1 of 1

Program: 867-s

Term: Date of Award to July 31, 2021

Title: Senate Disbursing Office Check Stub Forms

BASIS OF

ITEM NO. DESCRIPTION AWARD UNIT RATE COST UNIT RATE COST UNIT RATE COST UNIT RATE COST

I. COMPLETE PRODUCT:

Per Product...................................................................................

 (1) Make-ready and/or Setup.................................................................... 4 $0.00 $0.00 $500.00 ------- $0.00 $0.00 No Charge $0.00

 (2) Running Per 1,000 Copies............................................................................ 180 $65.00 $11,700.00 $28.50 ------- $51.05 $9,189.00 $57.81 $10,405.80

CONTRACTOR TOTALS $11,700.00 ------- $9,189.00 $10,405.80

DISCOUNT 0.00% $0.00 1.00% -------- 0.00% $0.00 0.00% $0.00

DISCOUNTED TOTALS $11,700.00 ------- $9,189.00 $10,405.80

AWARDED

CLARKSVILLE, TN DOVER, NH

CRABAR GBF INC. RELYCO SALES INC.

CURRENT CONTRACTOR

RR DONNELLEY RR DONNELLEY

LAUREL, MD CHEVY CHASE, MD

8/20/2020
Program 867-S Page 1 of 14

Specifications by JKB

Reviewed by MRN

U.S. GOVERNMENT PUBLISHING OFFICE

Washington, DC

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS

For the Procurement of

Senate Disbursing Office Check Stub Forms

as requisitioned from the U.S. Government Publishing Office (GPO) by the

Office of the Secretary of the Senate

Single Award

TERM OF CONTRACT: The term of this contract is for the period beginning Date of Award and ending 

July 31, 2021, plus up to four (4) optional 12-month extension period(s) that may be added in accordance with the 

“OPTION TO EXTEND THE TERM OF THE CONTRACT” clause in SECTION 1 of this contract.

BID OPENING: Bids shall be opened at 11:00 a.m., prevailing Washington, DC Time, on August 6, 2020, at the 

Government Publishing Office, Washington, DC. (Due to the COVID-19 pandemic, this will NOT be a public 

bid opening.)

BID SUBMISSION: Due to the COVID-19 pandemic, the physical office will NOT be open. Based on this, 

bidders must submit email bids to bidsapsdc@gpo.gov for this solicitation. No other method of bid submission 

will be accepted at this time. The program number and bid opening date must be specified in the subject line of 

the emailed bid submission. Bids received after 11:00 a.m. on the bid opening date specified above will not be 

considered for award. 

BIDDERS, PLEASE NOTE: These specifications have been extensively revised; therefore, all bidders are 

cautioned to familiarize themselves with all provisions of these specifications before bidding, with particular 

attention to: 

 GPO has issued a new Government Paper Specification Standards, No. 13, dated September 2019.

Prospective bidders should carefully read this publication as the applicable standards within become an 

integral part of this contract. The document is posted at https://www.gpo.gov/how-to-work-withus/vendors/forms-and-standards along with a list of major revisions.

Abstracts of contract prices are available at https://www.gpo.gov/how-to-work-with-us/vendors/contract-pricing.

For information of a technical nature, contact Jim Ballou at jballou@gpo.gov or (202) 512-0310.
Senate Disbursing Office Check Stub Forms Page 2 of 14

867-S (07/21)

SECTION 1. - GENERAL TERMS AND CONDITIONS

GPO CONTRACT TERMS: Any contract which results from this Invitation for Bid will be subject to the 

applicable provisions, clauses, and supplemental specifications of GPO Contract Terms (GPO Publication 310.2, 

effective December 1, 1987 (Rev. 01-18)) and GPO Contract Terms, Quality Assurance through Attributes 

Program for Printing and Binding (GPO Publication 310.1, effective May 1979 (Rev. 09-19)).

GPO Contract Terms (GPO Publication 310.2) – https://www.gpo.gov/docs/default-source/forms-and-standardsfiles-for-vendors/contractterms2018.pdf.

GPO QATAP (GPO Publication 310.1) – https://www.gpo.gov/docs/default-source/forms-and-standards-files-forvendors/qatap-rev-09-19.pdf.

GPO IMPRINT REQUIREMENT: The GPO imprint requirement, GPO Contract Terms, Supplemental 

Specification, No. 9, is waived.

