SF_1449.pdf

LEVEL 5C= AIS MODERATE RISK

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

OAG

7111 Security Boulevard 1st Floor - Rear Entrance Office of Acquisition and Grants

SOCIAL SECURITY ADMINISTRATION

CODE 16. ADMINISTERED BYCODE

X

X

511210

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR00600

RFPIFB

10. THIS ACQUISITION ISCODE

RFQ

14. METHOD OF SOLICITATION

13b. RATING

NAICS:

SMALL BUSINESS

1700 ET

05/24/2013

410-594-2032MONICA YANKLE

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

SSA-RFP-13-0015

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 4 3307-13-1004OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

Baltimore MD 21244-1811

TELEPHONE NO.

17a. CONTRACTOR/

Refer to RFP, Section H-2(e)

15. DELIVER TO

Baltimore MD 21244-1811 7111 Security Boulevard 1st Floor - Rear Entrance Office of Acquisition and Grants

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$35.50

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

ISSUE DATE

DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

11.

SEE SCHEDULE

12. DISCOUNT TERMS

THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

8(A)

Social Security Administration

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

This is a Request for Proposal (RFP) utilizing the Federal Acquisition Regulation (FAR) Part 12 AND 15 to purchase an OVERALL TOTAL SOLUTION for a streamlined remittance process and an automated system solution to collect fees from SSA's field offices for non-programmatic services. The Government anticipates awarding a single,Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract resulting from this solicitation, with a BASE YEAR and FOUR OPTION YEARS.

Individual Task Orders issued under this contract

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

JANE M. QUINN

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

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

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

OFFER

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REF.

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

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

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

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

STANDARD FORM 1449 (REV. 2/2012) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

may be Firm Fixed Price (FFP), Labor Hour (LH), or a combination of FFP and LH.

0001 Phase 1 - E-Commerce Software - Licenses to

Support Pilot Sites

0002 Phase 1 - Technical and Administrative Services

0003 Phase 1 - Implementation Support (On-Site Trainer)

0004 Phase 1 - Technical Documentation

0005 Phase 1 - Web-based or VOD Training Documentation

0006 Phase 1 - End User Written Guides

0007 Phase 1 - Gateway Services

0008 Phase 1 - Card Readers 50 EA

0009 Phase 2 - E-Commerce SW - Upgrade to Enterprise

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

4 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 4

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

SSA-RFP-13-0015

Licenses for Unlimited Users

0010 Phase 2 - E-Commerce SW - Maintenance Support

0011 Phase 2 - Technical and Administrative Services

0012 Phase 2 - Gateway Services

0013 Phase 2 - Card Readers 2560 EA

0014 Phase 2 - Training Documentation Updates

0015 Phase 2 - Technical Documentation Updates

0016 Phase 2 - Help Desk Documentation Updates

- CONTACT INFORMATION -

For questions regarding this solicitation, please contact Monica Yankle, Contract Specialist by email at monica.yankle@ssa.gov AND Kathy Fain, Contracting Officer at kathy.fain@ssa.gov.

- ATTACHMENTS -

Attachment No. 1 - Applicability of SSA’s Accessibility Requirements to EIT Solutions

Attachment No. 2 – List of SSA Field Offices

Attachment No. 3 – Payment Coupon Scan Line Format

Attachment No. 4 – Vantiv Key Confidentiality Agreement

Attachment No. 5 – Mutual Nondisclosure (VAR Continued ...

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

Sponsored by GSA

FAR (48 CFR) 53.110

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

4 4

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

SSA-RFP-13-0015

Certification

Attachment No. 6 – Instructions to Contractors Applicable to Section 508

Attachment No. 7 – Small Business Subcontracting Model Plan

Attachment No. 8 – Reference Authorization Letter

Attachment No. 9 – Evaluation Questionnaire

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

Sponsored by GSA

FAR (48 CFR) 53.110