A02 RFI Att 2 - Vendor Info MMCIP - SAM.pdf
PDF 86 KB Posted
- Attached to
- Miniaturized Large Volume Infusion System
- Solicitation number
- HT9425-25-RFI-MMCIP
- Issued by
-
Defense Health Agency
About this file
This is Attachment 2 of RFI No. HT9425-25-RFI-MMCIP, which is a company and product information form template issued by the Defense Health Agency. The form requests basic vendor information including company name, address, contact details, TIN, UEI number, CAGE code, NAICS code, web page, and locations. It also asks vendors to specify their small business status and other socio-economic classifications (such as 8(a), HUBZone, woman-owned, or veteran-owned status).
The form includes questions about the vendor's registration status in SAM.gov and ORCA, whether they have a GSA contract, and if their Miniaturized Large Volume Infusion System (MMCIP) product is available through GSA or the Defense Logistics Agency's E-CAT program. The final section requests identification of repair parts, including item names, part numbers, pictures, prices, weights, and shipping dimensions. This is a standard vendor information gathering template that would be used to collect basic qualification and product availability information from potential suppliers.
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Other files
| File | Type | Posted |
|---|---|---|
| A02 Att 1 MECs MMCIP - SAM.pdf | ||
| A02-RFI for SAM MMCIP.pdf |
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Text version
Attachment 2 RFI No. HT9425-25-RFI-MMCIP
COMPANY & PRODUCT INFORMATION
Instructions: Please fill in the information below for each question.
Questions: Response:
RFI Number: HT9425-25-RFI-MMCIP Company Name:
Company Address:
Point of Contact(s):
(should align with Cover Page)
Phone Number:
E-mail Address:
Tax Identification Number (TIN):
Unique Entity Identification (UEI) Number:
Cage Code:
NAICS:
Company Web Page:
Company Location(s):
Company is / is not a Small Business?
Other Socio-Economic Classifications:
(e.g. 8(a), HUB Zone, Woman-Owned, Veteran-Owned, Service- Disabled Veteran-Owned)
If 8(a), date that the company graduates from the program?
Company is / is not SAM.gov Registered?
Company is / is not ORCA Registered:
Company has GSA contract? (If so, please provide GSA contract no.)
Is the MMCIP is available for purchase via GSA? (If so, please provide SIN)
Is the MMCIP currently available for purchase via Defense Logistics Agency’s E-CAT program?
https://www.dla.mil/Troop- Support/Medical/ECAT/
Identify repair parts:
(i.e. Item Name, Part number, Pictures of repair parts, Price, Weight or/and shipping dimension of each repair part)
(end of Attachment 2 – Company Product & Information)
Attachment 2 RFI No. HT9425-25-RFI-MMCIP COMPANY & PRODUCT INFORMATION Instructions: Please fill in the information below for each question.
File details come from the government source that posted it. Updated .