Draft version

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

1. REQUISITION NO.

PAGE 1 OF

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

36C24125R0116

a. NAME

7. FOR SOLICITATION

INFORMATION CALL:

b. TELEPHONE NO. (No Collect Calls)

Melanie Stockman

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

Department of Veterans Affairs
Network Contracting Office 1 (NCO 1)
Contracting Officer (90C)

1 VA Center

Augusta ME 04330

11. DELIVERY FOR FOB DESTINATION UNLESS BLOCK IS

MARKED

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

UNRESTRICTED OR

% FOR:

EDWOSB

CST

339112

SIZE STANDARD:

1000 Employees

8(A)

13b. RATING

N/A

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

14. METHOD OF SOLICITATION

RFQ

CODE

IFB

16. ADMINISTERED BY

Department of Veteran Affairs
VA Connecticut
950 Campbell Avenue

X

RFP

CODE

Department of Veterans Affairs
Network Contracting Office 1 (NCO 1)
Contracting Officer (90C)

1 VA Center

Augusta ME 04330

West Haven CT 06516

CODE

16:00

SET ASIDE:

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

NAICS:

12. DISCOUNT TERMS

SEE SCHEDULE

17a. CONTRACTOR/OFFEROR

X

SMALL BUSINESS

15. DELIVER TO

8. OFFER DUE DATE/LOCAL

TIME

480-466-7938

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

Department of Veterans Affairs
Financial Services Center
http://www.fsc.va.gov/einvoice.asp

See VAAR 852.232-72

Austin TX 78714-9971

PHONE:

TELEPHONE NO.

UEI:

FAX:

EFT:

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

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

See CONTINUATION

20.

SCHEDULE OF SUPPLIES/SERVICES

19.
ITEM NO.

SEE ADDENDUM

Page

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

See CONTINUATION Page

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

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

X ARE

ARE NOT ATTACHED.

ARE

ARE NOT ATTACHED