SPE8EZ18Q0234.PDF
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- SPE8EZ18Q0234
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| RFQATTACH.SPE8EZ18Q0234.0000.DOCX | DOCX document |
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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
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.
SPE8EZ-18-Q-0234
2. DATE ISSUED
2018 JUL 03
3. REQUISITION/PURCHASE REQUEST NO.
0075082740
RATING
DO-C9
DLA TROOP SUPPORT
CONSTRUCTION & EQUIPMENT (OP M L&R)
700 ROBBINS AVENUE PHILA PA 19111
PHILADELPHIA PA 19111
USA
Buyer: Richard Balezzi PEPCSFC Tel: 215-737-4154 Email: richard.ballezzi@dla.mil
6. DELIVER BY (Date)
180 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 JUL 09
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: ______________________________
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 2 OF 7 PAGES
SPE8EZ-18-Q-0234
CONTINUED ON NEXT PAGE
SECTION B
SUPPLIES/SERVICES: 4210-01-583-8143
ITEM DESCRIPTION:
EXTINGUISHER,FIRE
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.
RQ011: REMOVAL OF GOVERNMENT IDENTIFICATION FROM NON-ACCEPTED SUPPLIES
SOURCE CONTROLLED
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.
THE APPROVED SOURCE(S) MUST MEET THE REQUIREMENTS OF
THE CURRENT REVISION OF THE SOURCE CONTROL DRAWING
OFFERORS NOT CITED AS APPROVED SOURCES IN THE
PURCHASE ORDER TEXT ARE REQUIRED TO
OBTAIN SOURCE APPROVAL FROM THE OEM. A COPY OF
THE SOURCE APPROVAL REQUEST, TECHNICAL DATA
PACKAGE OR CERTIFICATION OF PRIOR APPROVAL MUST
ALSO BE SUBMITTED TO DLA WITH THE OFFER.
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 7 PAGES
CONTINUED ON NEXT PAGE
SUPPLY/SERVICE: 4210-01-583-8143 CONT'D
TYPE I 60 MONTHS (5 YEAR) SHELF LIFE ITEM:
MATERIAL FURNISHED UNDER THIS CONTRACT/ORDER SHALL
HAVE AT LEAST 85% OF THE SHELF LIFE
REMAINING AT TIME OF DELIVERY. SHELF LIFE
MARKINGS (CURE AND EXPIRATION DATES) SHALL
BE IN ACCORDANCE WITH MIL-STD-129, LATEST
REVISION, AND SHALL BE SHOWN IN
CALENDAR QUARTER AND YEAR. EXPIRATION DATE
SHALL BE 5 YEARS FROM CURE DATE.
Hazard Communication Standard Notice:
Effective June 1, 2015, Federal Standard No. 313-E, Material Safety Data, Transportation Data and Disposal Data for Hazardous Materials Furnished to Government Activities, establishes the requirement for preparation and submission of Safety Data Sheets (SDS) in lieu of Material Safety Data Sheets (MSDS) by suppliers who provide hazardous materials to government activities.
The Occupational Safety and Health Administration (OSHA) has modified its Hazard Communication Standard (HCS) to conform to the United Nations Globally Harmonized System of Classification and Labeling of Chemicals.
As a result of this change, GSA revised Federal Standard No. 313-E requiring Safety Data Sheets for classifying chemicals and communicating the applicable information on labels.
In accordance with the revised standard after June 1, 2015:
1. Suppliers will be required to submit, to the contracting officer for review and approval prior to award, safety data sheets consistent with the requirements found at 29 C.F.R. 1910.1200 for hazardous materials delivered to the Government.
2. Suppliers will also be required to submit, to the contracting officer for review and approval prior to award, Hazardous Communication Standard (HCS) labels in accordance with 29 C.F.R. 1910.1200 requirements or current Consumer Product Safety Act (CPSA), Federal Hazardous Substance Act (FHSA) labels when subject to labeling requirements under those statutes. This product labeling is required for hazardous materials delivered to the Government.
3. Finally, suppliers must train their employees on the new safety data sheets, hazardous communication labels, and requirements of 29 C.F.R.
1910.1200.
