QUOTE FORM

** THIS IS NOT AN ORDER **

PLEASE PROVIDE DELIVERED PRICES (FOB DESTINATION)

REFERENCE: SPMYM4-27-Q-3039

SET ASIDE: TOTAL SMALL BUSINESS SET ASIDE

NAICS: 334417

QUOTE DUE: 10/30/2026; 8:00 AM HST

CONTACT

DLA MARITIME – PEARL HARBOR

CONTRACT SPECIALIST: Jaime Tam

Desk Phone: 808-473-8000 x4162
Email Quotes to: [email protected]

VENDOR INFORMATION

Vendor Name:
CAGE Code:
Phone:
Email:
Quoted Valid for ___ Days

*** PLEASE FILL OUT THIS FORM COMPLETELY***

** In accordance with FAR 52.204-7(b)(1), an Offeror is required to be registered in SAM when submitting an offer or quotation, and must be listed as active, to prevent unduly delaying award. Information, instructions, forms, etc. for the System for Award Management (SAM) are available at https://www.sam.gov/portal/public/SAM/ **

Attention: Provisions below MUST be filled in to be considered for award.

SHIPPING INFORMATION

FOB TERMS: DESTINATION

SHIP TO:

DoDAAC: N32253

Country Code: USA

PEARL HARBOR NAVAL SHIPYARD IMF

667 SAFEGUARD STREET, BLDG 167-1 RECV 808-

473-8000X4961

PEARL HARBOR, HI 96860-5033

UNITED STATES

Government Representative, DLA Distribution
Email: [email protected]

IMPORTANT NOTE: The below Required Delivery Date (RDD) shall be met or exceeded in order to ensure your offer is considered responsive. If no offers are received which meet or exceed the Government’s RDD, award may proceed to the LPTA offeror, and may be made based on soonest delivery.

GOVERNMENT RDD: 27 NOVEMBER 2026

PAYMENT INFORMATION

Preferred Method payment: Wide Area Workflow (WAWF)
Payment terms are always Net 30 AFTER the material has passed inspection and has been accepted. REQUEST AND RECEIVING REPORTS is applicable to this solicitation. Please note that the WAWF (Wide Area Work Flow) will be used as the method of payment for supplies and/or services procured under this solicitation. Information regarding WAWF is available on the internet at https://wawf.eb.mil.

YOUR COMPANY INFORMATION

YOUR BUSINESS SIZE: ___ Large (LG), ___ Small (SB), ___ Small-Disadvantaged Business (SDB), ___ Veteran-Owned Small Business (VOSB), ___ Women-Owned Small Business (WOSB), ___ Economically Disadvantaged Women-Owned Small Business (EDWOSB), ___ Service Disabled Veteran Owned Small Business (SDOVSB), ___ (HUBZONE), ___ (8a).

QUOTING AS MANUFACTURER? Yes ___ No ___

QUOTING AS: ___ AUTHORIZED DISTRIBUTOR or ___ THIRD PARTY DEALER

IS YOUR COMPANY’S PRICING INDEPENDENT FROM THE MANUFACTURER? Yes ___ No ___

Representations must be filled in below, and provided with the submission of the quote.