GABRIEL - 75008 PARIS

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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

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SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Gasoline Services Estimated Grand Total for Base Year

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

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27a.SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA FORMCHECKBOX

ARE FORMCHECKBOX

ARE NOT ATTACHED.

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27b.CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA FORMCHECKBOX

ARE FORMCHECKBOX

ARE NOT ATTACHED.

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28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN __1___ 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.

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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:

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

30c. DATE SIGNED

31b. NAME OF CONTRACTING OFFICER (Type or Print)

Michael K. Agner 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

STANDARD FORM 1449 (REV3/2005)

PREVIOUS EDITION IS NOT USABLE

Computer Generated

Prescribed by GSA - FAR (48 CFR) 53.212

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

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RECEIVED

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INSPECTED

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ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ____________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

CORRECT FOR

PARTIAL

FINAL

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COMPLETE

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PARTIAL

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FINAL

38. S/R ACCOUNT NO.

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41C. DATE

42b. RECEIVED AT (Location)

STANDARD FORM 1449 (REV. 3/2005) BACK