Sol

REQUEST FOR QUOTATION

THIS RFQ

(THIS IS NOT AN ORDER)

IS

PAGE

IS NOT A SMALL BUSINESS SET-ASIDE

OF

PAGES

1. REQUEST NUMBER

2. DATE ISSUED 3. REQUISITION/PURCHASE REQUEST NUMBER 4. CERT. FOR NAT. DEF.

UNDER BDSA REG. 2

AND/OR DMS REG. 1

5a. ISSUED BY National Institutes of Health

6. DELIVER BY (Date)

OD - Office of Logistics and
Multiple
Acquisition Operations
6100 Executive Blvd., Room 6B05
Bethesda, MD 20892-7511

7. DELIVERY

RATING

75N98027Q00044

FOB DESTINATION

5b. FOR INFORMATION CALL (NO COLLECT CALLS)

TELEPHONE NUMBER

NAME

NICHOLAS CAPOBIANCO

OTHER

(See Schedule)

9. DESTINATION

AREA CODE

NUMBER

+10

000-000000

a. NAME OF CONSIGNEE

8. TO:

b. COMPANY

a. NAME

b. STREET ADDRESS

c. STREET ADDRESS

c. CITY

d. CITY

e. STATE

d. STATE

f. ZIP CODE

e. ZIP CODE

IMPORTANT: This is a request for information and quotations furnished are not offers. If you are unable to quote, please so indicate on this form and return it to the address in Block 5a. This request does not commit the Government to pay any costs incurred in the preparation of the submission of this quotation or to contract for supplies or service. Supplies are of domestic origin unless otherwise indicated by quoter. Any representations and/or certifications attached to this Request for Quotation must be completed by the quoter.

10. PLEASE FURNISH QUOTATIONS TO THE

ISSUING OFFICE IN BLOCK 5a ON OR

BEFORE CLOSE OF BUSINESS (Date)

1630 ES

11. SCHEDULE (Include applicable Federal, State and local taxes)

ITEM NUMBER

SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(a)

(b)

(c)

(d)

(e)

(f)

The purpose of this COMBINED SYNOPSIS /
SOLICITATION is to provide NHLBI with
Upgrading PExA 2.1 to Vial-Based ("PExA
Cap") Collection and Related Supplies.
This Request for Quotations (RFQ) is
issued under FAR Part 12 and Subpart
13.1 as a Brand Name or Equal
competitive solicitation. The following
FAR and HHSAR provisions and clauses
apply to this solicitation and any
resulting purchase order (incorporation
by reference per FAR 52.252-1 &
52.252-2): FAR 52.204-7, 52.204-13,
52.204-16, 52.204-18, 52.204-24,
52.204-25, 52.204-27, 52.211-6,
Continued...

a. 10 CALENDAR DAYS (%) b. 20 CALENDAR DAYS (%) c. 30 CALENDAR DAYS (%)

12. DISCOUNT FOR PROMPT PAYMENT

NOTE: Additional provisions and representations

are

13. NAME AND ADDRESS OF QUOTER

a. NAME OF QUOTER

are not attached.

14. SIGNATURE OF PERSON AUTHORIZED TO

SIGN QUOTATION

b. STREET ADDRESS

15. DATE OF QUOTATION

b. TELEPHONE

AREA CODE

c. COUNTY

AUTHORIZED FOR LOCAL REPRODUCTION

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