SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 1. REQUISITION NO. Z- FORMTEXT 403 PAGE 1 OF FORMTEXT 11 2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE FORMTEXT 4. ORDER NO. 5. SOLICITATION NO. DABV01- FORMTEXT 04- FORMDROPDOWN - FORMTEXT 2332 6. SOLICITATION ISSUE DATE FORMTEXT February 23, 2004 7. FOR SOLICITATION INFORMATION CALL a. NAME FORMTEXT LtCol K.C. Wille b. TELEPHONE NO. (No collect calls) FORMTEXT (703) 270-0062 8. OFFER DUE DATE/LOCAL TIME FORMTEXT February 28, 2004 9. ISSUED BY CODE W910U1 10. THIS ACQUISITION IS 11. DELIVERY FOR FOB 12. DISCOUNT TERMS CPA Contracting Activity Republican Presidential Compound Baghdad, Iraq FORMCHECKBOX UNRESTRICTED FORMCHECKBOX SET ASIDE: % FOR FORMCHECKBOX SMALL BUSINESS DESTINATION UNLESS BLOCK IS MARKED FORMCHECKBOX SEE SCHEDULE APO AE 09335 FORMCHECKBOX SMALL DISADV. BUSINESS FORMCHECKBOX 13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700) FORMCHECKBOX 8(A) 13b. RATING SIC: SIZE STD: 14. METHOD OF SOLICITATION FORMCHECKBOX RFQ FORMCHECKBOX IFB FORMCHECKBOX RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE See SF 1449 Continuation Same as Block 9 17a. CONTRACTOR/ CODE OFFEROR FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE FORMTEXT Chief Financial Officer Republican Presidential Compound Baghdad, Iraq APO AE 09335 Invoicing@orha.centcom.mil FORMCHECKBOX 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 FORMCHECKBOX SEE ADDENDUM 19. ITEM NO. 20. SCHEDULE OF SUPPLIES/SERVICES 21. QUANTITY 22. UNIT 23. UNIT PRICE 24. AMOUNT FORMTEXT 0001 FORMTEXT Interconnecting Power Auto Transformer IAW attached specification FORMTEXT 1 FORMTEXT EA FORMTEXT FORMTEXT (Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA FORMTEXT 26. TOTAL AWARD AMOUNT (For Govt. Use Only) FORMTEXT FORMCHECKBOX 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA FORMCHECKBOX ARE FORMCHECKBOX ARE NOT ATTACHED. FORMCHECKBOX 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA FORMCHECKBOX ARE FORMCHECKBOX 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 FORMCHECKBOX 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) FORMTEXT LtCol K.C. Wille 31c. DATE SIGNED FORMTEXT 32a. QUANTITY IN COLUMN 21 HAS BEEN ACCEPTED, AND CONFORMS TO THE 33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED CORRECT FOR FORMCHECKBOX RECEIVED FORMCHECKBOX INSPECTED FORMCHECKBOX CONTRACT, EXCEPT AS NOTED FORMCHECKBOX PARTIAL FORMCHECKBOX FINAL 36. PAYMENT 37. CHECK NUMBER 32b. SIGNATURE OF AUTHORIZED GOVT REPRESENTATIVE 32c. DATE FORMCHECKBOX COMPLETE FORMCHECKBOX PARTIAL FORMCHECKBOX FINAL 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 42b. RECEIVED AT (Location) 42c. DATE REC’D (YY/MM/DD) 42d. TOTAL CONTAINERS AUTHORIZED FOR LOCAL REPRODUCTION SEE REVERSE FOR OMB CONTROL STANDARD FORM 1449 (10-95)