For more information on SDS, refer to OSHAs website, available at:
https://www.osha.gov/law-regs.html
For information on 29 C.F.R. 1910.1200, refer to the below link:
https://www.osha.gov/dsg/hazcom/index.html
Firetrace Aerospace LLC 3R5K2 P/N 913900 Oshkosh Defense, LLC 75Q65 P/N 3883951
IAW BASIC DRAWING NR 45152 3883951
REVISION NR A3 DTD 04/28/2010
PART PIECE NUMBER: 3883951
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .
0001 4210-01-583-8143 150.000 EA $ ________________ $ ________________
PRICING TERMS: Firm Fixed Price
QTY VARIANCE: PLUS 0% MINUS 0%
INSPECTION POINT: DESTINATION
ACCEPTANCE POINT: DESTINATION
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 4 OF 7 PAGES
CONTINUED ON NEXT PAGE
SUPPLY/SERVICE: 4210-01-583-8143 CONT'D
FOB: DESTINATION DELIVERY DATE: 180 DAYS ADO
PREP FOR DELIVERY:
PKGING DATA - MIL-STD-2073-1D, 15 DEC 1999
QUP:001 PRES MTHD:HM CLNG/DRY:X PRESV MAT:XX
WRAP MAT:XX CUSH/DUNN MAT:XX CUSH/DUNN THKNESS:X
UNIT CONT:ZZ OPI:M
INTRMDTE CONT:XX INTRMDTE CONT QTY:XXX
PACK CODE:U
MARKING SHALL BE IN ACCORDANCE WITH MIL-STD-129.
SPECIAL MARKING CODE:ZZ -ZZ Special Requirements
PALLETIZATION SHALL BE IN ACCORDANCE WITH MD00100452 REV B DATED JULY 01, 2008
SPECIAL PACKAGING REQUIREMENTS:
ANY MIL-STD-2073 LISTED CUSHIONING AND DUNNAGE MUST BE USED TO PREVENT
ANY MOVEMENT OF ALL CONTENTS INCLUDING BUT NOT LIMITED
TO:HOSES,ACCESSORIES,STRAPS,ETC.
DO NOT DOUBLE STACK FIRE EXTINGUISHER ON PALLET.
IP025: PACKAGING, MARKING, AND SHIPPING OF HAZARDOUS MATERIALS
PARCEL POST ADDRESS:
SW3215
DLA DISTRIBUTION BARSTOW
CENTRAL RECEIVING WHSE 7
REC OFFICER 760 577 6442
BARSTOW CA 92311-5014
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:
SW3215
DLA DISTRIBUTION BARSTOW
CENTRAL RECEIVING WHSE 7
REC OFFICER 760 577 6442
BARSTOW CA 92311-5014
US
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT .
0002 4210-01-583-8143 850.000 EA $ ________________ $ ________________
PRICING TERMS: Firm Fixed Price
QTY VARIANCE: PLUS 0% MINUS 0%
INSPECTION POINT: DESTINATION
ACCEPTANCE POINT: DESTINATION
FOB: DESTINATION DELIVERY DATE: 180 DAYS ADO
PREP FOR DELIVERY:
PKGING DATA - MIL-STD-2073-1D, 15 DEC 1999
QUP:001 PRES MTHD:HM CLNG/DRY:X PRESV MAT:XX
WRAP MAT:XX CUSH/DUNN MAT:XX CUSH/DUNN THKNESS:X
UNIT CONT:ZZ OPI:M
INTRMDTE CONT:XX INTRMDTE CONT QTY:XXX
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 5 OF 7 PAGES
CONTINUED ON NEXT PAGE
SECTION B
SUPPLY/SERVICE: 4210-01-583-8143 CONT'D
PACK CODE:U
MARKING SHALL BE IN ACCORDANCE WITH MIL-STD-129.
SPECIAL MARKING CODE:ZZ -ZZ Special Requirements
PALLETIZATION SHALL BE IN ACCORDANCE WITH MD00100452 REV B DATED JULY 01, 2008
SPECIAL PACKAGING REQUIREMENTS:
ANY MIL-STD-2073 LISTED CUSHIONING AND DUNNAGE MUST BE USED TO PREVENT
ANY MOVEMENT OF ALL CONTENTS INCLUDING BUT NOT LIMITED
TO:HOSES,ACCESSORIES,STRAPS,ETC.
DO NOT DOUBLE STACK FIRE EXTINGUISHER ON PALLET.
