SPE7L318Q0599.PDF

REQUEST FOR QUOTATIONS THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

4. CERT.FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

5. ISSUED BY

7. DELIVERY

9. DESTINATION

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5 ON OR

BEFORE CLOSE OF BUSINESS (Date)

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 5. 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 (See Continuation Sheets)

12. DISCOUNT FOR PROMPT PAYMENT

d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

14. SIGNATURE OF PERSON AUTHORIZED TO SIGN

QUOTATION

16. SIGNER

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not useable

STANDARD FORM 18 (REV. 6-95)

Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

1. REQUEST NO.

SPE7L3-18-Q-0599

2. DATE ISSUED

2018 APR 17

3. REQUISITION/PURCHASE REQUEST NO.

0073352521

RATING

DO-C9

DLA LAND AND MARITIME

LAND SUPPLIER OPNS VEHICLE SPT

PO BOX 3990

COLUMBUS OH 43218-3990

USA

Buyer: Karin Wilson PLCLB05 Tel: 614-692-3609 Fax: 614-693-1573 Email: KARIN.WILSON@DLA.MIL

6. DELIVER BY (Date)

223 DAYS ADO

8. TO:

c. CITY

d. STATE

b. STREET ADDRESS

a. NAME OF CONSIGNEE

e. ZIP CODE

a. 10 CALENDAR DAYS

b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS

15. DATE OF QUOTATION

a. NAME (Type or Print)

AREA CODE

c. TITLE (Type or Print)d. CITY

c. COUNTY

b. STREET ADDRESS

e. STATE f. ZIP CODE

See Schedule

2018 APR 30

NUMBER

FOB DESTINATION

OTHER

(See Schedule)

CAGE

b. TELEPHONE

See attached schedule to complete quote information.

Quoter must also complete the following:

a. Quotation is valid for 90 days from date specified in Block 10 above unless otherwise indicated: _____________ .

b. Prices quoted are:

___ Contained in Commercial Catalog or Published Price List No. ___________________ dated _______________ page __________ .

___ Contained in Internal Price List No. _______________dated ____________________, which may be examined at our facility.

___ Commercial sales of comparable quantities: Quantity ____________ ; Price _____________;

___ Customer ________________________.

___ Other (provide basis) ______________________________________ _______________________________________ .

c. FOB Point: ____ Destination ____ Origin Shipping Point (City, State) _________________________________________ .

d. If delivery period shown in Block 6 is unacceptable, provide best possible delivery: _________________________________.

e. Remittance Address (Name, Street, City, State, ZIP): Same as Block 13 unless otherwise indicated below:

f. Vendor FAX Number: ____________________ Vendor Toll-Free Number: ____________________ Vendor E-mail: ______________________________

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SPE7L3-18-Q-0599

CONTINUED ON NEXT PAGE

THIS SOLICITATION IS BEING ISSUED UNDER SEPA AUTHORITY

“This solicitation will be available on the Internet at http://www.dibbs.bsm.dla.mil/. Due to system constraints, it may take as long as three business days from the stated issue date for the solicitation to post to DIBBS.”

“THIS SOLICITATION INCORPORATES THE TERMS AND CONDITIONS SET FORTH IN THE REVISION OF THE DLA MASTER SOLICITATION FOR AUTOMATED SIMPLIFIED ACQUISITIONS IN EFFECT ON THE SOLICITATION ISSUE DATE. ALL REVISIONS OF THE DLA MASTER SOLICITATION FOR AUTOMATED SIMPLIFIED ACQUISITIONS CAN BE FOUND ON THE WEB AT: http://www.dla.mil/HQ/Acquisition/ Offers/eProcurement.aspx.”

