FULL

1. REQUISITION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

2. CONTRACT NO.

3. AWARD/

PAGE

1170874

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

4. ORDER NUMBER

FOR SOLICITATION

INFORMATION CALL:

b. TELEPHONE NUMBER

LOUIS LIEB

303-275-5393
82A7

CODE

JOB CORPS AQM

USDA FOREST SERVICE

1617 COLE BLVD

LAKEWOOD CO 80401

11. DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

15. DELIVER TO

CODE

X SMALL BUSINESS

10/16/2026

8. OFFER DUE DATE/LOCAL TIME

8(A)

100.00

X SET ASIDE:

% FOR:

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

621111

SIZE STANDARD:

$16

13b. RATING

14. METHOD OF SOLICITATION

REQUEST FOR

INVITATION

FOR BID (IFB)

REQUEST FOR

PROPOSAL

(RFP)

X QUOTE (RFQ)

16. ADMINISTERED BY

CODE

82A7

JOB CORPS AQM

USDA FOREST SERVICE

1617 COLE BLVD

LAKEWOOD CO 80401

BOXELDER JCC

22023 JOB CORP PLACE

NEMO SD 57759

17a. CONTRACTOR/

OFFEROR

UNRESTRICTED OR

13a. THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

67U4

ISSUE DATE

11/05/2026 1700 ES

WOMEN-OWNED SMALL

BUSINESS (WOSB)

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

X SEE SCHEDULE

(No collect calls)

10. THIS ACQUISITION IS

HUBZONE SMALL

BUSINESS

12. DISCOUNT TERMS

6. SOLICITATION

1282A727Q0004

a. NAME

9. ISSUED BY

5. SOLICITATION NUMBER

EFFECTIVE DATE

7.

OF

CODE

FACILITY

CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

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

19.
ITEM NO.

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

SEE ADDENDUM

IS CHECKED

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Medical Services; Boxelder Job Corps Center;
Nemo, SD
The Contractor shall provide Medical Services to
Boxelder JCC in accordance with the Terms and
Conditions herein.
This Firm Fixed Price contract is for a Base Year
with four (4) one year options, as well as a
potential 6 month extension which may be
exercised at the sole discretion of the
(Use Reverse and/or Attach Additional Sheets as Necessary) 26. TOTAL AWARD AMOUNT (For Government Use Only)

25. ACCOUNTING AND APPROPRIATION DATA

X 27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) 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.

X 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

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