1127347 Supporting and Additional Information.pdf

PDF 158 KB Posted

Attached to
Small Autoclave (qty 2) Federal contract opportunity
Solicitation number
12505B24Q0210
Issued by
Department of Agriculture Agricultural Research Service Field Research Implementation and Information Delivery Midwest Area

About this file

This document is a Supporting Information Form related to a federal contract opportunity for a Small Autoclave (Solicitation # 12505B24Q0210). The solicitation is issued as a 100% Total Small Business Set-Aside under the NAICS code 339113 (Surgical Appliance and Supplies Manufacturing) with a small business size standard of under 800 employees. Quotes must be submitted by 11:00 AM CT on June 25, 2024 and include a completed SF1449, Supporting Information Form, and provision FAR 52.212-3. The solicitation is issued by the U.S. Department of Agriculture Agricultural Research Service Midwest Area. The supporting information form captures the vendor's company details, socio-economic status, product manufacturing information, pricing, and delivery timeline.

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Sol_12505B24Q0210_Amd_0002.pdf PDF
Sol_12505B24Q0210_Amd_0001.pdf PDF
Sol_12505B24Q0210.pdf PDF

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Text version

United States Department of Agriculture

Research, Education, and Economics

Agricultural Research Service

Office of the Director ● Midwest Area Administrative Office Acquisitions & Personal Property/Fleet Team

1815 North University Street ● Peoria, IL 61604 USDA is an Equal Opportunity Provider and Employer

SUPPORTING INFORMATION FORM

Solicitation Title: Small Autoclave

Solicitation Number: 12505B24Q0210

Company Information:

Currently Registered and Active in the System for Award Management (SAM): ( ) Yes ( ) No

SAM Unique Entity Identifier (UEI) Number:

Company Legal Name: _____________________________________________

Doing Business As (if applicable): ____________________________________

Company Address as registered in the System for Award Management (SAM):

CAGE Code(s):

Socio-economic status for the NAICS code: ___________ (with a small business threshold of under ______________) – please check ALL that apply:

( ) Small Business Concern ( ) Disadvantaged

( ) SBA-certified 8(a) Program Participant ( ) SBA-certified HUB Zone Business

( ) Veteran Owned ( ) Service-Disabled Veteran Owned

( ) Woman-Owned ( ) Economically Disadvantaged Woman Owned

( ) Large Business

[ ] I confirm that my company is registered in the System for Award Management (SAM) with the socio-economic status identified above and the NAICS code specified or that my firm qualifies for the selected the socio-economic status under the applicable NAICS code.

United States Department of Agriculture

Research, Education, and Economics

Agricultural Research Service

Office of the Director ● Midwest Area Administrative Office Acquisitions & Personal Property/Fleet Team

1815 North University Street ● Peoria, IL 61604 USDA is an Equal Opportunity Provider and Employer

Quote Information:

Quote Number: _________________

Total Quoted Price:

Manufacturer’s Legal Name:

Product is Manufactured in the United States of America (is a domestic product*): ( )Yes ( )No

Manufacturing Address (for domestic products*):

Country of Origin (for nondomestic products**):

Time to Delivery: ( ) days ( ) weeks ( ) months

Quote Date:

Quote Expiration Date:

Certification:

I understand that incomplete sections, failure to provide all required documentation, and/or failure to sign this certification may remove my company’s quote from being put into consideration by the Government for award.

Signature:

Name:

Title:

Date:

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