3 - Socio-economic Status Template.docx
DOCX document 85 KB Posted
- Solicitation number
- 503102-20-Q-0020
- Issued by
-
Securities and Exchange Commission
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Text version
Socio-Economic Status Template
| Vendor: |
| <Input> |
| DUNS #: |
| <Input> |
| POC: |
| <Input> |
| Email: |
| <Input>@ <Input> |
| Phone #: |
| <Area Code>- <Input>- <Input> |
Summary/Notice (Cannot Be Deleted)
· The Font/Font size/Format criteria:
· The Font shall be New Times Roman and the Font size must be 12 or larger.
· The Vendor shall only use the boxes/tables/locations indicated to input the required information.
· No changing of the “Answer” boxes/tables width (Format). The box will expand in length (but, be aware of the overall page length).
· You may copy and paste from another document, but verify that the Font/Font Size/Format is, as required.
· If the Format, Font/Font size or the overall length is not within the stated limits, your submission will not be evaluated.
· After the completion of this template by the Vendor, the length of this document cannot exceed 3 pages (including this section).
· The file name must be as follows: Socio-economic Status – “Vendor’s Business Name”
· No other descriptive information should be included in the file name.
NAICS Code and SAM
1. General:
| Small Business? |
| <select> |
| Sub-SB Designation(s)? |
| <select>; <select>; <select>; <select>; <select>. |
| Registered in SAM? |
| <select> |
| Status = Active? |
| <select> |
| Active Exclusions? |
| <select> |
| Debt Subject to Offset? |
| <select> |
| Tax Delinquent status under 52.209-11(b)(1)&(2)? |
| <select> |
| FAR52.212-3 Certs current? |
| <select> |
2. S.A.M. – Applicable 52.219-1 Small Business Program Representations:
| NAICS |
| Name |
| NAICS Excep. |
| Size Standard |
| SB? |
| SB Subgroup? |
| 334111 | |
| Electronic Computer Manufacturing | |
| <Input> | |
| 1,250 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 334112 | |
| Computer Storage Device Manufacturing | |
| <Input> | |
| 1,250 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 334118 | |
| Computer Terminal and Other Computer Peripheral Equipment Manufacturing | |
| <Input> | |
| 1,000 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 423430 | |
| Computer and Computer Peripheral Equipment and Software Merchant Wholesalers | |
| <Input> | |
| 250/500 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 511210 | |
| Software publishers | |
| <Input> | |
| $41,500,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 517911 | |
| Telecommunications Resellers | |
| <Input> | |
| 1,500 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 517919 | |
| All other Telecommunications | |
| <Input> | |
| $35,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 519190 | |
| All other Information Services | |
| <Input> | |
| $30,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 541511 | |
| Custom computer programming services | |
| <Input> | |
| $30,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 541512 | |
| Computer systems design services | |
| <Input> | |
| $30,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 541519 | |
| Other computer related services | |
| <Input> | |
| $30,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 541519 | |
| Information technology value added resellers | |
| <Input> | |
| 150 Empl. | |
| <select> | <select>; <select> |
; <select>; <select>.
| 541990 | |
| All other Professional, Scientific and Technical Services | |
| <Input> | |
| $16,500,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
| 811212 | |
| Computer and office machine repair and maintenance | |
| <Input> | |
| $30,000,000.00 | |
| <select> | <select>; <select> |
; <select>; <select>.
3. Explanations or Misc. Information:
Page 2 of 2 Solicitation #: 503102-20-Q-0020 IT BOA
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