“DLAD Procurement Notes Incorporated By Reference (Nov 2016)

This solicitation incorporates one or more DLAD Procurement Notes by reference, with the same force and effect as if they were given in full text. The full text of a DLAD Procurement Note may be accessed electronically at http://www.

dla.mil/HQ/Acquisition/Offers/eProcurement.aspx and via 'References' on the DIBBS homepage

This solicitation contemplates an award based on destination inspection. If an offeror proposes inspection and acceptance at origin, then an evaluation factor IAW Procurement note E07 will be added to the offeror’s quoted/ offered price for each origin inspection. If phased deliveries are required or offered, each phase of delivery will be presumed to result in one inspection.

NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM 332991 SEE

http://www.sba.gov/content/table-small-business-size-standards

FOR THE CORRESPONDING SMALL BUSINESS SIZE STANDARD.

THIS BUY IS NOT FAST PAY

DFARS 252.225-7001, BUY AMERICAN AND BALANCE OF PAYMENTS PROGRAM,

APPLIES TO ALL QUOTES ABOVE THE MICRO-PURCHASE THRESHOLD.

THE FOLLOWING CLAUSES APPLY:

FAR 52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE

FAR 52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions FAR 52.203-12 Limitation on Payments to Influence Certain Federal Transactions DFARS 252.209-7004 Subcontracting with Firms that are owned or controlled by the government of a Terrorist country FAR 52.222-35 Equal Opportunity for Veterans FAR 52.222-37 Employment Reports on Veterans FAR 52.223-9 Estimate of Percentage of Recovered Material Content for EPA-Designated Items DFARS 252.225-7050 Disclosure of Ownership or Control by the Government of a Country that is a State Sponsor of Terrorism FAR 52.203-13 Restrictions on Certain Foreign Purchases

"OFFER SUBMISSION INSTRUCTIONS: ALL OFFERORS MUST SUBMIT THEIR QUOTES THROUGH DIBBS.

Once the evaluation process begins, late quotations will only be considered if the contracting officer determines that considering the late quotation is in the best interest of the Government and would not unduly delay the award"

Offerors are encouraged to submit price break information with their quotes. Solicitations which are manually evaluated and awarded at increased quantities may be awarded based on the price break information submitted with the offeror's original quotation without further solicitation or discussion.

If you anticipate quoting on a solicitation after the closing date, please submit a DIBBS quote with a bid type of “No Bid” and place an anticipated quote date or the reason you are not willing to quote. This does not prevent you from submitting an actual quote on DIBBS at a later date. It will overlay your previous no quote. This informs buyers of your intention to quote and prevents multiple calls for updates and cancelling of requirements assumed to be non-procurable due to no quotes/sources. The submission of an anticipated quote date does not preclude DLA from making an award to another acceptable timely offer.

This solicitation is issued under the First Destination Transportation (FDT) program to reduce the cost of transportation through the use of Government-arranged transportation utilizing Government contracts and rates. If this award is for FMS or has an APO/FPO ship-to address, these instructions do not apply.

For FDT Program Transportation Requirements, see Procurement Note C16 First Destination Transportation (FDT) Program, Government-Arranged Transportation for Manual Awards, C17 First Destination Transportation (FDT) Program – Shipments Originating from Outside the Contiguous United States, and Procurement Note C20 – Vendor Shipment Module (VSM).

Offers should be submitted based on FOB origin. For offerors whose shipments will originate from outside the

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 7 PAGES

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contiguous United States, the offeror’s f.o.b. origin price shall include transportation to a contiguous United States location that the offeror selects based on cost-effectiveness or other variables at the offeror’s discretion.

Additional information about FDT can be found at http://www.dla.mil/LandandMaritime/Business/Selling/DLA-Land-and- Maritime-Procurement-Initiatives/FDTPI/

"EVALUATION FACTORS FOR AWARD

Award will be made to the offeror(s) whose quote(s) conforms to the solicitation requirements and represents the best value to the Government. Past performance, offered delivery and price will be evaluated when making a comparative assessment of quotes. An award may be made to other than the lowest priced, technically acceptable, responsible offeror(s)."

