QUOTE FORM (No Clauses).docx
DOCX document 22 KB Posted
- Attached to
- HOSE ASSEMBLY
- Solicitation number
- SPMYM4-26-Q-3565
About this file
This is a Quote Form for a federal small business set-aside procurement issued by the Defense Logistics Agency (DLA) Maritime at Pearl Harbor Naval Shipyard. The solicitation SPMYM4-26-Q-3565 requires 15 units of a nitrile hose assembly with specific technical requirements: 4-inch inner diameter, 50 feet long, UV and abrasion-resistant nitrile tube and cover with non-slip grip exterior, helical wire reinforcement, heavy-duty camlock fittings with four stainless steel locking arms (copper alloy UNS No. 92200, 4" male/camlock to 4" female/camlock), fully assembled, and rated for full vacuum to 250 PSI. The quote must be submitted by July 29, 2026, at 1:00 PM HST to Vanessa Garcia at vanessa.a.garcia18.civ@us.navy.mil.
Vendors must provide delivered pricing on an FOB Destination basis to Pearl Harbor Naval Shipyard (DoDAAC N32253) and complete all required form sections including SAM registration status, business size classification, manufacturer information, delivery timeline, and payment terms (net 30 after inspection and acceptance via WAWF). Offerors must submit a Certificate of Conformance, hose test certification, and descriptive literature demonstrating compliance with purchase specifications. The evaluation will use Lowest Price Technically Acceptable (LPTA) criteria with vendor responsibility screening via SPRS. Inspection will occur at destination with QA-4 inspection (7-day inspection period). This procurement is set aside for small businesses (NAICS 326220) with a small business standard of 750 employees, and the Buy American Act with Balance of Payments applies for awards exceeding $15,000.
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Other files
| File | Type | Posted |
|---|---|---|
| PURCHASE SPECFICATION AND HOSE TEST CERTIFICATION.pdf | ||
| QUOTE FORM (No Clauses).docx | DOCX document | |
| II.S-1 Clauses Full Text Provisions and Clause.pdf |
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Text version
** THIS IS NOT AN ORDER **
PLEASE PROVIDE DELIVERED PRICES (FOB DESTINATION)
REFERENCE: SPMYM4-26-Q-3565
SET ASIDE: SMALL BUSINESS
NAICS: 326220
QUOTE DUE: 07/29/2026; 13:00 PM HST
CONTACT
DLA MARITIME – PEARL HARBOR
CONTRACT SPECIALIST: Vanessa Garcia Desk Phone: 808-473-8000 x3241 Email Quotes to: vanessa.a.garcia18.civ@us.navy.mil
VENDOR INFORMATION
Vendor Name:
CAGE Code:
Phone:
Email:
Quoted Valid for ___ Days
*** PLEASE FILL OUT THIS FORM COMPLETELY***
** In accordance with FAR 52.204-7(b)(1), an Offeror is required to be registered in SAM when submitting an offer or quotation, and must be listed as active, to prevent unduly delaying award. Information, instructions, forms, etc. for the System for Award Management (SAM) are available at https://www.sam.gov/portal/public/SAM/ **
Attention: Provisions below MUST be filled in to be considered for award.
SHIPPING INFORMATION
PLACE OF MFG/COUNTRY OF ORIGIN: _____________
ESTIMATED DELIVERY TO PEARL HARBOR__________ Calendar Days ARO
FOB TERMS: DESTINATION
SHIP TO:
DoDAAC: N32253 Country Code: USA
PEARL HARBOR NAVAL SHIPYARD IMF
667 SAFEGUARD STREET, BLDG 167-1 RECV 808-
473-8000X4961
PEARL HARBOR, HI 96860-5033
UNITED STATES
Government Representative, DLA Distribution Email: distrcustomerservice@dla.mil
IMPORTANT NOTE: The below Required Delivery Date (RDD) shall be met or exceeded in order to ensure your offer is considered responsive. If no offers are received which meet or exceed the Government’s RDD, award may proceed to the LPTA offeror, and may be made based on soonest delivery.
GOVERNMENT RDD: EARLIEST DATE
PAYMENT INFORMATION
PAYMENT TERMS______%______DAYS DISCOUNT TERMS __________________
Preferred Method payment: Wide Area Workflow (WAWF) Payment terms are always Net 30 AFTER the material has passed inspection and has been accepted.
REQUEST AND RECEIVING REPORTS is applicable to this solicitation. Please note that the WAWF (Wide Area Work Flow) will be used as the method of payment for supplies and/or services procured under this solicitation.
