PR-HQ-07-10476
1. REQUISITION NUMBERPAGE 1 OF
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMSPR-HQ-07-10476
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE4. ORDER NUMBER 5. SOLICITATION NUMBER 6.SOLICITATION ISSUE DATE
PR-HQ-07-10476
a. NAMEb. TELEPHONE NUMBER
(No collect calls)
8. OFFER DUE DATE/
INFORMATION CALL:7. FOR SOLICITATION
LOCAL TIME
KEITH D. UPAH202-564-08702/14/2007 03:00 PM
9. ISSUED BYCODE 10 . TH IS A CQ UIS ITIO N IS11. DELIVERY FOR FOB12. DISCOUNT TERMSDESTINATION UNLESS
Environmental Protection Agency
[ ] UNRESTRICTEDBLOCK IS MARKED[] SEE SCHEDULE
Bid and Proposal Room, Ronald Reagan Building, 6th Floor
[
X
] SET ASIDE:
Total
% FOR[ ] 13a. THIS CONTRACT IS A RATED ORDER
(3802R)
UNDER DPAS (15 CFR 700)[] SMALL BUSINESS
1300 Pennsylvania Avenue, N.W.
[] SMALL DISADV. BUSINESS[
]8
(A)13b. RATING
Washington, DC, DC 20004
NAICS :
541380
SIZE S TAN DAR D:14. METHOD OF SOLICITATION[] RFQ [] IFB [
X
] RFP15. DELIVER TO CODE 16. ADMINISTERED BYCODE17a. CONTRACTOR/FACILITY18a. PAYMENT WILL BE MADE BYCODEOFFEROR CODE CODE
Environmental Protection AgencyResearch Triangle Park Financial,Management Center (D143-02)Research Triangle Park, NC 27711
TEL EPH ONE NO.18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK BELOW[ ] 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFERIS CHECKED[] SEE ADDENDUM19. 20. 21. 22. 23. 24.ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UN IT UNIT PRICE AMOUNT
(Attach Additional sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA26. TOTAL AWARD AMOUNT
(For Govt. Use Only)
N/A
[] 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED.[] ARE [] ARE NOT ATTACHED.[] 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA [] ARE [] ARE NOT ATTACHED.28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN COPIES[] TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SETFORTH OR OTHERW ISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TOTHE TERMS AND CONDITIONS SPECIFIED HEREIN.29. AWARD OF CONTRACT: REFERENCEOFFER[] DATED . YOUR OFFER ON SOLICITATION (BLOCK5), INCLUDING ANY ADDITIONS OR CHANGES W HICH ARE SET FORTHHER EIN, IS A CCE PTE D AS TO ITE MS:30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA
(SIGNATURE OF CONTRACTING OFFICER)
30b. NAME AND TITLE OF SIGNER
(TYPE OR PRINT)
30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER
(TYPE OR PRINT)
KEITH D. UPAH
31c. DATE SIGNED32a. QUANTITY IN COLUMN 21 HAS BEENACCEPTED AND CONFORMS TO THE[ ] RECEIVED [ ] INSPECTED [ ] CONTRACT, EXCEPT AS NOTED33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIEDCORRECT FORPARTIAL FINAL36. PAYMENT[ ] COMPLETE [ ] PARTIAL [ ] FINAL37. CHECK NUMBER32b. SIGNATURE OF AUTHORIZED GOVT. REPRESENTATIVE 32c. DATE38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY42a. RECEIVED BY
(Print)
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 42b. RECEIVED AT
(Location)
42c. DATE REC'D
(YY/MM/DD)
42d. TOTAL CONTAINERSAUTHORIZED FOR LOCAL REPRODUCTION SEE REVERSE FOR OMB CONTROL NUMBER AND PAPERWORK
STANDARD FORM 1449
(10-95)BURDEN STATEMENT Prescribed by GSA - FAR (48 CFR) 53.212
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