SF_1449.pdf

SGE50017R0084

X X

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

SGE50017R0084

6. SOLICITATION ISSUE

DATE

04/27/2017

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

David A. Cubitt

b. TELEPHONE NUMBER (No collect calls)

c. EMAIL cubittda@state.gov

8. OFFER DUE DATE / LOCAL

TIME

05/17/2017 17:00:00

(CET)

9. ISSUED BY CODE FRANK 10. THE ACQUISITION IS X UNRESTRICTED OR SET ASIDE: % FOR

WOMEN-OWNED SMALL BUSINESS (WOSB)

SMALL BUSINESS ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

NAICS: 238190

HUBZONE SMALL

BUSINESS EDWOSB

SERVICE-DISABLED SIZE STANDARD:

VETERAN-OWNED

SMALL BUSINESS 8(A)

AMERICAN CONSULATE GENERAL FRANKFURT

GIESSENER STRASSE 30

ATTN: RPSO

FRANKFURT, 60435

GERMANY

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

SEE

SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS

RATED ORDER UNDER DPAS

13b. RATING

14. METHOD OF SOLICITATION

X RFQ IFB RFP

15. DELIVER TO CODE TBILI

AMERICAN EMBASSY TBILISI

11 G. Balanchine St.

ATTN: GSO

TBILISI, 0131

GEORGIA

16. ADMINISTERED BY CODE FRANK

AMERICAN CONSULATE GENERAL FRANKFURT

GIESSENER STRASSE 30

ATTN: RPSO

FRANKFURT, 60435

GERMANY

17a. CONTRACTOR/OFFEROR CODE FACILITY

CODE

Contact Duns

Telephone No.

18a. PAYMENT WILL BE MADE BY CODE TBILI

AMERICAN EMBASSY TBILISI

11 GEORGE BALANCHINE STREET

ATTN: FINANCIAL OFFICE

TBILISI

GEORGIA

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

(Use Reverse and/or Attach Additional Sheets as Necessary)

21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT

See Line Items Section

27a. SOLICITATION INCORPORATES BY REFERENCES 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, 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

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.

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 THE CONTRACTING OFFICER (TYPE OR PRINT)

David A. Cubitt 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 02/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

25. ACCOUNTING AND APPROPRIATION DATA

See Line Item Detail

26. TOTAL AWARD AMOUNT (For Govt. Use Only) mailto:cubittda@state.gov

19.

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

COMPLETE PARTIAL FINAL

37. CHECK NUMBER

PARTIAL FINAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. 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. 02/2012) BACK

Line Item Summary

Solicitation Number:

SGE50017R0084

Contract Number: Title: GG-TBILISI-FAC-Emergency Repairs to Mech. Systems Date of Solicitation:

04/27/2017

Line Item No. Description Quantity Unit Unit Price Total Cost

Mechanical System Repair Services: Firm-fixed price for the emergency repair work of:

two rotary screw 407 C chillers, utility plant controls, one primary chilled water pump, one secondary chilled water pump, one heat water pump, and the domestic water systems (including the domestic water controls) in the central energy plant, for the American Embassy Tbilisi, Georgia.

Price includes all professional services, overhead, labor, material, equipment and services, travel cost (if applicable), cost of insurance (other than DBA), cost of obtaining Irrevocable Letters of Credit (ILCs) and profit, to perform and complete all works in accordance with the Statement of Work (SOW), drawings, specifications and contract terms and conditions, and the Contractors Proposal.

Doc Ref No:

Delivery Date FOB:

08/31/2017 Destination

Value Added Tax (VAT); if required

Doc Ref No:

Delivery Date FOB:

Defense Base Act Insurance (DBA)

Doc Ref No:

Delivery Date FOB:

1.00

LT