النص مستخرج آلياً من صورة الوثيقة أو من ملف قديم، وقد يحتوي أخطاء في بعض الكلمات أو ترتيب الأسطر. الملف الأصلي هو المرجع.
7. REQUISITION NUMBER
PAGE 1 OF
SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS
11
Z-000132
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30
5. SOLICITATION NUMBER
6. SOLICITATION ISSUE
2. CONTRACT NO.
3. AWARD/EFFECTIVE 14. ORDER NUMBER
DATE
DATE
1JAN2004
DABV01-04-Q-2186
b. TELEPHONE NUMBER (Na collect
8. OFFER DUE DATEI
a. NAME
calls)
LOCAL TIME
7. FOR SOLICITATION
Barbara Heald
INFORMATION CALL:
914-360-5599
15JAN2004 17:00
12. DISCOUNT TERMS
110. THIS ACQUISITON IS
111. DELIVERY FOR
9. ISSUED BY
CODE
FOB DESTINATION
UNLESS BLOCK IS
MARKED
UNTESTRICTED
I SET ASIDE:
% FOR
CPA-Contracting Activity
SMALL BUSINESS
• SEE SCHEDULE |
Republican Presidential Compound I HUBZONE SMALL Baghdad, Irag BUSINESS
130. ODER CODER FAS A5 0TE 200)
APO AE 09335
13b. RATING
NAICS:
14. METHOD OF SOLICITATION
SIZE STANDARD:
DIFB
[ RFP
IX/ RFO
16. ADMINISTERED BY
15. DELIVER TO
CODE
CODE
MOE Warehouse
Same as Block 9
Baghdad, Iraq
18a, PAYMENT WILL BE MADE BY T7a. CONTRACTORT CODE CODE OFFEROR TELEPHONE NO.
186. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW C7176. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER IS CHECKED | SEE ADDENOUM UNIT QUANTITY UNIT PRICE AMOUNT ITEM NO.
SCHEDULE OF SUPPLES/SERVICES
LABORATORY TEST EQUIPMENT (BAYJI POWER
PLANT)
See attached Schedule.
(Use Reverse and/or Attach Additional Sheets as Necessary)
25. ACCOUNTING AND APPROPRIATION DATA
26. TOTAL AWARD AMOUNT (For Govt. Use Only) X ARE NOT ATTACHED 27a, SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 62.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA _ARE X ARE NOT ATTACHED _ARE
276. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 62.212-4. FAR 62.212-5 IS ATTACHED. ADDENDA
OFFER
J 29. AWARD OF CONTRACT: REF.
28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN
COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND
_ . YOUR OFFER ON SOLICITATION
ELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON AN
(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE
DDITIONAL SHEETS SUBJECT ТО THE TERMS AND CONDITIONS SPECIFIED HEREIN
SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:
731a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30a. SIGNATURE OF OFFEROR/CONTRACTOR 731c. DATE SIGNED J30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print) 30b. NAME AND TITLE OF SIGNER (Type or print) BARBARA HEALD STANDARD FORM 1449 (REV. 4/2002 AUTHORIZED FOR LOCAL REPRODUCTION Prescribed by GSA - FAR (48 CFR) 53.212 Reset PREVIOUS EDITION IS NOT USABLE
QUANTITY
AMOUNT
UNIT
UNIT PRICE
SCHEDULE OF SUPPLIES/SERVICES
ITEM NO.
Requested Delivery Date: 1 MAR 2004 Delivery: DDU (Delivered Duty Unpaid) via air freight to Ministry of Electricity Warehouse, Baghdad, Iraq Instructions:
1. All shipments shall be marked BAYJI POWER PLANT, "Iraq Reconstruction Program" and "Shipment in Transit for Humanitarian Purposes".
2. The contract number shall be clearly and visibly printed on each package, bundle, pallet and container.
32a. QUANTITY IN COLUMN 21 HAS BEEN LI ACCEPTED, AND CONFORMS O THE CONTRACT, EXCEPT AS NOTED:
• RECEIVED
• INSPECTED
732d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT 732c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE REPRESENTATIVE 32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE
324. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE
32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE
134. VOUCHER NUMBER
33. SHIP NUMBER
737. CHECK NUMBER
35. AMOUNT VERIFIED
36. PAYMENT
CORRECT FOR
_FINAL
I COMPLETE [ PARTIAL
SE SAC UN RARE SO SA VOUCHER NUMBER
40. PAID BY
742a. RECEIVED BY (Print)
41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 41b. SIGNATURE AND TITLE OF CERTIFVING OFFICER 41c. DATE
426. RECEIVED AT (Location) 42c. DATE REC'D (YY/MM/DD) T42d. TOTAL CONTAINERS STANDARD FORM 1449 (REV. 4/2002) BACK Reset