Jacket: 624-166

Title: Intake/Interview & Quality Review Sheet

Agency: IRS

Bid Opening: May 27, 2022 at 2:00PM

Bid Terms Discounted Total

$99,275.00 days $99,275.00

$106,100.00 2.0% 20 days $103,978.00

$130,348.00 2.0% 20 days $127,741.04

$160,002.00 0.25% 20 days $159,602.00

Incept LLC Print Package Postal $164,378.35 2.0% 20 days $161,090.78

MAR - A Qualfon Company

Contractor Name

Highland Computer Forms

NPC

Colonial Press

AWARDED
Specifications by TC Jacket 624-166

Page 1 of 11 IRS (4830-62) Req 2-05085

Reviewed by EBR

BID OPENING: Bids shall be opened at 2:00pm, prevailing Eastern Time, on May 27, 2022 at the U.S. 

Government Publishing Office, Atlanta GA. Due to the COVID-19 pandemic, this will NOT be a public bid 

opening.

ISSUE DATE: May 24, 2022

ANY QUESTIONS BEFORE AWARD CONCERNING THESE SPECIFICATIONS, CALL (404) 605-9160, EXT. 

4 (TRACI COBB). 

SPECIFICATIONS

U.S. Government Publishing Office (GPO)

Atlanta Regional Office

3715 Northside Parkway, NW

Suite 4-305

Atlanta, Georgia 30327

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)).

PRODUCT: Folded Form

TITLE: Intake/Interview & Quality Review Sheet

FORM NO: F13614-C (Rev. 10-2022) Cat #52121E

QUALITY LEVEL: III Quality Assurance Through Attributes (GPO Publication 310.1, effective May 1979 (Rev. 

09-19)) applies.

QUANTITY: 2,499,215 copies

PAGES: Face and Back

TRIM SIZE: 11 x 17" (flat); 11 x 8-1/2" (folded)

DESCRIPTION: 

Form prints type, rule, and screen matter in Black ink on the face and back. 

NOTE: Forms MUST be printed via offset printing. Digital printing, direct imaging (toner), and inkjet printing are 

not acceptable.

GOVERNMENT TO FURNISH: 

- Purchase Order will be emailed to the contractor upon award.

- Print file and JPG photo for page layout of folios 1 and 4 (see "ELECTRONIC MEDIA") will be emailed to the 

contractor.

- IRS carton shipping label (Form 6153) to be completed electronically will be furnished by IRS via e-mail after 

award (in a ZIP file with Form 2040)***. See "PACKING/LABELING" for additional labeling instructions.
Page 2 of 11 Jacket 624-166

- IRS Form 2040 in a fillable PDF file format will be furnished by IRS via e-mail after award (in a ZIP file with IRS 

Carton Shipping Labels) ***.

*** Contractor is required to have Adobe Acrobat 7.0 Professional (or more recent) software (not Adobe Reader) 

and the capability to receive via email and open file attachments compressed into a WinZIP (.zip) file format.

The contractor is required to complete and email IRS Form 2040 daily to the IRS when shipping begins. IRS Form 

2040 is in a fillable PDF file format. The majority of the information in the form will be filled in by the IRS prior to 

being sent to the contractor. The contractor is responsible for the verification and correctness of information 

supplied back to IRS. If there is any information missing or incorrect, please contact Keith Hedgspeth 

(Keith.R.Hedgspeth@irs.gov).

NOTES: 

1) The contractor MUST complete the Electronic IRS Form 2040 and transmit via email to IRS directly each day the 

product ships. Any delay or missed input could result in delay of payment. In order for the shipping results to be 

captured properly, the 2040 must NOT be removed from the original email (do not save to desktop or another file). 

This proper reply to the email ensures the contractor's compliance is captured. 

2) The use of free web-based mail servers such as Hotmail, Yahoo, or G-mail is not compatible for transmitting the 

IRS Form 2040 e-mail message.