Information regarding WAWF is available on the internet at https://wawf.eb.mil.
YOUR COMPANY INFORMATION
YOUR BUSINESS SIZE: ___ Large (LG), ___ Small (SB), ___ Small-Disadvantaged Business (SDB), ___ Veteran-Owned Small Business (VOSB), ___ Women-Owned Small Business (WOSB), ___ Economically Disadvantaged Women-Owned Small Business (EDWOSB), ___ Service Disabled Veteran Owned Small Business (SDOVSB), ___ (HUBZONE), ___ (8a).
QUOTING AS MANUFACTURER? Yes ___ No ___
Name of Quoted Manufacturer ___________________
QUOTING AS: ___ AUTHORIZED DISTRIBUTOR or ___ THIRD PARTY DEALER
IS YOUR COMPANY’S PRICING INDEPENDENT FROM THE MANUFACTURER? Yes ___ No ___
SAM CAGE CODE: ________________
Representations must be filled in below, and provided with the submission of the quote.
Offers received without completed representaions may not be considered for award.
PRINTED NAME_______________________________SIGNATURE_____________________________
DATE______________
MATERIAL INFORMATION
Shipping to be included in the Unit Price
| ITEM | DESCRIPTION | QTY | U/I | UNIT PRICE | TOTAL PRICE |
| CLIN 0001: HOSE ASSY | 15 EA |
Unit Price$________, Total Price$_______
CLIN 0001: DESCRIPTION
HOSE, NITRILE 4" I.D. X 50' LONG, (CONTINUED BELOW), CERTIFICATE OF CONFORMANCE REQUIRED UV & ABRASION RESISTANT NITRILE TUBE & NITRILE COVER. NON-SLIP GRIP EXTERIOR SURFACE FOR SAFETY AND HANDLING. HELICAL WIRE REINFORCED, W/HEAVY DUTY CAMLOCK FITTINGS & FOUR (4) STAINLESS STEEL LOCKING ARMS, COPPER ALLOY UNS NO. 92200, 4" M/CL X 4" F/CL, FULLY ASSEMBLED, RATING: FULL VACUUM TO 250 PSI.
PACKAGING REQUIREMENTS: PACKING TO PREVENT ANY DAMAGE INCLUDING KINKING, GOUGES, CUTS, OR ABRASIONS OF HOSE COVERS; OR DAMAGE/DEFORMATION OF END FITTINGS. PACKAGING SHALL NOT VIOLATE THE MINIMUM BEND
RADIUS OF HOSE ASSEMBLY (16 INCHES OR LESS)
***PLEASE COMPLETE BELOW TO BE CONSIDERED ACCEPTABLE
1. NOTE: OFFERORS MUST COMPLETE THE ATTACHED PROVISIONS 252.204-7016 AND INCLUDE THE COMPLETED PROVISIONS WITH THEIR OFFER.
2. QUOTE FORM (NO CLAUSES) HIGHLIGHTED
3. PLEASE SUBMIT HOSE TEST & CERTIFICATION – SEE REFER ATTACHED PURCHASE SPECIFCATION – SEE ATTACHED
ADDT’L MATERIAL INFORMATION
Is there a minimum order quantity? SPECIFY: __________ Are there any quantity breaks? RANGE AND PRICING: _______________
Does the item offered contain hazardous materials? No ___ Yes ___ (MSDS Required)
EVALUATION CRITERIA
☒ If checked, the Government anticipates making a single award (all or none), If this box is not checked, requirement will be evaluated for split award.
Source selection criteria:
1. TECHNICALLY ACCEPTABLE
1. PRICE
1. DELIVERY
Quotations submitted by each vendor will be evaluated in accordance with the specifications provided in the solicitation, and determined to be either acceptable or unacceptable. Technical submissions that do not meet the minimum requirements will be rated as "Unacceptable" and will no longer be considered for further competition or award. The Government intends to make an award without discussions.
☒ If checked, SPRS evaluation procedures apply to determine vendor responsibility.
Other than Certified Cost and Pricing Data may be requested to support fair and reasonable price determination.
INSPECTION
Inspection Location: ☒ Final Inspection at Destination Inspection Terms: QA1 ☐ , QA2 ☐ , QA3 ☐ , QA4 ☐ Inspection Time: QA-4 material has a 7-day inspection time and QA-2 and QA-3 have a 30-day inspection time.
BUY AMERICAN
DFARS Buy American Act - Balance of Payments applies if >$15,000.00.
DFARS Buy American Act - Free Trade Agreements may apply if > $25,000.00.
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