QUALITY ASSURANCE LEVELS AND STANDARDS: The following levels and standards shall apply to 

these specifications:

Product Quality Levels:

(a) Printing (page related) Attributes -- Level III.

(b) Finishing (item related) Attributes -- Level III.

Inspection Levels (from ANSI/ASQC Z1.4):

(a) Non-destructive Tests - General Inspection Level I.

(b) Destructive Tests - Special Inspection Level S-2.

Specified Standards: The specified standards for the attributes requiring them shall be:

Attribute Specified Standard

P-7. Type Quality and Uniformity OK Proofs/Furnished Sample

P-9. Solid and Screen Tint Color Match Pantone Matching System

OPTION TO EXTEND THE TERM OF THE CONTRACT: The Government has the option to extend the 

term of this contract for a period of 12 months by written notice to the contractor not later than 30 days before the 

contract expires. If the Government exercises this option, the extended contract shall be considered to include this 

clause, except, the total duration of actual production may not exceed five (5) years as a result of, and including, 

any extension(s) added under this clause. Further extension may be negotiated under the “EXTENSION OF 

CONTRACT TERM” clause. See also “ECONOMIC PRICE ADJUSTMENT” for authorized pricing 

adjustment(s).

EXTENSION OF CONTRACT TERM: At the request of the Government, the term of any contract resulting 

from this solicitation may be extended for such period of time as may be mutually agreeable to the GPO and the 

contractor.
Senate Disbursing Office Check Stub Forms Page 3 of 14

867-S (07/21)

ECONOMIC PRICE ADJUSTMENT: The pricing under this contract shall be adjusted in accordance with this 

clause, provided that in no event will any pricing adjustment be made that would exceed the maximum 

permissible under any law in effect at the time of the adjustment. There will be no adjustment for orders placed 

during the first period specified below. Pricing will thereafter be eligible for adjustment during the second and 

any succeeding performance period(s). For each performance period after the first, a percentage figure will be 

calculated as described below and that figure will be the economic price adjustment for that entire next period. 

Pricing adjustments under this clause are not applicable to reimbursable postage or transportation costs, or to 

paper, if paper prices are subject to adjustment by separate clause elsewhere in this contract.

For the purpose of this clause, performance under this contract will be divided into successive periods. The first 

period will extend from Date of Award to July 31, 2021, and the second and any succeeding period(s) will extend 

for 12 months from the end of the last preceding period, except that the length of the final period may vary. The 

first day of the second and any succeeding period(s) will be the effective date of the economic price adjustment 

for that period.

Pricing adjustments in accordance with this clause will be based on changes in the seasonally adjusted “Consumer 

Price Index For All Urban Consumers – Commodities less Food” (Index) published monthly in the CPI Detailed 

Report by the U.S. Department of Labor, Bureau of Labor Statistics.

The economic price adjustment will be the percentage difference between Index averages as specified in this 

paragraph. An index called the variable index will be calculated by averaging the monthly Indexes from the 12-

month interval ending three (3) months prior to the beginning of the period being considered for adjustment. This 

average is then compared to the average of the monthly Indexes for the 12-month interval ending April 31, 2020, 

called the base index. The percentage change (plus or minus) of the variable index from the base index will be the 

economic price adjustment for the period being considered for adjustment.

The Government will notify the contractor by contract modification specifying the percentage increase or 

decrease to be applied to invoices for orders placed during the period indicated. The contractor shall apply the 

percentage increase or decrease against the total price of the invoice less reimbursable postage or transportation 

costs and separately adjusted paper prices. Payment discounts shall be applied after the invoice price is adjusted.

PREAWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, 

the Government reserves the right to conduct an on-site pre-award survey at the contractor’s/subcontractor’s 

facility or to require other evidence of technical, production, managerial, financial, and similar abilities to 

perform, prior to the award of a contract. 

As part of the financial determination, the contractor in line for award may be required to provide one or more of 

the following financial documents:

1) Most recent profit and loss statement 

2) Most recent balance sheet 

3) Statement of cash flows 

4) Current official bank statement 

5) Current lines of credit (with amounts available)

6) Letter of commitment from paper supplier(s) 

7) Letter of commitment from any subcontractor 

The documents will be reviewed to validate that adequate financial resources are available to perform the contract 

requirements. Documents submitted will be kept confidential and used only for the determination of responsibility 

by the Government.