********************************************************************

ELECTRONIC MEDIA:

- PLATFORM: Unknown 

- SOFTWARE: ADDITIONAL SYSTEM TIME IS REQUIRED. One PDF file will be provided. 

NOTES: 

1) Contractor to create page layout to image as specified. 

2) When viewing page 1 (F13614-C) as right reading and then unfolding the form, page 2 will be at the top (on back 

of page 1) and page 3 will be below page 2 on the 11 x 17" form. 

3) When viewing page 1 (F13614-C) as right reading on the unfolded 11 x 17" form, page 4 is above page 1 with the 

page 4 header (F15080) on the right (see furnished JPG photo).

4) Rules at the head and foot of page 1 and page 2 must register.

- COLORS: Identified as Black. 

- FONTS: All fonts are Embedded and/or Embedded Subset. 

- OUTPUT: 150 line screen for all screen matter / 1200 dpi or higher for remainder.

NOTE: GPO Imprint does NOT print on this order!

ADDITIONAL INFORMATION:

- Contractor must have the ability to edit PDF files (when furnished by the Government).

- Contractor is not to request that electronic files provided be converted to a different format. If contractor wishes to 

convert files to a different format, the final output must be of the same or higher quality and at no additional cost to 

the Government.

- The contractor is cautioned that furnished fonts are the property of the Government and/or its originator. All 

furnished fonts are to be eliminated from the contractor's archive immediately after completion of the contract.

- Identification markings such as register marks, commercial identification marks of any kind, etc., GPO imprint, 

form number and revision date, carried in the electronic files, must not print on the finished product.

- Prior to image processing, the contractor shall perform a basic check (preflight) of the furnished media and 

publishing files to assure correct output of the required reproduction image. Any errors, media damage or data 

corruption that might interfere with proper file image processing must be reported to your contract administrator.
Page 3 of 11 Jacket 624-166

- The contractor shall create/alter any necessary trapping, set proper screen angles and screen frequency, and define 

file output selection for the imaging device being utilized. Furnished files must be imaged as necessary to meet the 

assigned quality level.

- When PostScript Files are not furnished - prior to making revisions, the contractor shall copy the furnished files 

and make all changes to the copy. 

- Upon completion of this order, the contractor must furnish final production native application files (digital 

deliverables) and one "press quality" PDF file with the furnished media. Storage media must be MAC/PC 

compatible. The digital deliverables must be an exact representation of the final product and shall be returned on the 

same type of storage media as was originally furnished. The Government will not accept, as digital deliverables, any 

proprietary file formats other than those supplied, unless specified by the Government. 

STOCK: 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.

JCP Code A63, Uncoated Canary Text, Basis Size 25 X 38", Basis Weight 50#

--or at Contractor's Option--

JCP Code D10, Canary Writing, Basis Size 17 X 22", Basis Weight 20#

INK: Black

MARGINS: Follow file setup* - inadequate (less than 1/4") gripper. *See "ELECTRONIC MEDIA" for additional 

information.

PROOFS: Deliver the following proofs(*) to the department on or before July 22, 2022. NOTE: On the day of 

shipping proofs, contractor MUST email the proof tracking numbers to Keith Hedgspeth 

(Keith.R.Hedgspeth@irs.gov) and Traci Cobb (tcobb@gpo.gov).

Contractor is responsible for all costs incurred in the delivery of proofs. Contractor will receive proof

approval/disapproval via email from the agency not longer than 2 workday(s) after date of proof receipt by the 

Government**. 

**NOTE: The date of receipt by the Government is NOT considered the first workday.

Contractor furnished proof approval letters will not be recognized for proof approval/disapproval. Only GPO 

generated proof letters will be recognized for proof approval/disapproval. Contractor must not print prior to receipt 

of an "OK to print" via email.

