Attachment 1-Questionnaire.pdf

70Z08422RWOPL0003

FABRICATION AND DELIVERY OF SHACKLE ASSEMBLIES

PINS AND SPLIT KEYS

SOURCES SOUGHT RESPONSE

QUESTIONNAIRE: Please ensure that as a minimum the following items are covered in your response:

1. Provide the following information:

Company Name:

Street Address:

City, State, Zip Code:

Primary Point of Contact:

Phone Number:

Email Address:

Unique Entity Identification Number:

Company CAGE Code:

Registered in the System for Award Management (SAM) database at https://Sam.gov/:

___Yes ___ No

2. Please indicate your company’s size status under the following NAICS Codes by placing and “X” in the appropriate blocks below:

NAICS Codes & Title

Small Business

Size Standard

Large Small 8(a) HUBZone* WOSB* VOSB* SDVOSB*

332111 – Iron and Steel Forging

Employees

*Acronyms:

HUBZone – Historically Underutilized Business Zone WOSB - Woman Owned Small Business VOSB - Veteran Owned Small Business SDVOSB - Service Disabled Veteran Owned Small Business

PINS AND SPLIT KEYS

SOURCES SOUGHT RESPONSE

3. Does your company regularly manufacture Shackles assemblies, Pins, Split Keys?

3(a) If so, please list the specific types and manufacturers.

3(b) How long has your company engaged in shackle assemblies, pins and split key fabrication/manufacturing? ___________

4. Relevancy of Experience:

4(a) Please list no more than three contracts your company is currently performing (or has completed within the last five years) that include the fabrication / manufacture and delivery of shackles assemblies, pins and split keys. Include the contract (including Federal Supply Schedules) number, title, contract type, and award amount.

Contract (1): ___________________________________________________________

Contract (2): ___________________________________________________________

Contract (3): ___________________________________________________________

4(b) For each of these contracts, identify whether your firm was the manufacturer or supplier/distributor. _________________________________________________

4(c) Were these contracts won competitively? Yes No . If not, list those which were not. _________________________________________________________

5. Manufacturing:

5(a) Indicate if the shackles assemblies, pins, split keys are manufactured in the United

States.

Yes No

PINS AND SPLIT KEYS

SOURCES SOUGHT RESPONSE

5(b) If not USA manufactured, specify country of manufacture:

6. Submission of this questionnaire signifies interest in submitting an offer for any resulting solicitation for fabrication and delivery of Shackles Assemblies, Pins and Split Keys?