Sol_140L4321Q0063.pdf

140L4321Q0063

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

08/03/2021 0040529432

1 66

1220 SW 3rd Avenue, 12th Floor

PORTLAND OR 97204

BLM OR-ST OFC PROC MGMT BR(OR952)

Multiple

BLM-OR COOS BAY DISTRICT OFFICE*

1300 AIRPORT LANE

NORTH BEND

OR 97459-2000

541 751-4231Joy Menguita

08/25/2021 1700 PS

FOB DESTINATION

OTHER

(See Schedule)X

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

WASTE WATER PUMPING, COOS BAY BLM DISTRICT

COOS BAY , OREGON

VENDOR NAME:____________________

VENDOR DUNS:____________________

VENDOR POC:_____________________

VENDOR EMAIL:___________________________________

VENDOR PHONE:___________________________________

Legacy Doc #: BLM Period of Performance: 10/01/2021 to 09/30/2022

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 66

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

140L4321Q0063

00010 BASE PERIOD: Waste Water Pumping

Groups 1 through 4

Product/Service Code: Z1ND

Product/Service Description: MAINTENANCE OF

SEWAGE AND WASTE FACILITIES

Delivery: 09/30/2022

00020 OPTION PERIOD ONE (1):Waste Water Pumping

Groups 1 through 4

(Option Line Item)

10/01/2022

Product/Service Code: Z1ND

Product/Service Description: MAINTENANCE OF

SEWAGE AND WASTE FACILITIES

Delivery: 09/30/2023

Period of Performance: 10/01/2022 to 09/30/2023

00030 OPTION PERIOD TWO (2): Waste Water Pumping

Groups 1 through 4

(Option Line Item)

10/01/2023

Product/Service Code: Z1ND

Product/Service Description: MAINTENANCE OF

SEWAGE AND WASTE FACILITIES

Delivery: 09/30/2024

Period of Performance: 10/01/2023 to 09/30/2024

00040 OPTION PERIOD THREE (3):Waste Water Pumping

Groups 1 through 4

(Option Line Item)

10/01/2024

Product/Service Code: Z1ND

Product/Service Description: MAINTENANCE OF

SEWAGE AND WASTE FACILITIES

Delivery: 09/30/2025

Period of Performance: 10/01/2024 to 09/30/2025

00050 OPTION PERIOD FOUR (4):Waste Water Pumping

Groups 1 through 4

(Option Line Item)

10/01/2025

Product/Service Code: Z1ND

Product/Service Description: MAINTENANCE OF

SEWAGE AND WASTE FACILITIES

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 66

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

140L4321Q0063

Delivery: 09/30/2026

Period of Performance: 10/01/2025 to 09/30/2026

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)