SSA-RFQ-11-1342.pdf

NO RISK LEVEL DESIGNATION

SSA-RFQ-11-1342

1. REQUEST NO.

5a. ISSUED BY

NAME

a. NAME

c. STREET ADDRESS

d. CITY

10. PLEASE FURNISH QUOTATIONS TO

THE ISSUING OFFICE IN BLOCK 5a ON

OR BEFORE CLOSE OF BUSINESS (Date)

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NO. 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG.1

RATING

6. DELIVERY BY (Date)

7. DELIVERY

9. DESTINATION

a. NAME OF CONSIGNEE

b. STREET ADDRESS

PAGE OF PAGES

5b. FOR INFORMATION CALL: (No collect calls)

TELEPHONE NUMBER

AREA CODE NUMBER

8. TO:

b. COMPANY

e. STATE f. ZIP CODE

c. CITY

d. STATE e. ZIP CODE

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 5a. 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 (Include applicable Federal, State and local taxes)

THIS RFQ

REQUEST FOR QUOTATION

(THIS IS NOT AN ORDER)

IS IS NOT A SMALL BUSINESS SET ASIDE

04/25/2011 3318-11-1152

1 2

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

Social Security Administration

Baltimore MD 21244-1811

Social Security Administration

410-966-4055 Rcvg Hrs: 6:00a-2:30p National Computer Ctr Loading Dock 6201 Security Blvd

Baltimore

MD 21235-2000

410 966-8765RICK BOLT

04/29/2011 1500 ET

FOB DESTINATION

OTHER

(See Schedule)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

THIS IS A REQUEST FOR QUOTATION (RFQ) FOR

EXTENSION OF LICENSES AND SUPPORT MANUFACTURED BY

GOOGLE. PLEASE PROVIDE A QUOTATION FOR THE

FOLLOWING:

Period of Performance: 05/02/2011 to 02/05/2012

0001 Part# GB-7007-500K-DN-DIS-EXT 2 EA Extension of existing licenses, Disconnected Support and Updates

SN# 8VG8NH1/ID S5-HFU7M225BESJA

SN# 5HK8NH1/ID S5-ABCV4425AGWAT

9 month extension per Google appliance 5/2/11 - 2/5/12

Continued ...

12. DISCOUNT FOR PROMPT PAYMENT

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%) d. CALENDAR DAYS

NUMBER PERCENTAGE

NOTE: Additional provisions and representations

13. NAME AND ADDRESS OF QUOTER

b. STREET ADDRESS

c. COUNTY

d. CITY e. STATE f. ZIP CODE

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

16. SIGNER

a. NAME (Type or print)

c. TITLE (Type or print)

a. NAME OF QUOTER

AREA CODE

NUMBER

15. DATE OF QUOTATION

b. TELEPHONE are are not attached

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

STANDARD FORM 18 (REV. 6-95)

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

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 2

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

SSA-RFQ-11-1342

* - INSTRUCTIONS TO VENDORS - *

Please submit your quote to rick.bolt@ssa.gov by 3:00 PM, April 29, 2011.

You must submit with their quotation the following articles:

• Completed Additional Information Sheet;

• Their Tax Identification Number (TIN);

• Their Dun & Bradstreet Number (DUNS); and

* - ATTACHMENTS - *

- Additional Information Sheet (2 pages)

- Commercial Clauses (5 pages)

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