Sol_140E0126Q0002.pdf
PDF 83 KB Posted
- Attached to
- HEARING CONSERVATION PROGRAM Federal contract opportunity
- Solicitation number
- 140E0126Q0002
About this file
This document is a Request for Quotation (RFQ) from the Bureau of Safety and Environmental Enforcement (BSEE) for a Hearing Conservation program for employees in the Gulf of America Region. The solicitation (Request No. 140E0126Q0002) seeks on-site audiometric hearing testing, training, hearing protection device fitting, and employee notification for up to 300 employees. The period of performance is from 02/01/2026 to 01/31/2028, with a base year and one option year.
The RFQ includes four line items: base year on-site audiometric testing (Item 00010), base year material/shipping/travel (Item 00020), option year one on-site audiometric testing (Item 00030), and option year one material/shipping/travel (Item 00040). All services are coded under Product/Service Code Q514 (Medical-Otolaryngology) and will be delivered to the BSEE Virginia Office located at 45600 Woodland Road in Sterling, VA. The quotation response is due by 01/05/2026 at 1700 ES, with the contracting officer identified as Bradford Kelly.
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Text version
140E0126Q0002
1. REQUEST NO.
5a. ISSUED BY
NAME
a. NAME
c. STREET ADDRESS
d. CITY
10. PLEASE FURNISH QUOTATIONS TO
THE ISSUING OFFICE IN BLOCK 5a ON
OR BEFORE CLOSE OF BUSINESS (Date)
2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.
UNDER BDSA REG. 2
AND/OR DMS REG.1
RATING
6. DELIVERY BY (Date)
7. DELIVERY
9. DESTINATION
a. NAME OF CONSIGNEE
b. STREET ADDRESS
PAGE OF PAGES
5b. FOR INFORMATION CALL: (No collect calls)
TELEPHONE NUMBER
AREA CODE NUMBER
8. TO:
b. COMPANY
e. STATE f. ZIP CODE
c. CITY
d. STATE e. ZIP CODE
IMPORTANT: This is a request for information, and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or services. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotations must be completed by the quoter.
11. SCHEDULE (Include applicable Federal, State and local taxes)
THIS RFQ
REQUEST FOR QUOTATION
(THIS IS NOT AN ORDER)
IS IS NOT A SMALL BUSINESS SET ASIDEX
12/11/2025
1 2
45600 Woodland Road, VAE-AMD Sterling VA 20166-9216
BSEE-Sterling ACQ Ops Branch Multiple
703 787-1149Bradford Kelly
01/05/2026 1700 ES
FOB DESTINATION
OTHER
(See Schedule)X
ITEM NO.
(a)
SUPPLIES/SERVICES
(b)
QUANTITY
(c)
UNIT
(d)
UNIT PRICE
(e)
AMOUNT
(f)
Header Text: Hearing Conservation program for BSEE. On-site audiometric hearing test on BSEE employees in the Gulf of America Region (GOAR) Period of Performance: 02/01/2026 to 01/31/2028
00010 On-site audiometric testing, training, hearing protection device fitting, and employee notification (NTE 300 Employees) (Base Year) Product/Service Code: Q514 Product/Service Description: MEDICAL-
OTOLARYNGOLOGY
Delivery: 01/31/2027 Delivery Location Code: 0011286121
BSEE VIRGINIA OFFICE
Continued ...
12. DISCOUNT FOR PROMPT PAYMENT
a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS
NUMBER PERCENTAGE
NOTE: Additional provisions and representations
13. NAME AND ADDRESS OF QUOTER
b. STREET ADDRESS
c. COUNTY
d. CITY e. STATE f. ZIP CODE
14. SIGNATURE OF PERSON AUTHORIZED TO
SIGN QUOTATION
16. SIGNER
a. NAME (Type or print)
c. TITLE (Type or print)
a. NAME OF QUOTER
AREA CODE
NUMBER
15. DATE OF QUOTATION
b. TELEPHONE are are not attached
AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition not usable
STANDARD FORM 18 (REV. 6-95)
Prescribed by GSA - FAR (48 CFR) 53.215-1(a)
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
NAME OF OFFEROR OR CONTRACTOR
2 2
CONTINUATION SHEET
REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
(A) (B) (C) (D) (E) (F)
140E0126Q0002
45600 Woodland Rd
Sterling VA 20166 US
Period of Performance: 02/01/2026 to 01/31/2027
00020 Material, shipping and travel (Base Year)
Product/Service Code: Q514
Product/Service Description: MEDICAL-
OTOLARYNGOLOGY
Delivery: 01/31/2027
Delivery Location Code: 0011286121
BSEE-VIRGINIA OFFICE
45600 Woodland Rd
Sterling VA 20166 US
Period of Performance: 02/01/2026 to 01/31/2027
00030 On-site audiometric testing, training, hearing protection device fitting, and employee notification (NTE 300 Employees) (Option
Year One)
(Option Line Item)
Anticipated Exercise Date 02/01/2027
Product/Service Code: Q514
Product/Service Description: MEDICAL-
OTOLARYNGOLOGY
Delivery: 01/31/2028
Delivery Location Code: 0011286121
BSEE VIRGINIA OFFICE
45600 Woodland Rd
Sterling VA 20166 US
Period of Performance: 02/01/2027 to 01/31/2028
00040 Material, shipping and travel (Option Year One)
(Option Line Item)
Anticipated Exercise Date 02/01/2027
Product/Service Code: Q514
Product/Service Description: MEDICAL-
OTOLARYNGOLOGY
Delivery: 01/31/2028
Delivery Location Code: 0011286121
BSEE-VIRGINIA OFFICE
45600 Woodland Rd
Sterling VA 20166 US
Period of Performance: 02/01/2027 to 01/31/2028
PR 44031885
CO BKelly
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
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