SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS | 1. REQUISITION NUMBER | |
OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 | | PAGE 1 OF | 4 | |
2 CONTRACT. NO. | 3. AWARDS | 4. ORDER NUMBER | 5. SOLICITATION NUMBER | 6. SOLICITATION |
HHSP233200530018B | EFFECTIVE DATE | | | ISSUE DATE |
| 09/06/2005 | | | |
7. FOR SOLICITATION | ![](https://capedge.com/proxy/10-Q/0001104659-05-052622/g193181kei001.jpg)
| a. NAME | | b. TELEPHONE NUMBER (No collect calls) | 8. OFFER DUE DATE/LOCAL TIME |
INFORMATION CALL: | PATRICK JOY | | 3014439265 | |
9. ISSUED BY | CODE | DAM | 10. THIS ACQUISITION IS |
| ý UNRESTRICTED OR oSET ASIDE: % FOR |
DHHS/PSC/SAS/DAM | |
PARKLAWN BUILDING, ROOM 5-101 | | o SMALL BUSINESS | oEMERGING SMALL |
5600 FISHERS LANE | | | BUSINESS |
ROCKVILLE MD 20857 | NAICS: 561320 | oHUBZONE SMALL |
| SIZE STANDARD: | | BUSINESS |
| $ 11.5 | oSERVICE-DISABLED VETERAN- | o8(A) |
| | | OWNED SMALL BUSINESS | |
11. DELIVERY FOR FOB DESTINA- | 12.. DISCOUNT TERMS | | | 13b. RATING |
| TION UNLESS BLOCK IS | As Indicated On Each Call | o13a. THIS CONTRACT IS A | | |
| MARKED | | | RATED ORDER UNDER | | 14. METHOD OF SOLICITATION |
o SEE SCHEDULE | | | DPAS (15 CFR 700) | | | oRFQ | oIFB | oRFP |
15. DELIVER TO | CODE | | 16. ADMINISTERED BY | CODE | DAM |
As Indicated On Each Call | DHHS/PSC/SAS/DAM |
| PARKLAWN BLDG., ROOM 5-101 |
| 5600 FISHERS LANE |
| ROCKVILLE MD 20857 |
| |
| |
17a. CONTRACTOR/ | CODE | 593489868 | FACILITY | | 16a. PAYMENT WILL BE MADE BY | CODE | SEE |
| OFFEROR | CODE | | |
| | | |
MEDICAL STAFFING NETWORK | | As Indicated On Each Call |
Attn: PAM SMITH | | |
901 YOMATO ROAD | | |
SUITE 110 | | |
BOCA RATON FL 33431- 4415 | | |
| | |
TELEPHONE NO. 561-322-1793 | | |
o17b. 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 | o SEE ADDENDUM |
19. | 20. | 21. | 22. | 23. | 24. |
ITEM NO. | SCHEDULE OF SUPPLIES/SERVICES | QUANTITY | UNIT | UNIT PRICE | AMOUNT |
| GSA Contract #: V797p4482A | | | | |
| Tax ID Number : 593489868 | | | | |
| DUNS Number : 007575160 | | | | |
| Contract Clause for the Offeror’s Veteran’s Administration issued Federal Supply | | | | |
| Schedule are incorporated by reference. | | | | |
| | | | | |
| I. Blanket Purchase Agreement (BPA) Terms and Conditions | | | | |
| | | | | |
| (1) Temporary Professional (and allied) Medical Staffing (TPMS) Services can be | | | | |
| ordered under the BPA on an as needed, as requested basis by all DHHS operating | | | | |
| divisions. All orders placed against any BPA resulting from this RFQ (“The BPA”) | | | | |
| | (Use Reverse and/or Attach Additional Sheets as Necessary) | | | | |
25. ACCOUNTING AND APPROPRIATION DATA | 26. TOTAL AWARD AMOUNT (For Govt.Use Only) |
As Indicated On Each Call | | $0.00 |
o27a. | SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4, FAR 52,.212-3 AND FAR 52.212-5 ARE ATTACHED. ADDENDA | o ARE | o ARE NOT ATTACHED |
o27b. | CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA | o ARE | o ARE NOT ATTACHED |
o28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN | | ý 29. AWARD OF CONTRACT: REF. | | OFFER |
| COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER | | DATED | | YOUR OFFER ON SOLICITATION (BLOCK 5), |
| ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL | | INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH |
| SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. | | HEREIN, IS ACCEPTED AS TO ITEMS: |
30a. SIGNATURE OF OFFEROR/CONTRACTOR | | 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) |
/s/ | Larry McPherson | | | /s/ | Patrick A. Joy | |
30b. NAME AND TITLE OF SIGNER (Type or Print) | 30c. DATE SIGNED | 31b. NAME OF CONTRACTING OFFICER (Type or print) | 31c. DATE SIGNED |
Larry McPherson CFO | 9/1/05 | PATRICK A. JOY | 09/06/2005 |
AUTHORIZED FOR LOCAL REPRODUCTION | Working Copy | | STANDARD FORM 1449 (REV. 3/2005) |
PREVIOUS EDITIONS IS NOT USABLE | | | | | Prescribed by GSA-FAR (46CFR) 53.212 |
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