Failure to provide the requested information in the time specified by the Government may result in the 

Contracting Officer not having adequate information to reach an affirmative determination of responsibility.
Senate Disbursing Office Check Stub Forms Page 4 of 14

867-S (07/21)

If the Government, during the preaward survey, concludes that the contractor does not or cannot meet all of the 

requirements as described in this contract, the contractor will be declared non-responsive. 

PREAWARD TEST: The contractor being considered for award shall be required to demonstrate their ability to 

print the items required in these specifications at the requisite quality level by completing a pre-award test. 

The Government reserves the right to waive the preaward test if there is other evidence that, in the opinion of the 

Contracting Officer, indicates that the contractor being considered for award has the capability to successfully 

produce the items required.

For the preaward test, the Government will furnish one (1) previously printed sample (printed face and back) to be 

used as a visual and construction guide. 

The prospective contractor shall provide 1,000 preaward test samples.

Each sample shall be printed and constructed in accordance with SECTION 2. – SPECIFICATIONS, and must be 

of the size, kind, and quality that the contractor will furnish. Preaward test samples must be printed on White 

High Quality Xerographic Copier, Laser Printer, basis weight: 28 lbs. per 500 sheets, 17 x 22”, equal to JCP 

Code O-61, as specified herein.

Samples will be inspected and tested and must comply with the specifications as to construction, kind, and quality 

of materials. The samples will be tested for conformance of materials and/or construction requirements. Samples 

will be tested on specified equipment to ensure successful usage under normal operating conditions (see 

“EQUIPMENT COMPATIBILITY” specified herein).

Final product must match furnished sample exactly, including glue.

The contractor shall submit the pre-award test samples to: U.S. Government Publishing Office, Central Receiving, 

Attn: Congressional Publishing Service (Ken DeThomasis/Shirley Forster), 44 H Street, NW, Washington, DC 

20401. 

Contractor must submit samples within three (3) workdays of receipt of test materials.

If the pre-award test samples are disapproved by the Government, the Government, at its option, may require the 

contractor to submit revised samples for evaluation. The contractor shall submit these revised samples within 

three (3) workdays upon notification of the required changes.

In the event the revised test samples are disapproved by the Government, the contractor shall be deemed to have 

failed to comply with the applicable requirements of these specifications and may be reason for a determination of 

non-responsibility.

All samples shall be manufactured at the facilities in which the contract production quantities are to be 

manufactured.

No charges will be allowed for costs incurred in the performance of this pre-award test.

ASSIGNMENT OF JACKETS, PURCHASE AND PRINT ORDERS: A GPO jacket number will be assigned 

and a purchase order issued to the contractor to cover work performed. The purchase order will be supplemented 

by an individual print order for each job placed with the contractor. The print order, when issued, will indicate 

the quantity to be produced and any other information pertinent to the particular order.
Senate Disbursing Office Check Stub Forms Page 5 of 14

867-S (07/21)

ORDERING: Orders may be issued under the contract from Date of Award through July 31, 2021, plus for such 

additional period(s) as the contract is extended. All print orders issued hereunder are subject to the terms and 

conditions of the contract. The contract shall control in the event of conflict with any print order. 

A print order shall be “issued” upon notification by the Government for purposes of the contract when it is 

electronically transmitted or otherwise physically furnished to the contractor in conformance with the schedule. 

REQUIREMENTS: This is a requirements contract for the items and for the period specified herein. 

Shipment/delivery of items or performance of work shall be made only as authorized by orders issued in 

accordance with the clause entitled “ORDERING.” The quantities of items specified herein are estimates only, 

and are not purchased hereby. Except as may be otherwise provided in this contract, if the Government’s 

requirements for the items set forth herein do not result in orders in the amounts or quantities described as 

“estimated,” it shall not constitute the basis for an equitable price adjustment under this contract.

Except as otherwise provided in this contract, the Government shall order from the contractor all the items set 

forth which are required to be purchased by the Government activity identified on page 1.

The Government shall not be required to purchase from the contractor requirements in excess of the limit on total 

orders under this contract, if any.

Orders issued during the effective period of this contract and not completed within that time shall be completed 

by the contractor within the time specified in the order, and the rights and obligations of the contractor and the 

Government respecting those orders shall be governed by the terms of this contract to the same extent as if 

completed during the effective period of this contract.