(*) PAPER SAMPLE: At the same time as submission of the proofs, contractor must submit one 8-1/2 x 11" 

unprinted PAPER SAMPLE of the actual paper to be used in the production of the contract requirements to each 

proof recipient. The sample must be of the kind and quality required by the specifications. The Government will 

rely on the sample only as a reference to the general appearance of the stock that will be provided by the contractor 

in conformance to the specifications. The Government assumes no contractual obligation to perform any inspection 

and test for the benefit of the contractor. The Government's failure to inspect and accept or reject the paper samples 

shall not relieve the contractor from responsibility, nor impose liability on the Government, for nonconforming 

paper.

(*) CONTENT PROOF: Four*** complete digital CONTENT proofs created using the same Raster Image 

Processor (RIP) that will be used to produce the product. Proof shall be collated with all elements in proper position 

(not pasted up), imaged face and back, trimmed and folded to the finished size/format of the product. 

***NOTE: Four proofs are required - three proofs will be sent to the agency and one proof will be held at the 

contractor's plant. Proof will not be returned to the contractor. 

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.
Page 4 of 11 Jacket 624-166

TRIMMING/FOLDING: Trim 4 sides. Fold from 11 x 17" to 11 x 8-1/2" (with page 1 (F13614-C) out) using one 

parallel fold along the entire 11" dimension at 8-1/2" from the top/bottom edge.

PACKING/LABELING: Shrink-wrap in units of 100 copies per package. NDC bulk shipment must be packed in 

quantities of 1,400 copies per carton*. *Contractor must NOT deviate from these quantities. 

All cartons must be packed solid with a maximum weight of 32 lbs per carton. Pack solid in corrugated or solid fiber 

shipping containers, bursting strength: 200p.s.i, minimum. Carton bottoms may be glued, stapled, or sealed with 

polyester tape (2 to 3 inches width, not reinforced), minimum 12kNm (65 lbs./inch) traverse tensile strength. If 

stapled, the cartons may only be stapled on the bottom and/or side; no staples are to be used on top. Cartons are to 

be sealed at the top with paper or polyester tape (2 to 3 inches width, not reinforced). Contractor will determine 

exact dimensions of carton in accordance with folded and/or trim size and weight of the product produced. Cartons 

must not exceed 17-1/2" (L) x 11-1/2" (W) x 9" (D) in exterior dimensions. NOTE: Packing peanuts/beads are not 

acceptable carton fillers.

*In some cases, there may be one carton with an odd quantity due to the quantity packed per carton not dividing 

equally in the quantity ordered. The label for that single carton MUST be labeled accurately with the carton quantity 

(see CARTON LABELING for electronically correcting label quantity). Place that odd carton at the top of the load.

CARTON LABELING: Contractor must reproduce shipping carton label at 100% on white paper from furnished 

PDF file, fill in appropriate fields and securely attach one label to each carton. NOTE: Carton labels contain 

barcodes; therefore, dot matrix printing is NOT acceptable. 

NOTE: "BLUE LABEL" COPIES ARE REQUIRED. DO NOT AFFIX THE IRS CARTON LABEL TO THE 

"BLUE LABEL" COPIES. 

 

All cartons must have IRS Shipping label affixed to one carton end only (never top, long side, or bottom). On 

cartons shipped via small package carrier (SPC), affix the SPC label on top of carton on the end nearest to IRS label. 

On small package carrier (SPC) boxes/envelopes, the IRS label is to be affixed to the top of each package and the 

SPC shipping label to the reverse side of the package (this includes advance distributions and IRS samples). All 

shipments to IRS National Distribution Center via SPC are to leave "To (Consignee) Address" field blank. Correct 

labeling of shipping cartons, in strict accordance with the requirements of these specifications, is essential to the 

identification, distribution and warehousing activities of the IRS. Use of any other label is prohibited and may be 

cause for rejection of reimbursement for any expenses incurred to correct use of improper labels. 

