7. REQUISITION NUMBER

7. REQUISITION NUMBER PAGE 1 OF SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS Z-00269 9 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-2201 b. TELEPHONE NUMBER (Na collect 8. OFFER DUE DATEI a. NAME calls) 7. FOR SOLICITATION LOCAL TIME Barbara Heald INFORMATION CALL: 914-360-5599 10JAN2004 12. DISCOUNT TERMS 110. THIS ACQUISITON IS 111. DELIVERY FOR 9. ISSUED BY CODE FOB DESTINATION UNLESS BLOCK IS MARKED % FOR IsET ASIDE: 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 "8A) 13b. RATING NAICS: 14. METHOD OF SOLICITATION SIZE STANDARD: [ RFP [X1 RFO 16. ADMINISTERED BY 15. DELIVER TO CODE CODE MOE Warehouse Same as Block 9 Baghdad, Iraq CODE 18a. PAYMENT WILL BE MADE BY CODE T7S. COMEROCTORT TELEPHONE NO. 186. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW [176. OHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN IS CHECKED | SEE ADDENOUM UNIT AMOUNT UNIT PRICE QUANTITY SCHEDULE OF SUPPLES/SERVICES ITEM NO. SIEMENS CIRCUIT BREAKERS (MUSSAIB POWER PLANT) GENUINE REPLACEMENT PARTS - DO NOT SUBSTITUTE 0001 EA Siemens Circuit Breaker, 6.9 KV, Vacuum CB, 3150A, UN 7.2 kV, IB 3150A, IK 40 kA, TK=3 sec 0002 EA 20 Siemen's Circuit Breaker, 6.9 kV, Vacuum CB, 1250A, (Use Reverse and/or Attach Additional Sheets as Necessary 26. TOTAL AWARD AMOUNT (For Govt. Use Only) 25. ACCOUNTING AND APPROPRIATION DATA 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 28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN J 29. AWARD OF CONTRACT: REF. 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 TO THE TERMS AND CONDITIONS SPECIFIED HEREII 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) 53.21 Reset PREVIOUS EDITION IS NOT USABLE QUANTITY AMOUNT UNIT SCHEDULE OF SUPPLIES/SERVICES ITEM NO. UNIT PRICE 0003 50 EA Vacuum Champer for 7.2 kV Circuit Breaker Type 3 - AF, I = 3150 Amp, UN(5) = 7.2 kV, IK=40 kA Requested Delivery Date: 15 March 2004 Delivery: CIF (Cost, Insurance, Freight) to MOE Warehouse, Baghdad, Iraq, via ground transportation Instructions: 1. All shipments shall be marked MUSSAYIB 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 • RECEIVED • INSPECTED [ ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: 732d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT 32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE REPRESENTATIVE 324. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE 32e. MAILING ADDRESS OF AUTHORIZED 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 PARTIAL, JFINAL 38. S/R ACCOUNT NUMBER 39. S/R 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