If shipment/delivery of any quantity of an item covered by the contract is required by reason of urgency prior to 

the earliest date that shipment/delivery may be specified under this contract, and if the contractor will not accept 

an order providing for the accelerated shipment/delivery, the Government may procure this requirement from 

another source.

The Government may issue orders which provide for shipment/delivery to or performance at multiple 

destinations.

Subject to any limitations elsewhere in this contract, the contractor shall furnish to the Government all items set 

forth herein which are called for by print orders issued in accordance with the “ORDERING” clause of this 

contract.

ADDITIONAL EMAILED BID SUBMISSION PROVISIONS: The Government will not be responsible for 

any failure attributable to the transmission or receipt of the emailed bid including, but not limited to, the 

following:

1. Illegibility of bid.

2. Emails over 75 MB may not be received by GPO due to size limitations for receiving emails.

3. The bidder’s email provider may have different size limitations for sending email; however, bidders are 

advised not to exceed GPO’s stated limit.

4. When the email bid is received by GPO, it will remain unopened until the specified bid opening time. 

Government personnel will not validate receipt of the emailed bid prior to bid opening. GPO will use the 

prevailing time (specified as the local time zone) and the exact time that the email is received by GPO’s 

email server as the official time stamp for bid receipt at the specified location.
Senate Disbursing Office Check Stub Forms Page 6 of 14

867-S (07/21)

PAYMENT: Submitting invoices for payment via the GPO fax gateway (if no samples are required) utilizing the 

GPO barcode coversheet program application is the most efficient method of receiving payment. Instruction for 

using this method can be found at the following web address:

http://winapps.access.gpo.gov/fms/vouchers/barcode/instructions.html. 

Invoices may also be mailed to: U.S. Government Publishing Office, Office of Financial Management, Attn: 

Comptroller, Stop: FMCE, Washington, DC 20401. 

For more information about the billing process, refer to the General Information of the Office of Finance web 

page located at: https://www.gpo.gov/how-to-work-with-us/vendors/how-to-get-paid

Contractor’s billing invoice must be itemized in accordance with the items in the “SCHEDULE OF PRICES.” 
Senate Disbursing Office Check Stub Forms Page 7 of 14

867-S (07/21)

SECTION 2. – SPECIFICATIONS

SCOPE: These specifications cover the production of check stub forms requiring such operations as printing, 

construction, packing, and distribution.

TITLE: Senate Disbursing Office Check Stub Forms.

FREQUENCY OF ORDERS: Approximately 2 to 6 orders per year.

QUANTITY: Approximately 35,000 to 100,000 copies per order.

NUMBER OF PAGES: Face and back.

TRIM SIZE: 8-1/2 x 11”.

GOVERNMENT TO FURNISH: One (1) previously printed sample (printed face and back) to be used as a 

visual and construction guide will be supplied with the first print order. The standard set will be required to be 

maintained throughout the term of the contract. Identification markings such as register marks, commercial 

identification marks of any kind, etc., must not print on the finished product.

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “GOVERNMENT

TO FURNISH,” necessary to produce the product(s) in accordance with these specifications.

PROOFS: 

NOTE: Proofs will be required on the first print order only. 

One (1) set of digital color content proofs. Direct to plate must be used to produce the final product with a 

minimum of 2400 x 2400 dpi. Proofs must be created using the same Raster Image Processor (RIP) that will be

used to produce the product. Proofs shall be collated with all elements in proper position (not pasted up), imaged 

face and back, trimmed and folded to the finished size of the product

If any contractor’s errors are serious enough in the opinion of the GPO to require revised proofs, the revised proofs 

are to be provided at no expense to the Government. No extra time can be allowed for this reproofing; such 

operations must be accomplished within the original production schedule allotted in the specifications.

Contractor must not print prior to the receipt of an “O.K. to Print.”

STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein or 

listed for the corresponding JCP Code numbers in the “Government Paper Specification Standards No. 13” dated 

September 2019.

Government Paper Specification Standards No. 13 - https://www.gpo.gov/docs/default-source/forms-andstandards-files-for-vendors/vol_13.pdf.

White High Quality Xerographic Copier, Laser Printer, basis weight: 28 lbs. per 500 sheets, 17 x 22”, equal to JCP 

Code O-61.
Senate Disbursing Office Check Stub Forms Page 8 of 14

867-S (07/21)

PRINTING: Print face and back in Pantone 286 (Blue). 

