A10 Attachment 1 SS Submittal Questionnaire.docx
DOCX document 18 KB Posted
- Attached to
- Tesuque Lagoon Improvements Federal contract opportunity
- Solicitation number
- 75H70123Q00019
About this file
This document is a submittal questionnaire for a sources sought notice related to the Tesuque Lagoon Improvements project. The questionnaire requests company information including name, website, physical address, SAM registration, point of contact, and bond capacity from interested vendors. It also asks whether the company would submit a proposal if a solicitation is issued for the project. Vendors are asked to describe their business type using SBA classifications and provide details of up to three similar past projects they have completed as a prime contractor or subcontractor within the last six years. Requested project details include name, dates, value, location, description of scope, and references. The related federal contract opportunity is a pre-solicitation notice for the Tesuque Lagoon Improvements project issued by the Department of Health and Human Services Indian Health Service. The notice includes the solicitation number but no other award details.
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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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