Attachment_02_Quote_Submission_Form.pdf

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Polymeric Pavement Repair Material Testing
Solicitation number
W912HZ-15-Q-7360
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Attachment_01_Performance_Work_Statement_Polymeric_Pavement_Repair_Material_Testing.pdf PDF

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QUOTE SUBMISSION FORM

Polymeric Pavement Repair Material Testing

Item Total Price Polymeric Pavement Repair Material Testing in accordance with Attachment 01 (Performance Work Statement)

Engineer Research and Development Center

Contracting Office EMAIL: Jody.Criss@usace.army.mil

601-634-5248

DELIVERY SCHEDULE: See Attachment 01 (Performance Work Statement).

2. REGISTERED IN THE SYSTEM FOR AWARD MANAGMENT (SAM), FORMERLY

CCR?

YES____ NO____

NOTE: If you are not registered with SAM (formerly CCR), an award cannot be made to your institution. You may register electronically at https://www.sam.gov/portal/public/SAM/.

Registering electronically will expedite the registration process but may not ensure registration prior to the award of the contract.

3. Please provide the following information:

Contractor Point of Contact: ______________________________________________________

Point of Contact Phone Number: ___________________________________________________

Point of Contact E-mail Address:___________________________________________________

Contractor DUNS #:_____________________________________________________________

Contractor Cage Code: ___________________________________________________________

Contractor Tax ID: ______________________________________________________________

This Quote is Valid Through the Following Date:______________________________________

Total PricePolymeric Pavement Repair Material Testing in accordance with Attachment 01 Performance Work Statement:
Contractor Point of Contact:
Point of Contact Phone Number:
Point of Contact Email Address:
Contractor DUNS:
Contractor Cage Code:
Contractor Tax ID:
This Quote is Valid Through the Following Date:
Check Box1: Off
Check Box2: Off

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