Printing on face consists of type and line matter and two jumbled character blockout areas. One blockout area is 

approximately 7-5/8 x 3-3/16”, approximately 3/8” from top edge of form. The other blockout area is 

approximately 7-5/8 x 3-3/16”, approximately 7-3/8” from top edge of form. (Follow furnished sample)

Printing on back consists of type and line matter only (follow furnished sample).

NOTE: GPO Imprint must not print on final product.

MARGINS: Margins will be as specified on the print order or furnished sample.

CONSTRUCTION: Follow furnished sample for the following –

Perforate (slit or slot without ink) vertically along the entire 11” dimension, 3/8” from the left and right edges. 

Perforate (slit or slot without ink) horizontally along the entire 8-1/2” dimension using a fine (dot) perforation at 3

5/8” and 7-3/8” from the top edge of form (to facilitate folding).

Back of Form –

Apply pressure seal glue (approximately 3/4 x 1/4”) on back in four places, centered on the 8-1/2” dimension

(Between vertical perforations), 1/8” from bottom edge of form. 

Apply pressure seal glue (approximately 1/8 x 1/2”) on back in nine places along both the right and left edges. 

Glue is to be vertical, 3/16” from outside edges, centered along the 11” dimension.

Face of Form –

Apply pressure seal glue (approximately 3/4 x 1/4”) on face in four places, centered on the 8-1/2” dimension

(Between vertical perforations), 3-3/16” from top edge of form. 

Apply pressure seal glue (approximately 1/8 x 1/2”) on face in three places along both the right and left edges. 

Glue is to be vertical, 3/16” from outside edges, at 9/16”, 1-7/8”, and 3-3/16” from top edge of form. 

Adhesive used in the production of the check stub form must meet the requirements set forth in the USPS Physical 

Standards for Machinable Letters and Cards. Glue (continuous or spot) may be used as applicable to the particular 

type of mail piece under USPS Physical Standards. The sealing devices must not interfere with the recognition of 

the bar code, price marking, postage information, or delivery or return addresses. In all cases, no additional tabs or 

seals may be used. Cellophane tape is not acceptable within the bar code clear zone. The quantity of adhesive and 

the strength of the seal must be sufficient to maintain the integrity of the piece throughout the mailing and delivery 

process.

EQUIPMENT COMPATIBILITY: Forms must be compatible with the following equipment –

PSMailers 7K Plus Modified. Speed – 11,000 per hour, double detection, 36” conveyor.

Adhesive used on forms must be pressure seal glue suitable for use on a High Speed Xerox Laser Printer.

Forms must be guaranteed to function on PSMailers 7K Plus Modified and High Speed Xerox Laser Printer.

PACKING: Pack suitable in shipping containers in units of 1,000 forms. Check stub forms must be packed flat.

All shipments which fill less than a shipping container must be packaged with materials of sufficient strength and 

durability and in such a manner which will guarantee that the product will not be damaged and the package will not 

open nor split when processed through a small package carrier delivery system.
Senate Disbursing Office Check Stub Forms Page 9 of 14

867-S (07/21)

LABELING AND MARKING: Contractor to download the “Labeling and Marking Specifications” form (GPO 

Form 905, Rev. 7-15) from GPO.gov, fill in appropriate blanks, and attach to shipping containers. 

DEPARTMENTAL RANDOM COPIES (BLUE LABEL): All orders must be divided into equal sublots in 

accordance with the chart below. A random copy must be selected from each sublot. Do not choose copies from the 

same general area in each sublot. The contractor will be required to certify that copies were selected as directed 

using GPO Form 917 – Certificate of Selection of Random Copies (located on GPO.gov). The random copies 

constitute a part of the total quantity ordered, and no additional charge will be allowed. 

Quantity Number of

Ordered Sublots

500 - 3,200 50

3,201 - 10,000 80

10,001 - 35,000 125

35,001 and over 200

These randomly selected copies must be packaged separately and identified by a special label (GPO Form 2678-

Departmental Random Copies (Blue Label)) that must be printed on blue paper and affixed to each affected 

container. This form can be downloaded from GPO.gov. The container and its contents shall be recorded separately 

on all shipping documents and sent to: U.S. Government Publishing Office, Central Receiving, Attn: Congressional 

Publishing Service (Ken DeThomasis/Shirley Forster), 44 H Street, NW, Washington, DC 20401.

A copy of the print order/specification and a signed Certificate of Selection of Random Copies must be included.