The following must be updated ELECTRONICALLY by the contractor, when not entered by IRS on the PDF label 

using Adobe Acrobat 7.0. DO NOT MAKE HAND-WRITTEN UPDATES TO THE LABEL UNDER ANY 

CIRCUMSTANCES.

--Carton # of #

--From Address

--To Address

--Carton Quantity

NOTE: Contractor must email a PDF proof of a completed label for copies shipping to the NDC. The email must be 

sent to Keith Hedgspeth (Keith.R.Hedgspeth@irs.gov) and Traci Cobb (tcobb@gpo.gov) at least two days prior to 

reproducing labels/carton labeling for inspection and approval of the title, product number, requisition number, and 

quantity match to barcode.

FAILURE OF THE CONTRACTOR TO COMPLETE THE PDF LABEL ELECTRONICALLY WILL RESULT 

IN THE SHIPMENT BEING REJECTED AND RE-LABELED AT THE CONTRACTOR'S EXPENSE. 

If a "0" is pre-filled in on the furnished PDF label, then contractor MUST change the "0" to reflect actual quantity 

inside cartons. Contractor must ensure that all cartons have the same quantity. The carton count field in the PDF 

file is directly linked to the barcode field; therefore, the contractor must press "enter" or "tab" after entering the 
Page 5 of 11 Jacket 624-166

quantity in order for the quantity to be reflected in the barcode. All changes to the carton count field MUST be 

made in the electronic label (not hand filled in) to whatever the true carton quantity is so that it is reflected on the 

label in both the quantity and barcode fields. NOTE: In the case of one carton with an odd quantity due to the 

quantity packed per carton not dividing equally into the quantity ordered, the label for that single carton must also be 

updated electronically to reflect the true quantity per carton.

Automated "Carton # of #" fields: To print the correct number of labels for each address with sequential carton 

numbers, input in the total number of cartons and press "Print Labels" button. Warning: Once the print button is 

pressed, printing cannot be canceled. Be sure all information is correct prior to printing labels.

PALLETS: All motor freight shipments require pallets.

Pallets for IRS consignments: Pallets must be type III and must conform to the Federal Specifications NN-P-71C, 

and any amendments thereto except for dimensions and single center stringer (see Exhibit 1 "IRS Pallet 

Specifications" sheet). Pallets must be 48" in length and 40" in width and must not exceed 5" in height. Full entry 

MUST be on the 40" width. Strict adherence to these dimensions is necessary to accommodate storage requirements 

of IRS National Distribution Center. Receipt of incorrect pallets may result in a charge for each incorrect pallet, 

which will be assessed against the contractor. This charge will cover additional costs incurred by IRS to repalletize 

the shipment onto correct pallets. 

PALLETIZING: Cartons shall be stacked on pallets using a reverse layer pattern, 9 cartons per layer, with a 

maximum height of 55", including pallet or a maximum of 7 layers (see Exhibit 1 "IRS Pallet Specifications" sheet 

for the 9 tier stacking method). Cartons must be fastened securely to the pallet in a manner that will prevent 

movement during transit but permit ready removal, without damage to the cartons, at destination. Do not use metal 

strapping or pallet caps for securing material on pallets. There must be no more than one partial pallet per 

destination.

PACKAGING AND PACKING PROBLEMS: In addition to other inspection procedures detailed elsewhere in 

these specifications, the contractor is responsible for correcting all packaging and packing problems (i.e. mislabeled 

cartons, IRS carton labels not being used or securely attached, cartons not being packed solid, incorrect pallets, or 

pallets not being layered right). The delivery will either be returned to the contractor to be corrected or the 

contractor may be billed by GPO for the amount that accrued in fixing the problem by an outside vendor. 

"Mislabeling" means any error on the carton label, which incorrectly states or identifies the title of the form; the 

form identification number; or the quantity of forms actually contained in the carton, or has any missing 

information, or is not securely attached.

SCHEDULE: 

Purchase Order will be emailed to the contractor on or before June 2, 2022. 

