SPMYM4-21-Q-0054.pdf

SEE ADDENDUM

(No Collect Calls)

SPMYM421Q0054 23-Feb-2021

b. TELEPHONE NUMBER

808-473-8000 X3314

8. OFFER DUE DATE/LOCAL TIME

08:00 AM 01 Mar 2021

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

SPMYM49. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

DAYNA K. CANTU

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

0 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SEE SCHEDULE

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

DLA MARITIME PEARL HARBOR

DAYNA CANTU

COMPETITIVE SOURCING DIVISION

667 SAFEGUARD ST

JBPHH HI 96860-5033

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE N32253 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

DLA DISTRIBUTION

GOVERNMENT REPRESENTATIVE

RECEIVING DEPT, CODE Z0S

667 SAFEGUARD ST, BLDG 167-1

JBPHH HI 96860-5033

TEL: 808-473-8000 X4961 FAX:

FAX:

TEL: 808-473-8000 X3314 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

NAICS:

335931

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF5

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

SPMYM421Q0054

Section SF 1449 - CONTINUATION SHEET

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 19 Each

CABLE, BNC

FFP

CABLE, BNCBNC COAXIAL CABLE, 10 FEET, MALE TO MALE

CONNECTORS D/T POC; ETHAN OSHIRO X3652, #058685

AVAILABLE AT PCB PART NO. 012A10

FOB: Destination

MILSTRIP: N3225303430203

MFR PART NR: 012A10

PURCHASE REQUEST NUMBER: N3225303430203

PROJECT: NY9

PSC CD: 6635

NET AMT

0002 12 Each

BNC T CONNECTOR

FFP

BNC T CONNECTORBNC T SHAPE CONNECTOR, BNC PLUG TO 2 BNC

JACKS D/T POC; ETHAN OSHIRO X3652, #058685

AVAILABLE FROM PCB AS MODEL 070A11

FOB: Destination

MILSTRIP: N3225303430205

MFR PART NR: 070A11

PURCHASE REQUEST NUMBER: N3225303430205

0003 2 Each

VIBRATION CALIBRATOR

FFP

VIBRATION CALIBRATORPORTABLE VIBRATION CALIBRATOR, PCB

MODEL 699B07

TO BE USED WITH PCB MODEL 600M121.

FOB: Destination

MILSTRIP: N3225303430206

MFR PART NR: 699B07

PURCHASE REQUEST NUMBER: N3225303430206

0004 2 Each

AUDIO AMPLIFIER

FFP

AUDIO AMPLIFIERPCB MODEL 600M121, MODULE FOR USE WITH

PORTABLE VIBRATION CALIBRATOR (PVC) PCB MODEL 699B07.

FOB: Destination

MILSTRIP: N3225303430207

MFR PART NR: 600M121

PURCHASE REQUEST NUMBER: N3225303430207

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government 0002 Destination Government Destination Government 0003 Destination Government Destination Government 0004 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 30-APR-2021 19 DLA DISTRIBUTION

GOVERNMENT REPRESENTATIVE

RECEIVING DEPT, CODE Z0S

667 SAFEGUARD ST, BLDG 167-1

JBPHH HI 96860-5033

808-473-8000 X4961 FOB: Destination

N32253

0002 30-APR-2021 12 (SAME AS PREVIOUS LOCATION)

0003 30-APR-2021 2 (SAME AS PREVIOUS LOCATION)

0004 30-APR-2021 2 (SAME AS PREVIOUS LOCATION)