SOLICITATION/CONTRACT
BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27

1.THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700)

RATING

PAGE    OF

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. SOLICITATION NUMBER

5. SOLICITATION TYPE

 SEALED BIDS (IFB)

 NEGOTIATED (RFP)

6. SOLICITATION ISSUE DATE

7. ISSUED BY

CODE

8. THIS ACQUISITION IS

 UNRESTRICTED OR

 SET ASIDE:

FOR:

 SMALL BUSINESS

 EMERGING SMALL BUSINESS

 HUBZONE SMALL BUSINESS

NO COLLECT CALLS

NAICS:
SIZE STANDARD:

 SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS

 8(A)

9. (AGENCY USE)

10. ITEMS TO BE PURCHASED (BRIEF DESCRIPTION)
 SUPPLIES            SERVICES

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT
WITHIN ______________________________________

12. ADMINISTERED BY

CODE

CALENDAR DAYS (60 CALENDAR DAYS UNLESS OFFEROR INSERTS A DIFFERENT PERIOD) FROM THE DATE SET FORTH IN BLOCK 9 ABOVE, THE CONTRACTOR AGREES TO HOLD ITS OFFERED PRICES FIRM FOR THE ITEMS SOLICITED HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO THE TERMS AND CONDITIONS STATED HEREIN.

13. CONTRACTOR FACILITY

CODE

FACILITY CODE

14. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NUMBER

DUNS NUMBER

 CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK:

15. PROMPT PAYMENT DISCOUNT

16. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION

 10 U.S.C. 2304
(              )

 41 U.S.C. 253
(              )

17.
ITEM NO.

18.
SCHEDULE OF SUPPLIES/SERVICES

19.
QUANTITY

20.
UNIT

21.
UNIT PRICE

22.
AMOUNT

23. ACCOUNTING AND APPROPRIATION DATA

24. TOTAL AWARD AMOUNT (FOR GOVERNMENT USE ONLY)

25.



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 CONTINUATION SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

26.



AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION NUMBER SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

27. SIGNATURE OF OFFEROR/CONTRACTOR

28. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

NAME AND TITLE OF SIGNER (TYPE OR PRINT)

DATED SIGNED

NAME OF CONTRACTING OFFICER

DATED SIGNED

NO RESPONSE FOR REASONS CHECKED

CANNOT COMPLY WITH SPECIFICATIONS

CANNOT MEET DELIVERY REQUIREMENT

UNABLE TO IDENTIFY THE ITEM(S)

DO NOT REGULARLY MANUFACTURE OR SELL THE TYPE OF ITEMS INVOVLED

OTHE (Specify)

WE DO

WE DO NOT, DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF ITEMS INVOLVED

NAME AND ADDRESS OF FIRM (Include Zip Code)

SIGNATURE

TUPE OR PRINT NAME AND TITLE OF SIGNER

FROM:

AFFIX
STAMP
HERE

TO:

SOLICITATION NO.  ___________________________

DATE AND LOCAL TIME  ______________________________

AUTHORIZED FOR LOCAL REPRODUCTION
PRREVIOUS EDITION NOT USABLE

STANDARD FROM 1447 (REV. 4/2008)
Prescribed by GSA – FAR (48 CFR) 53.214(d)