Print file will be emailed to the contractor on or before July 15, 2022.

Deliver proofs on or before July 22, 2022.

F.O.B. Contractor's City:

-Ship a total of 15 copies (IRS samples) to three addresses on or before October 25, 2022 - see "DISTRIBUTION" 

for quantity breakdowns and address information.

-Ship 2,499,000 copies to one address on or before October 25, 2022 - see "DISTRIBUTION" for complete 

address. NOTE: If any copies shipping to the NDC ship prior to October 25, 2022, the fifteen (15) IRS samples must 

ship within 24 hours of the NDC shipment.

-Ship 200 copies to one address on or before October 25, 2022 - see "DISTRIBUTION" for complete address.
Page 6 of 11 Jacket 624-166

The following information applies to all F.O.B. Contractor's City shipments:

- All consignments weighing less than 750 pounds must be shipped GROUND via a furnished IRS Small Package 

Carrier (UPS) account number. Contractor must notify the GPO contract administrator if the contractor does not 

have such an account, and one will be established for that contractor. Contractor must not use their own small 

package carrier account.

NOTE: The contractor must have the capability to generate the Small Package Carrier shipping labels electronically. 

Each label must provide the following 2 reference fields: Reference Field 1 - GPO Jacket Number; Reference Field 

2 - IRS Requisition Number.

- All consignments weighing over 750 pounds ship via IRS Government Bills of Lading. The contractor must 

contact Keith Hedgspeth (Keith.R.Hedgspeth@irs.gov) and Traci Cobb (tcobb@gpo.gov) to provide IRS with the 

exact ship date, plant hours, total number of boxes and pallets shipping to each destination, and weight of each 

shipment. IRS must be notified a minimum of five workdays prior to shipping so that GBL's may be cut and 

forwarded to the contractor in time to meet scheduled ship date. Upon receipt of the GBL, the contractor is 

responsible for contacting the carrier to arrange for pickup.

The contractor cannot be reimbursed for using his or her own small parcel carrier account and/or BL's, nor may 

GPO GBL's be cut for this order.

Transportation charges are a factor in determining award.

DISTRIBUTION: 

F.O.B. Destination:

- Deliver proof & paper sample on or before July 22, 2022 to a residential address in Hiawassee, GA 30546. 

- Deliver proof & paper sample on or before July 22, 2022 to a residential address in Flowery Branch, GA 30542. 

- Deliver proof & paper sample on or before July 22, 2022 to a residential address in Dacula, GA 30019. 

NOTES: 1) Complete residential addresses will be furnished after award. 2) On the day of shipping proofs, 

contractor MUST email the proof tracking numbers to Keith Hedgspeth (Keith.R.Hedgspeth@irs.gov) and Traci 

Cobb (tcobb@gpo.gov).

F.O.B. Contractor's City:

- Ship 5 copies (IRS samples) on or before October 25, 2022 to a residential address in Dacula, GA 30019. 

Complete address will be furnished after award.

- Ship 5 copies (IRS samples) on or before October 25, 2022 to a residential address in Flowery Branch, GA 30542. 

Complete address will be furnished after award.

- Ship 5 copies (IRS samples) on or before October 25, 2022 to a residential address in Hiawassee, GA 30546. 

Complete address will be furnished after award.

- Ship 2,499,000 copies on or before October 25, 2022 to: IRS/National Distribution Center, Receiving (309-556-

5169), 2525 Revenue Drive, Bloomington, IL 61705-2500. NOTE: If any copies shipping to the NDC ship prior to 

October 25, 2022, the fifteen (15) IRS samples must ship within 24 hours of the NDC shipment.

- Ship 200 “Blue Label*” copies on or before October 25, 2022 to: IRS/National Distribution Center, Blue Label 

Copies, 2525 Revenue Drive, Bloomington, IL 61705-2500.

