A2 - Sources Sought Information Request Form - Sewer Repair.pdf
PDF 139 KB Posted
- Attached to
- MTANG Sewer Slip Lining Sources Sought
- Solicitation number
- JKSE222409
- Issued by
-
Department of the Army National Guard
About this file
This document is a Sources Sought Information Request Form for potential contractors interested in a federal contract opportunity with NAICS code 237110. The form requires interested firms to provide comprehensive company information, including their System for Award Management (SAM) registration status, unique entity identifiers, and socioeconomic status. Firms must specify their business type, which includes options such as Small Business, HUB Zone Business, Service-Disabled Veteran-Owned Small Business, 8(a) Program Participant, Woman-Owned Business, and Small Disadvantaged Business. Additionally, companies must confirm their bonding capability by indicating their individual project and total aggregate bonding amounts. The form emphasizes that incomplete responses or failure to provide required documentation may disqualify a firm from being considered for a potential set-aside contract in accordance with Part 19 of the Federal Acquisition Regulation.
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Text version
SOURCES SOUGHT INFORMATION REQUEST FORM
NAICS CODE:
Interested firms please respond with this information form and the following requested information. Please complete all sections of the document.
1. COMPANY INFORMATION
Company Name:
Address as registered in System for Award Management (SAM):
Unique Entity ID and CAGE Code:
DUNS Number:
Socioeconomic status for the listed NAICS code - Please check all that apply:
______ By initialing this line, I confirm that my firm is registered in the System for Award Management (SAM) website (https://www.sam.gov) with the socioeconomic status identified above and the NAICS code specified in the sources sought notice; or that my firm qualifies and registration under the applicable NAICS code is in process.
Large Business
Small Disadvantaged Business
HUB Zone Business
Service-Disabled Veteran-Owned Small Business (SDVOSB)
8(a) Program Participant
Woman-Owned Business
Small Business
2. BONDING CAPABILITY
By responding to this Sources Sought Notice, I CONFIRM my firm, individually and/or through association with joint ventures or teaming partners, has bonding capability of amounts filled in below.
Individual Project Bonding:
Total Aggregate Bonding Capability:
3. CERTIFICATION
I understand that incomplete answers in sections or my failure to provide required documentation or failure to sign this certification may remove my firm from the Government's determination of whether to solicit the referenced project on a set-aside basis in accordance with Part 19 of the Federal Acquisition Regulation.
PRINT NAME/TITLE:
PHONE:
EMAIL:
SIGNATURE:
| fc-int01-generateAppearances: |
| SIGNATURE:_79UvDzmZjHjRuJwy3gZpDQ: |
| EMAIL:_6pX8*yPACPRfH82oUuTAJw: |
| PHONE:_78s4d0qRjnECoDNKMd80HA: |
| PRINT NAME/TITLE:_ad1vI-1RTROcd7x2kOEy5Q: |
| _ Total Aggregate Bonding_snhXyW-U47375CdjcIQEgg: |
| _ Individual Project Bond_BxN7lrh0IeM3Rh15xK9hVA: |
| Socioeconomic status for the l_6_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_5_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_4_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_3_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_2_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_1_CnzsvLBQ13tym47RDbtFRw: Off |
| Socioeconomic status for the l_0_CnzsvLBQ13tym47RDbtFRw: Off |
| DUNS Number:_46zfLllHe*lMPiB2Yypi*Q: |
| CAGE Code:_wLwhSj6OLD2aFsf-Hus6aw: |
| Address as registered in Syste_ewLCfwtZqfErB2AEws7e6Q: |
| Company Name:_E-w7MD9xYacI82OwIpv4gA: |
| NAICS CODE:_LTJsrpgysDO1AuUQbfditQ: 237110 |
File details come from the government source that posted it. Updated .