IP025: PACKAGING, MARKING, AND SHIPPING OF HAZARDOUS MATERIALS
PARCEL POST ADDRESS:
SW0400
DLA DISTRIBUTION RICHMOND
DISTRIBUTION OPERATIONS DDRV-G
8000 JEFFERSON DAVIS HWY
RICHMOND VA 23297-5900
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:
SW0400
DLA DISTRIBUTION RICHMOND
CHIPPENHAM PARKWAY RTE 150 ENTRANCE
GATE 13 BLDG 44 B BAY S.3RD STREET
RICHMOND VA 23297-5900
US
GOVT USE
External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date .
0001 0075082740 0001 N/A N/A N/A 07/28/2018
0002 0075082740 0002 N/A N/A N/A 07/28/2018
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 6 OF 7 PAGES
CONTINUED ON NEXT PAGE
SECTION A - SOLICITATION/CONTRACT FORM
52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (JUL 2016) FAR
SECTION I - CONTRACT CLAUSES
52.204-14 SERVICE CONTRACT REPORTING REQUIREMENTS (OCT 2016) FAR
52.204-15 SERVICE CONTRACT REPORTING REQUIREMENTS FOR INDEFINITE-DELIVERY CONTRACTS (OCT 2016) FAR
52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE (JUL 2016) FAR
52.204-20 PREDECESSOR OF OFFEROR (JUL 2016) FAR
As prescribed in 4.1804(d), insert the following provision:
(a) Definitions. As used in this provision -
“Commercial and Government Entity (CAGE) code” means -
(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity; or
(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.
“Predecessor” means an entity that is replaced by a successor and includes any predecessors of the predecessor.
“Successor” means an entity that has replaced a predecessor by acquiring the assets and carrying out the affairs of the predecessor under a new name (often through acquisition or merger). The term “successor” does not include new offices/divisions of the same company or a company that only changes its name. The extent of the responsibility of the successor for the liabilities of the predecessor may vary, depending on State law and specific circumstances.
(b) The Offeror represents that it [ ] is or [ ] is not a successor to a predecessor that held a Federal contract or grant within the last three years.
(c) If the Offeror has indicated “is” in paragraph (b) of this provision, enter the following information for all predecessors that held a Federal contract or grant within the last three years (if more than one predecessor, list in reverse chronological order):
Predecessor CAGE code:
Predecessor legal name:
(Do not use a “doing business as” name)
(End of provision)
SECTION J - LIST OF ATTACHMENTS
List of Attachments
File Name Description ATTACH_Clauses SPE8EZ18Q0234_Clauses
.docx
SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS
52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016) FAR
https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%204_18.html
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 7 OF 7 PAGES
SECTION K - REPRESENTATIONS, CERTIFICATIONS AND STATEMENTS (CONTINUED)
As prescribed in 4.1804(b), use the following provision:
(a) Definitions. As used in this provision -
“Commercial and Government Entity (CAGE) code” means -
(1) An identifier assigned to entities located in the United States or its outlying areas by the Defense Logistics Agency (DLA) Commercial and Government Entity (CAGE) Branch to identify a commercial or government entity; or
(2) An identifier assigned by a member of the North Atlantic Treaty Organization (NATO) or by the NATO Support and Procurement Agency (NSPA) to entities located outside the United States and its outlying areas that the DLA Commercial and Government Entity (CAGE) Branch records and maintains in the CAGE master file. This type of code is known as a NATO CAGE (NCAGE) code.
“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.
“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.
(b) The Offeror represents that it [ ] has or [ ] does not have an immediate owner. If the Offeror has more than one immediate owner (such as a joint venture), then the Offeror shall respond to paragraph (c) and if applicable, paragraph (d) of this provision for each participant in the joint venture.
(c) If the Offeror indicates “has” in paragraph (b) of this provision, enter the following information:
Immediate owner CAGE code:
Immediate owner legal name:
(Do not use a “doing business as” name)
Is the immediate owner owned or controlled by another entity?: [ ] Yes or [ ] No.
(d) If the Offeror indicates “yes” in paragraph (c) of this provision, indicating that the immediate owner is owned or controlled by another entity, then enter the following information:
Highest-level owner CAGE code:
Highest-level owner legal name:
(Do not use a “doing business as” name)
(End of provision) https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%204_18.html
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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'
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| ZSF18_BLOCK11: 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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File details come from the government source that posted it.