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 4 OF 7 PAGES

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SECTION B

SUPPLIES/SERVICES: 1005-01-571-6218

ITEM DESCRIPTION:

RING ASSEMBLY, TURRET ROTATION.

RD001: DEMILITARIZATION: SMALL ARMS WEAPONS AND PARTS AND ACCESSORIES

(CATEGORY I - MUNITIONS LIST ITEMS, CATEGORY I-DODM 4160.28-VOL.3)

RP001: DLA PACKAGING REQUIREMENTS FOR PROCUREMENT

RA001: THIS DOCUMENT INCORPORATES TECHNICAL AND/OR QUALITY REQUIREMENTS

(IDENTIFIED BY AN 'R' OR AN 'I' NUMBER) SET FORTH IN FULL TEXT IN THE

DLA MASTER LIST OF TECHNICAL AND QUALITY REQUIREMENTS FOUND ON THE WEB

AT: http://www.dla.mil/HQ/Acquisition/Offers/eProcurement.aspx. FOR

SIMPLIFIED ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE

SOLICITATION ISSUE DATE OR THE AWARD DATE CONTROLS. FOR LARGE

ACQUISITIONS, THE REVISION OF THE MASTER IN EFFECT ON THE RFP ISSUE DATE

APPLIES UNLESS A SOLICITATION AMENDMENT INCORPORATES A FOLLOW-ON

REVISION, IN WHICH CASE THE AMENDMENT DATE CONTROLS.

RQ002: CONFIGURATION CHANGE MANAGEMENT - ENGINEERING CHANGE PROPOSAL

REQUEST FOR VARIANCE (DEVIATION OR WAIVER)

RQ011: REMOVAL OF GOVERNMENT IDENTIFICATION FROM NON-ACCEPTED SUPPLIES

Exception to DWG 12460207 these are the approved sources Cage 69282 P/N 12460207-1 Cage 28666 P/N T2H2-38P2A

SAMPLING:

THE SAMPLING METHOD SHALL BE IN ACCORDANCE WITH MIL-STD-1916 OR ASQ

H1331, TABLE 1 OR A COMPARABLE ZERO BASED SAMPLING PLAN UNLESS OTHERWISE

SPECIFIED BY THE CONTRACT. IF THE APPLICABLE DRAWING, SPECIFICATION,

STANDARD, OR QUALITY ASSURANCE PROVISION (QAP) SPECIFIES CRITICAL, MAJOR

AND/OR MINOR ATTRIBUTES, THEY SHALL BE ASSIGNED VERIFICAITON LEVELS OF

VII, IV AND II OR AQLS OF 0.1, 1.0 AND 4.0 RESPECTIVELY. UNSPECIFIED

ATTRIBUTES SHALL BE CONSIDERED AS MAJOR UNLESS SAMPLING PLANS ARE

SPECIFIED IN APPLICABLE DOCUMENTS. FOR MIL-STD-1916, THE MANUFACTURER

MAY USE THE ATTRIBUTE OR VARIABLE INSPECTION METHOD AT THEIR OPTION OR

PER THE CONTRACT. MIL-STD-105/ASQ Z1.4 MAY BE USED TO SET SAMPLE LOT

SIZE, BUT ACCEPTANCE WOULD BE ZERO NON-CONFORMANCES IN THE SAMPLE LOT

UNLESS OTHERWISE SPECIFIED IN THE CONTRACT.

NOTE: THE CITED DRAWING IS A SOURCE CONTROLLED

DRAWING AND AS OF THE DATE OF THIS SOLICITATION

ONLY THE SOURCE(S) CITED ON THE DRAWING HAVE

BEEN APPROVED. EVEN THOUGH SOURCES AND APPROVED

PART NUMBERS ARE PROVIDED, THE ITEMS

FURNISHED MUST MEET THE REQUIREMENTS OF THE

CITED DRAWING. OFFERORS WHO ARE INTERESTED IN

QUALIFYING THEIR PRODUCT FOR PURPOSE OF FUTURE

ACQUISITION MUST CONTACT THE COGNIZANT DESIGN

ACTIVITY SPECIFIED ON THE SOURCE CONTROLLED

DRAWING.

