65--Surgical Scrubs

PAGE 1 OF 1. REQUISITION NO. 2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL TIME 9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR: SMALL BUSINESS HUBZONE SMALL BUSINESS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS (WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM EDWOSB 8(A) NAICS: SIZE STANDARD: 11. DELIVERY FOR FOB DESTINA- TION UNLESS BLOCK IS MARKED SEE SCHEDULE 12. DISCOUNT TERMS 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) 13b. RATING 14. METHOD OF SOLICITATION RFQ IFB RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE 17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE TELEPHONE NO. DUNS: DUNS+4: PHONE: FAX: 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED SEE ADDENDUM 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT (Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 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 ARE ARE NOT ATTACHED. 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS: 30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED AUTHORIZED FOR LOCAL REPRODUCTION (REV. 2/2012) PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212 7. FOR SOLICITATION INFORMATION CALL: STANDARD FORM 1449 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 7 None 556-18-4-5001-0103 36C25218Q9826 Pauline Ludwig +1 (555) 000-0000 0069D Great Lakes Acquisition Center (GLAC) Department of Veterans Affairs 115 S 84th St, Suite 100 Milwaukee WI 53214-1476 x 100 x N 315210 750 employees N/A 0069D Department of Veterans Affairs Captain James A Lovell FHCC 3001 Green Bay Rd North Chicago IL 60064 36C252 Great Lakes Acquisition Center (GLAC) Department of Veterans Affairs 115 S 84th St, Suite 100 Milwaukee WI 53214-1476 Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 Surgical Scrubs Purchase order 556-A8 Please reference all correspondence and invoices with the above number The Contracting officer is the only person authorized to modify or make changes to this contract. 556-3680169-5001-756400-2542-556-A8 070056100 x x x 1 Pauline Ludwig Contracting Officer SECTION B - CONTINUATION OF SF 1449 BLOCKS CONTRACT ADMINISTRATION DATA (Continuation from Standard Form 1449, block 18A.) 1. Contract Administration: All contract administration matters will be handled by the following individuals: A. CONTRACTOR: B. GOVERNMENT: Pauline Ludwig, Contract Specialist Great Lakes Acquisition Center 115 S 84th St. Milwaukee, WI 53214 +1 (555) 000-0000 2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with: [X] 52.232-33, Payment by Electronic Funds Transfer System for Award Management (Jul 2013) 3. INVOICES: Invoices shall be submitted in arrears in accordance with: a. 852.232-72 Electronic Submission of Payment Requests (Nov 2012) b. Upon Acceptance of Items FACSIMILE, E-Mail, and Scanned Documents are Not Acceptable forms of Submission for Payment Requests. For assistance setting up e-Invoice, the below information is provided: *OB10 e-Invoice Setup Information: +1 (555) 000-0000 *OB10 e-Invoice email: contact@example.gov *FSC e-invoice contact information: +1 (555) 000-0000 *FSC e-invoice email: contact@example.gov BASIS OF AWARD: The Government will make the award to the most fair and reasonably priced offer. SCHEDULE OF SUPPLIES/SERVICES AND PRICES/COSTS (SF 1449, Continuation of Blocks 19 24) Contractor shall provide the following Surgical Scrubs for the Captain James A Lovell FHCC, North Chicago, IL. Vendor shall be a certified SDVOSB/VOSB vendor certified in Vetbiz. Vendor shall be an Original Equipment Manufacturer (OEM) authorized dealer, authorized distributor, or authorized reseller for the proposed product such that the OEM warranty is provided and maintained by the OEM. All supplies shall be delivered FOB Destination. Brand Name Only Item No. Description QTY UNIT UNIT PRICE Total Price 1 Medline 610NTRS-CA Top, scrub, rev, a-stat, raspbry, ANG-CC SM 400 each 2 Medline 610NTRM-CA Top, scrub, rev, a-stat, raspbry, ANG-CC MD 1000 each 3 Medline 610NTRL-CA Top, scrub, rev, a-stat, raspbry, ANG-CC LG 1000 each 4 Medline 610NTRXL-CA Top, scrub, rev, a-stat, raspbry, ANG-CC XL 1000 each 5 Medline 610NTRXXL-CA Top, scrub, rev, a-stat, raspbry, ANG-CC 2XL 400 each 6 Medline 610NTRXXXL-CA Top, scrub, rev, a-stat, raspbry, ANG-CC 3XL 200 each 7 Medline 600NTRS-CA Pant, scrub, rev, a-stat, raspbry, ANG-CC SM 400 each 8 Medline 600NTRM-CA Pant, scrub, rev, a-stat, raspbry, ANG-CC MD 1000 each 9 Medline 600NTRL-CA Pant, scrub, rev, a-stat, raspbry, ANG-CC LG 1000 each 10 Medline 600NTRXL-CA Pant, scrub, rev, a-stat, raspbry, ANG-XL SM 1000 each 11 Medline 600NTRXXL-CA Pant, scrub, rev, a-stat, raspbry, ANG-CC 2XL 400 each 12 Medline 600NTRXXXL-CA Pant, scrub, rev, a-stat, raspbry, ANG-CC 3XL 200 each TOTAL Salients: Must all be delivered at once; no split shipments B.1 DELIVERY SCHEDULE ITEM NUMBER QUANTITY DELIVERY DATE 0001 SHIP TO: Captain James A Lovell FHCC 3001 Green Bay Rd North Chicago, IL 60064 USA All 30 days ARO SECTION C - CONTRACT CLAUSES C.1 52.212-4 CONTRACT TERMS AND CONDITIONS COMMERCIAL ITEMS (JAN 2017) ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS COMMERCIAL ITEMS C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) C.3 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS (DEC 2013) C.5 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2012) C.6 VAAR 852.246-71 INSPECTION (JAN 2008) (End of Addendum to 52.212-4) C.7 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS COMMERCIAL ITEMS (JAN 2018) 52.219-10, VA Notice of Total Service-Disabled Veteran Owned Small Business Set-Aside (Jul 2016) 852.219-74, Limitations on Sub-Contracting Monitoring and Compliance (Jul 2018) 852.232-72, Electronic submission of Payment requests (Nov 2012) 852.246-71, Inspection (Jan 2008) SECTION E - SOLICITATION PROVISIONS E.1 52.212-1 INSTRUCTIONS TO OFFERORS COMMERCIAL ITEMS (JAN 2017) ADDENDUM to FAR 52.212-1 INSTRUCTIONS TO OFFERORS COMMERCIAL ITEMS E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) E.3 52.214-21 DESCRIPTIVE LITERATURE (APR 2002) ALTERNATE I (JAN 2017) E.4 52.232-38 SUBMISSION OF ELECTRONIC FUNDS TRANSFER INFORMATION WITH OFFER (JUL 2013) E.5 VAAR 852.252-70 SOLICITATION PROVISIONS OR CLAUSES INCORPORATED BY REFERENCE (JAN 2008) (End of Addendum to 52.212-1) E.6 52.212-2 EVALUATION COMMERCIAL ITEMS (OCT 2014) E.7 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS COMMERCIAL ITEMS (NOV 2017) End of Document