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Sheet1 Offeror/CAGE: = Contractor Fill-In
| AMBULANCE DUCT ASSEMBLY |
| W9098S-17-T-0067 |
| CLIN 0001: Duct Assembly, Top Front | | | | | | | | | | | | | |
| P/N: 13015205RIA:19207 | | | | | | | | | | | | | |
| | | | Minimum Guaranteed Quantity: 150 | | | | | | | | | |
| | | | Ordering Period 1 | | Ordering Period 2 | | Ordering Period 3 | | Ordering Period 4 | | Ordering Period 5 | |
| Quantity Range | | | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight |
| 1 | - | 100 | | 10% | | 10% | | 10% | | 10% | | 10% |
| 101 | - | 300 | | 20% | | 20% | | 20% | | 20% | | 20% |
| 301 | | 500 | | 30% | | 30% | | 30% | | 30% | | 30% |
| 501 | - | 720 | | 40% | | 40% | | 40% | | 40% | | 40% |
| | | | | 100% | | 100% | | 100% | | 100% | | 100% |
| Ordering Period Evaluated Price | | | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | |
CLIN 0001 EVALUATED PRICE . . . . . . . . . . . . . . . . . . . . . $ - 0
| CLIN 0002: Air Duct Assembly, Vertical | | | | | | | | | | | | | |
| P/N: 13015069RIA:19207 | | | | | | | | | | | | | |
| | | | Minimum Guaranteed Quantity: 192 | | | | | | | | | |
| | | | Ordering Period 1 | | Ordering Period 2 | | Ordering Period 3 | | Ordering Period 4 | | Ordering Period 5 | |
| Quantity Range | | | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight |
| 1 | - | 100 | | 10% | | 10% | | 10% | | 10% | | 10% |
| 101 | - | 300 | | 20% | | 20% | | 20% | | 20% | | 20% |
| 301 | | 500 | | 30% | | 30% | | 30% | | 30% | | 30% |
| 501 | | 720 | | 40% | | 40% | | 40% | | 40% | | 40% |
| | | | | 100% | | 100% | | 100% | | 100% | | 100% |
| Ordering Period Evaluated Price | | | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | |
| | | | | | CLIN 0002 EVALUATED PRICE . . . . . . . . . . . . . . . | | | | | | $ - 0 | |
| CLIN 0003: Duct Assembly, Air, Rear | | | | | | | | | | | | | |
| P/N: 12561750RIA:19207 | | | | | | | | | | | | | |
| | | | Minimum Guaranteed Quantity: 150 | | | | | | | | | |
| | | | Ordering Period 1 | | Ordering Period 2 | | Ordering Period 3 | | Ordering Period 4 | | Ordering Period 5 | |
| Quantity Range | | | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight | Unit Price | Weight |
| 1 | - | 100 | | 10% | | 10% | | 10% | | 10% | | 10% |
| 101 | - | 300 | | 20% | | 20% | | 20% | | 20% | | 20% |
| 301 | | 500 | | 30% | | 30% | | 30% | | 30% | | 30% |
| 501 | - | 720 | | 40% | | 40% | | 40% | | 40% | | 40% |
| | | | | 100% | | 100% | | 100% | | 100% | | 100% |
| Ordering Period Evaluated Price | | | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | | $ - 0 | |
| CLIN 0003 EVALUATED PRICE . . . . . . . . . . . . . . . . . . . . . | $ - 0 |
| TOTAL EVALUATED PRICE . . . . . . . . . . . . . . . . . . . . . . . | $ - 0 |
| The offeror is required to fill in only the blue shaded boxes. | | |
| The Total Evaluated Price is calculated as follows: | | |
| 1. The Ordering Period Evaluated Price is the sum of the following calculation at each |
| quantity range: for each quantity range the price will be multiplied by the upper |
| limit of the quantity range then multiplied by the respective weight. |
| 2. The Evaluated CLIN price is the sum of each Ordering Period Evaluated Pricce for each |
| ordering period. |