PR5401378.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

PR5401378

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

SGY20016Q0003

6. SOLICITATION ISSUE DATE

7. FOR SOLICITATION

INFORMATION CALL

a. NAME

Jinelle Lewis

b. TELEPHONE NUMBER

8. OFFER DUE DATE/ LOCAL TIME

06/30/2016 / 1600hrs

9. ISSUED BY CODE

GY200 10. THIS ACQUISITION IS

AMERICAN EMBASSY GEORGETOWN

100 YOUNG AND DUKE STREETS, ATTN:

GSO

KINGSTON, GEORGETOWN

GUYANA

UNRESTRICTED

x_ SET ASIDE: % FOR

_ SMALL BUSINESS _ EMERGING SMALL

_ HUBZONE SMALL BUSINESS SMALL BUSINESS

_ SERVICE-DISABLED VETERAN OWNED _ 8(A)

NAICS:

SIZE STD:

11. DELIVERY FOR FOB 12. DISCOUNT

TERMS

13a. THIS CONTRACT IS A RATED ORDER

UNDER DPAS (15 CFR 700)

DESTINATION UNLESS BLOCK IS MARKED

_ SEE SCHEDULE

13b. RATING

14. METHOD OF SOLICITATION

x RFQ _ IFB _ RFP

15. DELIVER TO: Code 16. ADMINISTERED BY

Miami DA Office (DA_MI)

Goldbelt Specialty Services (305- 477-4140), 11380 NW 34th St

Doral FL 33178

UNITED STATES

AMERICAN EMBASSY GEORGETOWN

100 YOUNG AND DUKE STREETS, ATTN: GSO

GUYANA

117a. CONTRACTOR/OFFEROR COD E

NOVENDOR

0 FACILITY CODE

N/A

UNITED STATES

TELEPHONE NO:

18a. PAYMENT WILL BE MADE BY

AMERICAN EMBASSY GEORGETOWN

100 YOUNG AND DUKE STREETS, ATTN: FMO

KINGSTON, GEORGETOWN

GUYANA

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

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

SEE LINE ITEMS

(Use Reverse and/or Attach Additional Sheets as N ecessary)

25. ACCOUNTING AND APPROPRIAT ION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Onl y)

$0.00 USD

_ 27a.SOLICITAT ION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 AR E ATTACHED. ADDENDA _ ARE _ ARE NOT ATTACHED.

_ 27b.CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212- 5 IS ATTACHED. ADDENDA _ AR E _ ARE NOT ATTACHED.

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

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 TER MS AND CONDITIONS SPECIFIED

HEREIN.

_ 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 CONTRACTING OFFICER (Type or Print)

Brittany Carroll 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

11. SCHEDULE

(Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1 001 Police Bike Funding Information:

Total : $0.00

--------------- $0.00

1.00 EA $0.00 $0.00

2 Lights Funding Information:

200.00 EA $0.00 $0.00

3 Bag Funding Information:

4 Helmet Funding Information:

5 Mechanic Tool Ki ts Funding Information:

10.00 EA $0.00 $0.00

6 Bike Multi Tool Funding Information:

250.00 EA $0.00 $0.00

7 Repair Stand with Tote Bag Funding Information:

10.00 EA $0.00 $0.00