1. THIS CONTRACT IS A RATED ORDER Under DPAS (15 CFR 700) Rating C9E 2. CONTRACT (Proc., Inst., Ident.) No. MDA906-03-C-0010 3. EFFECTIVE DATE 1 September 2003 4. REQUISITION/PURCHASE REQUEST/PROJECT NO. 03-PRO-0096 5. ISSUED BY CODE CMD Department of...
Exhibit 10(gg)
AWARD / CONTRACT | PAGE 1 |
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1. | THIS CONTRACT IS A RATED ORDER Under DPAS (15 CFR 700) |
Rating | C9E | |||||||
2. | CONTRACT (Proc., Inst., Ident.) No. MDA906-03-C-0010 | |||||||||
3. | EFFECTIVE DATE 1 September 2003 | |||||||||
4. | REQUISITION/PURCHASE REQUEST/PROJECT NO. 03-PRO-0096 |
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5. | ISSUED BY | CODE | CMD | |||||||
Department of Defense | ||||||||||
TRICARE Management Activity | ||||||||||
00000 Xxxx Xxxxxxxxxx Xxxxxxx | ||||||||||
Aurora, Colorado 80011-9066 | ||||||||||
Xxxxx.Xxxxxxxx@xxx.xxx.xxx (303-676-3626) | ||||||||||
6. | ADMINISTERED BY (If other than Item) | CODE | CMD | |||||||
Xxxxxxx Xxxxxxx | ||||||||||
Contracting Officer | ||||||||||
000-000-0000 | ||||||||||
Xxxxxxx.xxxxxxx@xxx.xxx.xxx | ||||||||||
7. | NAME AND ADDRESS OF CONTRACTOR (No., Street, City, State and ZIP Code) | |||||||||
Humana Military Healthcare Services, Inc. | ||||||||||
000 Xxxx Xxxx Xxxxxx | ||||||||||
PO Box 740062 | ||||||||||
Louisville, Kentucky 40202-1438 | ||||||||||
Vendor ID: | ||||||||||
DUNS: | ||||||||||
CEC: | ||||||||||
Cage Code: | ||||||||||
TIN : | ||||||||||
8. | DELIVERY | |||||||||
FOB ORIGIN OTHER (See Below) | ||||||||||
9. | DISCOUNT FOR PROMPT PAYMENT | |||||||||
Net 30 | ||||||||||
10. | SUBMIT INVOICES | |||||||||
(4 copies unless other- | ||||||||||
wise specified) Address | ||||||||||
Shown In: Section G |
CODE | FACILITY CODE |
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11. | SHIP TO/MARK FOR | CODE ZD06 | ||||||
Department of Defense TRICARE Management Activity 00000 Xxxx Xxxxxxxxxx Xxxxxxx XXXXXX XX 00000-0000 |
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12. | PAYMENT WILL BE MADE BY | CODE | RMF | |||||
See Section G | ||||||||
13. | AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION: | |||||||
10 U.S.C. 2304 (c) ( ) 41 U.S.C. 253(c) ( ) | ||||||||
14. | ACCOUNTING AND APPROPRIATION DATA 9703030130.1889.102000 (CLINs 0001 and 0002 obligated) |
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15A. | ITEM NO. | |||||||
15B. | SUPPLIES/SERVICES | |||||||
South Contract see Schedule B Note: Total amount in block 15G includes Base Period plus all Option periods |
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15C. | QUANTITY |
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15D. | UNIT | |||||||
15E. | UNIT PRICE | |||||||
15F. | AMOUNT | |||||||
15G. | TOTAL AMOUNT OF CONTRACT | $ | ||||||
16. | TABLE OF CONTENTS |
(X) | Sec. | Description | Pages | |||||||
Part I – THE SCHEDULE | ||||||||||
X | A | Solicitation/Contract | 1 | |||||||
X | B | Supplies or Services and Prices/Cost | B1-B7 | |||||||
X | C | Description/Specs/Work Statement | C1-C11 | |||||||
X | D | Packaging and Marking | D-1 | |||||||
X | E | Inspection and Acceptance | E-1 | |||||||
X | F | Deliveries or Performance | F1-F5 | |||||||
X | G | Contract Administration Data | G1-G4 | |||||||
X | H | Special Contract Requirements | H1-H22 | |||||||
Part II – CONTRACT CLAUSES | ||||||||||
X | I | Contracts Clauses | I1-I11 | |||||||
Part III – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH. | ||||||||||
X | J | List of Attachments | J-1 |
Part IV – REPRESENTATIONS AND INSTRUCTIONS | ||||
K | Representations, Certifications and other Statements of Offerors | |||
L | Instrs., Conds, and Notices to Offerors | |||
M | Evaluation Factors for Award | |||
Contracting Officer will complete item 17 or 18 as applicable | ||||
17. X CONTRACTOR’S NEGOTIATED AGREEMENT (Contractor is required to sign this document and return 1 copies to issuing office.) Contractor agrees to furnish and deliver all items or perform all the services set forth or otherwise identified above and on any continuation sheets for the consideration stated herein. The rights and obligation of the parties to this contract shall be subject to and governed by the following documents: (a) this award/contract, (b) the solicitation, if any, and (c) such provisions, representations, certifications, and specifications, as are attached or incorporated by reference herein. (Attached are listed herein.) | ||||
18. AWARD (Contractor is not required to sign this document.) | ||||
Your offer on Solicitation number including the additions or changes made by you which additions or changes are set forth above, is hereby accepted as to the items listed above and on any continuation sheets. This award consummates the contract which consists of the following documents: (a) the Government’s solicitation and your offer, and (b) this award/contract. No further contractual document is necessary. | ||||
19A. | Name and Title of Signer (Type or Print) | |||
Xxxxx X. Xxxxx | ||||
President and CEO | ||||
19B. | NAME OF CONTRACTOR | |||
By: | /S/ Xxxxx X. Xxxxx | |||
(Signature of person authorized to sign) | ||||
19C. | Date Signed | |||
8/25/03 | ||||
20A. | NAME OF CONTRATING OFFICER | |||
XXXXX XXXXXXXX 000 000-0000 | ||||
Xxxxx.xxxxxxxx@xxx.xxx.xxx | ||||
20B. | UNITED STATES OF AMERICA | |||
By: | /S/ Xxxxx Xxxxxxxx | |||
(Signature of Contracting Officer) | ||||
20C. | Date Signed | |||
8/27/03 |
NSN 7540-01-152-8069 |
STANDARD FORM 26 (REV. 4-85) | |
PREVIOUS EDITION UNUSABLE | Prescribed by GSA – FAR (48 CFR) 53.214(a) |