36C24719Q0804-001.pdf

RESPONSE TO SOURCES SOUGHT – Endoscope cabinet for 9 scopes customized. CAVHCS 36C247-19-Q-0804 VENDOR: ____________________________________________________________________________________

General Requirements: DSI DAS-9P-LHG- COMP Cabinet D3 Customer 9 Scopes (3 each) OR EQUAL Salient Characteristics listed in source sought synopsis and proposed SOW :

In response to this announcement. If you are interested and capable of providing the required item, please complete the information below:

1. Company Name:

Address:

Contact Name:

Phone No:

Email:

DUNS:

2. Business size information Select all that applies:

☐ Small Business ☐ Emerging Small Business ☐ Small Disadvantaged Business ☐ Certified under Section 8(a) of the Small Business Act ☐ HubZone ☐ Woman Owned ☐ Certified and Verified Service-Disabled Veteran Owned Small Business (SDVOSB) ☐ Certified and Verified Veteran Owned Small Business (VOSB) ☐ Large Business ☐ Other: ____________

SDVOSB/VOSB must be registered in VIP (https:// www.vetbiz.gov)

Contractor must be registered with www.sam.gov

3. GSA Information:

FSS/ GSA Contract Holder Yes ☐ No ☐

FSS/ GSA Contract Number

Effective Date / Expiration Date http://www.vetbiz.gov/ http://www.sam.gov/

RESPONSE TO SOURCES SOUGHT – Endoscope cabinet for 9 scopes customized. CAVHCS 36C247-19-Q-0804 VENDOR: ____________________________________________________________________________________

4. Capability/ Product Information: Please submit your capabilities in regard to the salient characteristics being provided and any information pertaining to equal to items to establish capabilities for planning purposes.

a. Are you the manufacturer or a distributor of the items being researched above?

b. If you’re a small business and you are an authorized distributor/reseller for the items identified above, do you alter; assemble; modify; the items requested in any way?

c. If you do, state how and what is altered; assembled; modified?

d. If a distributor, is the product manufactured by a small business? (FAR 52.219-6, paragraph (d) )

5. Do you intend to submit an offer if a solicitation is issued?

6. Any other applicable information may be provided.

*** Submissions addressing Section (4) should show clear, compelling and convincing*** evidence that all equal to items" meet all the salient characteristics.

NOTE: Supplemental/Supporting documentation may be provided by the contractor.