SF1449_Fuel_Solicitation_Cover_Page.pdf

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

PR2810320 Page 1 of 1

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

SHA70014R0001

6. SOLICITATION ISSUE DATE

3/28/2014

7. FOR SOLICITATION

INFORMATION CALL

a. NAME

Rose Nicolas

b. TELEPHONE NUMBER

509-3458-3520

8. OFFER DUE DATE/LOCAL TIME

4/28/2014 / 10:00

9. ISSUED BY CODE

HA700 10. THIS ACQUISITION IS

AMERICAN EMBASSY PORT-AU-PRINCE

BLVD 15 OCTOBRE-TABARRE 41, ATTN:

GSO/PROCUREMENT

PORT-AU-PRINCE

HAITI

_ UNRESTRICTED

_ SET ASIDE: % FOR

_ SMALL BUSINESS _ EMERGING SMALL

_ HUBZONE SMALL BUSINESS SMALL BUSINESS _ 8(A)

_ SERVICE-DISABLED VETERAN OWNED

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

_ RFQ _ IFB x RFP

15. DELIVER TO: Code 16. Administered by:

AMERICAN EMBASSY PORT-AU-PRINCE

BLVD 15 OCTOBRE-TABARRE 41, ATTN:

GSO/WAREHOUSE

PORT-AU-PRINCE

HAITI

AMERICAN EMBASSY PORT-AU-PRINCE

BLVD 15 OCTOBRE-TABARRE 41, ATTN: GSO/PROCUREMENT

PORT-AU-PRINCE

HAITI

117a. CONTRACTOR/OFFEROR

NOVENDOR

CODE 0 FACILITY CODE

NOVENDOR

TELEPHONE NO:

18a. PAYMENT WILL BE MADE BY

AMERICAN EMBASSY PORT-AU-PRINCE

BLVD 15 OCTOBRE-TABARRE 41, ATTN: FMC

PORT-AU-PRINCE

HAITI

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 Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

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

_ 27a.SOLICITATION INCORPORATES BY REFERENCE 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. FAR 52.212-5 IS ATTACHED. ADDENDA _ ARE _ 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 TERMS 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)

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