Attach 10 Bankrupty-Ownership Disclosure Form.docx
DOCX document 31 KB Posted
- Attached to
- USALearning Training and Education Federal contract opportunity
- Solicitation number
- 24322622R0002
- Issued by
- Office of Personnel Management
About this file
This document is a request for proposal for training and education support products and services issued by the Office of Personnel Management. The solicitation seeks proposals for formal and informal learning instructional system design and support, simulator and virtual training, and organizational training and planning services. Offerors must submit proposals by May 20, 2022 using the Microsoft Teams platform. The requirement is set aside for small businesses with a NAICS code of 611430 and size standard of $12 million. The period of performance is one 5-year base period and two 5-year option periods. Evaluation will be based on technical merit with price considered; awards will be made to the highest technically rated offerors with reasonable prices. The place of performance includes government and contractor facilities across the continental United States and overseas locations as approved at the task order level.
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Text version
Request for Proposal 24322622R0002 USALearning® Training and Education Support Product and Services Indefinite Delivery, Indefinite Quantity (IDIQ) Contract
BANKRUPTCY AND OWNERSHIP DISCLOSURE
Current Company Name:
DUNS # used for this solicitation:
Tax ID Number (TIN):
Doing Business As (dba):
I certify that in the past five (5) years, under the name/dba, DUNS or TIN noted above, (check one and fill in, if applicable):
No bankruptcies have been filed.
| A bankruptcy has been filed. |
| If so, fill in date: |
List the Name and DUNS for all previous company names, parent companies, subsidiaries, mergers, acquisitions, consolidations, novations, or other changes in name/DUNS or structure for the past five (5) years, as well as disclose any bankruptcies in that same time period.
Company Name (and dba if applicable)
| DUNS # |
| Reason for other name, or relation to Current Business above |
(previous name, parent, subsidiary, merger, acquisition, consolidation, novation, etc) Any bankruptcies filed in past 5 years? (Yes or No)
(attach additional pages as necessary)
In addition to the above, the PRIME offeror must also disclose whether their company is for sale, either through their owners or through private equity firms. The Government reserves the right to use this information in evaluation of risk.
(Subcontractors shall simply state “Subcontractor to <Name of Prime>”)
Signature:
Date:
Name:
Title:
Phone:
Attachment 10 Page 2 of 2
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