AUTHORIZED FOR LOCAL REPRODUCTION RFQ DABV01-04-Q-2312

AUTHORIZED FOR LOCAL REPRODUCTION RFQ DABV01-04-Q-2312 SEE REVERSE FOR OMB CONTROL STANDARD FORM 1449 (10-95) SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 1. REQUISITION NO. Z00372 PAGE 1 OF 2 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NO. DABV01-04-Q-2312 6. SOLICITATION ISSUE DATE 06 FEB 2004 7. FOR SOLICITATION INFORMATION CALL a. NAME Don Croes email “croesd@baghdadforum.com” b. TELEPHONE NO. (No collect calls) (703) 270-0056 8. OFFER DUE DATE/LOCAL TIME See Page 2 9. ISSUED BY CPA Contract Activity Republican Presidential Compound Baghdad, Iraq APO AE 09335 CODE W910U1 10. THIS ACQUISITION IS UNRESTRICTED SET ASIDE: % FOR SMALL BUSINESS SMALL DISADV. BUSINESS 8(A) SIC: SIZE STD: 11. DELIVERY FOR FOB DESTINATION 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 MOE Warehouse Baghdad, Iraq 16. ADMINISTERED BY CODE Same as Block 9 17a. CONTRACTOR/ CODE OFFEROR FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE Chief Financial Officer Republican Presidential Compound Baghdad, Iraq APOE AE 09335 TELEPHONE NO. 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. ITEM NO. 20. SCHEDULE OF SUPPLIES/SERVICES 21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT 0001 0002 Pressure Regulator Valve, Manufactured by Masoneilan, Series 500, Model 525 Double Seated Reducing Regulator Diaphragm Washer for series 500 Manufactured by Masoneilan, Model 525 Double Seated Reducing Regulator (Attach Additional Sheets as Necessary) 1 2 Eeach Each 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 _____ COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. 29. AWARD OF CONTRACT: REFERENCE ___________________ OFFER DATED _________________. YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE 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 32a. QUANTITY IN COLUMN 21 HAS BEEN 33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED CORRECT FOR ACCEPTED, AND CONFORMS TO THE RECEIVED INSPECTED CONTRACT, EXCEPT AS NOTED PARTIAL FINAL 32b. SIGNATURE OF AUTHORIZED GOVT REPRESENTATIVE 32c. DATE 36. PAYMENT COMPLETE PARTIAL FINAL 37. CHECK NUMBER 38. S/R ACCOUNT NO. 39. S/R VOUCHER NO. 40. PAID BY 42a. RECEIVED BY (Print) 41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 1 42b. RECEIVED AT (Location) 42c. DATE REC’D (YY/MM/DD) 42d. TOTAL CONTAINERS RFQ DABV01-04-Q-2312 Requested Delivery Date is : 04/13/2004 or earlier Delivery: DDU(Delivered Duty Unpaid) via DHL Air Freight to Ministry of Electricity Warehouse, Baghdad, Iraq 1. 2. All shipments shall be marked “Iraq Reconstructions Program” and “Shipment in Transit for Humanitarian Purposes”. The Contract number shall be clearly and visibly printed on each package, bundle, pallet and container. CLOSING DATE: 29 FEBRUARY 2004; The Government intends to make award as soon as adequate competition is obtained by no sooner than 12 February 2004 5:00 Local time. . 2