Questionnaire_Rev._1.pdf

70Z08418BHQ00400

FABRICATION AND DELIVERY OF SWIVELS FOR

VARIOUS U. S. COAST GUARD LOCATIONS

SOURCES SOUGHT RESPONSE

MODIFIED QUESTIONNAIRE: Please ensure that as a minimum the following items are covered in your response:

1. Provide the following information:

Company Name:

Street Address:

City, State, Zip Code:

Primary Point of Contact:

Phone Number:

Email Address:

Company’s Unique Identification Number:

(formerly DUNS)

Company CAGE Code:

Registered in the System for Award Management (SAM) database at https://www.sam.gov/index.html:

___Yes ___ No

2. Please indicate your company’s size status under the following NAICS Codes by placing and

“X” in the appropriate blocks below:

NAICS Codes & Title Small

Business Size

Standard Large Small 8(a) HUBZone* WOSB* VOSB* SDVOSB*

334511 – Navigation, Guidance, Aeronautical and Nautical System and Instrument Manufacturing

Employees

*Acronyms:

HUBZone – Historically Underutilized Business Zone WOSB - Woman Owned Small Business VOSB - Veteran Owned Small Business SDVOSB - Service Disabled Veteran Owned Small Business https://www.sam.gov/index.html

3. Does your company regularly fabricate/manufacture/procure swivels?

3(a) If so, please list the specific types and manufacturers.

3(b) How long has your company engaged in swivel fabrication/manufacturing/procurement? ___________

4. Relevancy of Experience:

4(a) Please list no more than three contracts your company is currently performing (or has completed within the last five years) that include the fabrication / manufacture / procurement and delivery of swivels. Include the contract (including Federal Supply Schedules) number, title, contract type, and award amount.

Contract (1): ___________________________________________________________

Contract (2): ___________________________________________________________

Contract (3): ___________________________________________________________

4(b) For each of these contracts, identify whether your firm was the manufacturer or supplier/distributor. _________________________________________________

4(c) Were these contracts won competitively? Yes No . If not, list those which were not. _________________________________________________________

5. Manufacturing:

5(a) Indicate if the swivels are manufactured in the United States.

Yes No

5(b) If not USA manufactured, specify country of manufacture:

6. What is the likelihood of your company submitting an offer for any resulting solicitation for fabrication and delivery of swivels? ____________________________________