NOTE: All shipments must be completed via traceable means with signature verification. All quantities ship using 

the contractor's IRS/UPS account number or IRS issued GBL (depending on weight). USPS shipping methods are 

not acceptable for this procurement. Contractor is responsible for maintaining a shipping log that includes the 

contact, address, quantity ordered, and tracking/pro number(s) for each destination. Contractor must email shipping 
Page 7 of 11 Jacket 624-166

log to Keith Hedgspeth (Keith.R.Hedgspeth@irs.gov) and Traci Cobb (tcobb@gpo.gov) on day of shipping. Include 

GPO Jacket Number & IRS Requisition Number in the subject line of the email.

*DEPARTMENTAL RANDOM COPIES (BLUE LABEL): The order must be divided into 200 equal sublots. 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. 

These randomly selected copies must be packed 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 be sent in accordance with the distribution list (separately** from any other distribution to 

the same destination). A copy of the purchase order/specification and a signed Certificate of Selection of Random 

Copies must be included.

**Do NOT place carton containing Blue Label copies on a pallet shipping to the NDC. Blue Label copies MUST 

ship separately via IRS Small Package Carrier (UPS).

QUALITY ASSURANCE THROUGH ATTRIBUTES: The bidder agrees that any contract resulting from 

bidder’s offer under these specifications shall be subject to the terms and conditions of GPO Pub. 310.1 “Quality 

Assurance Through Attributes – Contract Terms” in effect on the date of issuance of the invitation for bid. GPO 

Pub 310.1 is available without charge from: U.S. Government Publishing Office, Atlanta Regional Office, 3715 

Northside Parkway, NW, Suite 4-305, Atlanta, Georgia 30327.

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 Specified Standard 

P-7 Type Quality and Uniformity File Setup

OFFERS: Offers must include the cost of all materials and operations for the total quantity ordered in accordance 

with these specifications. In addition, a price must be submitted for additional copies (per each, per hundred, or per 

thousand). The price of the additional quantities must be based on a continuing run, exclusive of all basic or 

preliminary charges and will NOT be a factor for determination of award.

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

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

will be accepted at this time.

The Jacket number (624-166) and bid opening date (May 27, 2022) must be specified in the subject line of the 

emailed bid submission. Bids received after 2:00pm Eastern Time on the bid opening date specified above will not 

be considered for award.

NOTE: Bidders are to fill out, sign/initial, and return pages 9 and 10. 

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 –
Page 8 of 11 Jacket 624-166

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.

PRE-AWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, the 

Government reserves the right to conduct an on-site preaward 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.

PAYMENT: Submitting invoices for payment via the GPO fax gateway utilizing the GPO barcode coversheet 

program application is the most efficient method of invoicing. 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. 

NOTE: Vendors are expected to submit invoices within 30 days of job shipping/delivery.

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.
Page 9 of 11 Jacket 624-166

CONTRACTOR: ____________________________

SHIPMENT(S): 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.

Bid Amount: ____________________________

Additional rate: _______________ Per _____ 

 

__________________

(Contractor’s Initials)

(COMPLETE AND SUBMIT THIS PAGE WITH YOUR BID)
Page 10 of 11 Jacket 624-166

DISCOUNTS: Discounts are offered for payment as follows: __________ Percent, _________calendar days. See 

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

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 

points(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.

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

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 Name) (GPO Contractor’s Code)

___________________________________________________________________________________________

(Street Address)

___________________________________________________________________________________________

(City – State – Zip Code)

By _________________________________________________________________________________________

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

___________________________________________________________________________________________

(Person to be Contacted) (Telephone Number) (Email)

****************************************************************************************************

THIS SECTION FOR GPO USE ONLY

Certified by: ___________________________ Contracting Officer: ___________________________

 (Initials and Date) (Initials and Date) 

***************************************************************************************************

(COMPLETE AND SUBMIT THIS PAGE WITH YOUR BID)
Page 11 of 1

1 Jacket 624-166

Exhibit #1