ALSO, MAY INCLUDE ADDITIONAL APPROVED SOURCES

THAT HAVE NOT BEEN REFLECTED ON THE DRAWING AT

THIS TIME.

CLASS I OZONE DEPLETING CHEMICALS ARE NOT TO BE

USED NOR INCORPORATED IN ANY ITEMS TO BE

DELIVERED UNDER THIS CONTRACT.THIS PROHIBITION

SUPERSEDES ALL SPECIFICATION REQUIREMENTS BUT

DOES NOT ALLEVIATE ANY PRODUCT REQUIREMENTS.

SUBSTITUTE CHEMICALS MUST BE SUBMITTED FOR

APPROVAL UNLESS THEY ARE AUTHORIZED BY THE

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SECTION B

SUPPLY/SERVICE: 1005-01-571-6218 CONT'D

SPECIFICATION REQUIREMENTS.

THIS ITEM HAS TECHNICAL DATA SOME OR ALL OF WHICH IS SUBJECT TO

EXPORT-CONTROL REGULATIONS. DISTRIBUTION OF THE TECHNICAL DATA AND

ELIGIBILITY FOR AWARD ARE LIMITED TO THOSE SUPPLIERS QUALIFIED THROUGH

JCP CERTIFICATION, OR TO THOSE LICENSED BY EITHER THE DEPARTMENTS OF

STATE OR COMMERCE; OR TO FOREIGN SUPPLIERS PURSUANT TO INTERNATIONAL

AGREEMENTS.

TO APPLY FOR JCP CERTIFICATION, COMPLETE DD FORM 2345, MILITARY CRITICAL

TECHNICAL DATA AGREEMENT, FORM IS AVAILABLE AT THE WORLD WIDE WEB

ADDRESS:

https://public.logisticsinformationservice.dla.mil/PublicHome/jcp/defaul t.aspx

OR BY WRITING TO:

DLA LOGISTICS INFORMATION SERVICE

FEDERAL CENTER

74 WASHINGTON AVE., NORTH

BATTLE CREEK, MI 49037-3084

TO MANUFACTURE THIS ITEM, NON-JCP CERTIFIED SUPPLIERS MUST SUBMIT A

CURRENT MANUFACTURING LICENSE AGREEMENT, TECHNICAL ASSISTANCE AGREEMENT,

DISTRIBUTION AGREEMENT OR OFF-SHORE PROCUREMENT AGREEMENT APPROVED BY

THE DIRECTORATE OF DEFENSE TRADE CONTROLS WITH THE OFFER, UNLESS AN

EXEMPTION UNDER THE PROVISIONS OF ITAR SECTION, 125.4 EXEMPTIONS OF

GENERAL APPLICABILITY, AND/OR EAR PART 740 ARE APPLICABLE.

NON-JCP CERTIFIED SUPPLIERS SEEKING EXPORT CONTROLLED TECHNICAL DATA ARE

REQUIRED TO PROVIDE THE CONTRACTING OFFICER WITH AN APPLICABLE AGREEMENT

OR IDENTIFY WHICH ITAR/EAR EXEMPTION APPLIES TO RECEIVE A COPY OF THE

EXPORT CONTROLLED TECHNICAL DATA.

NOTE: JCP CERTIFIED CONTRACTORS WHO RECEIVE TECHNICAL DATA PURSUANT TO

THEIR DD FORM 2345 CERTIFICATION MAY NOT FURTHER DISSEMINATE SUCH DATA

UNLESS FURTHER DISSEMINATION OF THE TECHNICAL DATA IS EXPRESSLY

PERMITTED BY DODD 5230.25.

