A10 Attachment 1 SS Submittal Questionnaire.docx
DOCX document 18 KB Posted
- Attached to
- Big Bend Community Sewer Renovation Federal contract opportunity
- Solicitation number
- 75H70123R00068
About this file
This document is a sources sought submittal questionnaire for a federal construction project. The questionnaire requests company information from potential offerors, including name, website, physical address, SAM registration, point of contact, and whether the firm intends to submit a proposal if a solicitation is issued. It also requests information on business type, such as Native American-owned, 8(a), HUBZone, SDVOSB, WOSB, or small business. Firms must submit documentation if claiming Indian Economic Enterprise status. Bonding capacity and at least two but no more than five recent construction projects of similar size and scope are also to be detailed, including contract value, location, completion date, description of work, and references.
The related federal contract opportunity is for the Big Bend Community Sewer Renovation project to be awarded by the Department of Health and Human Services Indian Health Service. The pre-solicitation provides high-level details about the upcoming procurement but no further requirements or technical specifications.
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Other files for this federal contract opportunity
| 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)
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