A copy of the Certificate of Selection of Random Copies must accompany the invoice sent to U.S. Government 

Publishing Office, Financial Management Service, for payment. Failure to furnish the certificate may result in 

delay in processing the invoice. 

QUALITY ASSURANCE RANDOM COPIES: In addition to the Departmental Random Copies (Blue Label), 

the contractor may be required to submit quality assurance random copies to test for compliance against the 

specifications. The print order will indicate the number required, if any. When ordered, the contractor must divide 

the entire order into equal sublots and select a copy from a different general area of each sublot. The contractor will 

be required to certify that the copies were selected as directed using GPO Form 917-Certificate of Selection of 

Random Copies (located on GPO.gov). Copies will be paid for at the running rate offered in the contractor’s bid 

and their cost will not be a consideration for award. A copy of the print order must be included with the samples. 

Business Reply Mail labels will be furnished for mailing the quality assurance random copies. The copies are to be 

mailed at the same time as the first scheduled shipment. A U.S. Postal Service approved Certificate of Mailing, 

identified by program, jacket, and print order numbers must be furnished with billing as evidence of mailing.

DISTRIBUTION: Deliver f.o.b. destination to: U.S. Government Publishing Office, Central Receiving, Attn: 

Congressional Publishing Service (Ken DeThomasis/Shirley Forster) 44 H Street, NW, Washington, DC 20401.

Upon completion of each order, all furnished material must be returned to: U.S. Government Publishing Office, 

Central Receiving, Attn: Congressional Publishing Service (Ken DeThomasis/Shirley Forster), 44 H Street, NW, 

Washington, DC 20401 All expenses incidental to picking up and returning materials and submitting proofs must 

be borne by the contractor.
Senate Disbursing Office Check Stub Forms Page 10 of 14

867-S (07/21)

SCHEDULE: Adherence to this schedule must be maintained. Contractor must not start production of any job 

prior to receipt of the individual print order (GPO Form 2511). Furnished material and proofs must be delivered to 

and picked up from: U.S. Government Publishing Office, Central Receiving, Attn: Congressional Publishing 

Service (Ken DeThomasis/Shirley Forster), 44 H Street, NW, Washington, DC 20401.

No definite schedule for pickup of material can be predetermined.

The following schedule begins the workday after receipt of notification of availability of print order and furnished 

material; the workday after notification will be the first workday of the schedule.

Contractor must submit proofs within two (2) workdays of receipt of notification of availability of print order and 

furnished material.

Proofs will be withheld no more than three (3) workdays from their receipt at the ordering agency until they are 

made available for pickup. (NOTE: The first workday after receipt of proofs at the ordering agency is day one (1)

of the hold time.)

When ordered, Contractor must complete production and distribution within 10 workdays of receipt of “O.K to 

print” on proofs or receipt of notification of availability of print order and furnished material as applicable.The 

ship/deliver date indicated on the print order is the date products ordered for delivery f.o.b. destination must be 

delivered to the destinations specified.

Unscheduled material such as shipping documents, receipts or instructions, delivery lists, labels, etc., will be 

furnished with each order or shortly thereafter. In the event such information is not received in due time, the 

contractor will not be relieved of any responsibility in meeting the shipping schedule because of failure to request 

such information.

Contractors are to report information regarding each order for compliance reporting purposes and include date of 

delivery (or shipment if applicable) for proofs and delivery schedules in accordance with the contract requirements 

by contacting Shared Support Services Compliance Section via e-mail to compliance@gpo.gov or by calling (202) 

512-0520 or faxing to (202) 512-1364. Personnel receiving the e-mail or call will be unable to respond to questions 

of a technical nature or transfer any inquiries.
Senate Disbursing Office Check Stub Forms Page 11 of 14

867-S (07/21)

SECTION 3. – DETERMINATION OF AWARD

The Government will determine the lowest bid by applying the prices offered in the “SCHEDULE OF PRICES” to 

the following units of production which are the estimated requirements to produce one (1) year’s production under 

this contract. These units do not constitute, nor are they to be construed as, a guarantee of the volume of work 

which may be ordered for a like period of time.

The determination of award estimates specified below are based on historical data. However, due to the current 

global pandemic, the contractor is put on notice that the estimated amounts of work anticipated on this contract 

may be significantly impacted during the first period of performance.