JBK MANUFACTURING, LLC DBA J B K 69282 P/N 12460207-1

ROTEK INCORPORATED 28666 P/N T2H2-38P2A

WESTERN RUBBER AND MFG 69292 P/N 12460207-1

IAW BASIC DRAWING NR 19207 12460207

REVISION NR C DTD 10/08/2010

PART PIECE NUMBER: 12460207-1

IAW REFERENCE DRAWING NR 19207 12460207-1

REVISION NR DTD 12/18/2012

PART PIECE NUMBER:

IAW REFERENCE DRAWING NR 19207 12460207-1

REVISION NR A DTD 06/30/2010

PART PIECE NUMBER:

IAW REFERENCE QAP 19207 12460207

REVISION NR A DTD 06/08/2008

PART PIECE NUMBER:

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .

0001 1005-01-571-6218 12.000 EA $ ________________ $ ________________

RING ASSEMBLY

,TURRE

QTY VARIANCE: PLUS 0% MINUS 0%

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 6 OF 7 PAGES

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SECTION B

SUPPLY/SERVICE: 1005-01-571-6218 CONT'D

INSPECTION POINT: DESTINATION

ACCEPTANCE POINT: DESTINATION

FOB: ORIGIN DELIVERY DATE: 223 DAYS ADO

PREP FOR DELIVERY:

PKGING DATA - MIL-STD-2073-1D, 15 DEC 1999

QUP:001 PRES MTHD:ZZ CLNG/DRY:Z PRESV MAT:ZZ

WRAP MAT:ZZ CUSH/DUNN MAT:ZZ CUSH/DUNN THKNESS:Z

UNIT CONT:ZZ OPI:A

INTRMDTE CONT:ZZ INTRMDTE CONT QTY:ZZZ

PACK CODE:U

MARKING SHALL BE IN ACCORDANCE WITH MIL-STD-129.

SPECIAL MARKING CODE:ZZ -ZZ Special Requirements

PACKAGING SHALL BE IN ACCORDANCE WITH SPECIAL

PACKAGING INSTRUCTION AK15716218.

PARCEL POST ADDRESS:

SW3121

DLA DISTRIBUTION ALBANY

TRANSPORTATION OFFICER

814 RADFORD BLVD BLDG 1221 DOOR 20

ALBANY GA 31704-1128

US

FOR TRANSPORTATION ASSISTANCE SEE DLAD PROC NOTE C19. FOR FIRST DESTINATION TRANSPORTATION (FDT) AWARDS SEE DLAD PROC

NOTE C20 AND

CONTRACT INSTRUCTIONS.

FREIGHT SHIPPING ADDRESS:

SW3121

DLA DISTRIBUTION ALBANY DDAG-T

MCLB BLDG 1221 DOOR 20

814 RADFORD BLVD

ALBANY GA 31704-1128

US

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .

0002 1005-01-571-6218 228.000 EA $ ________________ $ ________________

RING ASSEMBLY

,TURRE

QTY VARIANCE: PLUS 0% MINUS 0%

INSPECTION POINT: DESTINATION

ACCEPTANCE POINT: DESTINATION

FOB: ORIGIN DELIVERY DATE: 223 DAYS ADO

PREP FOR DELIVERY:

PKGING DATA - MIL-STD-2073-1D, 15 DEC 1999

QUP:001 PRES MTHD:ZZ CLNG/DRY:Z PRESV MAT:ZZ

WRAP MAT:ZZ CUSH/DUNN MAT:ZZ CUSH/DUNN THKNESS:Z

UNIT CONT:ZZ OPI:A

INTRMDTE CONT:ZZ INTRMDTE CONT QTY:ZZZ

PACK CODE:U

MARKING SHALL BE IN ACCORDANCE WITH MIL-STD-129.

SPECIAL MARKING CODE:ZZ -ZZ Special Requirements

PACKAGING SHALL BE IN ACCORDANCE WITH SPECIAL

PACKAGING INSTRUCTION AK15716218.

