A10 Attachment 1 SS Submittal Questionnaire.docx
DOCX document 20 KB Posted
- Attached to
- Georgeville Well Drilling
- Solicitation number
- 75H70125Q00027
About this file
The file is a Sources Sought Submittal Questionnaire for a municipal water well construction project by the Indian Health Service (IHS) in Goldendale, Washington. The project involves constructing a new 8-inch diameter, 450-ft deep municipal well for the Georgeville Community Water System, located on Off-Reservation Trust Land under the Confederated Tribes and Bands of the Yakama Nation's jurisdiction. The anticipated project magnitude is between $100,000 and $250,000, with a performance period of 180 calendar days after notice to proceed.
The sources sought is specifically seeking interest from small businesses, including Native American/Indian-Owned Businesses, 8(a) Certified, HUB-Zone, Women-Owned, Service Disabled Veteran-Owned, and other small business categories. Interested firms must complete a detailed questionnaire providing company information, bonding capacity, project experience, and for Indian-owned businesses, additional narrative responses about quality control and construction capabilities. Responses must be emailed to the Contract Specialist Thupten Tsering by the specified due date, with SAM registration being mandatory for consideration.
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Other files
| File | Type | Posted |
|---|---|---|
| A10 Attachment 2 IHS IEE Representation Form_Jan 2022.pdf |
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Text version
Sources Sought Submittal Questionnaire Company Information
Company Name
Website
Physical Address
SAM UEI Number
Point of Contact
Contact Name
Phone Number
Email Address
Proposal, Yes or No?
If a solicitation is issued, will your firm/company be submitting a proposal? Indicate Yes or No.
Type of Business
Native American-owned (IEE/ISBEE), SBA certified 8(a), SBA Certified HUB Zone, Service Disabled Veteran-Owned Small Businesses (SDVOSB), Women Owned Small Business (WOSB), and/or Small Businesses (SB). For more information refer to http://www.sba.gov. IEE firms must submit Attachment 1: IHS IEE Representation Form (Jan 2022) along with the controlling enterprise’s Tribal enrollment/certificate of Degree of Indian Blood documentation
Type of Business?
Bond Capacity
Single Bonding Capacity
Aggregate Bonding Capacity
Experience Submission
Requirements: Submit at least two (2) but no more than five (5) projects completed by your firm within the last six (6) years that are similar to the work that will be required under this project
PROJECT 1
Project Name and Number
Prime or Subcontractor?
Dates of Construction
Contract Value
Contract Location
Contract Completion Date
Description of Scope Performed and Complexity (expand as needed)
Federal, State, Tribal, or Other?
Project Reference(s)/Agency Point of Contact (Title, Name, Phone, Email)
PROJECT 2
Project Name and Number
Prime or Subcontractor?
Dates of Construction
Contract Value
Contract Location
Contract Completion Date
Description of Scope Performed and Complexity (expand as needed)
PROJECT 3
Project Name and Number
Prime or Subcontractor?
Dates of Construction
Contract Value
Contract Location
Contract Completion Date
Description of Scope Performed and Complexity (expand as needed)
Federal, State, Tribal, or Other?
Project Reference(s)/Agency Point of Contact (Title, Name, Phone, Email)
Indian-Owned Firms Questionnaire
Requirements: For Indian owned business, the contractor shall complete and submit a narrative addressing the following questions
| QUESTION |
| Response |
How is your company structured to handle quality control of the various disciplines of a construction project? (i.e., what position(s) (full-time/part-time) are employed under your company to perform QC?)
(expand as needed)
Does your company primarily handle the construction activities related to construction management by the prime contractor and if so, what are those activities?
(expand as needed)
Does your company self-perform any of the construction disciplines, if so, what are those disciplines?
(expand as needed)
File details come from the government source that posted it. Updated .