The following item designations correspond to those listed in the “SCHEDULE OF PRICES.”

(1) (2)

I. 4 180
Senate Disbursing Office Check Stub Forms Page 12 of 14

867-S (07/21)

THIS PAGE IS INTENTIONALLY LEFT BLANK.
Senate Disbursing Office Check Stub Forms Page 13 of 14

867-S (07/21)

SECTION 4. – SCHEDULE OF PRICES

Bids offered are f.o.b. destination.

Prices must include the cost of all required materials and operations for each item listed in accordance with these 

specifications.

Bidder must make an entry in each of the spaces provided. Bids submitted with any obliteration, revision, or 

alteration of the order and manner of submitting bids may be declared nonresponsive.

An entry of NC (No Charge) shall be entered if bidder intends to furnish individual items at no charge to the 

Government. 

Bids submitted with NB (No Bid), NA (Not Applicable) or blank spaces for an item may be declared 

nonresponsive.

The Contracting Officer reserves the right to reject any offer that contains prices for individual items of production 

(whether or not such items are included in the DETERMINATION OF AWARD) that are inconsistent or 

unrealistic in regard to other prices in the same offer or to GPO prices for the same operation if such action would 

be in the best interest of the Government.

All invoices submitted to the GPO shall be based on the most economical method of production. 

Fractional parts of 1,000 will be prorated at the per-1,000 rate.

I. COMPLETE PRODUCT: Prices offered shall include the cost of all required materials and operations necessary 

(including proofs and paper) for the complete production and distribution of the product listed in accordance with 

these specifications.

Makeready Running Per

and/or Setup 1,000 Copies

(1) (2)

Per Product..................................................................................................$___________ $___________

_______________

(Initials)
Senate Disbursing Office Check Stub Forms Page 14 of 14

867-S (07/21)

SHIPMENTS: Shipments will be made from: City ________________________ State ____________________.

The city(ies) indicated above will be used for evaluation of transportation charges when shipment f.o.b. contractor’s city 

is specified. If no shipping point is indicated above, it will be deemed that the bidder has selected the city and state 

shown below in the address block, and the bid will be evaluated and the contract awarded on that basis. If shipment is 

not made from evaluation point, the contractor will be responsible for any additional shipping costs incurred.

DISCOUNTS: Discounts are offered for payment as follows: ___________ Percent ___________ Calendar Days. See 

Article 12 “Discounts” of Solicitations Provisions in GPO Contract Terms (Publication 310.2).

AMENDMENT(S): Bidder hereby acknowledges amendment(s) number(ed) ____________________________.

BID ACCEPTANCE PERIOD: In compliance with the above, the undersigned agree, if this bid is accepted within 

____________ calendar days (60 calendar days unless a different period is inserted by the bidder) from the date for 

receipt of bids, to furnish the specified items at the price set opposite each item, delivered at the designated point(s), in

exact accordance with specifications. 

NOTE: Failure to provide a 60-day bid acceptance period may result in expiration of the bid prior to award.

BIDDER’S NAME AND SIGNATURE: Unless specific written exception is taken, the bidder, by signing and 

submitting a bid, agrees with and accepts responsibility for all certifications and representations as required by the 

solicitation and GPO Contract Terms – Publication 310.2. When responding by email, fill out and return one completed 

copy of all applicable pages that include the Jacket Number, Bid Price, Additional Rate, Discounts, Amendments, Bid 

Acceptance Period, and Bidder’s Name and Signature, including signing where indicated. Valid electronic signatures 

will be accepted in accordance with the Uniform Electronic Transactions Act, § 2. Electronic signatures must be 

verifiable of the person authorized by the company to sign bids. 

Failure to sign the signature block below may result in the bid being declared non-responsive. 

Bidder _____________________________________________________________________________________

 (Contractor’s Name) (GPO Contractor’s Code)

___________________________________________________________________________________________

 (Street Address)

___________________________________________________________________________________________

 (City – State – Zip Code)

By _________________________________________________________________________________________

(Signature and Title of Person Authorized to Sign this Bid) (Date)

___________________________________________________________________________________________

(Printed Name) (Telephone Number)

___________________________________________________________________________________________

(Email) (Fax Number)

___________________________________________________________________________________________

THIS SECTION FOR GPO USE ONLY

Certified by: __________ Date: __________ Contracting Officer: __________ Date: __________

(Initials) (Initials)

____________________________________________________________________________________________