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 7 OF 7 PAGES

SECTION B

SUPPLY/SERVICE: 1005-01-571-6218 CONT'D

PARCEL POST ADDRESS:

SW3227

DLA DISTRIBUTION RED RIVER

RECEIVING BLDG 499

10TH STREET AND K AVENUE

TEXARKANA TX 75507-5000

US

FOR TRANSPORTATION ASSISTANCE SEE DLAD PROC NOTE C19. FOR FIRST DESTINATION TRANSPORTATION (FDT) AWARDS SEE DLAD PROC

NOTE C20 AND

CONTRACT INSTRUCTIONS.

FREIGHT SHIPPING ADDRESS:

SW3227

DLA DISTRIBUTION RED RIVER

RECEIVING BLDG 499

10TH STREET AND K AVENUE

TEXARKANA TX 75507-5000

US

GOVT USE

External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date .

0001 0073352521 0001 N/A N/A 5330015716218 05/20/2019

0002 0073352521 0002 N/A N/A 5330015716218 03/12/2018

CONTINUATION SHEET

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CONTINUATION SHEET

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REQUEST FOR QUOTATIONS

THIS RFQ IS IS NOT A SMALL BUSINESS SET-ASIDE

4. CERT.FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

5. ISSUED BY

7. DELIVERY

9. DESTINATION

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5 ON OR

BEFORE CLOSE OF BUSINESS (Date) 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 5. 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 (See Continuation Sheets)

12. DISCOUNT FOR PROMPT PAYMENT

d. CALENDAR DAYS

NUMBER

PERCENTAGE

NOTE: Additional provisions and representations are are not attached.

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

16. SIGNER

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not useable STANDARD FORM 18 (REV. 6-95) Prescribed by GSA-FAR (48 CFR) 53.215-1(a)

8. TO:

See Schedule See attached schedule to complete quote information.

f. Vendor FAX Number: Vendor Toll-Free Number: Vendor E-mail:

e. Remittance Address (Name, Street, City, State, ZIP): Same as Block 13 unless otherwise indicated below:

d. If delivery period shown in Block 6 is unacceptable, provide best possible delivery:

c. FOB Point:

Origin Shipping Point (City, State) Destination Other (provide basis) Commercial sales of comparable quantities: Quantity ; Price ;

Customer Contained in Internal Price List No. dated , which may be examined at our facility.

Contained in Commercial Catalog or Published Price List No. dated page

b. Prices quoted are:

a. Quotation is valid for 90 days from date specified in Block 10 above unless otherwise indicated: __________________ .

Quoter must also complete the following:

NUMBER

FOB DESTINATION

OTHER

(See Schedule)

CAGE

PAGE OF

1.6 Requet for Quotation skim Standard form - RFQ Acrobat Distiller 4.0 for Windows D:20001024141244Z D:20090429133228-04'00'

Quoter must also complete the following:

a. Quotation is valid for 90 days from date specified in Block 10 above unless otherwise indicated: _____________ .

b. Prices quoted are:

___ Contained in Commercial Catalog or Published Price List No. ___________________ dated _______________ page __________ .

___ Contained in Internal Price List No. _______________dated ____________________, which may be examined at our facility.

___ Commercial sales of comparable quantities: Quantity ____________ ; Price _____________;

___ Customer ________________________.

___ Other (provide basis) ______________________________________ _______________________________________ .

c. FOB Point: ____ Destination ____ Origin Shipping Point (City, State) _________________________________________ .

d. If delivery period shown in Block 6 is unacceptable, provide best possible delivery: _________________________________.

e. Remittance Address (Name, Street, City, State, ZIP): Same as Block 13 unless otherwise indicated below:

f. Vendor FAX Number: ____________________ Vendor Toll-Free Number: ____________________ Vendor E-mail: ______________________________