A10 Sources Sought Submittal Questionnaire.docx
DOCX document 17 KB Posted
- Attached to
- Crow Creek Scattered Water and Sewer
- Solicitation number
- 75H70122R00071
About this file
This document contains a sources sought notice for a federal construction project. The Indian Health Service is seeking information from small businesses including Native American/Indian-owned, 8(a), HUBZone, women-owned, service-disabled veteran-owned, small disadvantaged, and veteran-owned firms to construct individual and community water and sewer facilities to serve ten home sites on the Crow Creek Reservation in South Dakota. Interested firms must respond by July 21 with company and bonding information, experience on two similar past projects as prime or subcontractor, and confirmation of future proposal submission. If solicited, the project valued between $250,000 to $500,000 will be set aside as a 100% small business opportunity under NAICS code 237110.
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Other files
| File | Type | Posted |
|---|---|---|
| A10 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 seven (7) 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
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
Federal, State, Tribal, or Other?
Project Reference(s)/Agency Point of Contact (Title, Name, Phone, Email)
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