Sources Sought Response Form.pdf
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- Solicitation number
- 12505B24Q0006
About this file
This document is a sources sought response form from the Department of Agriculture Agricultural Research Service Field Research Implementation and Information Delivery Midwest Area seeking information from interested vendors for a service contract for a Thermo iCAP 6300 Duo View ICP-OES spectrometer. Vendors are requested to provide company information including their name, address, CAGE code, SAM UEI number, and socio-economic status under the specified NAICS code. They must confirm their registration in SAM and certification under the applicable NAICS code. Interested vendors must complete and sign the form to be considered for the set-aside solicitation for this project in accordance with FAR Part 19.
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SOURCES SOUGHT RESPONSE FORM
NAICS Code: ______________
Interested vendors please respond with this information form and the following requested information. Please complete all sections of the document.
1. Company Information.
Company Name: ______________________________________________
Company Address as registered in the System for Award Management (SAM):
CAGE Code: ______________________________
SAM UEI NUMBER: ___________________________
Socio-economic status for the NAICS code – please check all that apply:
( ) Large Business ( ) Small Business
( ) Small Disadvantaged Business ( ) 8(a) Program Participant
( ) HUB Zone Business ( ) Woman-Owned Business
( ) Service-Disabled Veteran Owned Small Business (SDVOSB)
By responding to the Sources Sought Notice, I confirm that my firm is registered in the System for Award Management (SAM) https://www.sam.gov/ with the socio-economic status identified above and the NAICS code specified in the sources sought notice; or that my firm qualifies and registration under the applicable NAICS code is in process.
Certification:
I understand that incomplete answers in sections or my failure to provide required documentation or failure to sign this certification may remove my firm from the Government’s determination of whether to solicit the referenced project on a set-aside basis in accordance with Part 19 of the Federal Acquisition Regulation.
Name: _____________________________________
Title: ______________________________________
Signature: ____________________________________
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