47PG1024Q0001 Sources Sought - Questionaire 20231107.pdf

Sources Sought – GSA R6 GSA Fire Life Safety Surveys Blank Purchase Agreement (BPA) Questionnaire

MARKET RESEARCH QUESTIONNAIRE

(For Informational Purposes Only)

SELECT LOCATION YOUR SMALL BUSINESS HAS THE CAPABILITY OF PERFORMING FIRE

PROTECTION SURVEYS: (CHECK ALL LOCATION(S) BY MARKING WITH “X”) :

_____ National Capital Region _____ Region 4 _____ Region 8

_____ Region 1 _____ Region 5 _____ Region 9

_____ Region 2 _____ Region 6 _____ Region 10

_____ Region 3 _____ Region 7

1. Contractor Information:

Company Name: ____________________________________________________________________

Address: __________________________________________________________________________

Name of POC for firm: ______________________________________________________________

Phone Number of POC: ______________________________________________________________

Email Address of POC: ______________________________________________________________

*Joint Venture (JV) or Teaming Partner Information : (If applicable, circle one)

Firm Name: _________________________________________________________________________

Address: __________________________________________________________________________

Name of Primary POC : _______________________________________________________________

Phone Number of Primary POC: ____________________ POC Email Address :

*Indicate length of time JV or Teaming relationship has been established___________

2. Type of Small Business: The North American Industrial Classification System (NAICS) code for this potential procurement is 541330 (Engineering Services). The SBA small business size standard is $25.5 Million. Check all that apply.

▢ SBA certified 8(a) ▢ HUBZone ▢ Service-Disabled Veteran-Owned Small Business

▢ Woman-Owned Small Business ▢ Small Business ▢ Small Disadvantaged Business

3. Similar Experience:

a. Primary experience serving as: ▢ Prime ▢ Subcontractor

b. Years the firm has been in business: _____________

c. Has your firm completed projects within the four (4) state Region 6 within the last five (5) years?

▢ Yes ▢ No If yes, how many? _____________

d. If the answer to 4c is NO--Is your firm capable of performing projects within the four (4) state region? ▢ Yes ▢ No

e. Has your firm held and completed projects under a BPA or IDIQ contract in the past 3 years?

▢ Yes ▢ No

f. Is your firm currently registered and active in the System for Award Management Database?

▢ Yes ▢ No

g. If awarded this contract, could your firm begin work within 10 days of receiving a task order award?

▢ Yes ▢ No

h. Can your firm provide a 24 hour response time to orders?

▢ Yes ▢ No

Experience:

If the answer to Question 4e is YES, please complete this form for Two (2) projects that your firm has successfully completed within the past five (5) years (AS THE PRIME CONTRACTOR). Projects MUST consist of the following: total contract value between $2,000 and $2,000,000.00 in which the type of work performed is similar to that described in this announcement. Check all that applies to indicate the construction phase services provided.

Performance Period (calendar days):

Award Date: _____________________

Completion Date at Award: _____________

Actual Completion Date:_____________

Contract Award Amount: $____________________

Final Price (Including all options & mods):

Type of work: ▢ Fire Protection Facility Assessments ▢ Child Care Center Fire Evaluations

Contract Type:

▢ Firm-Fixed-Price (FFP) ▢ Other (explain): __________________

Project Title: ___________________________________________________________________

Location: ______________________________________________________________________

Project Summary:

Experience:

If the answer to Question 4e is YES, please complete this form for Two (2) projects that your firm has successfully completed within the past five (5) years (AS THE PRIME CONTRACTOR). Projects MUST consist of the following: total contract value between $2,000 and $2,000,000.00 in which the type of work performed is similar to that described in this announcement. Check all that applies to indicate the construction phase services provided.

Performance Period (calendar days):

Award Date: _____________________

Completion Date at Award: _____________

Actual Completion Date:_____________

Contract Award Amount: $____________________

Final Price (Including all options & mods):

Type of work: ▢ Fire Protection Facility Assessments ▢ Child Care Center Fire Evaluations

Contract Type:

▢ Firm-Fixed-Price (FFP) ▢ Other (explain): __________________

Project Title: ___________________________________________________________________

Location: ______________________________________________________________________

Project Summary: