Signed PO_75H71123P00240.pdf

ORDER FOR SUPPLIES OR SERVICES

3. ORDER NO. 4. REQUISITION/REFERENCE NO.

PAGE OF PAGES

5. ISSUING OFFICE (Address correspondence to) b. STREET ADDRESS

IMPORTANT: Mark all packages and papers with contract and/or order numbers. 1

1. DATE OF ORDER 2. CONTRACT NO. (If any) 6. SHIP TO:

a. NAME OF CONSIGNEE

c. CITY d. STATE e. ZIP CODE

7. TO:

a. NAME OF CONTRACTOR

f. SHIP VIA

8. TYPE OF ORDER

b. COMPANY NAME

c. STREET ADDRESS

d. CITY e. STATE f. ZIP CODE

9. ACCOUNTING AND APPROPRIATION DATA

a. PURCHASE b. DELIVERY

REFERENCE YOUR:

Please furnish the following on the terms and conditions specified on both sides of this order and on the attached sheet, if any, including delivery as indicated.

Except for billing instructions on the reverse, this delivery order is subject to instructions contained on this side only of this form and is issued subject to the terms and conditions of the above-numbered contract.

10. REQUISITIONING OFFICE

11. BUSINESS CLASSIFICATION (Check appropriate box(es))

a. SMALL b. OTHER THAN SMALL c. DISADVANTAGED d. WOMEN-OWNED

13. PLACE OF

a. INSPECTION b. ACCEPTANCE

14. GOVERNMENT B/L NO. 15. DELIVER TO F.O.B. POINT

ON OR BEFORE (Date)

16. DISCOUNT TERMS

17. SCHEDULE (See reverse for Rejections)

02/17/2023

75H71123P00240 IHS1466170

Oklahoma City Area IHS

701 Market Drive

Oklahoma City OK 73114

SHAWN D LYDAY

SHAWN LYDAY 1627606

LYDAY CONSTRUCTION LLC 3209 BE

3209 BENNETT ROAD

HOWE TX 75459

See Schedule

12. F.O.B. POINT

04/28/2023

OKLAHOMA CITY AREA OFFICE

701 MARKET DRIVE

OKLAHOMA CITY OK 73114

OKLAHOMA CITY OK 73114

ORACLE

ITEM NO.

(a)

SUPPLIES OR SERVICES

(b)

QUANTITY

ORDERED

(c)

UNIT

(d)

UNIT

PRICE

(e)

AMOUNT

(f)

QUANTITY

ACCEPTED

(g)

X

X

Destination Destination HHS NET 30P

f. SERVICE-DISABLED

VETERAN-OWNED

e. HUBZone

g. WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

h. EDWOSB

UEI: HFMWKRHX16D3

Contractor shall furnish and install a water service line in accordance with the statement of work and drawing.

Continued ...

19. GROSS SHIPPING WEIGHT18. SHIPPING POINT 20. INVOICE NO.

21. MAIL INVOICE TO:

a. NAME

b. STREET ADDRESS

(or P.O. Box)

c. CITY d. STATE e. ZIP CODE

SEE BILLING

INSTRUCTIONS

ON REVERSE

17(h)

TOTAL

(Cont.

pages)

17(i)

GRAND

TOTAL

$35,845.00

22. UNITED STATES OF

AMERICA BY (Signature)

23. NAME (Typed)

TITLE: CONTRACTING/ORDERING OFFICER

EDSON W. YELLOWFISH

$35,845.00

OPTIONAL FORM 347 (Rev. 2/2012)

Prescribed by GSA/FAR 48 CFR 53.213(f)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

02/21/2023

Oklahoma City Area IHS

701 Market Drive

Oklahoma City OK 73114

Oklahoma City OK 73114

DATE OF ORDER

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

02/17/2023 75H71123P00240

PAGE NO

(a) (b) (c) (d) (e) (f) (g)

Admin Office:

Oklahoma City Area IHS

701 Market Drive

Oklahoma City OK 73114

Period of Performance: 02/17/2023 to

04/28/2023

1 Contractor shall furnish and install a well 35845 J3 1.00 35,845.00 house with concrete slab, pump, pressure tank, electrical and water service line for

D Fetgatter in accordance with the statement of work and drawing.

Project Data:

132980.3.HGFK0000000-OKLAHOMA AREA

IHS.25235-ALL OTR SVCS.12/29/2022

Accounting Info:

2023.J5002IH.25235 Appr. Yr.: 2023

CAN: J5002IH Object Class: 25235

Funded: $35,845.00

Additional Provisions and Conditions (10 pages; 4-13 are attached hereto)

Scope of Work including Drawings (attached)

Statement of Work (4 pages), Drawing (1 page).

Davis Bacon General Wage Decision

OK20220030 Dated 01/06/2023 is hereby incorporated, 7 pages (attached)

FAR Clause 52.213-4 attached FAR Clause

52.204-7 applies

Oversite Monitor: Andrew Banta, Supervisory

Environmental Engineer

Office: 918-752-3172

Cell 918-752-9191

E-mail: andrew.banta@ihs.gov

Contract Specialist (C): Jeffrey Earnest, (IHS/OKC) 405-951-3740

Send original invoice to:

Oklahoma City Area Indian Health Service

Attention: Finance

Continued ...

Prescribed by GSA FAR (48 CFR) 53.213(f)

OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION

PREVIOUS EDITION NOT USABLE

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $35,845.00

DATE OF ORDER

ORDER FOR SUPPLIES OR SERVICES

SCHEDULE - CONTINUATION

CONTRACT NO.

AMOUNTUNIT

PRICE

UNITQUANTITY

ORDERED

SUPPLIES/SERVICESITEM NO.

IMPORTANT: Mark all packages and papers with contract and/or order numbers.

ORDER NO.

QUANTITY

ACCEPTED

02/17/2023 75H71123P00240

PAGE NO

(a) (b) (c) (d) (e) (f) (g)

701 Market Drive

Oklahoma City, OK 73114

Or Fax to: 405-951-3873

Invoice inquiries may be made to Denise

Karr at 405-951-3919 denise.karr@ihs.gov

The total amount of award: $35,845.00. The obligation for this award is shown in box

17(i).

Prescribed by GSA FAR (48 CFR) 53.213(f)

OPTIONAL FORM 348 (Rev. 4/2006)AUTHORIZED FOR LOCAL REPODUCTION

PREVIOUS EDITION NOT USABLE

TOTAL CARRIED FORWARD TO 1ST PAGE (ITEM 17(H)) $0.00